Abstract:
Back ground: Market based sanitation is a sanitation marketing whereby the household fully
pays at once or through installments to the supplier towards the purchase, construction
materials, upgrade or maintenance of and hand washing products entitled to toilet for the
desired improved latrine. Despite that different measures taken, market based sanitation
implementation still remain challenging in Asia and Sub-Saharan Africa including Ethiopia.
Households’ knowledge, attitude and practice towards market based sanitation guideline are
very important.
Objective: To assess knowledge, attitude and practice of households’ towards market based
sanitation approach and associated factors in Ambo District, West Shoa Zone, Oromia,
Ethiopia, 2021.
Methods: A mixed method study was employed. Community based cross sectional was
used among 419 randomly selected head of households using interviewer administered
structured questionnaire and explanatory sequential was employed for key informant interview
using open-ended questionnaire in Ambo district from October to November 2021and. The
collected data were entered into EPI Data version 3.1 and analyzed using SPSS version 21.0
software. Binary and multiple logistic analyses were carried out to identify factors associated
with knowledge, attitude, practice toward market based sanitation approach at 95%CI and p value of <0.05 and key informant interview were analyzed manually and quoted.
Results: A total of 419 respondents participated with 99.2% response rate. The study showed
that only 42.7 %( 95%CI: 38.1-47.8%) and 46.8 %( 95%CI: 42.1-52.3%) had good knowledge
and good practices respectively. Households who were living in open defecation free village
(AOR=4.47, 95%CI: 1.46-13.68); have understanding on village saving and loan association
(AOR=3.33, 95%CI: 1.01-5.53) times more likely to have good knowledge. Head of household
who had discuss and decide with family (AOR=2.78, 95%CI: 1.42-5.4) and having monthly
income above 500 birr were (AOR=2.87, 95% CI: 1.06-7.71) times more likely to have good
practice. From key informants’ poor implementation of market based sanitation guideline and
saving money that hinders household from purchasing sanitation products.
Conclusions: This study indicated that knowledge and practices of head of households towards
market based sanitation approach was low as compared to mean. Living in open defecation free
village and presence of village saving and loan association were significantly associated with
good knowledge. While monthly income and discussing and deciding with family were
significantly associated with good practice towards market based sanitation approach. National
market based sanitation guideline was not properly implementing and monitored in the district.
Thus, Ambo district health office should pay due attention to increase awareness and changes
utilization behavior and establish and encourage village saving and loan association.
