Utilization of environmental health services of urban health extension program and associated factors in Debre-tabor town, North-west Ethiopia

Abstract

Background: Studies in a number of countries have shown that wherever indiscriminate waste disposal is high, infant and child mortality rates are high. Although utilization of environmental health services is an important indicator for measuring success of the health extension program; data on environmental health services of urban health extension program are scarce in the study area and elsewhere in Ethiopia. Objective: To assess utilization of environmental health services of urban health extension program and associated factors in Debre-tabor town, Amhara region, Ethiopia. Methods: A community based cross sectional study was conducted in Debre-tabor town from September 1-30, 2013. A total of 422 households were included in the study using systematic sampling technique. Data were collected using structured questionnaire and analyzed using SPSS version 16.0. Degree of association between independent and dependent variables was assessed with a 95% confidence level and p-value less than 0.05 was used to detect statistical significance. The findings of quantitative data were triangulated with the qualitative one. Result: In this study 69.8% and 65.5% of households practiced proper solid and liquid waste management mechanisms respectively. Ninety three point five percent of households have latrine. Among the households with latrines, 76.5 % of the respondents have hand washing devices. Graduated as model family was predictor for availability of latrine and hand washing facilities (AOR= 3.18, 4.94) respectively. Income was found to be predictors for liquid waste management (AOR=1.82), and availability of latrine (AOR=3.70). House ownership was found to be predictor for availability of latrine (AOR=8.46). Educational status of respondents was found to be predictors for liquid waste management (AOR=1.83) and availability of latrine (AOR= 2.65). Financial problems, lack of water, lack refreshment training, were mentioned as reasons for not utilization of environmental health services of urban health extension program. Conclusion: Solid and liquid waste management practices were lower than from the target set in the health extension program implementation manual at least 75% of the package should be implemented. Latrine coverage was relatively lower from the national target of 100%, still there are households that use open deification. Educational status, house ownership, income and graduated as model family were main factors affecting environmental health services. Improving socio economic status of households, provision of continuous advice and technical support at household level on the utilization of environmental health service are recommended.