The Health Impact of Improving Environmental Sanitation through Community Involvement in Karrari Locality, Khartoum State (2011)

Improving environmental sanitation -solid waste, waste water, excreta disposal, drainage and community hygiene contribute significantly to the reduction of morbidity and mortality rate of infectious diseases. This prospective Interventional study was carried out in Alkhodeir area, Karrari Locality, which lies to the north of Umdurman, Khartoum State, Sudan. The main objective of the study is to determine the health impact of improving environmental sanitation through the community involvement. The area is chosen for the study as it is poor in all essential health services, the environmental sanitation is deteriorated, the area used to witness many watery diarrheal disease outbreaks from time to time, and the inhabitants' standard of living is very low. Stratified multi stage sampling technique was used to draw samples from the area. Three blocks ( 37-42-54) were chosen for the study.337 households were selected as a sample. Data was collected by questionnaire, focus group discussions, observation and interviews. A training session targeting volunteers from the selected area was conducted for seven days followed by an intervention which has continued for six months, it included creation of awareness among the community leaders, advocacy, creation of health committees, home visiting, exhibitions, cleaning campaigns, health talk, etc. The collected data was analyzed by the SPSS software programme and significant tests, using t-test and chi-square test. This education programme resulted in an increase in the numbers of participating participants in environmental sanitation from 3.3% to 43.9%, the significant change in behavior in regard to proper ways of refuse disposal, improvement of behaviors concerning disposal of children excreta, improve ways of handling water and good personal hygiene. There is significant reduction in the incidence rate of the main infectious diseases. On the basis of the findings a set recommendations was formulated as; health workers have to apply effective health education methods to create active involvement of the community members' towards their environmental sanitation and health workers have to establish societies to deal with health and social activities and to ensure the sustainability of the activities