Domestic water use and its implications for childhood diarrhoea in the Atwima Nwabiagya
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Date
November, 2015
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Abstract
It is estimated that diarrhoea is responsible for the deaths of 1.5 million children per year
making it the second leading cause of death in children under-five years globally. The
relationship between water quality and diarrhoea has received much attention in the
literature however much needs to be learnt about long-term variations in domestic water
use behaviour, per-capita water consumption and its relationship with childhood diarrhoea
in Sub-Saharan Africa in general and Ghana in particular. This panel study therefore
explored seasonal variations in domestic water use and its relationship with childhood
diarrhoea in households having children under-five years. A total of 378 households were
drawn from 4 communities in the Atwima Nwabiagya District, Ghana using simple
random sampling. The communities were surveyed in the wet season (June – August,
2012) and dry season (January – February, 2013) respectively. Quantitative data was
collected from mothers of under-five year old children using interviewer-administered
questionnaire and observation schedules whereas qualitative data was collected using
Focus Group Discussions (FGDs) and in-depth interviews. Multiple regression and
correlational analysis were used to examine the determinants of domestic water use for
households in the wet and dry seasons as well as for urban, peri-urban, piped and un-piped
households. Bi-variate and multivariate logistic regression were used to identify risk
factors associated with childhood diarrhoea and expressed in odds ratios (OR). A paired
sample t-test; t(255) = 10.92, p 0.001, showed a statistically significant variation in
mean per capita water use in the wet and dry seasons. Mean daily per capita water use was
estimated to be 54 liters in the wet (n = 263) and 22 liters in the dry season (n = 366).
Household size and size of the primary water storage vessel accounted for 9% of total
variation in per-capita water use in the wet season whereas household size, length of water
storage (days), duration of water service and size of the primary water storage vessel
accounted for 35% of the total variation in per-capita water use in the dry season.
Residential location (AOR= 3.01, 95% CI 1.61 – 5.63) showed a statistically significant
relationship with childhood diarrhoea in the wet season. In the dry season, the mother’s
age (AOR= 3.52, 95% CI 1.00 – 10.32), the mother’s educational level (AOR= 4.67, 95%
CI 1.80 – 12.13), storage of water outside the dwelling (AOR= 0.38, 95% CI 0.17 – 0.84)
and children often playing on the bare ground (AOR= 3.05, 95% CI 1.35 – 6.89) showed a
statistically significant relationship with childhood diarrhoea. This study concludes that
mean per-capita water use in households varied across the wet and dry seasons. The
number of under-five year olds was not a statistically significant determinant of per-capita
water use and no statistically significant association was found between per-capita water
use and childhood diarrhoea in the wet and dry season. The intensification of maternal
education on the mechanisms of transmission of environmentally related diseases such as
diarrhoea in the household was recommended. Other recommendations included the
provision and maintenance of adequate sanitation infrastructure, regular monitoring of per
capita water use and institutional capacity building. It was recommended that future
research focuses on an assessment of the microbiological quality of water sources and
stored water in the domestic domain.
Description
A Thesis submitted to the Department of Geography and Rural Development,
Kwame Nkrumah University of Science and Technology
in partial fulfilment of the requirements for the degree of Doctor of Philosophy.