ABSTRACT
Sanitation is a basic necessity that contributes to better human health, dignity and quality of life. The economic and social benefits of sanitation interventions create more time for productive pursuits, higher productivity, better performance at school and work, lower medical costs.Despite Nyeri County ranked by the Ministry of Health as number one county in terms of sanitation coverage, it has 25.4% unimproved sanitation and 0.3 % open defecation. This study was designed to identify the effect of water, sanitation and hand hygiene practices on diarrheal disease among community members in Nyeri County Kenya.The study adopted cross sectional study design.Data were drawn from 200 households sampled proportionately from two wards in Kieni East Sub-County selected through simple random sampling. A household survey was conducted to the adult household member who was present at home during time of the survey. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 23. The results showed that prevalence of diarrhea among the community members in the previous two weeks was 13%. Predictors of diarrhea in the community included Low level of education (OR 1.3, 95% CI 0.88-1.81); households with four or more members (OR 1.52, 95%CI1.03-1.76); unimproved water source (OR 1.52, 95% CI 1.11-1.83); Water inadequacy (OR 1.85, 95CI 0.36-1.97); Unavailability of toilet (OR 1.7, 95%CI 1.14-2.07); and, unavailability of handwashing facilities (OR 3.5 95%CI 1.55-2.99). The community has a very high toilet coverage,Gakawa ward 99% and Thengu ward 95%, however the hand washing facilities were low, 72% in Gakawa ward and 49% in Thengu ward. Again despite this moderate availability of handwashing facilities, fewer had soap, Gakawa ward 24% and Thengu ward 30%. The low availability of handwashing facilities with soap indicate that the community is not consistently practicing adequate handwashing practices.In conclusion, diarrhea remains an important public health concern in the study community. Occurrence of diarrhea could be decreased by interventions aimed to improve water availability, sanitation and hygiene. Nyeri County, Department of Health Services should initiate a sensitization program in Kieni East Sub-County on hand washing and hand hygiene. Such a program should target lowly educated and the poor. Distribution of free soap to the identified low income households would greatly aid efforts to enhance hand washing in the area.