Water safety, sanitation and hygiene related knowledge, attitudes and practices among household residents in peri-urban areas in Northwest Ethiopia

Background: People living is peri-urban areas in Sub-Saharan Africa are faced with the challenge of improving sanitation, hygiene and access to safe water supplies. However, there is limited information on the knowledge, attitudes and practices of household residents in relation to water safety, sanitation and hygiene. This study was carried out in three peri-urban areas to determine residents' knowledge, attitudes and practices, as well as ascertain their sources of drinking water and access to sanitation facilities. Methods: We conducted a cross-sectional study at household level in three peri-urban areas in May 2016. Data were collected through face-to face interviews using a structured questionnaire. Results: Overall, 590 adults took part in the study. The overall mean knowledge of adults in terms of water safety, sanitation and hygiene was 78.1% (95% CI: 76.7-79.4). Adults' favorable attitudes to water safety, sanitation and hygiene was 73.6% (95% CI: 71.1-76.1). Household water treatment (HWT) was practiced by one-third (34%) of the respondents. Chlorination, called wuha agare in Amharic, was a major (20%) method of HWT. Latrines were used by 523 (88.6%) respondents, with 129 (22%) using shared public latrines. Open defecation was practiced by 67 (11.3%) respondents. The respondents with a higher level of education had good knowledge and practices in relation to safe water, sanitation and hygiene compared to participants with no formal education (P<0.001). Hand washing with soap was more likely to be practiced by younger people (COR = 2.0; 95% CI: 1.3-3.0) and those who were formally educated (COR = 4.1; 95% CI: 2.3-7.3). The two-week diarrhea prevalence was significantly higher among households with no practice of HWT compared to households with HWT practices (21.2% vs 13%; P<0.02). Conclusions: The educational status of household residents was associated with good levels of knowledge, attitudes and practices in relation to water safety, sanitation and hygiene. HWT, open defecation and shared latrines are matters that still require intervention in peri-urban areas.