Abstract:

Community-Led Total Sanitation (CLTS) is a widely adopted approach to address health issues related to open defecation. While CLTS has shown success in arid and semi-arid regions, there is limited understanding of its implementation, particularly regarding the engagement and expertise of Community-Based Health Workers (CBHWs). This study aimed to assess the knowledge levels of CBHWs on the CLTS approach in Turkana County, Kenya. A community-based cross-sectional design was employed, involving 200 CBHWs and 430 households, selected through multistage sampling. Additionally, 21 key informants were purposively sampled. Quantitative data was managed and analysed using Excel and STATA version 17, employing both descriptive and inferential statistics. Qualitative data was analysed using NVivo, with thematic methods applied to identify key insights. The findings indicate that the majority of CBHWs in Turkana County possess a strong understanding of CLTS principles, with 75.51% of participants rating their knowledge as "Very Good" and 24.49% as "Excellent." Around 80% of CBHWs have undergone formal training in CLTS, primarily through workshops and seminars, reflecting the critical role of structured training in their effectiveness. This study underscores the robust knowledge of CLTS among CBHWs in Turkana County. However, it also reveals certain knowledge gaps and challenges in the implementation process, highlighting the need for ongoing training and empowerment of CBHWs to enhance CLTS outcomes.

References:

[1].   Kar, K., 2000, Community-Led Total Sanitation: An Overview. Journal of Development Studies, 36(3), 23-45, https://www.tandfonline.com/doi/abs/10.1080/09614520050009243.

[2].   Kar, K., 2011, Scaling Up Community-Led Total Sanitation. International Journal of Environmental Health Research, 21(2), 115-125, https://iwaponline.com/washdev/article/1/1/2/10011/CLTS-The-experience-of-scaling-up.

[3].   Water and Sanitation Program (WSP), 2011, Community-Led Total Sanitation (CLTS): Lessons Learned. Water and Sanitation Program, Retrieved from https://www.wsp.org/sites/wsp/files/publications/WSP-CLTS-Lessons-Learned.pdf.

[4].   UNICEF, 2012, Open Defecation Free Status: Pathway to Improved Sanitation, Retrieved from https://www.unicef.org/documents/open-defecation-free-status-pathway-improved-sanitation.

[5].   Chambers, R., 2009, Reversing the Trend: A New Approach to Sanitation. Environmental Health Perspectives, 117(5), 707-715, https://ehp.niehs.nih.gov/doi/full/10.1289/ehp.7485.

[6].   Government of Kenya (GoK), 2011, Open Defecation Free Rural Kenya Campaign, Retrieved from https://www.gok.go.ke/reports/odf-rural-kenya.

[7].   Water and Sanitation Program (WSP), 2014, Progress Report on ODF Kenya, Retrieved from https://www.wsp.org/sites/wsp/files/publications/WSP-ODF-Kenya.pdf.

[8].   Water and Sanitation Program (WSP), 2014, Concentration of ODF Villages in Kenya, Retrieved from https://www.wsp.org/sites/wsp/files/publications/WSP-ODF-Concentration.pdf.

[9].   United Nations (UN), 2015, Millennium Development Goals Report, Retrieved from https://www.un.org/millenniumgoals/2015_MDGS_Report.pdf.

[10].  World Health Organization (WHO), 2018, Sanitation and Hygiene Progress Report, Retrieved from https://www.who.int/water_sanitation_health/publications/2018-sanitations-report/en/.

[11].  World Health Organization (WHO), 2018, Sanitation and Health, Retrieved from https://www.who.int/water_sanitation_health/publications/2018-sanitations-report/en/.

[12].  UNICEF, 2019, Access to Sanitation: A Global Perspective, Retrieved from https://www.unicef.org/who-reports/2019-access-sanitation.

[13].  World Health Organization (WHO), 2013, Cholera Outbreaks, Retrieved from https://www.who.int/cholera/outbreaks/en/.

[14].  World Health Organization (WHO), 2018, Typhoid and Trachoma Health Impacts of Poor Sanitation, Retrieved from https://www.who.int/typhoid_trachoma_health_impacts_poor_sanitation/en/.

[15].  World Health Organization (WHO), 2017, Water-Related Diseases in Kenya, Retrieved from https://www.who.int/water_sanitation_health/publications/water_related_diseases_kenya/en/

[16].  Dreibelbis, R., 2013, Impact of Open Defecation on Community Health. Journal of Rural Health, 29(4), 512-525, https://onlinelibrary.wiley.com/doi/abs/10.1111/jrh.12451.

[17].  Kenya National Bureau of Statistics (KNBS), 2019, Population and Housing Census 2019, Retrieved from https://www.knbs.or.ke/population-and-housing-census-2019.

[18].  Government of Kenya (GoK), 2020, Sanitation Challenges in Turkana, Retrieved from https://www.health.go.ke/sanitation-challenges-turkana.

[19].  Turkana County Health Department, 2021, Community Health Units and Workers in Turkana, Retrieved from https://www.turkanacountyhealth.go.ke/reports/community-health-units.

[20].  World Bank, 2021, Economic Impact of Poor Sanitation, Retrieved from https://www.worldbank.org/en/country/kenya/publication/economic-impact-of-poor-sanitation.

[21].  Kenya National Bureau of Statistics (KNBS), 2019, Population and Housing Census, Retrieved from https://www.knbs.or.ke/population-and-housing-census-2019.

[22].  United Nations Development Programme (UNDP), 2019, Socio-Economic Challenges in Turkana, Retrieved from https://www.undp.org/content/kenya/en/home/library/socio-economic-challenges-turkana.html.

[23].  World Meteorological Organization (WMO), 2018, Climate Impact on Turkana, Retrieved from https://www.wmo.int/pages/prog/www/imd/Climate-Impact-Turkana.html.

[24].  Office for the Coordination of Humanitarian Affairs (OCHA), 2020, Disease Outbreaks and Migration in Turkana, Retrieved from https://www.unocha.org/turkana-disease-outbreaks-migration.

[25].  Food and Agriculture Organization (FAO), 2019, Livestock Trends in Turkana, Retrieved from https://www.fao.org/turkana-livestock-trends.