CHAPTER ONE

INTRODUCTION

Background of study

Environmental sanitation is defined according to World Health

Organization (WHO 2015) as the control of all factors in the human

environment, which exercise a deleterious effect on the population, their

development and survival. Environmental sanitation is also defined a set

of actions or fundamental process of collecting and safely disposing of

all kinds of waste within the environment with the intention of protecting

and promoting the individuals health and quality of life. Environmental

sanitation knowledge means the total information that the target

population has about sanitation and how to keep their community,

family and environment clean. Environmental sanitation attitude means

the way a person views something or tends to behave towards it. In

context of the present study, attitude refers to what the target

population feels or believes about environmental sanitation.

Environmental sanitation practice refers to the way by which people

demonstrate their knowledge and attitude through their actions.

1
 Housing is one of the most basic necessities of life and serves as a

great source of happiness. WHO (2014) describes the requirement for a

healthy residential environment in relation to proper setting and

construction as that which meets fundamental physical, psychological

and sanitary requirements. Good house should minimize physical and

biological hazards in the environment and should promote the health of

the inhabitants; poor setting is the most leading factors of slums.

Duneke (2013) states that slums do not just happen rather they

represent a pattern of life as determined by men. He gave reasons for

the existence of filthy environment and our congestion of residential

houses as inadequate government policy in housing and the intricacies

involved in acquiring land in Uturu community (Duneke, 2011).

The effect is over-crowding, inadequate water supply, accumulation of

refuse and poor drainage system. The above ill conditions perpetuate

poor health. Poor housing permits poor health. Some of these have

proved beneficial as well as hazards to man, especially women of child

bearing age, in Uturu Autonomous Community Abia State.

Environmental education helps to develop an ethical awareness of all

forms of life which humans share on this planet and impose limits on

human’s exploitation of other forms of life. This is in line with one of the

2
goals of environmental education as stated by UNESCO (2019) which is

“to develop a world population that is aware of and concerned about the

environment and its associated problems and which has the knowledge,

skills, attributes, motivation and commitment to work individually and

collectively towards solution of current problems and prevention of new

ones”. The Australian Association for Environmental Education (2013)

also defined environmental education as “an across-the-curriculum

approach to learning which helps individual and groups to understand

the environment, with ultimate aim of developing, caring and attributes

that will foster the desire and ability to act responsibly in the

environment. Environmental education is concerned not only with

knowledge, but also with feelings, individuals, through planned adult

educational programme to be aware and competent enough to

contribute without being prompted towards the building of a more

equitable and sustainable future.” (Oduro, 2012).

Environmental degradation is indeed a serious threat to most women of

bearing age in developing countries, especially in Uturu Abia State. It

adversely affects the state of health of the populace, hinders and

undermines development. Thus it deals to tame the environment and

this could be an achievement through proper environment sanitation.

3
The aim of proper environmental sanitation is to promote health and

prevent diseases. Man’s environment contains potential hazards such as

air pollution, polluted ground which could harm life in the same

environment (Oduro, 2012).

Proper environmental sanitation promote health, improve the quality of

the environment empower women of child bearing age, especially those

in Uturu, Abia State. Adult education is the instruction that is not

obligatory and structured and is learned outside the context of a formal

school. This term “Adult Education”, is often used as many international

and systematic educational enterprise, usually outside of traditional

schooling in which content is adapted to the unique needs to maximize

learning.

Women of childbearing age by simply having access to the

environmental sanitation disposal methods increase health, well-being

and economic productivity. However, in view of delay and lack of

modalities in the provision of environmental sanitation disposal method

among women of child bearing age in Uturu Community where the

majority of people live without any systematic ways of waste disposal.

The increase in population has led to insufficient environmental

4
sanitation and increase the generation of both solid and liquid waste

(Choker, 2013).

In the absence of effective environmental sanitation disposal methods,

some women of childbearing age and members of Uturu community rely

on natural process (UNEP, 2016). That is defecting in open fields or on

water surface. In the option, human waste is directly disposed off into

the river canals, channels which cause severe environmental health

conditions of women of childbearing age in Uturu Community.

In this area, increase in population and lack of proper environmental

sanitation has led to cases of outbreak of diseases, which adversely

affects and hampers developments. For instance, there was a serious

outbreak of gastroenteritis in Uturu in the year 2006, in which many

people died (Emile, 2012). Moreover, several reports from

epidemiology, monitoring a devaluation unit of health Department Uturu

Community shows various cases of outbreak of some chicken pox,

malaria, measles, gastroenteritis and typhoid among children and the

members of the community. This is the result of lack of environmental

sanitation.

5
Statement of problem

In Uturu Autonomous community, women of child bearing age find

it difficult to keep and maintain clean environment. Some of them lack

the knowledge, attitude and do not practice proper environmental

sanitation. For instance, so many women of childbearing age misuse

incineration method and it creates toxic gas as such which can harm the

local population and pollute groundwater. Modern incineration takes

elaborate measures to reduce the amount of toxic products. But the

concern has increased in recent years about the level of toxic that is

released when burning mixed waste. Also poorly managed landfill by

women of child bearing age in Uturu autonomous Community, Abia

State creates a number of adverse environmental problems; including air

pollution attracts vermin and pollutes groundwater (MDG Report, 2018).

Also, the use of polythene bags in packaging refuse, garbage disposal

waste and other wares and the proliferation of fast food joints which

uses packages cooked food in nylon or polythene bags is an eye sore.

Many families in Uturu Community are dirty. Open spaces, market

places, car packs, churches are littered with refuse. In most cases,

drainage gutters are clogged or totally blocked and many compounds

are hemmed in by solid waste, posing health threats to children who

6
play and live around the area (UNDP, 2010). Several efforts have been

made by the leaders of Uturu community to ensure that the community

is always clean. Still women of child bearing age in Uturu community do

not see the necessity and benefits of proper disposal of their waste and

this is probably due to lack of education which result to rapid spread of

infectious diseases. Adaobi (2019)

Improper environmental sanitation by women of childbearing age can

cause risk to public health by attracting pest that carry germs e.g. flies,

mosquitoes and rats and allowing them to breed. Such breeding may

encourage the spread of diarrheal diseases and other diseases like:

dengue fever, yellow fever and bubonic plague in Uturu Community. For

instance, house flies that enter kitchen after landing on waste dumps

can transfer bacteria by landing on food, increasing the incidence of

diarrhea. Thrown away tins, glass bottles, plastic bags and container can

hold water where mosquitoes and other insects can breed. Bacteria,

expired medicine, used engine oil and other dangerous waste such as:

dirty kerosene and fuel can be dangerous to the health of Uturu

Villagers. If dumped on the ground and leaked into groundwater, rivers,

gutters, ponds and ingested by persons swimming, playing or collecting

7
drinking water can contract typhoid, diarrhea and other dangerous

diseases (Daramolo, 2015).

In addition, modern household waste disposed by women of

childbearing age is full of dangerous chemical in Uturu Community. For

example, many points and batteries contain lead and electronic goods

carry hazardous substance. As aforementioned, when waste is

improperly disposed like used pads and papers used by women of

childbearing age can damage the environment and consequently affect

human health. Government has a responsibility to protect the

environment and their citizens by implementing appropriate waste

disposal measures. It is based on all these problems that the researcher

investigated the administration of environmental sanitation among

women of childbearing age in Uturu Community and its implications for

adult education (WHO, 2013).

Objectives of the Study

The objectives of the study were to:

 Determine the knowledge of women of child bearing age in Uturu

towards environmental sanitation in their community

8
  Describe the attitude of women of child bearing age towards

environmental sanitation

 State the practice of women of child bearing age towards

environmental sanitation in their community.

Significance of Study

The present study showed the attitude, knowledge and practice of

women of child bearing age towards environmental sanitation in Uturu

Autonomous Community, Abia State. The anticipated data on attitude,

knowledge and practice of women of child bearing age towards

environmental sanitation emerged from the present study are significant

not only to women of child bearing age; but also Abia State Ministries of

Health and Information, Abia State environmental health intervention

researchers and women of child bearing age to adapt to positive attitude

knowledge and practice of environmental sanitation.

Data generated will help Abia State Ministries of Health to educate

both women of child bearing age and the entire population on the

importance of environmental sanitation in their health. Also, they will

educate the women of child bearing age on how to dispose their refuse,

garbage and waste properly. Not only that through this education, they

will know how to keep their environment clean especially in their

9
kitchen, and how to cover their pots properly in order to avoid rats,

cockroaches, flies urinating on their food (Gupta, 2010).

Research Questions

The following research questions were posed to guide the study in

Uturu Autonomous Community Abia State.

1. What is the knowledge of women of childbearing age towards

environmental sanitation?

2. What is the attitude of women of child bearing age towards

environmental sanitation?

3. What is the practice of women of child bearing age towards

environmental sanitation?

Scope of the study

The study focused on the knowledge, attitude and practice of

environmental sanitation in Uturu community. The study was limited to

childbearing age 15-45 years’ women in Uturu community only.

10
Operational definition of terms

Knowledge of environmental sanitation among women of

childbearing age means the total information that the target

population has about sanitation and how to keep their community,

family and environment clean.

Attitude of environmental sanitation among women of child

bearing age means what the target population feels or believes about

environmental sanitation

Practice of environmental sanitation among women of child

bearing age is refers as the way by which people demonstrate their

knowledge and attitude through their actions.

11
 CHAPTER TWO

LITERATURE REVIEW

Conceptual review

The concept of attitude, knowledge and practice of environmental

sanitation among women of child bearing age in Uturu Community

entails the control of water supplies, excreta disposal, waste water

disposal, refuse disposal, vectors of diseases, housing conditions, food

supplies and the safety of the working environment. Environmental

sanitation according to World Health Organization (2015) is defined as

the control of all those factors in man’s physical environment which

exercise or may exercise a deleterious effect on his physical

development, health and survival. Also, according to the National

Sanitation Foundation of USA, (NSF, 2012), the word sanitation is

defined as a way of life that is expressed in the clean home, farm,

business, neighborhood and community.

Inadequate sanitation is a major cause of disease worldwide and

improving sanitation is known to have a significant beneficial impact in

health, because it shapes the personality of a person, a region and even

a nation Eric (2011). Everyone has the right and obligation to clean and

12
maintain a healthy environmental sanitation obstacle factors are as

follows:

1. Environmental friendly development cost a lot

2. Lack of shame culture so that people do not hesitate to throw

garbage anywhere, ant and in front of anyone especially by the

women of child bearing age in Uturu

3. Lack of knowledge and understanding of society about the dirty

environmental garbage waste and pollution.

4. Lack of knowledge about waste utilization and waste

management.

Napari and Cobbinah (2014) in their research on attitude, knowledge

and practice of environmental sanitation among women of child bearing

in Uturu, indicated that poor attitudes of women of child bearing age

towards environmental sanitation coupled with lack of knowledge and

practice have affected the development of Uturu community in many

ways. First, the poor attitude toward environmental sanitation is the

major cause of choked sewage system with solid waste as a

consequence and also flooding has become a normal phenomenon

accompanying rainfall in Uturu community. This situation does not only

worsen the environmental sanitation conditions, but threatens the live of

13
residents especially during heavy downpour. Secondly, the poor state of

environmental sanitation in Uturu community has contributed to various

infectious diseases such as malaria, cholera and diarrhea.

Also, Uturu community reported high incidence of early mortality rates in

the community which they believes poor environmental sanitation is a

key contributing factor. Mmon and Mnon (2011) commented on

environmental sanitation and public health challenges in a rapidly

growing city of the third world. The case of domestic waste and diarrhea

incidence in Uturu, Abia State Nigeria, that poor environmental

sanitation practice exhibited in the disposal of solid wastes, wastewater

and excreta, cleaning of drainage including personal, household and

community and in order to achieve proper environmental sanitation

practice, good sanitation attitude and availability of facilities and services

must work in unison. They also stressed that numerous studies have

shown that the incidence of many disease is reduced when people have

access to and make regular use of adequate sanitary installations.

Uzum and Saglam (2016) studied environmental attitude, scale

development and validation and opined that women of child bearing age

who have negative attitude towards environmental sanitation will be

insensitive to environmental problems and may adopt behaviours that

14
damage the environment. So the enhancement of the environment

knowledge of women of child bearing age in Uturu leads to the

development of positive attitudes towards the environment Nick (2013).

Also attitudes of women of child age in Uturu community towards

environmental sanitation and an individual who has a positive attitude

towards the environment tends to act positively, approaches, show

concern, support and assist the environment, but an individual whose

attitude is negative towards the environmental sanitation tends to be

indifferent to it or alternate, criticize or even damage it. Effective

management of environmental sanitation requires strategies that bring

about fundamental change in how women of child bearing age perceive

environmental sanitation in Uturu community.

Mc Cornville (2018) conducted a research on assessing sustainable

approaches to sanitation planning and implementation in West African

and asserted that improving sanitation is not only about installing

technological system, but also about changing the hygiene and

defecation practices of the local population. Mirian observed that lack of

environmental sanitation and unsafe water has significant negate health

impact on people and due to unsafe water, inadequate sanitation and

unhygienic, people suffer from allergies and diseases. According to them

15
unsafe drinking water, poor environmental sanitation, unsanitary food

preparation, improper disposal of waste and unclean household

environment constitute a major burden on health and leads to diseases

in children and total population.

Knowledge of environmental sanitation by women of child

bearing age

Environmental sanitation knowledge is defined as the total information

that the target population has about sanitation and how to keep the

environment/community clean. The overall purposes of environmental

sanitation knowledge are to provide a healthy living environment for

everyone, to protection the health and natural resources such as surface

water, groundwater, soil and to provide safety and security and dignity

for people when they defecate or urinate Ife, (2017).

Effective sanitation systems provide barriers between excreta and

humans in such a way as to break the disease transmission cycle (for

example in the case of fecal –borne disease) (WHO, 2012).

Pathogens are excreted by infected individuals and if not contained or

treated, may present a risk to humans who come in contact with them

(Agu, 2013). These individuals can also be exposed to pathogens

16
through drinking water or eating food contaminated with pathogens

found in human excreta. Adequate knowledge of environmental

sanitation protects the health of the population in Uturu and improves

safety (Agu, 2013). These includes appropriate cleaning of environment

keeping the kitchen clean. Removal of empty cans, bottles etc., also

clearing of bushes around our homes which provide hidden place for rat

and snakes. It also serves as a breeding place for mosquitoes etc.,

(Mirian, 2019).

Environmental sanitation knowledge promotes hygiene (Obi, 2011).

Some surfaces may still have viruses and other pathogens that could

stick to clothing and items before infecting a host.

It is the part of women of childbearing age in Uturu to practice personal

hygiene to make sure that they remain clean and do not carry around

unhealthy particles in their bodies (Obi and Nzu, 2016). If an

environment is sanitized as well, then the community that lives in it is

also cleaner and healthier than those living in ignored areas.

Attitude of environmental sanitation by women of child bearing

age

17
This refers to what the target populations feels or believe about the

environmental sanitation attitudes includes the process of collecting and

safety disposal of all kinds of waste within the environment (WHO,

2015). This involves provision of facilities and services for the safe

disposal of waste, the maintenance of hygienic conditions and

prevention of diseases. This involves provision of facilities and services

for the disposal of waste, the maintenance of hygienic conditions and

prevention of diseases. This leads to the improvement of health

wellbeing of hygienic conditions and prevention of diseases. This leads

to the improvement of health wellbeing and productivity and benefits

the individuals, household and productivity and benefits the individuals,

household and community through the provision and practice of

adequate sanitation good hygiene and the use of safe water (WHO,

2012).

About 1% of the global burden of disease and one third of all annual

deaths in low and middle – income countries resulting from inadequate

water sanitation and hygiene is believed to be due to poor

environmental sanitation (Adam, 2016).

Furthermore, a correlation has also been observed between poverty,

child infancy and diseases in developing countries with inadequate

18
sanitation which poses a significant public health risk, childbearing in

particular are most vulnerable to health (Adam, 2016). Therefore,

interactions targeted at sanitation improvements can significantly

enhance health and wellbeing of the population by preventing, reducing

the severity and impact of diseases associated with poor sanitation.

Practice of environmental sanitation by women of child bearing

age

Environmental sanitation practice refers to resident’s involvement in

provision, utilization and maintenance of environmental sanitation

facilities and services and adherence to environmental legislation

(Daramola, 2015). In Uturu, adequate environmental sanitation practices

have not ensured. They are characterized by lack of basic amenities and

poor sanitation habits (Ademiluyi, 2016).

General access to environmental sanitation facilities and services by

women of child bearing age in Uturu community are poor (Akpabio,

2012). Uturu are characterized by population growth which is not

accompanied by a corresponding increase in the delivery of

environmental sanitation facilities and services capable of enhancing

environmental sanitation practices. The resultant effects of these are

19
unsanitary and unhealthy conditions that are prevalent in Uturu

community (Daramola, 2012).

Poor environmental sanitation practices exhibited in the disposal of solid

waste, waste water and excreta, cleaning of drainage including personal,

household and community hygiene significantly contribute to infant and

child mortality (Mmon and Mmon, 2011). This is contrary to the notion

of environmental sanitation which aims at developing and maintaining a

clean, safe and pleasant physical environment in all human settlements

(IRC, 2016) environmental sanitation comprises the disposal and

treatment of human excreta, solid waste and wastewater control of

disease vectors, and provision of washing facilities for personal and

domestic hygiene which work together to form a hygiene environment

(Scherteriteib, et al., 2015).

Improved environmental condition affects positively a wide range of

development indicators. Thus, environmental sanitation is a channel to

improved quality of life of the individuals and a contributor to their

social, economic and physical development (Olewoporoku, 2013).

Numerous studies have shown that the incidence of many diseases is

reduced when people have access to, and make regular use of adequate

sanitary installatio (Aremu, 2012, Mohammed 2011, Mnon and Mnon,

20
2011). It has been documented that about 24% of global diseases with

mortality ratio is caused by environmental exposures which can be

averted (WHO, 2016).

Nevertheless, most of those deaths are preventable through adequate

environmental sanitation practices.

Theoretical framework

Theory plays vital role in health education research. Theories and

models are essential health education tools for solving health problems

and most useful implements as they are tools, used in tackling health

challenges (Debarr, 2004). Theory is a systematic process explaining

correct observations that are peculiar aspects of life (Babbles, 2003).

These theories suggest the ways in which individuals perceive their

states, health condition and attitude towards it, which in turn influence

the nature, attitude and level of taking healthy precautions and attitude.

This study is hinged on four theoretical frame works in explaining

attitude, knowledge and practice towards environmental sanitation.

They include the following:

The health belief model (HBM)

21
Stretcher et al., (1997), described health belief model (HBM) as a theory

that explains why people do or do not engage in preventive health

measures; such as: getting tested for a disease, eating healthy food and

exercising or keeping their environment clean. It is one of the models

which adopted theories from other disciplines and one of such is the

behavioural science to study health problems. (Pedding et al., (2010)

argued that it is one of the most widely recognized and used models in

health behaviour applications (Slovic 2010) also intimates that the

models explains why people would or would not use available preventive

services.

The presupposition is that people who feared disease are influenced by

the type of health activities they do. This is seen in the degree of fear

(perceived threat), and the expected fear reduction action so far as that

supposed reduction seemed to overweigh practical and psychological

barriers to taking action. The researcher thinks that the fear of disease

is not enough for people to engage in activities that will prevent them,

but the awareness that certain preventive activities can help reduce the

threat is important. Hence should women of child bearing age in Uturu

be equipped with knowledge about activities that can prevent waste

related diseases they will engage in them to prevent diseases.

22
Perceived susceptibility

This refers to how much individuals believe that they are vulnerable to

or at risk from some illness Mathew (2014). In relation to this study, if

women of childbearing age believe that poor way of managing waste

generated in their homes poses a risk and they are at risk to such health

hazards then their attitude will change. They will thereby adopt good

sanitation practices based on the knowledge that they are vulnerable.

For instance, making them aware that plastic waste which does not

degenerate easily tend to block culverts, leaving in its waste stagnant

water that can cause floods and also serve as a breeding place for

mosquitoes that leads to the high incidence of malaria case, typhoid,

cholera and other contagious disease will make them to adopt practices

aimed at avoiding these negative outcomes Mathew (2014).

Perceived severity

This refers to how serious the individual believes the consequences of

being ill are Pai (2018). The study bears on the presupposition that if

the women of child bearing age know that the risk associated with poor

23
sanitation can be fatal, they will change their attitude and engage in

practice that improves sanitation in their home. For example, if the

women of child bearing age know that the risk associated with poor

sanitation can be fatal, they will change their attitude and engage in

practice that improves sanitation in their home for example, if the

women of child bearing age knew that dirty surrounding breed flies

which settle on food items and make them unwholesome and cause a

deadly disease like cholera, they will change their attitude.

Perceived effectiveness

This refers to the expected benefits if one engages in the protective

behaviour. Fitting this into the study, if women of child bearing realizes

that by disposing of waste, especially plastic waste into the gutters or

market will actually increase the risk of contracting sanitation related

diseases they are more likely to engage in proper sanitation practice. To

this end, women of child bearing age will be healthy and go their daily

activities let or hindrance Pia (2018).

Empirical review

Adegboyega (2010) assessed knowledge, attitude and practice (KAP) of

environmental sanitation among women of childbearing age Osun state,

24
Nigeria. Poor hygiene practice and inadequate sanitary conditions play

major roles in the increased burden of communicable diseases within

developing countries. The study evaluated the knowledge, attitude and

practices (KAP) of environmental sanitation among women of

childbearing age in Osogbo Osun State and assessed the extent to which

proper knowledge of environmental sanitation was associated with

environmental sanitation characteristics. This cross-sectional study

comprised of 669 “women of childbearing age who were interviewed by

trained staff. Data consist of sanitation and waste disposal practice,

knowledge about sanitation, personal hygiene characteristics, and

presence of fecal-borne disease. The findings of the study underscore

the need for more proper disposal of waste intervention programmes in

rural villages, and provide objective evidence that may guide the

development of comprehensive health in rural Osun state successful

implementation of the findings is likely to substantially attenuate

transmissible disease burden borne by women of childbearing age.

Oyibo (2012) assessed knowledge and practice of basic environmental

sanitation among women of child bearing aged – 17-35 years in Abraka,

Delta State, Nigeria. The study covers an area of 21.2 square kilometer

and is located on longitude 50.45 0N and 60 1500E of the meridian. It is

25
in the tropical rain forest area of Nigeria and comprises of nine

communities namely: Otororho, Uhruoka, Ekrejeka, Oria, Ajalomi, erho,

ugono, urhorie and umighe with river ethiope running through. The

official language of the people in urhobo and their major occupation is

farming. A maximum sample size of 384 was obtained using fischer’s

formular for population above ten thousand (Araoye, 2013).

Although the computed minimum sample size was 384, a multi-stage

sampling technique was however used to select a total of 476 women of

child bearing age who gave assent for the study as follows. In the first

stage 100 women of childbearing age selected from the total number in

Abraka by simple random sampling technique. In the second stage,

using the women’s register, a stratified simple random technique

(proportional sampling) was used to select women of child bearing age

from its lineages.

The study instrument was a pre-tested structure interviewer

administered questionnaires which elucidated information of geographic

characteristics of the women of childbearing age and assessed their

knowledge and practice related to basic environmental sanitation. Data

collected was entered into the computer using the spss (version 15.0)

software. A simple descriptive analysis was carried out to give the

26
general over view of the population. This was followed by bivariate

analysis. The level of significance was set at p < 0.05. Ethical approval

of the study was obtained from the health ethics and research

committee of the Delta state university teaching hospital, Delta State.

The average knowledge and practice scores related to basic

environmental sanitation recorded among women of child bearing age

studied were 74.6% and 54.9% respectively. This high level of

knowledge related to basic environmental sanitation as 27.4%, 37.0%

and 46.3% of them sweep their environment, cut grasses that surround

their house. The study revealed that although a sizeable number of the

women studied adequate knowledge related to basic environmental

sanitation, their practices related to the same was poor.

Emeka (2016) assessed knowledge and practice of environmental

sanitation among women of child bearing age in Imo State. Proper

knowledge and practice of environmental sanitation plays critical role in

avoiding communicable diseases and benefit the women of child bearing

age to enjoy healthy and productive marital life. The present study

evaluated the knowledge and practice related to environmental

sanitation among women of child bearing age in Imo State. The cross

sectional study involving 428 women of child bearing age were

27
conducted in Owerri. Out of 428 women 155 were from grade 1 (275),

164 from grade 3(38%) and 149 from grade 5(35%). The mean age for

the women was 8.61 years (SD=1.91). The ability to define

environmental sanitation was significantly higher among women of child

bearing age (95%) (N=194) as compared to old women (82%)

(N=183). Health worker and media the commonly source of knowledge

provider about environmental sanitation. With the exiting knowledge and

practice related to environmental sanitation among women of child

bearing age, health worker and media can play positive and significant

role to improve it further. The study used SPSS (21) to enter and

analyze the data using chi-square and ANOVA Statistic test.

Sarker (2013) assed environmental sanitation among women of

child bearing age living in a slum of Kolkata, India. For women of child

bearing age maintenance of environmental sanitation helps to improve

the quality of life and longevity. This was undertaken to find out the

knowledge and practice of environmental sanitation among women of

child bearing age living in slum area. To identify any misconception

among them regarding the maintenance of environmental sanitation to

find out their morbidity pattern. And to elicit the relationship between

practice o f environmental sanitation among the women of child bearing

28
age. A cross-sectional observational study was conducted among 104

women of child bearing age in the slum area of chelta, Kolkata, India

with the help of predesigned, pre-tested and structured questionnaires.

Data were analyzed statistically by simple proportion and tests of

significance (Z-test and chi-quare test) as when necessary.

This study shows that the range of women of child bearing age

ranged from 15-20 years maximum number (84) of women of child

bearing age (80.77%) being between 17-19 years. Among 104 women

of child bearing age 20-30 were 43 (41.35%) and 35 (58.65%).

Maximum women of child bearing age (79) were Hindus (73.08%) and

rest (28) were Muslims (26.92%). It was found out that women of child

bearing age (19-25%) were knowledgeable than the women of

childbearing age in slum area. Even misconception does exist on certain

indications of environmental sanitation among the women of child

bearing age and the literary status of their mother. The future of any

society depends considerably on the health of its children. The health

workers and media are constructive shapers of women of childbearing

age health, behavior should play a responsible role in early education of

women of child bearing age on environmental health.

29
 CHAPTER THREE
RESEARCH METHODOLOGY

Research design:
This is a descriptive survey study that aims at studying the knowledge,
attitude and practice of environmental sanitation among women of
childbearing age in Uturu Abia State. According to Shona (2019),
descriptive research aims to accurately and systematically describe a
population, situation or phenomenon.

Area of the study

Uturu is bordered to the North by Ndi-Okoroukwu, Isiagu and Mile 2, all

in Eboyi state, the south by Okigwe and Ihube all in Imo State, to the

East by Ugwuntu and Nkwuo-nta all in Isuikwuato, Abia State and to the

west by Lokpa-nta, Abia State. Uturu is divided into two parts, Ihette

and Ikegba. From Ihette part equally have two linkages (achara and

mba-ugwu); while the Ikegha is made up of five linkages; Akpukpa,

Isunabo, Nvurunvu, Umumara and Ndundu, with a total of thirty-nine

(39) sub-linkages also known as clans (Oyinbo, 2012).

Population of the study

30
The population comprises of women of childbearing age within the age

bracket 15-45 years. The estimated population the age of 15-45 is right

hundred and twenty eight (828) and out of the 828 who were present

400 were picked for the study that is Sample size.

Sampling technique:
A convenience sampling method was used that is sampling that involves
the sample being drawn from the part of the population that is close at
hand. The woman of childbearing age used were those available in
village and those who were open to talk about environmental sanitation.

Instrument for data collection:

A self employed questionnaire was used to collect data and necessary
information. The questionnaire was designed in three (4) sections:
section A: comprised of the respondents demographic data: section B:
which comprised of the knowledge woman of childbearing age towards
environmental sanitation section C: Attitude of woman of childbearing
age towards environmental sanitation section D Practice of woman of
childbearing age towards environmental sanitation

Instrument for data collection:

A self employed questionnaire was used to collect data and necessary
information. The questionnaire was designed in three (3) sections:
section A: comprised of the respondents demographic data: section B:
which comprised of the knowledge of parents towards sex education
and section C: which dealt with the attitude of parents towards sex
education.
31
Validity of instrument:
Validity of instrument is the ability for an instrument to measure what it
is designed to measure. In this work the questionnaire was presented to
the project supervisor for face and content validity the instrument was
evaluated through the judgment of the project supervisor and two other
experts in research. They cross matched the arrangements of questions
on the questionnaire and made corrections after which it was confirmed
valid and approved by the project supervisor.

Reliability of instrument:
To test the reliability of instruments a pilot study was carried out using
400 woman of childbearing age in Uturu Abia State the result was
collected and rooted. The results were analyzed and a high level of
consistency was achieved. This shows that the instrument was reliable.
Method of data collection:
The questionnaires were personally distributed by the researcher. The
woman of childbearing age were briefed on the purpose of the study,
how to complete/fill the questionnaire and retrieval of the instrument. A
total of eighty (400) questionnaires were administered to the
respondents and were retrieved after 1 hour 30 minutes. A total of
400(100%) copies of the questionnaires were retrieved.
Method of data analysis:
The data collected were analyzed using simple percentages and tables.
Ethical consideration:

32
The ethical consideration and guidelines governing Public Health
research were carefully utilized during the course of the study. The
researcher ensured the following during the process: confidentiality of
responds were assured, anonymity of respondents was protected and
maintained by not including any self identifying information throughout
the study.

33
 CHAPTER FOUR

PRESENTATION AND ANALYSIS OF DATA

Demographic data:

The socio demographic data of respondents were represented as shown in the

table below: Table 1: showing the demographic data of the respondents

Variable No of Percentage%
respondent
1. Age of respondents
17-20 100 7.5%
20-30 100 25%
31-40 100 17.5%
40-45 100 50%
Total 400 100%
2. Sex of Respondents

Female 400 100%

Total 400 100%
3. Marital Status of Respondents

Married 385 82.5%

Divorced 15 17.5

Total 400 100%

4. Religion of respondents
Christianity 400 100%
Islam - -
African tradition - -
Total 400 100%
34
From the analysis above, 100(7.5%) of the respondents fall between the age of

17-20, 100(25%) of respondents fall between the age of 20-30, 100(17..5) %

of the respondents fall between the age of 31-40 and 100(50%) of the

respondents fall between the age of 40 - 45; 100% of the respondents were

female, 385(82.5%) of the respondents were married ; 15(17.5) were divorced

100% of the respondents were Christianity religion.

SECTION B: TABLE 2

This section deals with knowledge of woman of childbearing age towards

environmental sanitation

RESEARCH QUESTION 1: what is environmental sanitation?

S/n Options Frequency Percentage

A Experimenting environmental sanitation 120 40%
B A process of acquiring information and 80 10%

forming right attitude about

environmental sanitation.

C Guiding woman of childbearing age to 100 25%

learn about environmental sanitation

D Teaching woman of childbearing age on 100 25%

how to keep the environmental clean

Total 400 100%

Section C TABLE 3:

35
This section deals with Attitude of woman of childbearing age towards

environmental sanitation

RESEARCH QUESTION 2: Attitude of woman of childbearing age towards

environmental sanitation

S/n Options Frequency Percentage

A Women of childbearing age 250 31.25%
like washing their dirty
clothes
B Women of childbearing age 50 37.5%
defecate at open spaces
C Women of childbearing age 50 6.25%
removes empty cans and
rubbers
D Women of childbearing age 50 25%
like mopping and keeping
their environment clean.

Total 400 100%

TABLE 4:

RESEARCH QUESTION 3: what age is right age of women of childbearing age

to start environmental sanitation

S/n Options Frequency Percentage

A 15-20yrs 40 6.25%
B 20-30yrs 160 62.5%
C 30-40yrs 170 18.75%
D 40-45yrs 30 12.5%

36
 Total 400 100%

SECTION D TABLE 5

This section deals with Practice of women of childbearing age towards

environmental sanitation (15-45yrs) in Uturu Abia State

No Question Strongly Agree Disagree Strongly

agree disagree
Lack of knowledge and 37 22 12 9

adequate information about

environmental sanitation
Religion, moral values and 34 24 15 7

cultural believe hinder women

of childbearing age practicing

environmental sanitation.
Poor knowledge of 36 20 14 10

environmental sanitation

affects environmental

sanitation .
Total 107 66 41 16
Mean average 35.6 22 13.6 8.6

Note: SA+A = Acceptance

D+SD = Rejection
37
Mean average of SA = 107/3 =35.6

Mean average of A = 66/3 = 22

Mean percentage of acceptance = SA+A X 100/100 = 35.6+22X100/100 =

57.6%

Mean average of D = 4^1/ 3 =31.6

Mean average of SD = 26/3 = 8.6

Mean percentage of disagreement = D+SDX100/100 =

13.6+8.6X100/100=22.2%

The grand percentage of agreement 57.6% which is higher and positive shows

practice of environmental sanitation among women of childbearing age in

Uturu Abia State.

CHAPTER FIVE

DISCUSSION ON FINDINGS

OBJECTIVE 1:

To determine the level of knowledge of women of childbearing age towards

environmental sanitation, Abia State. Result from table 2 revealed that

120(40%) of the respondents (women of childbearing age) understood

environmental sanitation to be experimenting environmental sanitation;

38
80(10%)of women of childbearing age understood environmental sanitation as

the process of acquiring information and forming right attitude about

environmental sanitation ; 100(25%) understood it to mean guiding women of

childbearing age to learn about environmental sanitation; and 100(25%) of

the respondents understood it to be teaching women of childbearing age on

how to keep the environment clean.

This is in accordance to (Adegboyega,2010) who the assessed knowledge,

attitude and practice (KAP) of environmental sanitation among women

of childbearing, that Poor hygiene practice and inadequate sanitary
conditions play major roles in the increased burden of communicable
diseases within developing countries.
Results from table 3 revealed that 250(31.25%) of the respondents (women of

childbearing age) like washing their dirty clothes, 50(37.5%) of women of

childbearing age defecate at open places; 50(6.25%) of women of childbearing

age removes empty cans and rubbers; and 50(25%) owomen of childbearing

age like mopping and keeping their environment clean.

Results from table 4 = what age is right age of women of childbearing age to

start environmental sanitation this table revealed that 40 (6.25%) of the

respondents think that the right age to start environmental sanitation is 15-

20years; 160(62.5%) of the respondents think that the right age to start

environmental sanitation is 20-30years; 170(18.7%) of the women of

childbearing age think that the right age to start environmental sanitation is

39
30-40years; 30(12.5%) of women of childbearing age think that the right time

to start environmental sanitation is 40-45years.

OBJECTIVE 2

To determine the attitude of woman of childbearing age towards

environmental sanitation (15-45yrs) in Uturu Abia State. Data analyzed in

table 5 revealed practice of woman of childbearing age towards

environmental sanitation. Responses: From table 5 were recorded as strongly

agree + agree= acceptance, strongly disagree + disagree= rejection. From the

data, respondents agree that religion, moral values and cultural beliefs hinder

women of childbearing age from providing environmental sanitation, Poor

knowledge of environmental sanitation affects environmental sanitation .

The grand percentage is (57.6%) showing that there are Practice of women of

childbearing age towards environmental sanitation (15-45yrs) in Uturu Abia

State

SUMMARY

The study was carried out to access the level of knowledge, attitude and

practice of women of childbearing age parents towards environmental

sanitation in Uturu Abia State. The study discussed the knowledge,

40
 attitude and practice of women of childbearing age towards

environmental sanitation. The objectives of the study were to

determine the knowledge of women of child bearing age in Uturu

towards environmental sanitation in their community, to describe

the attitude of women of child bearing age towards environmental

sanitation, to state the practice of women of child bearing age

towards environmental sanitation in their community.

A descriptive survey was used, the researcher carried out the research using

sampling method so out of the target population of 828 a sample size of 400

were used. Typed and structured questionnaire were distributed to the sample

of study. The data collected were analyzed and represented using tables and

percentage.

Based on the findings of the present study the discussion and

conclusion, the following recommendations are hereby presented:

appropriate training seminar and workshops should be organized

regularly for women of childbearing age to be aware of the importance

of having attitude towards accepting internalizing and adopting high

positive attitude towards environmental sanitation. Environmental

sanitation components should be inculcated in the school curriculum.

41
There should laws against those that defecate and poor their waste on

the road side or gutters

Conclusion

In conclusion the study is on the knowledge, attitude and practice of woman

of child bearing age towards environmental sanitation in Uturu Abia State at

the end of the study it was discovered that lack of adquate knowledge of

environmental sanitation hinders women of childbearing from providing

proper attitude and practice of environmental sanitation.

42
Recommendations

Based on the findings of the present study the discussion and

conclusion, the following recommendations are hereby presented.

1) Appropriate training seminar and workshops should be organized

regularly for women of childbearing age to be aware of the

importance of having attitude towards accepting internalizing and

adopting high positive attitude towards environmental sanitation.

2) Environmental sanitation components should be inculcated in the

school curriculum

3) There should laws against those that defecate and poor their

waste on the road side or gutters

Limitation of study

The study was constrained by some problems which are discussed

below;

The fact that to the best knowledge of the researcher, there dearth of

literature in Nigeria in the issue of attitude, to knowledge and practice of

women of childbearing age towards environmental sanitation again no

43
completed work that compared the same socio-demographic variables

are available this affected the presentation of this present study as there

was no previous study with which to make comparison.

Secondly Finance; due to finance constraint at the time of the fest, it was not

easy to collect data on the research topic owing to the fact that a lot of

limitations where made back home to the drench.

APPENDIX I

Department of Public Health,

Faculty of Health Sciences,
Abia State University, Uturu.
Abia State.

Dear Respondents,

44
I am a final year of the above mentioned institution, carrying out a
research study on “Knowledge, attitude and practice of environmental
sanitation among women of child bearing age in Uturu, Abia State.”

I hereby plead with you to sincerely complete the questionnaire.

However, it is solely for academic purposes and I assure that whatever

information obtained from the questionnaire will be held with utmost

confidentiality.

Thanks for your co-operation.

Yours faithfully,
……………………
Ochulor Chinyere Mirian
(Public Health Student)

APPENDIX II

Date:____________
TO WHOM IT MAY CONCERN
LETTER OF INTRODUCTION

45
The bearer miss__________________________________is a final year

student of the Department of Public Health Abia State University, Uturu,

Abia State. She is conducting a research on the

topic:______________________________________________________

__________________________________________________________

As part of the requirements for the Award of “Bachelor Degree” (BSc.) in

Public Health.

This is to request your kind co-operation to facilitate access to

information and other necessary assistance.

Thanks for your co-operation.

____________________ __________________
Mrs. Clara Okoye Prof. E. Enwereji
(Supervisor) (Head of Department)

QUESTIONNAIRES

Questionnaire on the attitude, knowledge and practice of women of child

bearing age towards environmental sanitation in Uturu autonomous

community, Abia State.

46
Department of Public Health Abia State Uturu

The researcher is an undergraduate student of the above Department in

partial fulfillment of the requirements for the award of Degree in Public

Health. She is conducting on research on “attitude, knowledge and

practice of women of child bearing age towards environmental sanitation

in Uturu autonomous community, Abia State.

She seeks your cooperation to honestly respond to the statement. All

information obtained would only be used for the purpose of this study

and will therefore be held confidential.

Section A: Demographic Data of respondents

Instruction: please read the questions carefully and tick ( ✓) at the
appropriate places.
1. What is your age range?
A.17 - 20
B. 20 - 30
C. 31- 40
D. 40-45

2. What is your gender?

A. Female

3. Marital status?
A. Single

47
B. Married
C. Divorced

4. What is your Religion?

A. Christianity
B. Islamic
C. African traditionalist
Section B: knowledge of parents towards environmental sanitation, ( ✓)
the correct options:

5. What is environmental sanitation?

A. Process of acquiring information and forming right attitude about
environmental sanitation
B. Guiding women of childbearing to learn about environmental
sanitation
C. Teaching women of childbearing age on how to keep the
environment clean

6. Attitude of women of childbearing age towards environmental

sanitation
A. Women of childbearing age like washing their dirty clothes
B. Women of childbearing age defecate at open spaces
C. Women of childbearing age removes empty cans and rubbers
D. Women of childbearing age like mopping and keeping their
environment clean.
7. What is the right age of women of childbearing age to start
environmental sanition

48
 A. 15-20yrs
B. 20-30yrs
C. 30-40yrs
D. 40-45yrs

Practice of women of childbearing age towards environmental sanitation,

please tick(√) the appropriate box under the following headings strongly
agree (SA), Agree (A), Disagree (D), Strongly Disagree (SD).

Question SA A D S
8. Lack of knowledge and adequate information about
environmental sanitation hinders women of
childbearing age practicing environmental sanitation
9. Religion, moral values and cultural believe hinders
women of childbearing age practicing environmental
sanitation
10. Poor knowledge of environmrntal sanitation affects
practicing of environmental sanitation

REFERENCES

Adegboyega, J., (2010). Knowledge, Attitudes and Practice (KAS) of

environmental sanitation among women of child bearing age in
Osun state. Journal of medical Hygiene. 2010; 51(2): 73-79.

49
Araoye, M.E, (2013). Textbook of Mothers Health. University of Ibadan
Press Ltd. 2013.

Brown, Gupta, Oyibo (2012). Food allergy knowledge, attitudes and

belief of present with Health Journal 16(5): 522-527.
CDC, (2016). Dental Carries. Diseases Control priority project. Available
at www.nebi.nlm.nhi.gov.com.

Choker, BA., (2013). Environmental Awareness and Effective Pollution

control in P.O Sada, environmental issue and management in

Nigeria, pp. 325-338. Lagos: Evans Brothers.

Cooper, and Schinder (2017). Environmental sanitation and family’s

health Action

Daramola, OP., (2015). Environmental sanitation practices in residential

areas of Ibadan Metropolis, A PhD Thesis Submitted to the

Department of Urban and Regional Planning, Obafemi Awolowo

University Ile-Ife Nigeria.

Daramola, R.T, (2015). Environmental sanitation practice in residential

areas of Ibadan Metropolis; A Ph.D. thesis submitted to
Department of Urban and Regional Planning, Obafemi Awolowo
University. Ile-Ife Nigeria.

Duneke, (2011). Some environmental factors affecting health in Nigeria:

Onitsha metropolitan area, Ecological Restoration and Science

Education. 3(3): 105-114.

50
Duneke, N.M, (2013). The Impact of Environmental Sanitation on the
environment and published health: An Introductory Briefing (Rep
No EUR) /CP/ EHNA 010401 (A); World Health Organization,
Regional Office for Europe.

Duneke, S.S, (2011). Some environmental factors affecting health in

Nigeria: Onitsha metropolitan area, Ecological Restoration and
Science Education. 3(3): 105-114.
Emeka, (2016). Relationship of environmental sanitation with nutrition

morbidity profile; a study among women of child bearing age in

South Kolkata. Indian Journal of Medicine. 35(2): 208-3.

Emile, Adaobi (2012). Waste Management Environmental Best practices

Guidelines. A Partnership for sustainable and profitable Diary
Farming in Western Australia 3(33):345-945

Freduah, G., (2014; & Oduro, 2012). Deficit in formal land management

and informal responses under rapid urban growth, and

international perceptive, gender, environment and epidemiology in

Accra metropolitan area Ghana.

Gupta et al., (2010). Food allergy knowledge, attitudes and belief of

present with Health Journal 16(5): 522-527.

Hai & Jack, (2015). A General Textbook of Nursing: A Comparative

Guide to the Final State Examination. Ulusses 4th edition P.355.

51
Kalua, (2015). Understanding Research Methodology in health: Ibadan,

Amazing grace and educational business services.

Mohammed, et al., (2013). Moham’s Textbook of Prevention and social

medicine 19th edition, Jabalpar Mls Banarasidas Bhahot.

Moronkola, D.A., Abe CV., and Ogunmmiyi (2011).Relationship of

environmental sanitation with nutrition and morbidity profile; a
study among women of child bearing age in South Kolkata Indian J
com med, 35(2):208-3.
Moronkola, O.A. Alze, CV & Ogunmmuyi, (2011). Creating Health

promoting schools in China; A project started from deforming

health promotion internationals 15(3): 197-206.

Obi, K. and Nzu, T.R (2016).Some environmental factotre affecting halth

in Nigeria. Onisha, metropolitan area, Ecological Restoration and
Science Education 3(3):105-1144.
Oduro,.D, Duneke, J. (2012). Global and sanitation Assessment Report.
Geneva: World Health Organization.
Onwasigwe, E.N (2015). Effects of Health Education on the Perception

of environmental sanitation and Personal Hygiene Among Women

of childbearing age. Orient Journal of Medicine. 14(4); 34-36.

Oyibo, PG. (2012). Basic environmental sanitation, knowledge and

practice among women of childbearing Age 15-40 years in Abraka,

Delta State, Nigeria. Continental Journal of Tropical Medicine.

52
Sarkar, (2013). Relationship of health knowledge with attitude towards

health and healthful practice of Mothers in Nigeria. An unpublished

thesis in the Department of human kinetic and health education;

Abu Zaria.

UBE, (2016). Mandatory environmental sanitation in families reduces

absenteeism due to infectious illness among women of

childbearing age, intervention study, American Journal of

Infectious Control. 2016; Vol. 37. Pp. 820-826.

UNESCO, (2019). Environmental Sanitation and community participation

enhancing local programmes. Published by United Nations
Environmental Programme.

UNPE, (2010). MDG’s Report, 2008. Waste management, environmental

best practice guidelines. A Partnership for sustainable and
profitable dairy farming in Western Australia. Accessed online on
12th May, 2015.

UNPE, (2010). MDG’s Report, 2008. Waste management, environmental

best practice guidelines. A Partnership for sustainable and

profitable dairy farming in western Australia. Accessed online on

12th-May,-2015-at

http://www.gtp.com.gu/westerndairy/inewsfiles/best-practice-

dairy-environmental-effluentmagementpdf

53
WHO, (2013). Water supply and Sanitation corroborative council and
sanitation assessment.

WHO, (2013). Water supply and Sanitation corroborative council and

sanitation assessment.

54