INTRODUCTION:
Water
is the prime necessity of living things. Water intended for human drinking should
be both wholesome and safe, which is free from all harmful chemicals and pathogenic
agents and is used domestic purposes and pleasant in taste. Water is a basic element
of primary health care which is the key to attainment of health for all. Much of
the ill health which affects the mainly in the developing countries is due to lack
of safe and wholesome water supply (1). Water is used by humans in many ways. The
main purposes of water are domestic, public, industrial and agricultural purposes.
There can be no state of positive health without safe water. Water pollution is
a growing hazard in developing countries, owing to human activity. The main pollutants
are natural and acquired impurities, industrial and agricultural wastes which may
be dissolved and suspended in the water. The main hazards of water pollution are
biological and chemical agents thus leading to water borne diseases (2). The water
supply to the community should be kept free from all foreign and polluting ingredients.
The water sanitation has great significance. Water purification and sanitation aims
to protect the water supply by removing the organic, suspended and dissolved matter
in the water and make the water physically, chemically and bacteriological suitable
for drinking (3). Much of the ill health in India due to poor environmental sanitation
mainly water sanitation in respect to the increased necessity and usage of water.
Due to various developmental process such as urbanization, industrialization etc,
the water pollution is more and more; comparatively less resources for water sanitation
and safe water supply. Due to this poor sanitation of water, globally increased
episode of water born diseases are existing. The high death rate, infant mortality
rate, sickness rate and poor standards of health are in fact largely due to poor
water sanitation. A study conducted by AndrewCotton and Richard Francy on “Hygiene
awareness for rural water supply and sanitation project” showed that more than 68.75%
of people are using untreated water for domestic purposes, 77% of people where having
pit toilet in the yard and 60.25% of people gets the water born diseases. Another
report of water technology (2004) done a study on “Sanitation assessment of water
waste treated by stabilization ponds for potential reuse in agricultural irrigation
and sanitation assessment showed 4 months assessment of water sample showed 31%
of soil form eggs, fecal streptococci an average 99.64% and in disinfected water
is free of salmonella and parasite hence, it is safe for domestic purpose. All the
above data shows the necessity of water sanitation. Thus the research study was
focused on water sanitation and creation of awareness among the public. Ii is in
this wake the descriptive study to assess the knowledge and attitude on water sanitation
among adults in the urban community area in the Belgaum District, Karnataka was
undertaken.
MATERIAL
AND METHODS:
Operational
definitions:
1.
Knowledge on Water Sanitation:
In
this study, it refers to the awareness of adults on water sanitation, meaning, purposes,
and sources of water, water pollutions, hazards, water purifications methods and
advantages of water sanitation.
2.
Attitude on Water Sanitation:
In
this study it refers to the opinion of adults on water sanitation.
3.
Water Sanitation:
In
this study it refers to the activities and measures which remove the dissolved and
suspended impurities of water and make the water physically, chemically and bacteriologically
suitable for drinking.
4.
Adults:
In
this study it refers to the men and women between the age group of 18-44 years.
5.
Urban Community:
In
this study it refers to the people residing in a town or city.
The following assumptions were made for
the study:
1.
Water sanitation is necessary to prevent
much of the ill health in India.
2.
Urban community people will have knowledge
on some extent.
3.
Urban community people will have positive
attitude towards water sanitation.
Delimitations:
· The study is delimited only to urban community people.
· The study is limited to the adults (18- 44 years).
· The study is limited to the adults of Vadagaon urban community,
Belgaum.
· The study is limited to only 50 samples.
Research
approach and design:
Non
experimental design and descriptive approach was used in this study. Descriptive
studies are aimed at the accurate portrayal of the characteristic of person, situation
or group and the frequently with which certain phenomenon occurs. In this study
the descriptive approach was used and aimed at investigating the knowledge on selected
water sanitation measures and attitudes of adults on water sanitation.
Setting
of the study:
The
study was conducted in urban community area Vadagaon at Belgaum.
Variables:
Independent
Variables:
Age,
sex, type of house, education, religion, type of family, monthly income of family,
source of drinking water, information on water sanitation.
Dependent
Variables:
Knowledge
and attitude of adults.
Population:
The
target population of the study was adults of selected urban community area, Vadagaon, Belgaum
(Age group 18-44 years).
Sample
size:
The
sample size consists of 50 adults, both males and females belong to urban community
area at Vadagaon, Belgaum.
Sampling
technique:
Sampling
is the process of selecting a portion of population to represent the entire population.
Convenient and purposive sampling technique was used here.
Development
and description of the tools:
The
tool for data collection was developed and self-reporting questionnaire consisted
of three parts.
Part 1.
Demographic data sheet consisting
of ten items.
Part 2.
Assessment of knowledge on selected
aspects of water sanitation, containing 20 items.
Part 3.
Assessment of attitude on water
sanitation, containing ten items.
Scoring
procedure:
1.
Structured knowledge assessment
Questionnaire on water sanitation:
The
knowledge questionnaire comprises of 20 questions with multiple choice. The total
score is 20, the correct response will be given with score 1.
2.
Structured Attitude Scale on
Water Sanitation:
It
measures the opinion or believes of adults, both men and women about water sanitation
which comprised of 10 Statements. The total score was 20. It was a five point scale
which consisted of both positive and negative statements. Every correct response
was awarded 2 (Strongly Agree) and 1(Agree). The scoring was done in following ways:
|
Type of statement
|
Strongly Agree
|
Agree
|
Uncertain
|
Disagree
|
Strongly
Disagree
|
|
Positive
Statement
|
2
|
1
|
0
|
0
|
0
|
|
Negative
Statement
|
0
|
0
|
0
|
1
|
2
|
Data
collection procedure:
The
data was collected by distributing the self reported questionnaire after getting
due permission from the medical officer, urban PHC Vadagaon. The adults were included
in the sample. After a brief introduction on research and water sanitation, they
were allowed 25 minutes to complete the questionnaire including demographic variables.
Plan
for data analysis:
Both
descriptive and inferential statistics were used to analyze the data collected.
I.
Descriptive Statistics:
1.
Frequency and percentage distribution
were used to analyze the demographic data of adults.
2.
Mean and standard deviation to identify
the knowledge and attitude on water sanitation among the adults.
3.
Distribution of scores of knowledge
and attitude on water sanitation to be interpreted by summarizing the scores into
three categories;
·
Knowledge on water sanitation:
Inadequate < 49, moderately adequate 50-74and adequate
>75.
·
Attitude on water sanitation:
Low positive attitude <49, Positive attitude 50-74 and
High positive attitude >75.
II.
Inferential Statistics:
1.
Intra co-relation method to find the correlation between knowledge and attitude.
2.
Chi-square test used for association of knowledge and attitude with demographic
variables.
Data
analysis and interpretation:
The
analysis and interpretation of data collected from 50 adults from Vadagaon urban
community area of Belgaum, Karnataka. The data has been tabulated and analyzed according
to the objectives.
Organization
of data:
Section I: Demographic variables of the adults.
Section II: Assessment of knowledge and attitude on water sanitation
among Adults.
Section III: Correlation between knowledge and attitude on water sanitation
Section IV: Association of demographic variables with knowledge and
attitude on water sanitation among adults.
RESULTS
AND DISCUSSION:
The
results obtained from the study with the detailed discussion on the findings of
the study are interpreted from the statistical analysis and presented further. The
findings are discussed in the order of relation to the objectives of the study with
related literature.
Characteristics
of selected demographic variables of the samples.
·
30% were in the age group
of 37-44 years.
·
60% were female samples.
.
·
40% were had pucca house.
·
32% had secondary education.
·
60% belongs to Hindu religion
·
54% stayed in nuclear family.
·
46% of family’s monthly
income was Rs. 2001-5000.
·
62% used corporation water
for drinking.
·
64% were not received information
on water sanitation.
Assessment
of knowledge on water sanitation among adults:
The
mean value of knowledge on water sanitation of adults was 45.2 which fall in the
level of inadequate knowledge. This findings coincides with the findings of the
study conducted by (4), on assessment of knowledge, attitude & practices on
water handling, sanitation and defecation practices among the household adults in
rural southern India (Tamilnadu), which stated that 83.3% were unaware about water
sanitation. Based findings of the present study revealed that 54% of the people
had inadequate knowledge on water sanitation, 42% had moderately adequate knowledge
and 4% only with adequate knowledge on water sanitation. Similar kind of response
was reported by a study on the impact of a school based safe water and hygiene programme
on knowledge and practices of students and their parents in Nyanza Province, Western
Kenya. This study shows that 99% of students used to drink water from the projects
storage containers, 69% believed that water is necessary to treat before drinking,
47% of parents boiled water for drinking, 46% parents were aware about water sanitation
and 25% were having a positive attitude towards the water sanitation (5). Same trend
was observed in a report depicting that 83.2% were not aware of water sanitation,
46.6% expressed dissatisfying waste disposal in a study conducted at Epword, Harore
Zimbabwe to assess excreta and waste disposal facilities available and their impact
on water sanitation and related diseases (6). Contrast to this, 74.28 % of assessed
population had good knowledge and 57.14 % positive attitude was reported by a study
done on the assessment of knowledge, attitude and practice regarding water sanitation
and hygiene of mothers under age five children by following hand wash methodology
(7).
Assessment
of the attitude on water sanitation of adults:
The
mean value of attitude of adults on water sanitation was 36.8 with standard deviation
of 11.3%. This findings shows that people have low positive attitude towards water
sanitation. It also depicts that people are possessing false belief regarding water
sanitation. Only 25% of the population had heard or read of water fluoridation from
a representative sample of 2220 adults was interviewed the South Africa to assess
attitude towards water fluoridation. Nearly 61.9% indicated that fluoride should
be added to drinking water if it can reduce tooth decay. While 9% were not in favor
and 29% was uncertain (8).
Correlation
between knowledge and attitude of adults on water sanitation:
The
finding showed that there is a positive correlation between knowledge and attitude
on water sanitation (r = 0.143). This suggests that the adults in urban area will
develop positive attitude towards water sanitation. The findings from an educational
intervention for altering water sanitation shows that 82% of samples had poor hygiene
practices on the water sanitation; the diarrhea disease rate is 1.7% more because
of poor water sanitation. As a result of intervention the levels of knowledge about
disinfecting water and disease transmission more significantly among participants
and water quality in households improved (9,10).
Association
of demographic variables with knowledge on water sanitation among adults in urban
area:
The findings depicts that there is no association between
knowledge on water sanitation and demographic variables such as age, sex, type
of house source of drinking water, religion, family income, type of family,
education, socio economic status and health education (11,12).
Section
I: Demographic variables of adults.
Table
1: Frequency and Percentage distribution demographic variables of adults on water
sanitation n=50
|
Characteristics
|
Frequency
|
Percentage
|
|
Age
in years
|
|
|
|
18-24
|
11
|
22
|
|
24-31
|
13
|
26
|
|
31-37
|
11
|
22
|
|
37-44
|
15
|
30
|
|
Sex
|
|
|
|
Female
|
30
|
60
|
|
Male
|
20
|
40
|
|
Type
of house
|
|
|
|
Pucca
|
20
|
40
|
|
Semi
pucca
|
15
|
30
|
|
Kutcha
|
15
|
30
|
|
Education
|
|
|
|
Illiterate
|
3
|
6
|
|
Primary
|
15
|
30
|
|
Secondary
|
16
|
32
|
|
Collegiate
|
10
|
20
|
|
Above
collegiate
|
6
|
12
|
|
Religion
|
|
|
|
Hindu
|
30
|
60
|
|
Muslim
|
6
|
12
|
|
Jain
|
4
|
8
|
|
Christian
|
5
|
10
|
|
Others
|
5
|
10
|
|
Type
of family
|
|
|
|
Nuclear
|
27
|
54
|
|
Joint
|
18
|
36
|
|
Extended
|
5
|
10
|
|
Monthly
income
|
|
|
|
<2000
|
8
|
16
|
|
2001-5000
|
23
|
46
|
|
5001-7000
|
11
|
22
|
|
>7000
|
8
|
16
|
|
Source
of drinking water
|
|
|
|
Corporation
water
|
31
|
62
|
|
Public
tap
|
6
|
12
|
|
Bore
well
|
6
|
12
|
|
River
|
5
|
10
|
|
Stream
|
2
|
4
|
|
Health
education
|
|
|
|
Yes
|
18
|
32
|
|
No
|
32
|
64
|
Association
between attitude on water sanitation and demographic variables:
It
denotes that there is no significant association between attitude on water sanitation
and demographic variables such as age, sex, religion, family income, type of house,
education, sources of drinking water and health education.
Table
1 describes the demographic data of the samples regarding their age, 46% belongs
to 24-31 years and 60% were females (Fig1, 2).40% of sample lives in pucca house,
32% of people had secondary education, 60% were Hindu religion and 54% belongs to
nuclear family (Fig3, 4, 5, 6). 46% of sample’s monthly income is about Rs. 2001-5000.
62% of people were taking water from corporation and 64% of samples did not participate
in any health education programme (Fig7, 8, 9).
Fig.
1: Percentage distribution of age of adults
Fig.
2 Percentage distribution of sex of adults
Fig.
3 Percentage distribution of Type of House of adults
Fig.
4 Percentage distribution of Education of adults
Fig.
5 Percentage distribution of Religion of adults
Fig.
6 Percentage distribution of Type of Family of adults
Fig.
7 Percentage distribution of monthly income of adults
Fig.
8 Percentage distribution of Source of Drinking Water of adults
Fig.
9 Percentage distribution of Health Education of adults
Section
II: Assessment of knowledge on water sanitation and attitude towards water sanitation
among adults.
Table
2: Distribution of knowledge on water sanitation. n= 50
|
Knowledge
|
Number
|
Percentage
|
|
Inadequate
(1-49)
|
27
|
54
|
|
Moderately
Adequate (50-74)
|
21
|
42
|
|
Adequate
(>75)
|
2
|
4
|
Table
2 describes that 54% of adults have inadequate knowledge on water sanitation and
42% have moderately adequate knowledge and 4% have adequate knowledge on water sanitation
(Fig10).
Table
3: Mean and standard deviation of knowledge on water sanitation among adults. n
= 50
|
Statistics
|
Knowledge Score
|
|
Mean
|
45.2
|
|
Standard
deviation
|
16.03
|
Table
3 shows that the adults have a mean knowledge of 45.2 on water sanitation with a
standard deviation of 16.03. (Fig.11)
Table
4: Distribution of Attitude on water sanitation among adults
|
Attitude
|
Number
|
Percentage
|
|
Low
Positive Attitude (1-49)
|
40
|
80
|
|
Positive
Attitude (50-74)
|
10
|
20
|
|
High
Positive Attitude (>75)
|
-
|
-
|
Table
4 explains that 80% of adults have low positive attitude on water sanitation, 20%
have positive attitude and nobody has high positive attitude (Fig12).
Table
5: Mean and Standard Deviation of Attitude on water sanitation among adults. n
= 50
|
Statistics
|
Attitude
Score
|
|
Mean
|
36.8
|
|
Standard
Deviation
|
11.37
|
Table
5 shows that the adults have mean attitude of 36.8 on water sanitation with the
standard deviation of 11.37.
Table
7 denotes that there is no significant association between attitude on water sanitation
and demographic variables such as age, sex, religion, family income, source of drinking
water, education, type of family, type of house, health education.
CONCLUSION:
The
adults of Vodagaon urban community area had moderately adequate knowledge on water
sanitation and positive attitude towards water sanitation. These findings reveal
that the importance of giving education to the community regarding water sanitation
reduced the increased rate of morbidity and mortality of people caused by water
borne diseases. If the provisions are given on adequate knowledge and facilities
for safe water system, it will improve the health of the people (13).
The
following implications are drawn from the studies conducted which are vital concerns
to the field of nursing services, nursing education, nursing administration and
nursing research.
Nursing
Services:
The
nurse should give adequate health education in the community as well as hospital
setup on water sanitation, purposes and prevention of communicable diseases. This
practice helps the people to maintain safe water system. The main purpose should
be on the prevention of communicable diseases by educating the community people.
Nursing
Education:
The
nurses are there with the public more time than any other health professionals.
Thus, it is essential to include the chapter on water sanitation in nursing curriculum.
This supports the emerging nurses to emphasis more on water sanitation and thereby
reduces the morbidity and mortality rate of water borne diseases.
Nursing
Administration:
The
nursing administrators should focus on health promotion and prevention of diseases
through home visit, and mass health education programmes. The health workers in
the hospital as well as community should be trained regarding water sanitation for
the prevention of water borne disease diseases and its prevalence.
Nursing
Research:
Nursing
research should focus on publications of water sanitation, prevention on water borne
diseases and the effectiveness of education and training the Health workers and
family members in various aspects of water sanitation to the better health of community.
The
following studies can be under taken to strengthen the nursing research.
·
The same study can be conducted in
different regions of the state or nation so as to compare the results.
·
The same study can be conducted on
larger samples so as to generalize the results.
·
The short term training program and
its effectiveness can be analyzed through a pre and post test method.
·
Similar kind of study can be conducted
among different populations.
ACKNOWLEDGEMENTS:
The
authors gratefully acknowledge the Principal, P. D. Bharatesh College of Nursing,
Belgaum for his constant support, encouragement and providing the required facilities
for the successful completion of the study. We express our most sincere gratitude
to
the staff of P. D. Bharatesh College of Nursing, Belgaum,
for their support, guidance and valuable suggestions throughout the study. Our deep
sense of gratitude to the concerned medical officer and public of Vadagoan, Belgaum
for permitting to conduct the study. Our heartfelt thanks to Mrs. Aditi Misra, English
Professor, Bharatesh PU College, Belgaum, for editing the manuscript.
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