ASSESSMENT OF WATER AND SANITATION ACCESSIBILITY AND PREVALENCE OF WATER-RELATED DISEASES IN BARINGO COUNTY, KENYA

ABSTRACT
Accessibility to potable water is a fundamental right for dignity and well-being. In spite of this observation, over 1.1 billion people lack access to safe drinking water. This is particularly true in the Sub-Saharan Africa and South East Asia regions. The main aim of this study was to Assess Water and Sanitation Accessibility and Prevalence of water-related diseases in Marigat town Baringo County, Kenya. The study employed a Cross-sectional household survey. Stratified random sampling method was used to select household respondents. A structured questionnaire was administered to households’ heads to elicit information relating to objectives of the study. Samples of drinking water were collected from water sources (boreholes, rivers, and springs) and at point of use (households) and analyzed for Escherichia coli and Total coliform bacteria using the Most Probable Number method. In situ measurements of PH and temperature were carried out using a Wagtech International portable meter. Clinical health records from the local health centres were also reviewed to assess the Prevalence rates of some of the water-related diseases. The study findings indicated that there was a significant association between level of education and covering of water storage container (P< 0.05). There were significant differences among water sources in terms of E. coli (F (2, 21) = 3.629, p < 0.05) and Total Coliform (F (2, 21) = 4.041, p < 0.05) during dry season. Similar observations were made during the Wet season for E. coli (F (2, 21) = 4.090, p < 0.05) and Total Coliform (F (2, 21) = 1.893, p < 0.05). Further, there were significant interactions between the water sources & season E. coli (F (2, 42) = 7.66, p < 0.01) and Total Coliform (F (2, 42) = 5.494, p < 0.05). Drinking water in large plastic storage containers (herein referred to as skyplast) had the highest E. coli and Total Coliform concentrations. Typhoid was the most prevalent water-related disease during the dry season (10%) while Diarrhea (3%) most prevalent during the wet season. All drinking water at abstraction and point of use for Marigat residents are microbiologically contaminated and therefore pose serious health risks to consumers of such water. Thus there is need for Public health awareness campaigns on household water management to curb incidences of water- related diseases. Public health practitioners at county and national levels need to ensure that households have adequate access to potable water and improved sanitation.

CHAPTER ONE
INTRODUCTION
Background Information
Water and sanitation are essential elements for human survival and well-being (Ahiablame et al, 2012). Water and sanitation significantly affect women and children, with children having the highest susceptibility to illness. Poor sanitation and water quality contribute to approximately 1.5 million annual deaths in children below 5 years of age worldwide. This has been observed especially in urban areas where millions of urban poor women lack access to adequate water and sanitation even though this is considered a basic human right (WHO, 2014). About 1 billion people throughout the world don’t have access to improved drinking water supplies and 2.5 billion people live without adequate sanitation facilities. In 2012, worldwide, the percentage of those with an adequate supply of water and sanitation was found to be 89% and 86% respectively in urban areas (World Bank, 2015)

Drinking water quality is still an issue of concern for human health in developing and developed countries worldwide. According to the report by WHO, (2014) every year, 4 billion cases of water-related diseases causes at least 3.4 million deaths worldwide, making it one of the leading causes of morbidity and mortality. Most of the victims are children under the age 5 of years, that die of illnesses caused by organisms that thrive in water sources contaminated by raw sewage (WHO, 2014). Inadequacy of water and sanitation and water- related disease prevalence are wide spread especially in Sub-Saharan Africa where utilities lack efficient and transparent management system. The principal challenge for Africa in the urban sphere is to address how its cities respond to the enormous challenges of rapid development, urban expansion, increased demand for services, threats to supply of water, constrained and failing urban planning systems, and institutional practices. The sustainability of human urbanization and growth in economy is threatened by the growing scarcity of water (Vaziri & Tolouei, 2010)

Poor quality of drinking water is associated with the spread of water-related diseases such as cholera, dysentery and Haemolytic Uremic Syndrome (Montgomery & Elimelech, 2007). These diseases are commonly reported in low-income countries as provision of safe water, sanitation and hygiene is sub-optimal (Rana, 2009). In developing countries, accessibility of safe drinking water is still a problem and most people use the available unimproved water sources such as dams and rivers often microbiologically unsafe as a result, the most well-known water-related diseases such as cholera, amoebic dysentery and typhoid are reported from majority of the African countries especially in tropical areas of the region including Rwanda (WHO, 2010).

In Kenya, 80% of the residents live in arid and semi-arid lands (ASALs). The provision of safe drinking water and sanitation are some of the major challenges the livelihoods in the ASALs face and have been recognized as some of the major developmental challenges the country is facing towards the realization of the vision 2030 (GoK, 2007) and in meeting the United Nations Sustainable Development Goals 3 and 6 respectively (WHO, 2016). Approximately, 80% of Kenyans continue to have inadequate access to water, drink unsafe water, and spend much time and money trying to acquire it. As a result, most people suffer and die due to water-related diseases which account for 60% of all diseases in Kenya (Kandji, 2006). On water access, in urban areas, only about 40% of the habitants have direct access to piped water (Herrero et al., 2010). The rest obtain water from kiosks, vendors, illegal connections or from wells. Only about 40 % of those with access to piped water receive water daily (Nyangeri & Ombongi, 2007)

According to a report by National Drought Management Authority, (2014) water sources currently in use in Baringo County include water pans, dams, natural rivers, traditional river wells, springs, boreholes and lakes. Water shortage is prevalent with 76.5 % of the people in Baringo County using unimproved water source (KNBS & SID, 2013). This is caused by the low rainfall received and cyclic droughts and that have hindered development of livestock and farming activities, as people spend many hours daily looking for water. A report on water and sanitation in Kenyan counties revealed that 2.0% of the human population in Marigat sub-counties depend on boreholes, ponds and dams for their domestic water uses (KNBS & SID, 2013). However, these water sources are categorized as unimproved (WHO, 2008). Most of the population does not have access to good sanitation and 5% of the population has access to improved sanitation and this poses a major health hazard among the residents of Baringo County. It is against this background a study was conceived to assess water and sanitation accessibility and prevalence of water-related diseases in the study area.

Statement of the Problem
Water-related diseases are among the major public health problems in developing countries, Kenya not being an exceptional. Continuous use of unsafe water from unprotected sources such as streams likely to be contaminated coupled with low education awareness has contributed to the escalation of water-related disease prevalence that could lead to high morbidity and mortality in all age groups particularly in children under 5 years of age. Thus this study tried to establish whether there was a link between household hygiene practices, seasonality, and level of education to influence prevalence of water-related diseases in the study area.

Objectives
General objectives
To assess water, sanitation accessibility and prevalence of water-related diseases in Marigat town, Baringo County during wet and dry season

Specific objectives
1. To determine household access to sources of water and sanitation facilities in the study area

2. To evaluate household water management practices in the study area

3. To determine the occurrence and concentrations of microorganisms in water samples at the source and point of use in the study area in the dry and wet season

4. To characterize the prevalence of water-related diseases in the study area in the dry and wet season

Research Questions
1. How accessible is water and sanitation and which are the most common sources of water and sanitation facilities in the study area?

2. How do households in the study area manage water and is water in the households contaminated with pathogens?

3. What is the prevalence of water-related disease in the study area?

4. Is there any relationship between water sources, season, point of use and microbial density?

Justification of the Study
Accessibility to adequate water and sanitation and prevalence of water-related diseases in the urban areas has been a major issue of concern. This study was in line with the United Nations Sustainable Development Goal three, which is geared towards ensuring healthy lives and well-being for all and goal six, whose aim is to ensure availability and sustainable management of water and sanitation for all. This study was also in line with the Kenyan constitution article 42 that states that everyone has a right to a clean and healthy environment which includes the right to have environment protected for the present and future generations through legislative and other measures especially those contemplated in article 69 and have obligations to the environment. This study contributes to the African vision 2025 which ensures equitable and sustainable use of water for socioeconomic development. This study also contributes to the social pillar on water and sanitation target of Kenya’s Vision 2030, which aims at ensuring improved water sources in both rural and urban areas. Data from this study is beneficial to the residents within Baringo County, Ministry of Health, and policy makers in addressing water sanitation and accessibility in the urban areas of the county.

Scope of the Study
The study was confined in Marigat urban centre. The town is located in Baringo County which is an ASAL area. The study was carried out using a cross-sectional survey. There have been reports on the out breaks of water-related diseases such as typhoid and diarrhoea in study area. The study focused on water and sanitation accessibility and Prevalence of water- related diseases (Typhoid and Diarrhoea) during wet and dry season in Marigat Sub-County Health Centres. The study also involved analysis of microbial quality of the drinking water that determined concentration of microorganisms in water samples from both the source and the point of use in the wet and dry season.

Limitation of study
The limitations were as follows:
1. Language barrier from the respondents this limitation mitigated by use of locally educated persons to interpret what the local respondents were saying.

2. Some respondents were unwilling to participate in filling the questionnaires, but this limitation was mitigated by use of the local chiefs to talk to them on the importance of this research to them. The types of questionnaires were designed in such a way to build their confidence.

3. Owing to relatively high illiteracy levels documented in drylands especially in the study area, some respondents faced a challenge while filling in questionnaires this limitation was mitigated by training locally educated people that filled in the information provided by these respondents.

Assumptions of the study
The study assumed that:

1. Households selected provided a true representation of water and sanitation accessibility and prevalence of water-related diseases in the study area.

2. Water-related disease prevalence was explained from the clinical health records reviewed from the health centres within the study area.

3. There was a relationship between independent (Sources of water and sanitation accessibility, microbial quality of the water and household water management practices) and dependent variable (water-related disease prevalence).

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Item Type: Kenyan Material  |  Attribute: 65 pages  |  Chapters: 1-5
Format: MS Word  |  Price: KSh900  |  Delivery: Within 30Mins.
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