The Effect of Water Sanitation and Hygiene (WASH) Practices on the Incidence of Diarrheal Diseases

CHAPTER ONE

1.1 Background of the Study

Access to clean water, proper sanitation, and good hygiene practices is essential for maintaining public health. Together, these three components—Water, Sanitation, and Hygiene (WASH)—form the foundation for preventing infectious diseases, especially diarrheal illnesses. According to the World Health Organization (WHO, 2023), unsafe water and poor sanitation are among the leading causes of diarrheal diseases globally. These conditions contribute significantly to child morbidity and mortality, particularly in low- and middle-income countries.

Diarrheal diseases are largely preventable, yet they remain one of the top causes of death among children under five years. The Centers for Disease Control and Prevention (CDC, 2022) estimates that about 1.5 million children die each year from diarrhea, mainly due to contaminated water and poor hygiene. Effective WASH practices can break this cycle by reducing exposure to pathogens that cause illness.

Communities with improved access to clean water, functional sanitation facilities, and awareness of handwashing practices experience fewer cases of diarrhea. Studies show that simple interventions, such as handwashing with soap and proper disposal of human waste, can reduce diarrheal incidence by up to 40 percent (UNICEF, 2023). Despite these benefits, many households still lack access to safe water sources and adequate sanitation.

Environmental conditions, cultural behaviors, and economic factors influence how people manage water and hygiene. In some areas, open defecation and unsafe water storage are common practices that promote disease transmission. Evaluating how WASH practices affect diarrheal disease incidence is, therefore, vital for designing sustainable interventions that improve community health.

1.2 Statement of the Problem

Despite global efforts to improve WASH services, diarrheal diseases continue to affect millions of people, especially children under five. Poor hygiene, inadequate sanitation facilities, and consumption of unsafe water remain major risk factors. Many communities rely on contaminated water sources for drinking and domestic use. Additionally, lack of knowledge about hygiene practices increases vulnerability to infections.

Government and non-governmental organizations have introduced WASH programs, but their impact remains uneven due to inconsistent implementation, poor maintenance, and low community participation. The persistence of diarrhea-related illnesses indicates that existing interventions are not reaching all target populations effectively.

This study seeks to assess the relationship between water sanitation and hygiene practices and the incidence of diarrheal diseases. It aims to identify gaps in current WASH practices and suggest strategies for reducing the disease burden.

1.3 Objectives of the Study

The main objective of this study is to examine the effect of WASH practices on the incidence of diarrheal diseases.

The specific objectives are to:

1. Assess the level of access to safe drinking water among households.

2. Examine sanitation and hygiene practices in the study area.

3. Determine the relationship between WASH practices and the occurrence of diarrheal diseases.

4. Suggest effective interventions to improve WASH practices and reduce diarrhea incidence.

1.4 Research Questions

1. What is the level of access to safe water in the study area?

2. What are the common sanitation and hygiene practices among residents?

3. How do WASH practices influence the occurrence of diarrheal diseases?

4. What strategies can improve WASH behavior and reduce the incidence of diarrheal diseases?

1.5 Significance of the Study

This study is important because it highlights how poor WASH conditions contribute to preventable diseases. The findings will help policymakers and health planners understand the role of clean water and hygiene in disease prevention. It will also guide communities on adopting safer practices that promote health and well-being.

Furthermore, the study will support ongoing public health initiatives by identifying weaknesses in WASH implementation. The results can inform future programs aimed at achieving Sustainable Development Goal 6, which focuses on ensuring access to clean water and sanitation for all.

1.6 Scope of the Study

The study focuses on water sanitation and hygiene practices and their effects on diarrheal diseases. It examines households within a defined area to understand their access to clean water, type of sanitation facilities, and hygiene behavior. The study does not cover other water-related illnesses such as cholera or typhoid.

1.7 Operational Definition of Terms

Water Sanitation and Hygiene (WASH): A collective term for programs aimed at improving access to clean water, safe sanitation, and good hygiene practices.

Diarrheal Diseases: Illnesses characterized by frequent and watery stool, often caused by infections from contaminated food or water.

Sanitation: The safe disposal of human waste to prevent disease transmission.

Hygiene: The practice of maintaining cleanliness to promote health and prevent disease.

Access to Safe Water: The availability of water from reliable and uncontaminated sources for domestic use.

CHAPTER TWO

2.0 Literature Review

2.1 Concept of Water, Sanitation, and Hygiene (WASH)

Water, sanitation, and hygiene are interrelated components that play a critical role in preventing disease. Access to clean water ensures that people can drink, cook, and clean safely. Sanitation involves the safe management of human waste, while hygiene focuses on maintaining cleanliness to prevent infection. The WHO (2023) describes WASH as an essential public health measure that supports human dignity and well-being.

Effective WASH programs reduce the spread of fecal-oral diseases such as diarrhea, cholera, and dysentery. They also contribute to improved nutrition and child development. Communities that adopt good hygiene practices experience fewer health risks and better overall productivity (UNICEF, 2023).

2.2 The Burden of Diarrheal Diseases

Diarrheal diseases are a leading cause of sickness and death among children under five years, especially in developing countries. The CDC (2022) reports that unsafe water and poor sanitation account for about 88 percent of diarrheal cases worldwide. Contaminated water sources, improper waste disposal, and poor hygiene contribute to the continuous transmission of pathogens.

In many areas, limited infrastructure and weak health systems worsen the problem. Diarrheal episodes often lead to dehydration, malnutrition, and, in severe cases, death. Repeated infections also weaken the immune system and hinder child growth. Reducing diarrhea requires sustainable improvements in WASH services and behavior change among community members.

2.3 Relationship Between WASH Practices and Diarrheal Diseases

The relationship between WASH and diarrhea is well established. Unsafe water exposes individuals to bacteria, viruses, and parasites that cause illness. Lack of toilets or poor waste disposal increases the spread of pathogens through the environment. Likewise, poor hygiene practices, such as failure to wash hands after defecation, facilitate disease transmission (WHO, 2023).

Empirical studies reveal that households with access to improved water sources and sanitation facilities report lower rates of diarrhea. Handwashing with soap before eating and after using the toilet is one of the simplest and most effective preventive measures (UNICEF, 2023). However, knowledge alone is not enough; consistent behavior and accessibility are key to maintaining good health outcomes.

2.4 Barriers to Effective WASH Practices

Several factors hinder effective WASH practices. Economic constraints often prevent households from constructing or maintaining proper sanitation facilities. Cultural beliefs and traditional practices sometimes discourage toilet use or promote unsafe water handling. Inadequate infrastructure also limits access to clean water and safe waste disposal, particularly in rural communities (Adeola & Musa, 2022).

Furthermore, low awareness and weak policy enforcement contribute to poor hygiene behavior. Communities may lack information on how diseases spread or how simple actions can protect their health. Improving WASH outcomes requires addressing these barriers through education, investment, and strong community engagement.

2.5 Empirical Review

Several researchers have examined the relationship between WASH practices and diarrheal diseases. For instance, Adebayo (2021) found that households with access to safe water and improved sanitation reported fewer cases of diarrhea among children. Similarly, Adeola and Musa (2022) discovered that handwashing with soap reduced diarrheal incidence by nearly 35 percent in communities where awareness campaigns were implemented.

In another study, Bello and Ahmed (2023) observed that lack of clean water and poor hygiene behaviors were major predictors of diarrheal outbreaks in peri-urban settlements. Their findings emphasized the need for continuous monitoring and education to sustain healthy practices.

2.6 Theoretical Framework

This study is guided by the Social Ecological Model (SEM). The SEM explains that health behaviors are influenced by multiple levels of factors—individual, interpersonal, community, and policy. In the context of WASH, individual behavior (such as handwashing) is shaped by social norms, community infrastructure, and government policies (Bronfenbrenner, 1979).

At the individual level, awareness and personal responsibility determine hygiene behavior. At the community level, cultural beliefs and environmental conditions influence how sanitation and water are managed. Policy-level interventions, such as public investments in water systems, create enabling environments for good WASH practices.

2.7 Summary of Literature Review

The reviewed literature confirms that effective WASH practices are essential for preventing diarrheal diseases. Access to clean water, improved sanitation, and consistent hygiene behavior significantly reduce disease transmission. However, barriers such as poverty, cultural norms, and inadequate infrastructure hinder progress.

Empirical studies highlight that education and awareness campaigns have positive effects on behavior change. The Social Ecological Model underscores the need for multi-level interventions that combine individual action with community and policy support. Strengthening WASH programs is, therefore, crucial to achieving better health outcomes and reducing diarrheal diseases among vulnerable populations.