Full Project – WATER HYGIENE KNOWLEDGE, ATTITUDE, PRACTICE AND ENHANCEMENT STRATEGIES AMONG WOMEN ATTENDING ANTENATAL CARE IN PLATEAU STATE, NIGERIA

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TABLE OF CONTENTS

Title Page

Approval Page

Certification Page

Dedication

Acknowledgements

Table of Contents

List of Tables

List of Figures

Abstract

CHAPTER ONE: Introduction

Background to the Study

Statement of the Problem

Purpose of the Study

Research Questions

Hypotheses

Significance of the Study

Scope of the Study

CHAPTER TWO: Review of Related Literature

Conceptual Framework

Water Hygiene

Knowledge

Attitude

Practice

Measurement of knowledge, attitude and practice

Enhancement strategies

Demographic factors associated with water hygiene

Schematic representation of conceptual framework

Theoretical Framework

Social Cognitive Theory (SCT)

Theory of Change of Attitude (TCA)

Stages of Change /Transtheoretical Model (TTM)

Schematic representation of theoretical framework

Empirical Studies

Summary of Literature Reviewed

CHAPTER THREE:  Methods

Research Design

Area of the Study

Population of the Study

Sample and Sampling Techniques

Instruments for Data Collection

Validity of the instruments.

Reliability of the instruments.

Method of Data Collection

Method of Data Analysis

CHAPTER FOUR: Results and Discussions

Results

Discursion

CHAPTER FIVE: Summary, Conclusion and Recommendations

Summary

Conclusions

Recommendations

References

Abstract

In some cases in Plateau State, water was got from source closest to the user irrespective of its quality. Moreover, fetched water was mixed with stored one, which is troubling and point to problems among others. Therefore, the aim of this study was to investigate the water hygiene KAP of women attending ANC in Plateau State and the outcome used to proffer water hygiene KAP enhancement strategies. To achieve the main purpose, the study determined water hygiene KAPof women attending ANC in Plateau State using ten research questions and six hypotheses tested at 0.05 level of significance. Descriptive survey research design was used for the study. The population for the study consisted of 150,913 (all the women who attended ANC in Plateau State in 2014). The sample size for the study was 777 drawn from the population using multi stage sampling procedure. Two types of instruments (WaHKAPQ & WaHESQ) used for the study were validated by five experts from the Department of Human kinetics and Health Education and Measurement and Evaluation, University of Nigeria, Nsukka. The Cronbach Alpha reliability index of WaHKAPQ was .80 and WaHESQ, .89. The research questions were answered using descriptive statistic of frequencies, percentages and means. The Chi-square statistic was used to test all the null hypotheses at 0.05 level of significance. The findings of the study revealed that majority (61.6%) of women who attended ANC possessed correct knowledge regarding water hygiene, water collection (75%), water source protection (74.8%) and water transportation (74.2%) while more than half of women possessed correct knowledge regarding water storage (58.3%) and about half of women possessed correct knowledge regarding PoU of water (49.2%) whereas over 30 per cent of women possessed correct knowledge regarding water purification (37.1%). Also, more than half (56.4%) of women expressed positive attitude regarding water hygiene while majority of the women expressed positive attitude regarding water source protection (76.7%) and water storage (70.2%) whereas over one half of the women displayed positive attitude towards water purification (58.5%), water transportation (51.8%) and PoU of water (50.5%) while 30.6 per cent of women expressed positive attitude regarding water collection (30.6%). Also, the finding showed that women attending ANC practised: water hygiene (overall always = 32.7%, sometimes = 23.7%, rarely = 22.9%); water source protection (always = 49.9%, sometimes = 32.6%, rarely = 10.4%); water collection (always = 40.7%, sometimes = 25.6%, rarely = 16.3%), water storage (sometimes = 40.5%, always = 38.6%, rarely = 8.9%); water purification (always = 37.7%, sometimes = 33.7%, rarely = 20.3%), transportation of water (always = 34.2%, sometimes = 20.1%, rarely = 15.7%) and point-of-use (PoU) of water (sometimes = 32.7%, always = 29.5%, rarely = 17.2%). The findings further showed that there was no significant difference with regard to practices of water hygiene of women who attended ANC based on location (overall c ² = 2.077, P-value .586 > .05), storage of water ( c ² = 1.638 > P = .672, df = 3), transportation of water ( c ² = 2.107 > P = .551, df = 3), water collection ( c ² = 3.25 > P =

.422, df = 3), PoU of water ( c ² = 1.999 > P = .591, df = 3), water source protection ( c ² = 1.584 > P = .673, df = 3) and purification of water ( c ² = 1.884 > P = .607, df = 3). In addition, the findings of the study also showed that the enhancement strategies of water hygiene KAP were adjudged very appropriate with cluster means of 2.55 with SD of 559, which fell between 2.49 – 3.00; means of 2.62 with SD = .515, which fell between 2.49 – 3.00 and 2.65 with SD = .496, which fall between 2.49 – 3.00 among others. Based on the findings of the study, it was recommended among others that women attending ANC should practise the items contained in the water hygiene enhancement strategy aspects of the strategies on attitude towards water hygiene. This becomes necessary so as to influence all women attending ANC in both rural and urban areas express positive attitude towards water hygiene.

CHAPTER ONE

Introduction

Background to the Study

Water hygiene knowledge, attitude, practice (KAP) and enhancement strategies are key to ensuring the sustenance of good health, wellbeing, comfort and survival of man, including women attending antenatal care (ANC). This is because water has impurities that affect it in the environment. These impurities are often ingested as a result of man’s inability to embark on correct water hygiene, which results to dire consequences. For instance, in many homes, water related diseases have been one of the leading causes of mortality and morbidity in developing countries (World Health Organization and United Nation International Children Fund [WHO/UNICEF], 2000). In addition, WHO (2004) further revealed that approximately 88 per cent of water related diseases were attributable to unsafe water use, inadequate sanitation and hygiene. Furthermore, the consequences of inappropriate water hygiene according to UNICEF/WHO (2009) led to diarrhoea that killed 1.5 million children of less than five years of age annually more than deaths from acquired immune deficiency (AIDS), malaria and measles combined globally. According to Craun, Brunkard, Yoder, Roberts, Carpenter, Wade,…Roy (201 0), from 1971 to 2006, 54 per cent of reported water related disease outbreaks were due to the use of untreated water. Jones (2011) showed that 37 per cent of people not using improved source of water lived in sub-Saharan Africa, which included Nigeria and Plateau State. Jones further pointed that poor practices of water hygiene were on the increase and accounted for 2.2 million children deaths of less than 5 years of age.

The scourge of water related diseases had been on the increase. Nigeria Center for Disease Control – NCDC reported an increase in wate r borne diseases with 9,006 cases and 106 deaths in the first quarter of 2014 (Leo, Sadiq, Alao, Auwal, Liman & Mohammed, 2014). When untreated water was ingested, cholera occurred (Igomu, 2011). It may be in this regard that in 2013, Plateau State government reported 130 cases of cholera disease and 11 deaths (Sadiq, Auwal & Joseph, 2013). Therefore, the ingestion of untreated water can lead to many health problems such as gastrointestinal illness, reproductive problems and neurological disorders (Center for Disease Control [CDC], 2013). Moreover, infants, young children, pregnant women, the elderly and patients with compromised immune system due to AIDS, chemotheraphy or transplant medications may be especially susceptible to illness (United States Environmental Protection Agency [USEPA], 2013).

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