Teachers and Sanitation Promotion: An Assessment of Community-Led Total Sanitation in Ethiopia.
Teachers and Sanitation Promotion: An Assessment of Community-Led Total Sanitation in Ethiopia.
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DOI：
10.1021/acs.est.6b01021
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发表时间：
2016-06-21
影响因子：
11.4
通讯作者：
Bartram J
中科院分区：
文献类型：
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作者：
Crocker J;Geremew A;Atalie F;Yetie M;Bartram J
社区主导的完全卫生设施(CLTS)是一种参与性的解决露天排便问题的方法，在以前的研究中已经证明是成功的，但还没有关于执行安排和背景改变的有效性的研究。我们使用准实验研究设计来比较埃塞俄比亚的两种干预措施：传统的CLTS，其中卫生工作者和当地领导人提供便利，以及另一种方法，其中教师提供便利。2012年，国际埃塞俄比亚计划对来自111个村庄的教师和来自54个村庄的卫生工作者和领导人进行了CLTS促进方面的培训。受过培训的协调员随后在各自的村庄实施了为期一年的CLTS。厕所的拥有率、使用和质量通过家庭调查进行衡量。通过调查和访谈来探讨干预措施之间的差异。与教师辅助的开放式排便相关的开放式排便减少比传统的开放式排便减少8.2%(p=0.048)。教师的职责相互竞争，最初缺乏当地领导人的支持，这可能降低了他们的成功。教师可能更适合在促进卫生设施方面发挥支持作用，而不是领导作用，因为他们确实展示了能力和参与度。露天排便总体下降了15.3个百分点，但在基线露天排便低于30%的情况下没有变化。有稳定地板的厕所拥有率总体上升了8.7个百分点。在干预期间，改善的厕所所有权没有改变。CLTS最适合露天排便高的地方，因为在基线露天排便低的地方，卫生做法或厕所升级没有显着变化。
Community-led total sanitation (CLTS) is a participatory approach to addressing open defecation that has demonstrated success in previous studies, yet there is no research on how implementation arrangements and context change effectiveness. We used a quasi-experimental study design to compare two interventions in Ethiopia: conventional CLTS in which health workers and local leaders provided facilitation and an alternative approach in which teachers provided facilitation. In 2012, Plan International Ethiopia trained teachers from 111 villages and health workers and leaders from 54 villages in CLTS facilitation. The trained facilitators then implemented CLTS in their respective villages for a year. Latrine ownership, use, and quality were measured with household surveys. Differences between interventions were explored using surveys and interviews. The decrease in open defecation associated with teacher-facilitated CLTS was 8.2 percentage points smaller than for conventional CLTS (p = 0.048). Teachers had competing responsibilities and initially lacked support from local leaders, which may have lessened their success. Teachers may be more appropriate for a supporting rather than leading role in sanitation promotion because they did demonstrate ability and engagement. Open defecation decreased by 15.3 percentage points overall but did not change where baseline open defecation was below 30%. Ownership of a latrine with stable flooring increased by 8.7 percentage points overall. Improved latrine ownership did not change during the intervention. CLTS is most appropriate where open defecation is high because there were no significant changes in sanitation practices or latrine upgrades where baseline open defecation was low.