title: A cross sectional study: latrine coverage and associated factors among rural communities in the District of Bahir Dar Zuria, Ethiopia.
abstract: BACKGROUND
  Lack of sanitation facilities is a serious health risk and obliges people to practice open defecation, thereby increasing the risk of disease transmission. The aim of this study was to assess latrine coverage and the associated factors among the rural communities in district of Bahir Dar Zuria, Ethiopia.
  
  
  METHODS
  A community-based cross-sectional study was conducted on 608 households in district of Bahir Dar Zuria. First, the district was stratified based on the distance from Bahir Dar city. Then, ten kebeles (the smallest administrative units) were selected from the 32 rural kebeles in the district. After the kebeles had been identified, the households were selected by systematic sampling method using existing list of all households as a sampling frame. Intervals (Kth)) for selecting households were determined by dividing the number of households with the sample size allocated for each kebele. After determining the Kth interval, the first household was selected randomly. The next households were identified systematically onwards by adding cumulatively Kth intervals to the first selected household .Data were collected by means of a pretested, standardized questionnaire and observation checklist. Data analysis was carried out using SPSS version 16.
  
  
  RESULTS
  Of the 608 households, 355 (58.4%) had pit latrines and only 220 (62.0%) were functional (providing services during data collection). One hundred eighty seven (52.7%) had been constructed two or more years prior to the time of the study and 202 (56.9%) latrines required maintenance. The availability of latrines was twice higher in households with an income of 5000 or more Ethiopian Birr (1USD = 17.5 Ethiopian Birr) per year (adjusted odds ratio [AOR], 1.55; 95% confidence interval [CI], 1.06-2.27) than those who hand an income less than 5000 Birr per year; the availability of latrines was twofold higher in households visited by health professional at least three times a month (AOR, 2.29; 95% CI, 1.33-3.93) than those that received no visits. The latrine coverage was about two times higher in households that were less than 30 minutes walk from a health institution (AOR, 1.57; 95% CI, 1.11-2.22) than households that were over 30 minutes walk. The latrine coverage was lower in households located in distant areas (AOR, 0.53; 95% CI, 0.36-0.77) than in households closer to the city.
  
  
  CONCLUSIONS
  Latrine coverage in District of Bahir Dar Zuria was far from the national target of 100%. The availability of latrines was affected by income level, frequency of visits by health workers, walking time from local health institutions, and distance from Bahir Dar. Therefore, it is recommended that the frequency of supportive visits be increased and that special attention be given to households in inaccessible areas.
authors: College of Medicine and Health Sciences, Bahir Dar University, P,O, Box-693, Bahir Dar, Ethiopia. workuawo@yahoo.com
authors: Worku
authors: W
authors: Awoke
authors: Semahegn
authors: S
authors: Muche
mesh_terms: D003430:Cross-Sectional Studies; D005002:Ethiopia; D005260:Female; D006801:Humans; D008297:Male; D012424:Rural Population / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014038:Toilet Facilities / Q000706:statistics & numerical data*
references: Trop Med Int Health. 2007 Jun;12(6):772-82
references: 17550475
references: Int J Epidemiol. 2010 Apr;39 Suppl 1:i193-205
references: 20348121
references: Trop Med Int Health. 2006 Sep;11(9):1406-15
references: 16930263
references: Int J Environ Health Res. 2007 Dec;17(6):443-52
references: 18027197
references: Int Health. 2011 Dec;3(4):251-8
references: 24038498
references: Environ Health Perspect. 2002 May;110(5):537-42
references: 12003760