WATER HYGIENE KNOWLEDGE, ATTITUDE, PRACTICE AND ENHANCEMENT STRATEGIES AMONG WOMEN ATTENDING ANTENATAL CARE

1.1 Introduction

Water Hygiene is fundamental to the prevention and control of communicable diseases in water and maintaining good health. Many communicable diseases of public health importance which affect pregnant women are caused by poor water hygiene. Water hygiene is very old concept related to medicine, as well as to peculiar and specialized care practices related to most aspects of living.

According to Ali et al., (2013), hygiene refers to practices associated with ensuring good health and cleanliness. Good hygienic care as well as practices in terms of personal hygiene contributes to a large extent on factors relating to healthful living and prevention of hazards from diseases. These health risk factors are directly related to some important daily activities implicated with worthy operational actions and obligatory responsibilities (Ali et al, 2013).

As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitation of the study and Definition of terms.

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1.2 Background of Study

Water hygiene knowledge, attitude, practice and enhancement strategies are key to ensuring the sustenance of good health, wellbeing, comfort and survival of man, including women attending antenatal care (ANC). This is because water has impurities that affect it in the environment. These impurities are often ingested as a result of man’s inability to embark on correct water hygiene, which results to dire consequences. For instance, in many homes, water related diseases have been one of the leading causes of mortality and morbidity in developing countries (World Health Organization and United Nation International Children Fund [WHO / UNICEF], 2000).

Water is an important ingredient necessary to all forms of life. Mathur (2007) viewed water as a great cleaning agent that is used both externally and internally. Moshby (2009) defined water as a chemical compound, which one molecule contains one atom of oxygen and two atoms of hydrogen. In addition, Sobsey (2002) pointed that water carrying vessels should be between 10-25 liters capacity, rectangular or cylindrical with one or more handles and flat bottoms for portability and ease of storage among others.

Leeds (2014) conceived water as a compound that is made of two parts, hydrogen and one part oxygen. Quotes (2015) posited that water is the fluid which descends from the clouds in rain and which forms rivers, lakes, seas and oceans. Water as used in this study refers to any clear, colourless, odourless, pleasant tasting liquid that is necessary for all forms of life.

Water is required in the human body for the maintenance of vital physiological and biochemical processes such as digestion, respiration, excretion and circulation. Water used for these purposes need to be clean, clear and free from harmful substances, minerals, chemicals and microorganisms. This implies that water introduced into the human body must be safe. The consumption of safe water does not cause illness or health problems but maintains health. Safe water ought to be free from dirts, wastes, feaces and germs. Also, it must be free from poisonous chemical compounds or the presence of chemicals, which must be below permitted level and minerals therein not exceeding tolerant level. It must also be tasteless, colourless, odourless, and drinkable. Unfortunately, water often contains particles, dirts, microorganisms, bacteria of cocci, bacilli or flagella, coliforms, viruses, algae, Escherichia coli, Pseudomonas aeruginosa, Campylobacter spp, Salmonella spp, protozoas of Crysptosporidium and giardia lamblia thus making it unclean. In other to make water clean and safe for use, measures of hygiene like purification of water among others become important.

Water hygiene eliminates or removes impurities and microorganisms from water to keep it safe for use. According to Business (2015), water hygiene is a process for enhancing the quality of water so that it meets the quality criteria for its fitness for intended use. To achieve correct water hygiene, Mintz, Reiff and Tauxe (1995) revealed that one needs to have container with single opening five to eight centimeters in diameter with strong, tightly fitting cover that makes it easy to fill and add disinfectant but difficult to immerse hands or utensils.

It was obvious that the water situation in the State was plagued with concerns. No wonder, Chollom et al. (2013) revealed that contaminants in the water used in the State posed serious hazard to human health. This implied that it affected all and sundry, especially women attending ANC because of their condition. Moreover, the State authorities paid lip service to issues of safe water. This was because the existing water treatment facilities were not maintained as large sums of monies was voted and publicized over the media with plausible intended water projects completed only on paper but not on ground for the people to benefit. The consequences involved the collection and use of water from all sources whether safe or unsafe. Moreover, the way and manner water was collected, transported, stored and used by women attending ANC seemed troubling.

Therefore, in Nigeria where the research was carried out, the activities that was conducted is to know the Water Hygiene Knowledge, Attitude, Practice and Enhancement Strategies among Women Attending Antenatal Care.

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1.3 Statement of Problems

Investigation revealed that striving to get safe water requires scaling up safe water sources and ensuring that portable water reaches the homes in safe or hygienic state and used in such state by all and sundry including women attending ANC. Regrettably, people including women who attended ANC and received hygienic orientation in health facilities of Delta State collected water from different sources such as streams, rivers, surface water and shallow wells. Some collected water with wide opened containers.

In addition, the surroundings of the wells and boreholes which water for domestic use was got appeared unhygienic. Stray animals used spilled water around the drinking water source.

Furthermore, freshly collected water was mixed with stored water for use. Moreover, water was scooped from stored container at home. Women who attended Antenatal Care allowed little children scooped from stored water before use. They preferred and got water from any source closest to them for domestic use irrespective of its quality.

The inadequate data on water hygiene Knowledge, Attitude and, Practice of women who attended ANC and received hygienic orientation in health facilities of Delta State was the gap this study filled. Based on existence of the aforementioned in the State, this study determined the water hygiene KAP among women attending ANC in Delta State and the outcome used and proffered the water hygiene enhancement strategies.

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1.4 Aim and Objectives of Study

The aim of the study is to scrutinize the Water Hygiene Knowledge, Attitude, Practice and Enhancement Strategies among Women Attending Antenatal Care. In achieving this aim, the following specific objectives were laid out as follows:

1. To examine the level of education of water hygiene practice among women attending Antenatal Care in Delta State;
2. To assess the attitude of women attending Antenatal Care towards water hygiene;
3. To determine the water hygiene knowledge and practice of women attending Antenatal Care in Delta State; and
4. To identify the enhancement strategies of water hygiene awareness among women attending Antenatal Care in Delta State.

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1.5 Research Questions

The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:

• What is the level of education of water hygiene practice among women attending Antenatal Care in Delta State?
• What is the water hygiene knowledge and practice of women attending Antenatal Care in Delta State?
• What is the attitude of women attending Antenatal Care towards water hygiene?
• What are the enhancement strategies of water hygiene awareness among women attending Antenatal Care in Delta State?

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1.6 Research Hypothesis

In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.

Hypothesis One

• H0: There is no significant difference in the water hygiene knowledge of women attending ANC based on level of education in Delta State.
• H1: There is significant difference in the water hygiene knowledge of women attending ANC based on level of education in Delta State.

Hypothesis Two

• H0: There is no significant enhancement strategies awareness among women attending Antenatal Care towards water hygiene
• H1: There is significant enhancement strategies awareness among women attending Antenatal Care towards water hygiene

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1.7 Significance of Study

The result of the findings would be useful to women attending ANC and their family members. Through the findings on attitude towards water hygiene negative attitude towards water hygiene, which women attending ANC and their family members had would be modified or altered after their negative effects are exposed.

Additionally, the change or modification in the negative attitude towards water hygiene of women attending ANC and their family members would curtail the negative attitude towards water hygiene thereby promoting the health and wellbeing of women attending ANC and their family members when they understand the consequences of the expression of negative attitude towards water hygiene.

Furthermore, health educators on the other hand would use the findings on the attitude towards water hygiene of women attending ANC and publicize it as a means for sensitizing the vulnerable groups. As attitude towards water hygiene are published in reputable journals, they would enrich global data on the subject matter. When this is done, it would help to expand the literature on such aspects and also sensitize the public in general and women attending ANC in particular on the attitude towards water hygiene that are inimical to health.

Finally, this study will be of immense benefit to other researchers who intend to know more on this study and can also be used by non-researchers to build more on their research work. This study contributes to knowledge and could serve as a guide for other study.

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1.8 Scope of Study

The scope of the research is focused on Water Hygiene Knowledge, Attitude, Practice and Enhancement Strategies among Women Attending Antenatal Care using Warri Central Hospital in Delta State as a case study.

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1.9 Limitations of the Study

During the course of this study, there were some problems encountered which stood as limitations to the research work. Some of the limitations include:

1. Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
2. Research Material: availability of research material is a major setback to the scope of the study.
3. Initial Cooperation Delay from Respondents: A particular limitation of this work came as a result of the respondent refusal to offer their cooperation at the initial time they were contacted. This contributed in making the success of this research study difficult.
4. Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).

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1.10 Definition of Terms

Water Hygiene:

Water Hygiene is fundamental to the prevention and control of communicable diseases in water and maintaining good health.

Hygiene:

Hygiene refers to practices associated with ensuring good health and cleanliness (Ali et al., 2013).

Education:

It is the process of giving systematic instruction especially at a school or university.

Health:

Health is the level of functional and metabolic efficiency of a living organism. In humans it is the ability of individuals or communities to adapt and self-manage when facing physical, mental, psychological and social changes with environment.