DEPARTMENT OF BIOLOGICAL SCIENCE

TJR FAULKNER COLLEGE OF SCIENCE & TECHNOLOGY

UNIVERSITY OF LIBERIA

ASSESSING THE EFFECTS OF OPEN DEFECATION AND IT IMPACT ON

THE RESIDENTS OF FDA COMMUNITY, PAYNESVILLE - LIBERIA.

BY
JOHNSON P. DOLO
ID #: 92637

A RESEARCH PROPOSAL PRESENTED TO THE

DEPARTMENT OF BIOLOGICAL SCIENCE IN PARTIAI FULFILMENT
OF THE REQUIREMENT FOR THE AWARD OF
BSC DEGREE IN GENERAL BIOLOGY

NOVEMBER, 2023
 DECLARATION
I hereby declare that, this research work is my own original work towards a BSc in General
Biology and that, it contains no material previously published by another person nor material
which has been accepted for the award of any other Diploma/degree of the university except
for the references cited and duly acknowledged. I am however responsible for any lapses
therein.
Johnson P. Dolo ………………… …… ……………………
Student’s Name & ID Signature Date

Certified by:
Mr. Kieh ………………… …… ……………………
Supervisor’s Name Signature Date

Certified by:
Professor ………………… …… ……………………
Head of Department Signature Date
 ACKNOWLEDGEMENT
This research work is a work that has been possible by the grace of ALMITHY GOD. It has
always been by His Strength, knowledge and wisdom that my feeble mind could undertake
such project work attachment. May His Name be praised now and forever more, Amen.

My sincere gratitude goes to Mr. Albert, a teacher of biology is who was my supervisor
during the project Mr. Kieh a teacher at the Biology Department for taking their precious
time to guide me throughout the project, given me daily advises. Also I am very much
grateful to the entire staff of the Biology Department

Anybody who in one way or the other contributed towards making this research as success
but has not been mention is not forgotten.

I THANK YOU ALL.

 DEDICATION
I dedicated this piece of work to my family, especially my late father, Mr. Richard Dolo, my
mother, Lorpu Dolo and my wife, Mrs. Korpo Dolo for their encouragement and support. A
very big ‘bravo’’ goes to the ALMITHY GOD for given me good health and strength
throughout the internship study period.
ABSTRACT
 TABLE OF CONTENTS

DECLARATION..................................................................................................................... I
ACKNOWLEDGEMEN........................................................................................................ II
DEDICATION...................................................................................................................... III
ABSTRACT........................................................................................................................... IV
LIST OF TABLES............................................................................................................. VIII
LIST OF FIGURES.............................................................................................................. IX
LIST OF ABREVATIONS.................................................................................................. XI
CHAPTER ONE...................................................................................................................... 1
INTRODUCTION................................................................................................................... 1
1.1 BACKGROUND OF THE STUDY ................................................................................ 1
1.2 Problem Statement ............................................................................................................. 1
1.3 Main Research Objective ................................................................................................... 2
1.4 Specific Research Objectives.............................................................................................. 2
1.5 Research Questions............................................................................................................. 3
1.6 Significance of the Study.................................................................................................... 3
CHAPTER TWO..................................................................................................................... 4
LITERATURE REVIEW....................................................................................................... 4
2.1 INTRODUCTION............................................................................................................. 4
2.2 World Toilet Facility Coverage........................................................................................... 5
2.3 Toilet Use............................................................................................................................ 6
2.4 Sanitation Related Targets under the MDGs....................................................................... 6
2.5 Metting the MDGs Targets.................................................................................................. 7
2.6 DEFINITION OF TERMS............................................................................................... 9
2.7 Why People Do Defecate In The Open............................................................................. 12
2.8 The Impacts of Open Defecation....................................................................................... 14
2.9 Prevention of Open Defecation......................................................................................... 14
2.10 Integrated initiatives........................................................................................................ 15
2.11 Simple Sanitation Technology Options........................................................................... 15
CHAPTER THREE.............................................................................................................. 17
METHODOLODGY............................................................................................................. 17
3.1 Research Method............................................................................................................... 17
3.2 Study Design..................................................................................................................... 17
3.3 Research Setting................................................................................................................ 17
3.4 Study Population............................................................................................................... 17
3.5 Sampling Procedure.......................................................................................................... 18
3.6 Techniques of Data Collection.......................................................................................... 18
3.7 Research Instruments........................................................................................................ 18
3.8 Validity and Reliability..................................................................................................... 19
3.9 Limitations of the Study.................................................................................................... 19
3.10 Ethical Consideration...................................................................................................... 19
LIST OF TABLES
LIST OF FIGURES
 LIST OF ABREVATIONS

OD Open Defecation
UNICEF United Nations Children's Education Fund
NGO Non Governmental Organization
MDG Millennium Development Goal
WHO World Health Organization
JMP Joint Monitoring Programme
UN United Nations
WTD World Toilet Day
ODF Open Defecation Free
CLTS Community Led Total Sanitation
WASH Water Sanitation and Hygiene
WATSAN Water Sanitation
SDG Sustainable Development Goal
BBC British Broadcasting Co-operation
UK United Kingdom
YMA Yendi Municipal Assembly
IRIN Integrated Regional Information Network
RING Resiliency In Northern Ghana
NCCE National Commission on Civic Education
USA United States of America
GSS Ghana Statistical Service
 CHAPTER ONE: INTRODUCTION

1.1 BACKGROUND OF STUDY

Open Defecation (OD) is the practice of people defecating outside and not into designated
toilet facilities. Open defecation according to the United Nations International Children’s
Education

Fund (UNICEF) Ghana’s representative, Mr. Abu Mubarik, is the practice of attending to
natures call in the bushes, at the beaches, in drains and dumps. About one billion people
practice open defecation worldwide which is approximately 15% of the world population.
Countries such as India, Pakistan, Nigeria, Sudan and Ghana are well noted for practicing
open defecation. In 2013, World toilet day was celebrated as an official UN day for the first
time and term ‘open defecation’ was in high level speech to draw attention to this issue. In
developing countries the situation is strongly associated with poverty and lack of toilet
facilities (Myjoyonline.com, 3rd may 2017). Whiles open defecation causes little harm when
done in what sparsely populated area, forest or camping site situation, it becomes a
significant public health issue when it occurs in more densely populated area. In Ghana, the
Northern Region is declared as the region which is mostly engaged in the act. Children below
5years normally defecate just outside their houses or homes and people between the ages of 6
to 60 years goes to bush to defecate (Daily graphic June 23rd, 2014). Open defecation
perpetuates the vicious cycle of diseases. Countries where open defecation is most widely
practice have the highest number of death.

1.2 Problem Statement

Open defecation is an old sanitation issue globally, and in developing countries in particular,
which persist till date despite its damning effects. Why the practice continues to persist is a
question that remains largely unanswered.

The term open defecation is widely used in literature about water, sanitation and health issues
in developing community. Open defecation causes public health problems in areas where
people defecate in fields, urban parks, rivers and open trenches in close proximity to the
living space of others. Open defecation is increasingly becoming alarming in the FDA
community, putting residents at the risk of sanitation related diseases such as cholera,
diarrhoea, and typhoid. Human faeces are found in open spaces and in-between houses, some
rapped in black polythene bags, with the resultant stench and flies nuisance. The sight and
smell of faeces within residential neighborhoods reduce the aesthetic quality of the
environment and causes embarrassment to residents and visitors to the community.

In Tamale, May 21st, 2015 the Northern Regional Co-coordinating council has set December
2017 deadline to ensure that all communities in the region attain open defecation free status
to improve sanitation among the people to prevent outbreak of diseases. Open defecation
cause health problems which should be address with immediate effect. Open defecation
causes water borne diseases which are transmitted via fecal pathogens in water. Diseases such
as trachoma, cholera, hepatitis, polio, typhoid and others are cause by defecating into water
bodies. Young children are particularly vulnerable to ingesting faeces of other people that are
lying around after open defecation, because they crawl on the ground, walk bare foot and put
things in their mouth without washing their mouth.

1.3 Main Research Objective:

To assess the effect of open defecation and its impact on the residents of FDA Community.

1.4 Specific Research Objectives:

 To estimate the number of people engages in open defecation in FDA community.
 To assess the reasons why people openly defecate in FDA community.
 To ascertain if there are by-laws concerning open defecation in FDA community.
 To establish the negative implications of open defecation in FDA.

1.5 Research Questions

 How many people in FDA community are engaged in open defecation?
 What are the reasons for FDA community members resorting to open defecation?
 Are the people of FDA aware of the effects of open defecation on their health?

1.6 Significance of the Study

The study will help educate the residents of FDA community on the effects of open
defecation so as to adopt appropriate measures to combat its practices. It is also to serve as a
reference point to assist policy makers in decision making
 CHAPTER TWO: LITERATURE REVIEW

2.1 INTRODUCTION
Laudable information pertaining to the study has been obtained from related literature of
previous research works, magazines, newspapers, and newsletters, books and the internet.
Some reliable previous study shows that over 1 billion residents practice open defecation
worldwide. Out of the 1 billion, Africa and Asia are the continents who engage themselves
mostly in the practice. Research conducted by the coalition of NGOs in water and sanitation
in the year 2016 indicates 82% of residents in Upper East, 69% of residents in the Northern
region, 56% of residents in the Upper West and 30% in the Volta Region defecate openly.
Open defecation is the practice of defecation without any kind of sanitation system and is
generally accepted to lead to health problems such as cholera, dysentery, diarrhea, jaundice,
typhoid, polio, and intestinal worms, either by direct handling of excrement or contamination
of clean water supply. Open defecation causes public health problems in areas where people
defecate in fields, urban parks, rivers and open trenches in close proximity to the living space
of others. Eliminating open defecation is the main aim of improving access to sanitation
worldwide and is a proposed indicator for sustainable development goals. Even if toilets are
available, people still need to be convinced to refrain from open defecation and use toilets.
Therefore, the need for behavioral change is critical in addition to the provision of toilets. A
preference for open defecation may be due to traditional cultural practices or lack of access to
toilets, or both. About 892 million people of the global population practice open defecation.
India has the highest number of people practicing open defecation, nearly 525 million people,
or over a third of the population. Most of it occurs in rural areas, where the prevalence is
estimated at 56% of the population as opposed to urban areas, where prevalence is estimated
at 75%. The prevalence of open defecation as part of voluntary, recreational outdoor
activities in remote areas is difficult to estimate, but is also of very little concern from public
health, environmental and human dignity perspectives. In developing countries however, the
situation is entirely different. Here, open defecation is a practice strongly associated with
poverty and exclusion particularly when it comes to less remote and less rural areas, such as
urban informal settlements. Statistical assessment to improve sanitation in Ghana stood at
15% against MDGs target of 54% to attain by the end of 2016. It would be recalled that in
2014, the country recorded a massive outbreak of cholera. According to the situational report
of World Health Organization (WHO) Country Office in Ghana, the epidemic affected 123
out of the 216 districts in the 10 regions. It gave a cumulative of 26,286 cases with 211
deaths.

2.2 Worldwide Toilet Facility Coverage

Toilet facility coverage is an indicator for improved sanitation and coverage. It is not the
same everywhere and every time, that is to say toilet facility coverage changes through time
and space. As reported by WHO/UNICEF Joint Monitoring Programme (JMP) for Water
Supply and Sanitation in 2008, 62 percent of the world’s population have access to improved
toilet facility, 8 percent share an improved toilet facility with one or more households, and
another 12 percent use an unimproved toilet facility, whilst the rest (18 percent) of the people
practice open defecation (WHO/UNICEF, 2008, p.8).

Generally, water and sanitation are not given the attention they deserve as against other
sectors like education, health and defense. However, in some developing countries, sanitation
lags behind water. As statistic shows in 2004, 1.1 billion people in the developing countries
did not have access to a required amount of safe water, whilst at the same period about 2.6
billion people which is about 50 percent of the whilst at the same period about 2.6 billion
people which is about 50 percent of the developing world’s populations do not have access to
basic toilet facility (Watkins, 2006, p.14).

In 2006, less than half of the people in 54 countries used an improved sanitation facility, out
of which 75 percent were in sub-Saharan Africa. Generally, about 53 percent of the world’s
population now lives in rural communities and they account for more than 70 per cent of the
people without improved sanitation. Because of urbanization, interventions for improvement
in sanitation have not been able to match with these improvements. In 21 countries in sub-
Saharan Africa, only 16 per cent of the poorest quintile of the population has access to
improved sanitation, compared to 79 per cent of the population in the richest quintile. About
25 percent of the people in the developing world live without any form of toilet facility. An
additional 15 percent use toilet facilities that do not ensure hygienic separation of human
waste from human contact. Due to limited toilet facilities people resort to open defecation.
Even though open defecation is declining in all regions, it continues to be practiced by almost
half the population in Southern Asia and more than 25 percent of people living in sub-
Saharan Africa. Of the 1.2 billion people worldwide who practice open defecation, more than
one billion live in rural areas (UN, 2008, p.41). The provision of sanitary infrastructure varies
from the developed world to the developing world.

In high-income countries, there is 100 percent coverage in the provision of sanitation

facilities. There is increasing use of the private sector in the provision of the facilities even
though the government provides most of the facilities. In middle-income countries, a number
of sanitation infrastructures are available but it is often in poor condition. The service
delivery systems are most often than not underfunded, mismanaged and lack maintenance.
Lower-income countries have serious sanitation problems. They have less sanitation
infrastructure than high- and middle income countries and their institutions and management
systems are incapacitated (UN-Habitat,
2003, p.167)

2.3 Toilet use

As a result of inadequacy in the provision of toilet facilities in many cities in the developing
world, a large number of the residents practice open defecation or defecate in some materials
like waste paper or plastic bag. This practice has been given different terminologies in
different cities like wrap and throw in Cebu (Philippines) or flying toilets in Accra (Ghana).
UN-Habitat 2003, reported that Hardoy et al, (2001) conducted studies in many cities
including Addis Ababa, Bangalore (India), Colombo (Sri Lanka), Dhaka (Bangladesh),
Kingston (Jamaica), and Ouagadougou and has found open defecation to be a serious
problem (UN-Habitat, 2003, p.173).

2.4 Sanitation and Hygiene Related Targets under the Millennium Development Goals

2.4.1 Goal 3: Achieving Universal Primary Education

2.4.1.1 Target 3: Ensure that, by 2015, children everywhere, boys and girls alike, will be
able to complete a full course of primary schooling. To ensure that children everywhere
complete a full course of primary schooling there is the need to reduce illness related to water
and sanitation and this will encourage school children to attend school especially girls.
Providing separate sanitation facilities like toilets and urinals for girls in schools increases
their school attendance
2.4.2 Goal 4: Reduced Child Mortality

2.4.2.1Target 4: Reduce by two-thirds, by 2015, the under-five mortality rate.

This can be achieved through the provision of improved sanitation, safe drinking water
sources and greater quantities of domestic water for washing. Sanitation and safe water in
health-care facilities help ensure clean delivery and reduce neonatal deaths.

2.4.3 Goal 5: Improving Maternal Health

2.4.3.1 Target 8: Reduce by three-quarters the maternal mortality ratio . Anemia and other
conditions that affect maternal mortality can reduce drastically through improved health and
nutrition. Safe drinking water and basic sanitation are needed in health-care facilities to
ensure basic hygiene practices following delivery.

2.4.4 Goal 6: Combating Disease

2.4.4.1Target 8: To halt by 2015, and begin to reverse, the incidence of malaria and other
major diseases. Provision of safe drinking water and improved basic sanitation help prevent
water-related diseases, including diarrheal diseases, Schistosomiasis, filariasis, trachoma and
helminthes. About 1.6 million deaths per year are attributed to unsafe water, poor sanitation
and lack of hygiene. Improved sanitation reduces diarrhea by 37.5 percent; hand washing can
reduce the number of diarrheal cases by up to 35 percent.

2.4.5 Goal 7: Environmental Sustainability

2.4.5.1Target 10: Halve by 2015, the proportion of people without sustainable access to safe
drinking water and basic sanitation. The ecosystem can better be managed if adequate
treatment and disposal of excreta and waste water is provided. 07, pp. 6-7) For domestic
water supply and sanitation.

2.5 Meeting the Millennium Development Goals Target

On the whole the world is on track for the target for water due mainly to progress in China
and
India, but only two regions, namely East Asia and Latin America are on track for
sanitation.On current trends, Sub-Saharan Africa will reach the water target in 2040 and the
sanitation target in 2076 and South Asia is 4 years off track for sanitation. Measured on a
country by country basis, the water target will be missed by 234 million people, with 55
countries off track. The sanitation target will be missed by 430 million people, with 74
countries off track. For Sub-Saharan Africa to get on track, connection rates for water will
have to rise from 10 million a year in the past decade to 23 million a year in the next decade.
South Asia’s rate of sanitation provision will have to rise from 25 million people a year to 43
million a year (Watkin,
2006: 16-17).

2.6 DEFINITION OF TERMS

2.6.1 Open defecation

The term "open defecation" became widely used in the water, sanitation, and hygiene
(WASH) sector from about 2008 onwards. This was due to the publications by the Joint
Monitoring Programme for Water Supply and Sanitation (JMP) and the UN International
Year of Sanitation. The JMP is a joint program by WHO and UNICEF to monitor the water
and sanitation targets of the Sustainable Development Goal Number 6.

For monitoring purposes, two categories were created: 1) improved sanitation and (2)
unimproved sanitation. Open defecation falls into the category of unimproved sanitation. This
means that people who practice open defecation do not have access to improved sanitation.
In 2013 World Toilet Day (WTD) was celebrated as an official UN day for the first time. The
term "open defecation" was used in high-level speeches, that helped to draw global attention
to this issue (for example, in the "call to action" on sanitation issued by the Deputy Secretary-
General of the United Nations in March 2013).

2.6.2 Open defecation free

"Open Defecation free" (ODF) is a phrase first used in Community-Led total Sanitation
(CLTS) programs. ODF has now entered use in other contexts. The original meaning of ODF
stated that all community members are using sanitation facilities (such as toilets) instead of
going to the open for defecation. This definition was improved and more criteria were added
in some countries that have adopted the CLTS approach in their programs to stop the practice
of open defecation. The Indian Ministry of Drinking Water and Sanitation has in mid-2015
defined ODF as "the termination of fecal-oral transmission, defined by:
1. No visible feces found in the environment or village and
2. Every household as well as public/community institutions using safe technology option for
disposal of feces".
Here, 'safe technology option' means toilets that contain feces so that there is no
contamination of surface soil, groundwater or surface water; flies or animals do not come in
contact with the open feces; no one handles excreta; there is no smell and there are no visible
feces around in the environment. This definition is part of the Swachh Bharat Abhiyan (Clean
India Campaign).

2.6.3 WASH ( Watsan, WaSH): is an acronym that stands for "water, sanitation and
hygiene".
Universal, affordable and sustainable access to WASH is a key public health issue within
international development and is the focus of Sustainable Development Goal (SDG) 6.
Several international development agencies assert that attention to WASH can also improve
health, life expectancy, student learning, gender equality, and other important issues of
international development. Access to WASH includes safe water, adequate sanitation and
hygiene education. This can reduce illness and death, and also reduce poverty and improve
socio-economic development.

2.6.4 Sanitation
Sanitation refers to public health conditions related to clean drinking water and adequate
treatment and disposal of human excreta and sewage. Preventing human contact with feces is
part of sanitation, as is hand washing with soap. Sanitation systems aim to protect human
health by providing a clean environment that will stop the transmission of disease, especially
through the fecal–oral route. For example, diarrhea, a main cause of malnutrition and stunted
growth in children, can be reduced through sanitation.

2.6.5 Improved sanitation

Improved sanitation is a term used to categorize types or levels of sanitation for monitoring
purposes. The term was coined by the Joint Monitoring Program (JMP) for Water Supply and
Sanitation of UNICEF and WHO in 2002 to help monitor the progress towards Goal Number
7 of the Millennium Development Goals (MDGs).
2.6.6 Unimproved sanitation
The opposite of "improved sanitation" has been termed "unimproved sanitation" in the JMP
definitions. Sanitation facilities that are not considered as "improved" (also called
"unimproved") are: Public or shared latrine (meaning a toilet that is used by more than one
household),
Flush/pour flush to elsewhere (not into a pit, septic tank, or sewer).

2.6.7Hygiene
Hygiene is a set of practices performed to preserve health. According to the World Health
Organization (WHO), "Hygiene refers to conditions and practices that help to maintain health
and prevent the spread of diseases”. Personal hygiene refers to maintaining the body's
cleanliness.

Many people equate hygiene with 'cleanliness,' but hygiene is a broad term. It includes such
personal habit choices as how frequently to take a shower or bathe, wash hands, trim
fingernails, and change and wash clothes. It also includes attention to keeping surfaces in the
home and workplace, including bathroom facilities, clean and pathogen-free.

2.6.8 Joint Monitoring Program for Water Supply and Sanitation

The Joint Monitoring Program (JMP) for Water Supply and Sanitation by WHO and
UNICEF is the official United Nations mechanism tasked with monitoring progress towards
the Sustainable Development Goal Number 6 (SDG6) since 2016. Until 2015, JMP was
tasked with monitoring the Millennium Development Goal (MDG) relating to drinking water
and sanitation (MDG 7, Target 7c), which was to: "Halve, by 2015, the proportion of people
without sustainable access to safe drinking-water and basic sanitation".

The JMP is housed within the World Health Organization and UNICEF, and supported by a
Strategic Advisory Group of independent technical and policy experts as well as various
Technical Task Forces convened around important specific topics.

2.6.9 International Year of Sanitation

The year 2008 was declared the International Year of Sanitation by the United Nations in
conjunction with the Water for Life Decade.
The United Nations General Assembly has declared 2008 the International Year of
Sanitation.
Worldwide there are roughly 2.6 billion people who do not have access to basic sanitation
today.
The goal of 2008 as the International Year of Sanitation was to help raise awareness of this
crisis and to accelerate progress towards reaching the UN’s Millennium Development Goals
(MDG’s) and cutting the number of people without access to basic sanitation in half by the
year 2015.

2.6.10 World Health Organization

The World Health Organization (WHO) is a specialized agency of the United Nations that is
concerned with international public health. It was established on 7 April 1948, and is
headquartered in Geneva, Switzerland. The WHO is a member of the United Nations
Development Group. Its predecessor, the Health Organization, was an agency of the League
of Nations.

2.6.11 UNICEF
The United Nations Children's Education Fund (UNICEF), originally known as the United
Nations International Children's Emergency Fund, was created by the United Nations General
Assembly on 11 December 1946, to provide emergency food and healthcare to children and
mothers in countries that had been devastated by World War II. The Polish physician Ludwik
Rajchman is widely regarded as the founder of UNICEF and served as its first chairman from
1946. On Rajchman's suggestion, the American Maurice Pate was appointed its first
executive director, serving from 1947 until his death in 1965. In 1950, UNICEF's mandate
was extended to address the long-term needs of children and women in developing countries
everywhere. In 1953 it became a permanent part of the United Nations System, and the words
"international" and "emergency" were dropped from the organization's name, though it
retained the original acronym, "UNICEF
2.6.12 Sustainable Development Goal 6
Sustainable Development Goal 6 (SDG6 or SDG 6), one of 17 Sustainable Development
Goals established by the UN in 2015. It calls for clean water and sanitation for all people.
The official wording is: "Ensure availability and sustainable management of water and
sanitation for all." The goal has eight targets to be achieved by at least 2030. Progress toward
the targets will be measured by using eleven "indicators."

SDG6 is closely linked with other Sustainable Development Goals (SDGs). For example,
improving sanitatiWorld on also helps make cities more sustainable (Goal 11). Sanitation
improvements can lead to more jobs (Goal 8) which would also lead to economic growth
(Goal
8). SDG6 progress improves health (Goal 3) and social justice (Goal 16).

2.6.13 Toilet Day

World Toilet Day (WTD) is an official United Nations international observance day on 19
November to inspire action to tackle the global sanitation crisis. Worldwide, 4.5 billion
people live without "safely managed sanitation" and around 892 million people practice open
defecation. Sustainable Development Goal 6 aims to achieve sanitation for all and end open
defecation.
World Toilet Day exists to inform, engage and inspire people to take action toward achieving
this goal. World Toilet Day was established by the World Toilet Organization in 2001.
Twelve years later, the UN General Assembly declared World Toilet Day an official UN day
in 2013.

2.7 Why People Do Defecate In The Open?

Several scholars have tried to study the reasons why people defecate in the open. (Cavill,
Chambers Vernon 2015 sustainability and CLTS). In some places even people with toilets in
their houses prefer to defecate in the open. The reasons for open defecation are varied. It can
be voluntary or semi voluntary choice (United Nations Deputy Secretary- General’s call to
Action on Sanitation 19th October 2014). A few broad factors that result in the practice of
open defecation are listed below:

2.7.1Poor quality of toilet: Sometimes they have access to a toilet, but the toilet might be
broken, or of poor quality such as very dirty and smells bad, not well lit, lack door, or may
not have water. Toilets with maggots or cockroaches are also disliked by people and hence
they go out to defecate. ( In 2016, Kunwar BaiYadav BBC News India)

2.7.2 Risky and unsafe: Some toilets are risky to access. There may be a risk to personal
safety, such as they may be dangerous to access at night due to lack of lights, criminals
around them, the presence of animals such as snakes and dogs. Women and children who do
not have toilets inside their houses are often found to be scared to access shared or public
toilets, especially at night.
Accessing toilets that are not located in the house, might be a problem for disabled people,
especially at night. (Joint Monitoring Programme for water supply and sanitation,
WHO/UNICEF. 12th March 2015)

2.7.3 Too many people using a toilet: This is especially true in case of shared or public
toilets.
If too many people want to use a toilet at the same time, then some people always prefer
going out to defecate instead of waiting for their turn in the shared toilet. Some people might
not be able to wait for their turns in public of shared toilet when they have diarrhea (or a
result of an irritable Bowel Syndrome emergency).

2.7.4 Social norms: Open defecation is a part of people’s life and daily habit. It is an ancient
practice and is hard for many people to stop practicing it. It is a part of a routine or social
norm.
Also, there may often be social taboos where, a father-in-law may not use the same toilet as
daughter-in-law, in the same household.

2.7.5 Lack of behavior change: Communities often have toilets, yet people love to defecate
in the open. Often these toilets are provided by the government or other organization and the
people do not like them, or do not value them. They continue to defecate in open also older
people are often found to defecate in the open and they are hesitant to change their behavior
and go inside a closed toilet.( Devine J, 2009 Introducing Sanifoam)

2.7.6 Fear of the pit getting filled: People are scared that their toilets pits will get filled very
fast if all family members use it every day. So they continue to go out to delay the toilet pit
filling up, in the case of a pit latrine.
2.7.7 Combining open defecation with other activities: Some people love to walk early in
the morning, to look after their farms. Some consider it as a social activity, especially women
who like to take some time to go out of their homes. While on their way to the fields for open
defecation they can talk to other women and sometimes take care of their animals. (Lennon, S
2011, Sanitation and hygiene applied research for equity UK).

2.7.8 Presence of toilets but not privacy: Some toilets do not have a real door, but have a
cloth hung as a door. In some communities toilets are located in places where women are shy
to access them due to the presence of men around.

2.7.9 Love being in nature: This happens mostly in less populated or rural areas, where
people walk outside early in the morning and go to defecate in the fields or bushes. They love
being in nature and fresh air around them, instead of defecating in a closed space such as a
toilet using a hole in the ground, that smells or has flies and lacks light. There may be cultural
or habitual preference for defecating “in the open”, beside a local river or stream, or even the
bush.

2.7.10 Lack of awareness: In places where people do not know about the benefits of using
toilets as a result of lack of education on the need to use the toilet.

2.8 The Impacts of Open Defecation

The negative public health impacts of open defecation are the same as those described when
there is no access to sanitation at all. Open defecation and lack of sanitation and hygiene in
general is an important factor in causing various diseases, most notably diarrhea and
intestinal worm infections but also typhoid, cholera, hepatitis, polio, trachoma, and others. In
2011, infectious diarrhea resulted in about 0.7 million deaths in children under five years old
and 250 million lost school days. It can also lead to malnutrition and stunted growth in
children. Certain diseases are grouped together under the name of water borne diseases,
which are transmitted via fecal pathogens in water. Open defecation can lead to water
pollution when rain flushes feces that are dispersed in the environment into surface water or
unprotected wells. Open defecation was found by the WHO in 2014 to be a leading cause of
diarrheal death. Averages of 2,000 children under the age of five die every day from diarrhea.
Young children are particularly vulnerable to ingesting feces of other people that are lying
around after open defecation, because young children crawl on the ground, walk barefoot,
and put things in their mouths without washing their hands. Feces of farmed animals are
equally a cause of concern when children are playing in the yard. Those countries where open
defecation is most widely practiced have the highest numbers of deaths of children under the
age of five, as well as high levels of malnourishment (leading to stunted growth in children),
high levels of poverty and large disparities between rich and poor. Research from India has
shown that detrimental health impacts (particularly for early life health) are even more
significant from open defecation when the population density is high: The same amount of
open defecation is twice as bad in a place with a high population density average like India
versus a low population density average like sub-Saharan Africa. There are also strong
gender impacts: the lack of safe, private toilets makes women and girls vulnerable to violence
and is an impediment to girl’s education. Women are at risk of sexual molestation and rape as
they search for places for open defecation that are secluded and private, often during hours of
darkness.

2.9 Prevention of Open Defecation

There are several drivers used to eradicate open defecation, one of which is behavior change.
SaniFOAM (Focus on Opportunity, Ability and Motivation) is a conceptual framework which
was developed specifically to address issues of sanitation and hygiene. Using focus,
opportunity, ability and motivation as categories of determinants, SaniFAOM model
identifies barriers to latrine adoption while simultaneously serving as a tool for designing,
monitoring and evaluating sanitation interventions. The following are some of the key drivers
used to fight against open defecation in addition to behavior change: Political will, Sanitation
solutions that offer a better value than open defecation, stronger public sector local service
delivery systems and creation of the right incentive structures.

2.10 Integrated initiatives

Efforts to reduce open defecation are more or less than same as those to achieve the MDG
target on access to sanitation. A key aspect is awareness rising (for example via the UN
World Toilet
Day at a global level), behavior change campaigns, increasing political will as well as
demand for sanitation. Community-Led Total Sanitation (CLTS) campaigns have placed a
particular focus on ending open defecation by “triggering” the communities themselves into
action. As
India has such a high number of people practicing open defecation, various Indian
governmentled initiatives are ongoing to reduce open defecation in that country. It began as
the “Total Sanitation Campaign”, which was relaunched as Nirmal Bharat Abhiyan in 2012
and integrated into the wider Swachh Bharat Abhiyan (Clean India Mission) in 2014. Also in
2014, UNICEF began a multimedia campaign against open defecation in India, urging
citizens to “take their poo to the loo”.

2.11 Simple Sanitation Technology Options:

There are some simple sanitation technology options available to reduce open defecation
prevalence if the open defecation behavior is due to not having toilets in the household and
shared toilets being too far or too dangerous to reach example; at night.

2.11.1 Toilets bags: People might already use plastic bags (also called flying toilets) at night
to contain their feces. However, a more advanced solution of plastic toilet bag has been
provided by the Swedish company who are producing the “Peepoo bag”, a “personal, single-
use, selfsanitizing, fully biodegradable toilet that prevents feces from contaminating the
immediate area as well as the surrounding ecosystem”. This bag is now being used in
humanitarian responses, schools and urban slims in developing countries.

2.11.2 Bucket toilets and urine diversion: Buckets toilets are a simple portable toilet option.
They can be upgraded in various ways, one of them being urine diversion which can make
them similar to urine diverting dry toilets. Urine diversion can significantly reduce odors
from dry toilets. Examples of using this type of toilet to reduce open defecation are the
“MoSan” toilet (used in Kenya) or the urine-diverting dry toilet promoted by SOIL in Haiti.

CHAPTER THREE: METHODOLODGY

3.1 Research Methodology

Research methodology is understood as an embodiment of the various steps that are generally
adopted by a researcher in studying his/her research problem along with the logic behind their
adaptation. This chapter provided a clear presentation on the processes of how this research
was completed scientifically. It involved the research design and sampling procedure to be
used in conducting the research.

3.2 Study Design

According to the Babbie (2004), the design for the study includes an outline of what the
researcher will do from writing the hypothesis and its operational implications to the final
analysis of data. It constitutes the blueprint for the collection, measurement and analysis of
data. The research design was a cross-sectional non-experimental survey. This decision was
inspired by the fact that cross-sectional non-experimental survey is a design in relation to
which data collection will be predominant by administering questionnaire to more than one
case of single point in time. Besides, it allowed the researcher to carry out this study in a
natural, real-life setting like FDA, thus increasing the external validity of the study
The study design will show case the factors leading to open defecation and its associated
impact on the residents of FDA. Descriptive survey study will be used for my research.
Descriptive survey study describes the pattern of disease occurrence and health related
conditions by persons, place and time. The study was done fairly, quickly and easily.

3.3 Research Setting

My study setting was carried out in FDA, Yendi Municipality in the Northern Region of
Ghana because the practice of open defecation is rampant in the residence. The study
included residents of all ages.

3.4 Study Population

Out of about 2,000 people in FDA, only 60 people were used for the study. This comprises 32
male and 28 female of which 36.67% (20) are between 21 - 35years of age. This sample was
used due to the limited time frame for the study and logistics constrains.

3.5 Sampling Procedure

Sampling Procedure is a detailed description of the processes followed to arrive at the study
sample (Babbie, 2004). The researcher carefully selected number of units for a study in such
a way that the units represent the larger group from which they were selected. Sampling
procedure captures the population, unit of analysis, sampling technique and the sample size.
I used both probability and non-probability technique to collect data. The specific
nonprobability method employed was accidental sampling where most available respondents
was used for the study. Accidental sampling is a sampling technique where the researcher
goes to the field and interviews whoever is available.

3.6 Techniques Of Data Collection

Interview Guide, Observation and Questionnaires
To attain my objectivity, a set of questionnaires and interviews were molded and spread to
the respondents to obtain data. Observations were also made to facilitate the data collection.
With expectations being that, items in the questionnaire, interview guide and observations
would reflect the relatives of the objectives of the study.

3.7 Research Instruments

The source of my information was both primary and secondary as a tool for data collection.
The tool that was used in gathering views from respondents are questionnaire, interview and
observation. My primary data used was interview and questionnaires consisting of close
ended questions. Interview is a verbal face to face questioning between a researcher and an
interviewee. Questionnaire is a form containing a list of questions which aid to gather
information for a survey.

3.8 Validity and Reliability

Validity is the extent to which a measuring reflects what it was intended to measure
(Oxford’s Dictionary). It concern about the truthfulness of the study. Reliability on the other
hand refers to consistency of the study (Oxford’s Dictionary) I collected data directly from
the people of FDA residents by means of interview, questionnaire and observation. Validity
and reliability are very important in all research work in other to determine the outcome of
the study. To make the research valid and reliable, objectives was set as well as organized
literature review compiled. This enables the study to be reliable and free from errors.

3.9 Limitations of the Study

The participation of some residents of FDA actively, during my interview and questioning so
as to attain a fair result was a challenged for my study. These include lack of experience and
logistics constrains.
3.10 Ethical Consideration
Ethical concerns are expedient when planning and conducting research. The researcher made
sure to adhere to all the ethical issues that will help in conducting a good and responsible
research. In view of this, the prospective research participants were given as much
information as might be needed to make an informed decision about whether or not they wish
to participate in the study. Prospective participants were made to understand that they could
also withdraw from the study at any point in time. Moreover, information provided was
treated as confidential as possible. The researcher verbally explained to the participants that
whatever information given was not going to be disclosed to the media or any other person
who was not related to the study. Finally, as part of exercising a high level of confidentiality,
anonymity was highly respected. The research was devoid of the names of the prospective
participants. All entry was carried out in FDA residents. All necessary protocol was observed
taking into consideration, chiefs, stakeholders as well as community leaders. The importance
of this study was explained to people of FDA to gain their concern or permission.