ABSTRACT:

Background: Access to improved sanitation, adherence to good hygienic practices and adequate supply of safe water, are very crucial factors for the health and wellbeing of people within the household and to the entire community. Household sanitation and hygiene promotion has largely been done by community health workers in most places in Tanzania and worldwide, especially in rural and marginalized areas. Despite the presence of community health workers in Tanzania, WASH-sensitive indicators such as diarrhea, stunted growth and typhoid still prevail. However, little has been done on assessing their knowledge, attitude and practices regarding household sanitation and hygiene. So this study aimed to assess knowledge, attitude and practices among community health workers on household sanitation and hygiene at Mbarali and Mbeya rural districts in Mbeya region, south-west highlands of Tanzania.

Methods: The study used descriptive cross-sectional design. The sample size was estimated by using Yamane formula for calculating sample size. Data for the study were collected for one month, by two well trained research assistants and the principal investigator, whereby questionnaire guide and observation checklist were used as data collection methods. Data were entered in STATA version 15 databases by two research assistants, and then data were cleaned, validated and analyzed. Results were presented in charts and tables.

Results: A total of 391CHWs were recruited. Out of 391CHWs, 184 (47.1%) had adequate knowledge regarding household sanitation and hygiene, while 207(52.9%) CHWs had inadequate knowledge. 74.4% of the CHWs had positive attitude towards, whilst 25.6% of the participants had negative attitude regarding household sanitation and hygiene. A total of 128 (33.0%) had good practices, while (67.1%) of the participants had poor practices regarding household sanitation and hygiene. High education level and short period of time from the last training on sanitation and hygiene was found to be associated with adequate knowledge (p=0012) and (p=0.008) respectively. Female partcipants was found to be have good practices (p=0.015) than their male counterparts. Observation checklist revealed that, of the total 391CHWs, 206(52.7%) CHWs did not receive the needed cooperation from the community members, though they had all necessary requirements for house to house visit. On house to house visit only 28 CHWs had all necessary equipments. None of the CHWs had allowance at the end of visit.

Conclusion: The findings of this study underline the need to re- checking CHWs programs to match their needs as per their roles so as to strengthen the knowledge, attitude and practices hence ensuring efficiency in their provision of primary health services and promotion of improvement in household sanitation and hygiene particulary in household sanitation and hygiene.