Project – The Influence of Community Sanitation Practices on the Prevention of Diarrhoeal Diseases: A Study of Selected Communities in Oyo State

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

Diarrhoeal diseases remain an important public health problem, particularly in communities where access to safe water, adequate sanitation and appropriate hygiene practices is limited. Diarrhoea is generally defined as the passage of three or more loose or liquid stools within a day and is commonly caused by bacterial, viral and parasitic infections. The transmission of these infections is closely associated with contaminated food and water, unsafe disposal of human waste and poor personal hygiene. The World Health Organization (WHO, 2024) identifies diarrhoeal disease as a preventable and treatable condition that continues to contribute substantially to illness and death, especially among children under five years. The organization further emphasizes that safe drinking water, improved sanitation and handwashing with soap are among the important measures for reducing diarrhoeal disease transmission. Thus, sanitation practices within communities constitute an important component of disease prevention and public health protection.

Community sanitation refers broadly to the practices, facilities and behaviours through which human waste, household refuse and wastewater are safely managed within a community. It includes the availability and use of toilets and latrines, prevention of open defecation, proper disposal of solid waste, drainage maintenance, wastewater management and maintenance of clean surroundings. Effective sanitation prevents human excreta and other sources of contamination from entering water, food and living environments. According to the World Health Organization (2018), safe sanitation is essential for protecting health because inadequate sanitation creates pathways through which infectious diseases can spread. WHO also stresses that sanitation interventions require not only appropriate technologies and infrastructure but also behavioural interventions, monitoring and effective management. Consequently, the presence of sanitation facilities alone may not guarantee protection against disease if community members do not consistently use and maintain them appropriately.

The relationship between sanitation and diarrhoeal diseases is particularly important because many diarrhoeal infections are transmitted through faecal contamination. Human faeces may contaminate drinking-water sources, food, household surfaces, soil and hands when sanitation systems are inadequate or poorly maintained. Open defecation, overflowing toilets, poorly constructed latrines, indiscriminate disposal of refuse and stagnant wastewater can therefore create environmental conditions that facilitate the transmission of diarrhoeal pathogens. The WHO (2024) notes that contaminated water and food, unsafe sanitation and poor hygiene contribute to the spread of diarrhoeal infections caused by organisms such as Escherichia coli, Salmonella, Shigella, Giardia and Cryptosporidium. Safe sanitation is consequently not merely an environmental concern but an essential public health intervention capable of interrupting the faecal–oral transmission pathway.

Beyond the provision of toilets and waste-disposal facilities, community sanitation practices involve regular environmental cleaning and the adoption of behaviours that reduce opportunities for disease transmission. Handwashing with soap after defecation and before food preparation or consumption, proper disposal of children’s faeces, safe storage of drinking-water and appropriate management of household waste are examples of behaviours that complement sanitation infrastructure. WHO (2023) identifies safe water, improved sanitation and handwashing with soap at critical times as key interventions for preventing diarrhoeal diseases. Similarly, WHO (2019) explains that water, sanitation and hygiene are interconnected components of public health because weaknesses in one area can increase health risks within households and communities. Therefore, prevention of diarrhoeal diseases requires a combination of facilities, environmental management and consistent health-protective behaviours among community members.

The issue is particularly significant in Nigeria, where inadequate water, sanitation and hygiene conditions continue to expose many households to preventable health risks. UNICEF Nigeria reports that poor access to improved water and sanitation contributes to high morbidity and mortality among Nigerian children under five, while contaminated water and poor sanitary conditions increase vulnerability to water-borne diseases, including diarrhoea. UNICEF Nigeria further reports that a substantial proportion of the diarrhoeal and enteric disease burden is associated with inadequate water, sanitation and hygiene conditions. These problems may be compounded by poverty, limited infrastructure, population growth, inadequate waste-management services and differences in household capacity to access and maintain sanitation facilities. The continuing WASH challenges therefore make community sanitation an important area for public health research and intervention in Nigeria.

Oyo State provides an important setting for examining the relationship between sanitation practices and diarrhoeal diseases because recent evidence from the state demonstrates that sanitation conditions remain a relevant public health concern. Aremu et al. (2025), in a study conducted in a rural community in Oyo State, examined household sanitation facilities and childhood diarrhoea among 426 female caregivers of under-five children. The study reported that 20.2% of participants reported childhood diarrhoea, while 20.6% practised open defecation; only 44.6% of households had access to basic sanitation and 23.0% had safely managed sanitation services. The researchers also reported a significant difference in diarrhoea prevalence between households practising open defecation and those with safely managed sanitation facilities. These findings provide local evidence that household sanitation conditions are associated with diarrhoeal disease and demonstrate the importance of examining sanitation practices within communities in Oyo State.

The prevention of diarrhoeal diseases therefore requires greater attention to how sanitation facilities are accessed, used, maintained and supported at the community level. Although government agencies, health authorities and development organisations have promoted water, sanitation and hygiene interventions, the effectiveness of such interventions can depend on community participation, availability of appropriate facilities, environmental conditions, socioeconomic circumstances and sustained behavioural practices. The WHO (2018) emphasizes that sanitation policies and interventions should address infrastructure, behavioural practices, risk management and monitoring, while the WHO (2024) recognizes improved sanitation, safe water and handwashing as central measures for reducing diarrhoeal disease. In Oyo State, where recent research has documented sanitation deficiencies and an association between household sanitation and childhood diarrhoea, investigating community sanitation practices can provide useful evidence concerning the extent to which sanitation behaviours contribute to disease prevention. It is against this background that this study examines the influence of community sanitation practices on the prevention of diarrhoeal diseases in selected communities in Oyo State.

1.2 Statement of the Problem

Diarrhoeal diseases remain a significant public health concern despite being largely preventable through relatively well-established interventions. Poor sanitation, unsafe drinking water and inadequate hygiene create conditions that facilitate the transmission of diarrhoeal pathogens within households and communities. The World Health Organization (2024) reports that diarrhoeal disease continues to cause substantial morbidity and mortality globally, particularly among children under five, and identifies contaminated food and water, inadequate sanitation and poor hygiene as important transmission pathways. This indicates that the persistence of diarrhoeal disease is not only a consequence of inadequate medical treatment but also reflects continuing environmental and behavioural challenges. When communities lack adequate sanitation facilities or fail to use and maintain them properly, residents may remain exposed to preventable sources of infection.

In Nigeria, inadequate WASH conditions continue to create challenges for disease prevention, particularly among vulnerable populations. UNICEF Nigeria reports that poor access to improved water and sanitation contributes to morbidity and mortality among children under five and that diarrhoeal and enteric diseases are strongly associated with inadequate WASH conditions. The problem may be more pronounced in communities where households have limited access to improved toilets, reliable water supplies, appropriate waste-disposal systems and effective drainage. In such settings, practices such as open defecation, indiscriminate refuse disposal, poor wastewater management and inadequate hand hygiene may persist and increase opportunities for faecal contamination. The continued existence of these environmental risk factors suggests that improving community sanitation practices remains necessary for reducing preventable diarrhoeal disease.

The problem is also evident from recent empirical evidence in Oyo State. Aremu et al. (2025) found that childhood diarrhoea occurred among 20.2% of participants in their rural Oyo State study, while 20.6% of the population practised open defecation. The study also found that only 44.6% of households had access to basic sanitation services and 23.0% had safely managed sanitation services. Importantly, households practising open defecation recorded a substantially higher prevalence of childhood diarrhoea than households with safely managed sanitation facilities. Although this study provides valuable evidence concerning household sanitation and childhood diarrhoea in a rural community, there remains a need to examine sanitation practices more broadly at the community level, including environmental cleanliness, waste disposal, toilet use, drainage and hygiene-related behaviours.

The central problem, therefore, is that diarrhoeal diseases may continue to occur in communities where preventable environmental risk factors remain inadequately controlled. There is a need to establish whether the sanitation practices adopted by residents of selected communities in Oyo State are sufficiently effective to reduce exposure to diarrhoeal infections. Understanding the relationship between community sanitation practices and diarrhoeal disease prevention is important for community health education, environmental sanitation programmes and public health planning. Without adequate local evidence on sanitation behaviours and their influence on diarrhoeal disease prevention, interventions may focus predominantly on treatment rather than addressing environmental and behavioural factors that contribute to transmission. This study therefore seeks to assess the influence of community sanitation practices on the prevention of diarrhoeal diseases in selected communities in Oyo State.

1.3 Purpose of the Study

The main purpose of this study is to examine the influence of community sanitation practices on the prevention of diarrhoeal diseases in selected communities in Oyo State.

Specifically, the study seeks to:

1. assess the level of community sanitation practices among residents of selected communities in Oyo State;
2. determine the level of knowledge of residents regarding sanitation practices and the prevention of diarrhoeal diseases;
3. examine the relationship between community sanitation practices and the prevention of diarrhoeal diseases in the selected communities; and
4. identify the major challenges affecting effective sanitation practices and diarrhoeal disease prevention among residents of the selected communities.

1.4 Research Questions

The following research questions will guide the study:

1. What is the level of community sanitation practices among residents of selected communities in Oyo State?
2. What is the level of knowledge of residents regarding sanitation practices and the prevention of diarrhoeal diseases?
3. What relationship exists between community sanitation practices and the prevention of diarrhoeal diseases in the selected communities?
4. What are the major challenges affecting effective sanitation practices and diarrhoeal disease prevention among residents of the selected communities?

1.5 Research Hypothesis

The following null hypothesis will be tested at the 0.05 level of significance:

H₀: There is no significant relationship between community sanitation practices and the prevention of diarrhoeal diseases among residents of selected communities in Oyo State.

1.6 Significance of the Study

The study will be significant to residents of the selected communities because it will provide information on the importance of proper sanitation practices in reducing exposure to diarrhoeal diseases. The findings may encourage households to improve practices such as toilet use, proper disposal of human waste, safe handling of household refuse, maintenance of clean surroundings, proper wastewater disposal and handwashing.

The study will also be useful to community health workers and public health practitioners. The findings may assist them in identifying sanitation-related behaviours that require greater attention during health education and community mobilisation programmes. Information generated from the study may help health workers develop more targeted messages on diarrhoeal disease prevention and environmental sanitation.

Government agencies and local authorities responsible for environmental health and sanitation may also benefit from the study. The findings may provide local evidence that can assist in planning sanitation campaigns, waste-management programmes, environmental inspections, drainage maintenance and community-based health interventions. The evidence may also help identify areas where residents require additional sanitation infrastructure or behavioural support.

The study will be useful to community leaders and community-based organisations because effective sanitation often requires collective participation. The findings may encourage community leaders to support sanitation activities, environmental clean-up exercises, proper waste disposal and measures aimed at reducing open defecation and environmental contamination.

Finally, the study will contribute to the academic literature on sanitation and diarrhoeal disease prevention. It may serve as a reference material for students, researchers and public health professionals interested in environmental health, community health, water, sanitation and hygiene, and infectious disease prevention, particularly within the Nigerian context.

1.7 Scope of the Study

The study will focus on the influence of community sanitation practices on the prevention of diarrhoeal diseases in selected communities in Oyo State. The study will examine sanitation practices such as availability and use of toilet facilities, prevention of open defecation, disposal of household refuse, wastewater management, drainage maintenance, environmental cleanliness, handwashing and other hygiene-related practices.

The study will also examine residents’ knowledge concerning the relationship between sanitation and diarrhoeal disease prevention, as well as perceived challenges affecting effective sanitation practices. The study will be restricted to selected communities in Oyo State and will involve residents who meet the study’s inclusion criteria.

1.8 Operational Definition of Terms

Community: A group of people living within a defined geographical area and sharing common environmental, social and infrastructural conditions.

Community Sanitation: The facilities, behaviours and activities undertaken by individuals and communities to safely manage human waste, household refuse, wastewater and the general environment.

Diarrhoeal Disease: A condition characterized by the passage of three or more loose or liquid stools in a day, usually resulting from gastrointestinal infection caused by bacteria, viruses or parasites.

Prevention: Measures undertaken to reduce the occurrence, transmission or recurrence of diarrhoeal diseases.

Sanitation Practices: Specific behaviours and activities related to toilet use, human-waste disposal, refuse disposal, wastewater management, environmental cleaning and maintenance of sanitary surroundings.

Open Defecation: The practice of defecating in open areas rather than using a toilet or other appropriate sanitation facility.

Hygiene: Practices undertaken by individuals to maintain cleanliness and reduce exposure to disease-causing microorganisms, including appropriate handwashing and food-handling practices.

Selected Communities: The communities within Oyo State that will be specifically chosen as the study locations according to the sampling procedure adopted for the research.

Project – The Influence of Community Sanitation Practices on the Prevention of Diarrhoeal Diseases: A Study of Selected Communities in Oyo State