Health outcomes of DryOnsite Sanitation, Water Services and Hygiene Education in eThekwini District,

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Health outcomes of Dry-Onsite Sanitation, Water
Services and Hygiene Education in eThekwini
District, Durban, South Africa
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FUNDING

• eThekwini Municipality,
• World Health Organisation
• Swedish Institute of Infectious Disease
• Stockholm and Environmental Institute / SIDA

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BACKGROUND (cont.)

• South African National Targets
• Provide adequate sanitation for all by 2010
• Safe water 2007
• eThekwini Municipality
• Free basic water supply
• 200 l / household /day
• Urine diversion toilets (onsite dry sanitation)
• Health hygiene education.
• Requested evaluations to assess health outcome.

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SAMPLE SELECTION

• Multi-stage random sampling approach.
• Stage 1 Random selection
• 1 Intervention 1 Control Area
• North, South West Sub-District.
• Intervention Areas (I)
• Mzinyathi (I1N )
• Mtamuntengayo (I2W)
• Sawpitts (I3S)
• Control Areas (C)
• Ogunjini (C1N)
• Bux Farm (C2W)
• Adams Mission (C3S)

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Use of GIS maps and data-base for sample selection
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DATA COLLECTION HANDLING

• Data collected from key-respondents
• 2 trained fieldworkers.
• Data collection tools
• Household questionnaire
• Repeat visit questionnaire
• Observational checklist
• Each household visited every two weeks for 6
  visits to reduce information bias.
• Data captured using EpiData.
• Data processed analysed using SPSS vers. 13

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Number () of Households,
Household Members Density in Intervention
Control Areas in EcoSan Study, eThekwini, 2006.
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Number () of Households,
Household Members Density in Intervention
Control Areas in EcoSan Study, eThekwini, 2006.
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Incidence Rate (IR) Adjusted Incidence Rate
Ratio (IRR) of Diarrhoea in Intervention
Control Areas
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Incidence Rate Difference (IRD) Number Needed
to Treat (NNT) of Diarrhoea in Intervention
Control Areas
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Episodes of Diarrhoea Vomiting Diverted Due to
Sanitation Intervention in Ethekwini 2007

• Episodes of diarrhoea reduced
• Episodes averted / person X Households X People
  / household
• 1.57 X 56377 X 5.4
• 477 964 episodes of diarrhoea averted
• Episodes of vomiting reduced
• Episodes averted / person X Households X People
  / household
• 0.35 X 56377 X 5.4
• 106 552 episodes of vomiting averted

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Summary of Innovation

• Request for evaluation by key stake-holders
• Sample Selection
• GIS GPS in per-rural areas
• Sample Size

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Summary of Innovation (cont.)

• Information
• Prospective collection of outcome incidence
• Repeat visit every 2 weeks for 3 months
• Person-days
• All sample homesteads geo-referenced
• Site for future studies
• Cryptococcus, Giardia, Parasites