Community Knowledge and Attitude on Community Led Total Sanitation after Open Defecation-Free Certification of Balaka District in Malawi

Laston Kamwana – Malawi Adventist University, Malamulo College of Health Sciences, Department of Public Health
Mavuto Tembo – Mzuzu University. Department of Water and Sanitation
Russel Chidya – Mzuzu University. Department of Agribusiness.
Email: lastonkamwana@gmail.com

Abstract: Community-Led Total Sanitation is a sanitation behaviour change approach aimed at stopping open defecation. It compels communities to sustainably construct latrines, use them and wash their hands with soap after open defecation. Change of behaviour for the Sustainability of these practices is a challenge as communities return to open defecation. The study evaluated community knowledge and attitude toward Community-Led Total Sanitation in Balaka District, the first Open Defecation Free certified model District in Malawi four years after Open Defecation Free status certification. Descriptive cross-sectional study design adopting both quantitative and qualitative data collection methods was used. Data was collected from heads of household (438) and Focused Group Discussion (6) sessions. Communities have adequate knowledge on Community-Led Total Sanitation and Open defecation status and a positive attitude towards Community-Led Total Sanitation implementations and open defecation status despite having very low hand washing facility coverage (36%, n=158) and hand washing with soap after defecation (24% n = 105). Knowledge has no influence on latrine use and hand washing facility construction (p >0.05) while attitude has influence on hand washing facility constriction (p <0.05) in Balaka. Emphasis is required on health promotion on hand-washing facility construction and washing hands with soap to to ensure sustainable sanitation practices beyond ODF certification.