ASSESSING THE IMPACT OF WATER , SANITATION AND HYGIENE INTERVENTIONS ON DIARRHEA DISEASE PREVALENCE AMONG CHILDREN UNDER (5) FIVE YEARS IN UDU LOCAL GOVERNMENT OVWIAN DELTA STATE

Abstract

This study assessed the impact of water, sanitation, and hygiene (WASH) interventions on diarrhea disease prevalence among children under five years in Udu Local Government Area, Ovwiang, Delta State. A cross-sectional survey research design was adopted for the study, with data collected through a structured questionnaire. The sample consisted of 133 respondents, selected using a simple random sampling technique. Data collected was analyzed using SPSS version 27, with the t-test applied to test the hypotheses. The findings of the study revealed significant improvements in the prevalence of diarrhea diseases following the implementation of WASH interventions. A majority of respondents agreed that WASH programs, including improved water supply, sanitation, and hygiene practices, had substantially reduced diarrhea morbidity in the community. However, challenges such as inadequate maintenance of facilities and poor hygiene practices at the household level contributed to the continued prevalence of diarrhea, despite the interventions. Additionally, the study found that socio-demographic factors such as education level and knowledge of non-immunization complications had a moderate impact on health-seeking behaviors, including decisions to immunize children. The t-test results confirmed that the observed differences were statistically significant at the 5% level of significance, indicating that WASH interventions had a notable effect on reducing diarrhea cases among children. Based on these findings, the study concluded that while WASH interventions have contributed to the reduction of diarrhea diseases in Udu LGA, there is still a need for improved maintenance of water and sanitation facilities, as well as ongoing community education to reinforce hygiene practices. The study also recommended further research to explore other underlying factors that influence the persistence of diarrhea cases and to assess the long-term impact of WASH interventions in similar regions.

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

Diarrhea remains one of the leading causes of morbidity and mortality among children under five years of age globally, particularly in developing countries. The high incidence of diarrhea in these regions is largely attributed to inadequate access to clean water, poor sanitation, and insufficient hygiene practices, which significantly contribute to the prevalence of waterborne diseases. The World Health Organization (WHO) and the United Nations International Children's Emergency Fund (UNICEF) have long emphasized the importance of improving water, sanitation, and hygiene (WASH) as essential strategies for reducing the burden of diarrhea-related illnesses. According to WHO (2020), despite significant progress in recent years, diarrhea still accounts for a significant number of child deaths worldwide. Inadequate WASH facilities, particularly in sub-Saharan Africa, continue to exacerbate the problem, where sanitation coverage remains low and access to clean water is limited.

In Nigeria, the situation is dire, with diarrhea diseases posing a major public health threat, especially among children under five. The country has one of the highest rates of diarrhea-related mortality in the world. The high vulnerability of young children to diarrhea can be attributed to their developing immune systems, lower body mass, and higher fluid turnover (WHO, 2023). These factors make children more susceptible to dehydration and other severe complications that arise from diarrhea. In addition, the Nigerian context is marked by inadequate sanitation infrastructure, limited access to safe drinking water, and poor hygiene practices, all of which exacerbate the high incidence of diarrhea among children. These challenges are further amplified in rural and semi-urban areas, where the gaps in access to improved WASH facilities are even more pronounced (Nwidu et al., 2022).

Delta State, located in the Niger Delta region of Nigeria, mirrors the broader national challenges of inadequate WASH infrastructure. Udu Local Government Area (LGA), which is one of the 25 LGAs in the state, is characterized by poor sanitation facilities, lack of access to potable water, and low levels of hygiene education. These conditions significantly increase the risk of waterborne diseases, including diarrhea, among the population, particularly children under five. According to Dahunsi et al. (2024), access to clean drinking water and improved sanitation systems in many parts of the state remains limited, with many communities still relying on unimproved water sources such as rivers, ponds, and shallow wells. Inadequate sanitation facilities further compound the problem, leading to the contamination of drinking water and the spread of pathogens that cause diarrhea.

The impact of poor WASH conditions on children's health in Udu LGA is evident, with high rates of diarrhea morbidity and mortality reported among young children. Studies have shown that poor sanitation, including the lack of proper sewage disposal systems and open defecation practices, is a significant contributor to the spread of diarrheal diseases in rural Nigerian communities (Kumpel et al., 2023). In Udu LGA, many households lack access to latrines or sanitation facilities, forcing children to play in contaminated environments, which further increases their exposure to diarrhea-causing pathogens. The situation is compounded by the limited awareness of hygiene practices, as many parents and caregivers are not well-informed about the importance of handwashing, safe water storage, and the proper disposal of human waste (Nwidu et al., 2022).

Over the years, various interventions have been implemented in Nigeria, including Udu LGA, with the aim of improving WASH conditions and reducing the prevalence of diarrhea. These interventions have included the provision of boreholes and water treatment systems, the construction of latrines and toilets, and the promotion of hygiene education campaigns. According to Ayandiran et al. (2022), the provision of safe drinking water through boreholes and other water treatment systems has led to some improvements in the water quality in certain parts of the country. However, challenges remain in ensuring that these interventions reach all communities, particularly those in remote or underserved areas. Furthermore, while water quality improvement has been achieved in some places, the lack of sustainable sanitation practices and the limited availability of hygiene education have hindered the overall success of these interventions.

In recent years, efforts have also been made to address the educational aspect of WASH. Hygiene education programs aimed at promoting handwashing, safe water storage, and other preventive measures have been implemented in various communities in Delta State, including Udu LGA. Studies have shown that hygiene promotion campaigns can have a significant impact on reducing the prevalence of diarrheal diseases by encouraging behaviors such as proper handwashing and the safe handling of water (Yaya et al., 2022). However, despite these efforts, the impact of such programs has been uneven, with many communities still lacking the necessary resources or infrastructure to fully implement the recommended hygiene practices. This highlights the need for continued investment in both infrastructure and education to achieve long-term improvements in child health outcomes.

The effectiveness of these WASH interventions in reducing the prevalence of diarrhea diseases among children under five in Udu LGA is yet to be fully assessed. While there have been some successes in improving water quality and sanitation infrastructure in certain areas, the overall impact of these interventions on the incidence of diarrhea remains unclear. According to He et al. (2022), the lack of reliable data on the effectiveness of WASH interventions in rural Nigerian communities makes it difficult to determine their true impact on public health. Furthermore, the complex interplay of social, cultural, and economic factors that influence WASH practices in rural communities must also be considered when evaluating the success of these interventions. These factors include the affordability and accessibility of water and sanitation facilities, the cultural norms surrounding hygiene practices, and the level of community engagement in WASH programs.

This study aims to assess the effectiveness of WASH interventions in reducing the prevalence of diarrhea diseases among children under five in Udu LGA, Delta State. The study seeks to evaluate the extent to which improved access to clean water, sanitation facilities, and hygiene education has influenced the incidence of diarrhea in this vulnerable population. By examining the impact of these interventions, the study aims to provide valuable insights into the successes and challenges of WASH programs in rural Nigerian communities. The findings of this research will contribute to the ongoing efforts to improve child health in Nigeria and other similar settings, and inform future interventions aimed at reducing the burden of waterborne diseases among children.

1.2 Statement of the Problem

Diarrheal diseases remain a significant health problem in Nigeria, particularly among children under the age of five. Despite numerous interventions aimed at improving water, sanitation, and hygiene (WASH) conditions, the prevalence of diarrhea remains high, especially in rural areas like Udu Local Government Area (LGA) in Delta State. The lack of access to clean water, inadequate sanitation infrastructure, and poor hygiene practices continue to contribute to the high incidence of waterborne diseases, including diarrhea, among young children (Nwidu et al., 2022). While interventions such as the provision of clean water, sanitation facilities, and hygiene education campaigns have been implemented in several parts of the country, the effectiveness of these interventions in reducing diarrhea rates in Udu LGA has not been fully evaluated.

Previous research on WASH interventions in Nigeria has often focused on the provision of water sources and sanitation infrastructure but has neglected to comprehensively assess the impact of these interventions on the incidence of diarrhea among children. According to Dahunsi et al. (2024), while some areas have seen improvements in water quality and sanitation facilities, the full extent of these improvements in terms of child health outcomes, particularly the reduction in diarrhea cases, remains unclear. There is a gap in the research that specifically addresses how access to safe water, improved sanitation, and hygiene education contribute to the reduction of diarrhea diseases in rural communities like Udu LGA.

Moreover, existing studies on WASH interventions often fail to take into account the cultural, social, and economic factors that influence hygiene behaviors and water usage in rural Nigerian settings. The impact of these factors on the success of WASH programs has not been sufficiently explored, leading to a limited understanding of the barriers and challenges faced by communities in adopting proper hygiene practices (Yaya et al., 2022). A lack of data on the sustainable implementation of hygiene education programs in these areas further complicates the assessment of their effectiveness in reducing diarrhea.

This study seeks to address these gaps by evaluating the effectiveness of WASH interventions specifically in Udu LGA, Delta State. It will examine not only the availability and quality of water and sanitation facilities but also the role of hygiene education in reducing diarrhea diseases among children. By exploring the local context, including social, cultural, and economic factors, this research will provide a comprehensive understanding of the effectiveness of these interventions and contribute to the development of more targeted and sustainable WASH programs in similar rural communities across Nigeria.

1.3 Objective of the Study

The main objectives of this study are:

1. To assess the impact of water, sanitation, and hygiene (WASH) interventions on the prevalence of diarrhea among children under five years in Udu Local Government Area, Delta State.
2. To evaluate the effectiveness of improved water supply, sanitation facilities, and hygiene practices in reducing diarrhea morbidity among children in the study area.
3. To identify the factors that contribute to the persistence of diarrhea disease among children, despite the interventions implemented.

1.4 Research Questions

The study will be guided by the following research questions:

1. What is the impact of water, sanitation, and hygiene interventions on the prevalence of diarrhea diseases among children under five years in Udu Local Government Area?
2. How effective have the improved water supply, sanitation facilities, and hygiene practices been in reducing diarrhea morbidity in the study area?
3. What are the factors that contribute to the continued prevalence of diarrhea among children, despite existing WASH interventions in Udu LGA?

1.5 Research Hypotheses

The study will test the following hypotheses:

1. H₀: There is no significant impact of water, sanitation, and hygiene interventions on the prevalence of diarrhea diseases among children under five years in Udu Local Government Area.

H₁: Water, sanitation, and hygiene interventions have a significant impact on the reduction of diarrhea prevalence among children under five years in Udu Local Government Area.

2. H₀: Improved water supply, sanitation facilities, and hygiene practices do not significantly reduce the incidence of diarrhea diseases among children in Udu Local Government Area.

H₁: Improved water supply, sanitation facilities, and hygiene practices significantly reduce the incidence of diarrhea diseases among children in Udu Local Government Area.

3. H₀: The persistence of diarrhea diseases among children in Udu LGA is not influenced by factors such as cultural practices, education, and socioeconomic status.

H₁: The persistence of diarrhea diseases among children in Udu LGA is influenced by factors such as cultural practices, education, and socioeconomic status.

1.6 Significance of the Study

This study holds significant importance for several reasons. First, it carries important policy implications, particularly for policymakers, public health authorities, and development organizations in Udu Local Government Area (LGA) and other similar regions. By assessing the effectiveness of water, sanitation, and hygiene (WASH) interventions in reducing the prevalence of diarrhea, the findings will offer critical insights that can help refine existing strategies. The data generated will provide policymakers with evidence to ensure that resources are allocated to the most effective interventions, potentially leading to more targeted and impactful public health efforts. Understanding what works and where improvements are needed will allow for the better allocation of resources and the design of interventions that can produce measurable results in reducing childhood diarrhea and improving overall health outcomes.

The study will also contribute significantly to health promotion efforts by highlighting the critical role that improved water, sanitation, and hygiene play in public health. It will provide a comprehensive understanding of how access to safe water, proper sanitation, and hygiene education can mitigate the burden of waterborne diseases like diarrhea. This will, in turn, underline the importance of ongoing health education campaigns aimed at promoting better hygiene practices and safer water usage, especially among caregivers and communities. The findings can help shape future health communication strategies and educational materials tailored to the needs of the target populations, ensuring that key health messages are effectively delivered and adopted.

Additionally, this research will make a valuable academic contribution by adding to the growing body of literature on the impact of WASH interventions on child health in Nigeria. It will provide new data and insights that can serve as a foundation for future studies on the topic. The findings may also inform further research on similar public health issues, contributing to a more nuanced understanding of the interplay between environmental factors, hygiene practices, and child health. Moreover, it will support future interventions in the region, offering data-driven recommendations that can enhance the effectiveness of ongoing and future WASH programs.

Finally, the study will directly benefit communities in Udu LGA and similar areas. By disseminating the findings, the study will empower local stakeholders, including community leaders, health workers, and caregivers, with the knowledge necessary to understand the importance of clean water, proper sanitation, and hygiene in preventing waterborne diseases. It will encourage communities to take proactive measures to improve public health, fostering a more community-driven approach to tackling health challenges and ensuring long-term positive outcomes for children and families in the region.

1.7 Scope of the Study

The study will focus on children under the age of five years residing in Udu Local Government Area, Delta State, Nigeria. It will assess the impact of water, sanitation, and hygiene interventions on the prevalence of diarrhea diseases within this specific group. The study will also explore factors that influence the effectiveness of these interventions, such as cultural practices, socioeconomic status, and education. The scope of the study is limited to Udu LGA due to its unique demographic and geographic characteristics, which make it an ideal case study for assessing the impact of WASH interventions in rural Nigerian communities.

1.8 Operational Definition of Terms

• Water Supply: The provision of clean and safe drinking water to households, schools, and healthcare facilities in Udu Local Government Area.
• Sanitation: The provision of safe and hygienic waste disposal systems, including toilets and sewage treatment facilities, in the study area.
• Hygiene: The practice of maintaining cleanliness, especially in relation to handwashing, food preparation, and waste disposal, to prevent the spread of diseases.
• Diarrhea: A condition characterized by the frequent passage of loose or liquid stools, which can lead to dehydration and other complications, particularly among children.
• Waterborne Diseases: Diseases transmitted through contaminated water, including diarrhea, cholera, and typhoid fever.
• Intervention: Any action or program aimed at improving water, sanitation, and hygiene conditions, including the provision of clean water, sanitation facilities, and hygiene education.
• Prevalence: The proportion of individuals in a given population who are affected by a particular disease or condition, in this case, diarrhea, during a specific period.
• Children Under Five: Refers to children who are under the age of five years, a group that is highly vulnerable to diarrhea-related morbidity and mortality.