International Journal of Public Health and Epidemiology Research

Vol. 5(2), pp. 130-137, August, 2019. © www.premierpublishers.org. ISSN: 1406-089X

Research Article

Status of Sanitation and Hygienic Conditions in Urban

Communities in Gomoa East District, Ghana
Godfred Safo-Adu1*, Ernest Ngman – Wara2, James Awuni Azure3
1,2Department of Integrated Science Education, Faculty of Science Education, University of Education, Winneba, Ghana
3Department of Biology Education, Faculty of Science Education, University of Education, Winneba, Ghana

The study examined the sanitation and hygienic conditions in urban communities in Gomoa East
District in Central Region of Ghana. A cross sectional survey research design was adopted for
the study. Simple random sampling technique was used to select 360 inhabitants from three urban
communities. A structured questionnaire was used for data collection. Descriptive and inferential
statistics were used to analyse the data. The study revealed that tap water was the major source
of drinking water in the communities, usually purchased from water vendors and stored in closed
containers. Most inhabitants (42.5 %) used Public Ventilated Improved Pit (VIP) latrines. Some
household toilets (21.7 %) never had covers whilst the ones which had covers too were not closed
after they had been used. As a result, most toilets produced offensive odour. Unwholesome
environmental practices such as open dumping and burning of garbage were prevalent in the
study area. The result of the multiple logistic regression showed significant association between
gender and their participation in community sanitation exercise (p < 0.05) with male showing more
participation than females (OR = 0.516, C.I = 0.308 – 0.865). The state of sanitation and hygienic
conditions in the Gomoa East District was inadequate. There is the need for the District
Environmental Health and Sanitation Department to establish and enforce a more robust
environmental sanitation approach and health education to improve upon sanitary conditions in
the Gomoa East District.

Keywords: Drinking water, Hygienic conditions, Refuse disposal, Sanitation, Toilet facility

INTRODUCTION

Sanitation is one of the basic determinants of quality of life
and human development index (Sheetal & Shashikantha,
2016). It is a fundamental requirement to ensure safe
health, environment and overall wellbeing of the society.
Unless proper functional sanitation facilities are in use to
complement the right types of hygienic behaviour,
communities will be vulnerable to recurrent incidences of
water and sanitation diseases (Chariar and Sakthivel,
2011). It has been realized that improving sanitation is
known to have a significant beneficial impact on both
health in households and across communities (WHO,
2016). Sanitation and good hygiene are therefore
fundamental to human health, survival, growth and
development.
A high proportion of ill health can be traced to adverse
environmental factors such as water, soil and air pollution,
poor housing conditions, presence of animal reservoir and
insect vectors of diseases (Ekong, 2015). Environmental
sanitation is the control of all these factors in human’s
physical environment which may exercise a deleterious
effect on their physical environment, health and survival. It
could also be seen as principle and practice of effecting
healthful hygienic conditions in the environment to
promote public health and welfare, improve quality of life
and ensure a sustainable environment (Alabi, 2010). The
essential components of environmental sanitation include:
solid waste management, excreta and sewage
management, sanitary inspection of premises, adequate
portable water supply, pest and vector control, weeds and
vegetation control and management of urban drains.
*Corresponding Author: Godfred Safo-Adu, Department
of Integrated Science Education, Faculty of Science
Education, University of Education, Winneba, Ghana. E-
mail: gsafoadu@gmail.com, Tel: +233541084097

Status of Sanitation and Hygienic Conditions in Urban Communities in Gomoa East District, Ghana
Safo-Adu et al. 131
Poor sanitation and hygienic conditions play a major role
in increased burden of communicable diseases in
developing countries (Sah et al., 2013). Globally, 2.3 billion
people still do not have basic sanitary facilities such as
toilet or latrines. Of these 892 million still defecate in the
open, for example in the street gutters, behind bushes or
into open bodies of water (UNECEF & WHO, 2017). Poor
sanitation is linked to transmission of diseases such as
cholera, diarrhoea, dysentery, hepatitis A, typhoid and
poliomyelitis. UNICEF and WHO (2017) reiterated that
inadequate sanitation is estimated to cause 280 000
diarrhoeal deaths annually and it is a major factor in
several neglected tropical diseases including intestinal
worms, schistosomiasis, and trachoma. It is estimated
that around 37.7 million individuals are affected by water –
borne diseases. Annually 1.5 billion children are estimated
to die from diarrhoea diseases each year (Fonyuy, 2014).
A review of the evidence from several studies suggested
that improving personal, domestic and community hygiene
and water would provide a sustainable reduction in spread
of trachoma (Pruss & Mariotti, 2000). Diarrhoea accounts
for 11% of all deaths in poor countries. This toll could be
reduced by a key measure such as improving water
supplied, sanitary facilities and hygienic practices by 26%
(Gwatkin and Guillot, 2000). District analytical report
released by Ghana Statistical Service (2014) reveals that,
the main methods of solid waste disposal in urban
communities in the Gomoa East District are dumping in an
open space (76.3 %) and burning (31.7 %). Moreover, one
out of ten households have no sanitary facilities and
therefore resorts to the use of bush, beach and field to
dispose of human waste. A research conducted by Ekong
(2015) in Akwa Ibom State, Nigeria revealed that
unwholesome practices such as open refuse dumping and
building of pit latrine close to houses were prevalent. In
addition, about 20 % of respondents used pit latrine whilst
2 % of respondents used bucket latrine. Also, a study
conducted by Mohd and Malik (2017) revealed hat 55. 6 %
respondents never followed any method of drinking water
treatment whilst only 11 % respondents cleaned their
water storage containers daily.
It is increasingly accepted that environmental and
sanitation factors were significant determinants of health
and illness in poor countries (Shyramsundar, 2002). Nsiah
-Gyaabah (2004) estimated that about 400 million people
or one third of the population in developing countries did
not have safe drinking water and safe sanitary facilities.
Similarly, many studies in the area of environmental
sanitation, hygiene and health indicated that the lack of
sanitation and hygiene placed people at higher risk of
diarrhoea, a disease resulting from lack of safe water and
sanitation (Caincross et al., 2003, Jody et al., 1987). A
study conducted by Sah et al. (2013) on knowledge and
practice of water and sanitation application in Chandragad
VDC of Jhapa District revealed that people drinking
untreated water suffered from water related diseases such
as diarrhoea (38.46 %) followed by dysentery (9.89 %)
Status of Sanitation and Hygienic Conditions in Urban Communities in Gomoa East District, Ghana
respectively. Also, people devoid of latrine facilities
suffered from diarrhoea (40.74 %) followed by dysentery
(12.03 %) respectively.
Ghana Statistical Service (2012) revealed that only 2.8 %
of refuse was collected by local authorities and that about
20 % of the population still had no toilet facility as at 2003.
As important as knowledge of sanitation and hygienic
conditions are to healthcare planning, a search of the
available literature did not reveal any study on these two
critical determinants of health in Gomoa East District apart
from the Gomoa District analytical report released by
Ghana Statistical Service (2014), which as stated
elsewhere showed that one out of ten households has no
sanitary facilities and therefore resort the use of bush,
beach and field. For this reason this study was designed
to fill the gap. This study examined the sanitation and
hygienic conditions in urban communities in the Gomoa
East District in the Central Region of Ghana. Specifically,
the study sought to; assess the state of sanitation and
hygienic conditions in urban areas in Gomoa East District
and determine whether there is an association between
demographic characteristics of respondents and their
community sanitation exercise participation.
The following questions guided the study:
1. What is the state of sanitation and hygienic conditions
in urban communities in Gomoa East District?
2. What is the association between demographic
characteristics of respondent’s and their participation
in community sanitation exercise?
The research findings and recommendations would be
useful to the Gomoa East District assembly when
formulating or reviewing policies on water and sanitation
interventions.
MATERIALS AND METHODS
The study was conducted in three urban communities
(Potsin, Asebu and Pamadi) in Gomoa East District in the
Central Region of Ghana. The district occupies 539.69
square kilometers located in the south-eastern part of the
Central Region and has a population of 207, 071,
comprising 47.3 % males and 52.7 % females (GSS,
2012). A cross sectional survey was adopted in the study.
According to Sedgwick (2014), a across sectional survey
is generally quick, easy and cheap to perform. Also, it is
particularly suitable for estimating the prevalence of
behaviour in a population. A sample of 360 was estimated
for the study using StatCalc in Epi Info Version 7
developed by the American Center for Disease Control
and Prevention, Atlantic, Georgia, 2010.
A random sampling technique was employed to obtain 40
households from each of three urban communities. Three
people (adults male and female and one youth) were
purposively selected to form the study sample of 360. A
 Int. J. Public Health Epidemiol. Res. 132

structured questionnaire was used to collect the data. The would have been discarded if the analysis were restricted
questionnaire contained 18 items divided into four sections to complete cases, and also for imputing values of
(Sections A to D). Section A solicited the demographic correlated variables. It also increases the external and
characteristics of the respondents. Section B collected internal validity of the research findings (Vach, 1994;
data on the sources of drinking water and storage options Dodge, 1985).
in households. Section C was to assess toilet used and
hygienic conditions whilst section D sourced information
on household refuse storage and method of disposal of the RESULTS
refuse generated in the households.
The demographic distribution of respondents is presented
The instrument was reviewed by experts in the in Table 1.
Department of Integrated Science Education of University
of Education, Winneba to ensure their face and content Table 1: Demographic information of respondents (N =
validity after which they were pre- tested in urban 360)
communities in Gomoa West District with similar Variables Number of Percentages
characteristics of people in the urban communities of the respondents (%)
study area to estimate their reliabilities. The items were Male 173 48.0
subjected to item analysis in order to identify those whose Sex Female 187 52.0
removal or modification would enhance the internal 10 – 17 86 24.0
consistency of the instruments. The Statistical Package for Age 18 and 274 76.0
Services and Solution (SPSS) was used to determine the above
Cronbach alpha coefficient value for the instrument. An Student 133 37.0
alpha value of 0.87 was obtained for the questionnaire. Farmer 50 13.8
The responses of participants indicated that they Civil servant 29 8.1
understood the questions and that the wordings of the Occupation Clergy 0 0
items were appropriate. Politician 3 0.8
Trader 112 31.1
The consent of the Gomoa East District Assembly and No 33 9.2
chiefs in the area were sought before collecting the data. occupation
Respondents gave out the information voluntarily and Primary 123 34.2
were assured that whatever information they gave out Educational Secondary 179 49.2
would be treated confidentially. Five teaching assistants in status Tertiary 32 8.9
the Department of Integrated Science at University of (Highest) None 26 7.7
Education (UEW) were trained and engaged as research
assistants. A day’s training was held for the research Out of the 360 respondents who filled the questionnaire,
assistants before data collection commenced. 164 respondents (48.0%) were males and 178
respondents (52.0%) were females. Table 1 revealed that
The responses of the participants were entered into 24.0 % of respondents were between 10 – 17 years, whilst
Statistical Package for Social Sciences (SPSS) version 20 76.0 % were 18 years and above. Majority of the
for analysis. Frequencies and percentages were computed respondents were students (37.0%) and traders (31.1 %)
for categorical variables. Chi-square analysis was used to whilst few were civil servants (8.1 %) and politicians (0.8
examine associations between categorical variables. Also, %). About 14 % of the respondents were farmers whilst 9.2
multiple logistic regression was used to examine % had no occupation. About half of the respondents (49.7
multivariate associations. ‘No response’ was regarded as %) had secondary education as the highest level of
missing values and so were treated using imputation education whilst (34.2 %) had primary education as their
technique. Thus, the missing values on a variable were highest level of education. Only 8.9 % and 7.2 % had
substituted with mean of observed values for the same tertiary education and non-formal education respectively.
variable. This was done to achieve a complete data set on
which standard statistics can be applied (Rubin, 1986; The source of water supply to households including
Little and Rubin, 1987). According to Little and Rubin purification and storage option is shown in Table 2.
(1987) imputation retains data in incomplete cases that

Status of Sanitation and Hygienic Conditions in Urban Communities in Gomoa East District, Ghana
Safo-Adu et al. 133

Table 2: Water source, storage and treatment options (N = 360)

Variable Number of respondents Percentage (%)
Main source of drinking Tap water 261 72.5
water Sachet water 44 12.2
Ground water 25 6.9
Rain water 24 6.7
Stream 6 1.7
Method of water storage Closed containers 313 86.9
Open containers 31 8.6
Used directly 9 2.5
Others 7 2.0
Treat water before Yes 113 31.4
drinking No 247 68.6
Boiling 105 29.2
Water treatment option Filtration 63 17.5
Chlorination 16 4.4
None 176 48.9
Distance of source of Far from the house 87 24.0
water from house Close to the house 273 76.0

The main source of drinking water in the study area was
tap water (72.5 %), followed by sachet water (12.2 %),
borehole water (6.9 %), rainwater (6.7%) and stream (1.7
%). The main source of water was close to households.
About 69 % of respondents never treated their water
before drinking. This may be because they obtained their
water from the tap which has already been treated by
Ghana Water Company Agency. Boiling of water was the
most certain water treatment/purification method adopted
by some respondents (31.4 %) within household.
Furthermore, about 87 % of respondents stored their
drinking water in closed containers. The few participants
who stored their drinking water in open containers
constituted 8.6 %.
The toilet facility used by inhabitants in the study area is
shown in Table 3.

Table 3: Toilet facilities used in households (N= 360)

Variable Number of respondents Percentage (%)
Type of toilet Pit latrine 99 27.5
Flush 78 21.7
VIP latrine 153 42.5
Bucket latrine 4 1.1
No facility (Bush) 24 6.7
No response 2 0.5
Toilet use Public 187 52.5
Private 37 10.3
Private but shared 127 35.6
No response 6 1.7
Reason for no personal No land for toilet 27 7.5
toilet There is land but no money 231 64.2
There is no need 3 0.8
No provision was made in the 79 21.9
building 20 5.5
No response
Toilet Covered Not covered after use 156 43.3
Covered after use 90 25.0
Toilet has no lid 78 21.7
Occasionally covered 28 7.8
No response 8 2.2
Offensive Odour from Yes 244 67.8
Toilet No 101 28.0
No response 15 4.2

Status of Sanitation and Hygienic Conditions in Urban Communities in Gomoa East District, Ghana
 Int. J. Public Health Epidemiol. Res. 134

The results showed that most inhabitants (42.5 %) used participants (28 %) reported to have toilet facilities which
Ventilated Improved Pit (VIP) latrine followed by pit latrine never produce offensive odour. The participants (52.5 %)
(27.5 %). About 22 % of respondents used flush toilet who used public toilet facilities were more than participants
whilst 6.7 % defecated in bushes and open fields. Most (10.3 %) who used private toilet facilities. Moreover, about
respondents (43.3 %) never covered their toilet facilities 36 % of respondents used private but shared toilet
after use. In addition, few respondents (21.7 %) had toilet facilities. Lack of money was the main reason why
facilities with no lids. Respondents who covered their participants never had their own toilet facility.
toilets occasionally after use constituted 7.8 %.
Nonetheless, only 1 out of 4 persons covered their toilet The hygienic practices prevalent within households are
facilities after use. Also, about 68 % of the participants had presented in Table 4.
toilet facilities that produced offensive odour. Few
Table 4: Hygienic practices of respondents (N= 360)
Variable Number of respondents Percentage (%)
Washed hands after toilet Yes 335 93.0
use No 24 6.7
No response 1 0.3
Items used to wash hands Water only 33 9.2
Water and soap 309 85.8
Water and dettol 15 4.2
No response 3 0.8
Regularity of toilet wash Daily 129 35.8
Weekly 150 41.7
Monthly 19 5.3
Occasionally 37 10.3
Not cleaned before 3 0.8
No idea 15 4.2
No response 7 1.9
Items used to wash toilet Water only 93 25.8
facility Water and soap 72 20.0
Water and dettol 184 51.1
No response 11 3.1

A greater proportion of the respondents (93 %) washed
their hands after using the toilet whilst few respondents
(6.7 %) did not. Participants (85.8 %) who washed their
hands with water and soap were more than participants
(9.2 %) who washed their hands with water only.
Respondents who washed their hands with water and
dettol only constituted 4.2 %.
The distribution of waste disposal methods among
respondents based on their sex and educational level is
shown in Table 5 and 6 respectively.

Table 5: Univariate association between respondents method of refuse disposal and their sex (N=360)
Sex Method of Refuse Disposal
OB f(%) OD f(%) Bf (%) MWD f(%) Total f(%) X2 p – Value
Male 61(16.9) 65 (18.1) 5(1.3) 42 (11.7) 173 (48.0)
Female 51 (14.1) 103(28.6) 2 (0.6) 31 (8.6) 187(52.0) 12.057 0.007**
Total 112 (31.1) 168(46.7) 7 (1.9) 73(20.3) 360 (100)
OB= Open Burning; OD=Open Dumping; MWD = Municipal Waste Disposal; **Significant Association

Table 6: Univariate association between respondent’s method of refuse disposal and their educational Level
Method of waste Educational level Total
disposal Primary f(%) Secondary f(%) Tertiary f(%) None f(%)
Burning 31 (8.6) 64(17.8) 12(3.3) 15(4.2) 122(33.9)
Open Dumping 62(17.2) 69(19.1) 18(5.0) 18(5.0) 167(46.4)
Burying 0(0.0) 14 (3.9) 0(0.0) 0(0.0) 14(3.9)
MWD 15(4.2) 29(8.1) 13(3.6) 0(0.0) 57(15.8)
Total 108 (30.0) 176 (48.9) 43 (11.9) 33 (9.2) 360(100)
X2 21.081
p -Value 0.0012**
MWD = Municipal Waste Disposal **Significant Association
Status of Sanitation and Hygienic Conditions in Urban Communities in Gomoa East District, Ghana
Safo-Adu et al. 135
Chi-square test showed that there was statistically
significant association between method respondents
employed in disposing refuse and their sex (p = 0.007, p
< 0.05), and with their educational qualification (p = 0.012,
p < 0.05). A minimum of secondary education correlated
with method respondents used to dispose of their refuse.
The multiple logistic regression results of the association
between respondent’s participation in community
sanitation exercise and their demographic characteristics
is presented in Table 7.
Table 7: Multiple regression results of the association
between respondents’ participation in community
sanitation and their demographic characteristics
Variables
Sex Education Constant
(Male/Female) (H/L)
B - 0.662 0.467 - 1.311
S.E 0.264 0.264 .414
Wald 6.312 3.130 10.054
p– 0.012* 0.077 0.002
Value 0.516 1.595 0.269
OR 0.308 – 0.951 – NA
95 % 0.865 2.675
CI
There was statistically significant association between
gender and their participation in community sanitation
exercise (B = 0.662, Wald test = 6.312, p = 0.012, p <
0.05).
DISCUSSION
This study examined sanitation and hygienic conditions in
urban communities in Gomoa East District in Central
Region of Ghana. The results on the demographic
information of respondents revealed that the number of
respondent females were more than the number of
respondent’s males by 2%. Also, a greater proportion of
respondents (76 %) were 18 years and above whilst few
respondents (24 %) were between 10 – 17 years. About
half of the respondents (49.7 %) had secondary education
as their highest level of education. The major source of
water for drinking in the study area was tap water (72.5 %)
usually purchased from water vendors. This is in par with
the study conducted by Ekong (2015), who reported that
77.9 % of respondents used tap water as their major
source of water for drinking at Akwa Ibom state in Nigeria.
This is also in contrast to a study in Benin where the source
of water for drinking was borehole (50.4 %) and a marginal
22 % for tap water (Isah and Okojie, 2007). About one out
of every 15 persons used borehole water and rain water
as a source of drinking water. A greater proportion of
inhabitants (76 %) revealed that the source of water was
closed to their households whilst few (24 %) responded
otherwise. Most respondents (68.6 %) never treated their
water before drinking while the few respondents (31.4 %)
Status of Sanitation and Hygienic Conditions in Urban Communities in Gomoa East District, Ghana
who treated their water before drinking by boiling (29.3 %),
filtration (17.5 %) and chlorination (4.3 %). Nonetheless, a
high proportion of respondents (86.9 %) stored their water
in closed containers while few respondents (8.6 %) stored
their water in open containers. The participants who stored
their water in open containers and never treated their water
before drinking might be increasing their risk of exposure
to waterborne diseases (Mohd & Malik, 2017).
The study showed that majority of the respondents (42.5
%) used Ventilated Improved Pit (VIP) latrine. This implies
that respondents in the study area used improved toilet
facilities (UNICEF & WHO, 2006). This finding is in
contrast to the study conducted by Ekong (2015), who
reported that majority of respondents (68.6 %) used flush
toilets in Akwa Ibom state in Nigeria. Most respondents
(52.5 %) used public toilet and private but shared toilets
(35.6 %) whilst few respondents (10.3 %) used private
toilets. One out of every fifteen persons defecated in open
fields and bushes whilst one out of every four persons
used pit latrine. Again, this finding is in contrast to the
finding of the Ghana Statistical Service (2014) which
revealed that one out of ten households has no sanitary
facilities and therefore resorts to the use of bush, beach
and field to dispose of human waste. Major constraints to
households not having toilets facility were: lack of money
and unavailability of land. The results showed that about
43 % of respondents never covered their toilet facilities
after use while few respondents (21.7 %) had toilets
facilities with no lids. As a result, most toilet facilities
produced produce offensive odour in the study area.
Furthermore, respondents (41.7 %) who washed their
toilet facilities weekly were more than respondents (35.8
%) who washed their toilet facilities daily and they did so
with water and soap.
Few respondents (0.8 %) never washed their toilet
facilities at all. Again, this is an unhygienic practice and
could increase the risk of participant’s exposure to
diseases. Nonetheless, about 5 and 10 % of respondents
washed their toilet facilities occasionally and monthly
respectively. Respondents who washed their toilet
facilities with water only constituted 20 %. Also, most
respondents washed their hands after using toilet facilities
with water and soap. This was a sound hygienic practice
as it would help reduce over 40 % risk of diarrhoea and
typhoid exposure (Mold & Malik, 2017).
The major method of refuse disposal employed by
households was open dumping (49.6 %), followed by open
burning (33 %). Few respondents disposed of their refuse
by burying (2.1 %) and disposal into municipal
containment. Open dumping and burning of solid waste
could have adverse health effect on humans and the
environment as a whole. This is in par with the study
conducted by Duru et al. (2017) in Orlu, Imo State in
Nigeria where the commonest solid waste disposal
practices among respondents was open dumping (49.8
%). The result of the multiple logistic regressions (table 7)

showed statistically significant association between
gender and their participation in community sanitation
exercise (B = 0.662, Wald test = 6.312 p = 0.012, p <
0.05). Male participation in community sanitation exercise
was 0.5 times higher than that of females (OR = 0.516, C.
I = 0.308 – 0.865). There was however no statistically
significant association between the respondents’ level of
education and their participation in community sanitation
exercise (B = 0.467, Wald test = 3.130, p = 0.077, p >
0.05). Also, participation of persons with higher
educational qualification in community sanitation exercise
was 1.5 times higher than persons with lower level
educational qualification.
CONCLUSION AND RECOMMENDATIONS
The study showed that inhabitants in urban communities
in the Gomoa East District in the Central Region of Ghana
have environmental sanitation challenges. Respondents
disposed of their solid waste through unwholesome means
such as open dumping and open burning. Male
respondents adopted safer and environmental friendly
refuse disposal methods than females. Also, respondents
who had secondary qualification (highest) adopted safe
refuse disposal methods than those with primary and
tertiary qualifications. The major source of drinking water
was tap water usually purchased from water vendors
closed to households. Majority of the populace do not treat
their water before drinking even though they were stored
in closed containers. The study revealed that most
inhabitants used public toilets which were Ventilated
Improved Pit (VIP) latrines. One out of every fifteen
persons defecated in open fields and bushes whilst one
out of every four persons used pit latrine. Some household
toilets never had covers whilst the ones which have covers
too were not closed after they had been used, as a result
they produced offensive odour in the study area. Lack of
money was the major constraint to households not having
toilet facilities. It can be concluded that the state of
sanitation and hygienic conditions in the study area was
inadequate.
It is recommended that:
1. The District Environmental Health and sanitation
Department in collaboration with Environmental
Protection Agency should establish and enforce a
more robust environmental sanitation approach and
health education to improve upon sanitary conditions
in the Gomoa East District.
2. The District Environmental Health Sanitation
Department should liaise with the District Works
Department (DWD) to educate inhabitants in the
Gomoa East District on the need to disinfects their
water before drinking, have proper sanitary facilities,
clean their toilets, provide covers for their toilets, close
toilets after use, desist from open burning and
indiscriminate dumping of refuse at unauthorized
areas
Status of Sanitation and Hygienic Conditions in Urban Communities in Gomoa East District, Ghana
Int. J. Public Health Epidemiol. Res. 136
3. The local government should continually review and
update existing legislation with respect to urban
planning, building standards, infrastructure, and
environmental regulations in order to make them more
realistic, attainable, and compactible with local
conditions.
ACKNOWLEDGEMENTS
We would like to thank the 2017 National Service
personnel in the Department of Integrated Science
Education of University of Education, Winneba who helped
in the data collection during the study.
REFERENCES
Alaba JO. (2010). Environmental Sanitation in Nigeria.
Retrieved from http//Nigeriamasterweb.com.
Cairncross S. (2002). Sanitation in the developing world.
Current status and future solutions. International
Journal of Environmental Health Research. 13(1): 23 –
31.
Chariar VM, Sakthivel RS. (2011). Ecological sanitation
practitioner’s handbook, New Delhi.
Dodge Y. (1985). Analysis experiments with missing data.
New York. Willey series in probability and mathematical
statistics.
Duru CB, Iwu AC, Diwe KC, Uwakwe, KA, Merenu IA,
Madubueze UC, Okedo- Alex IN, Ndukwu EU, Ohale I,
Nwaigbo E. (2017). Environmental Sanitation
Practices: A case study of Solid Waste Management in
semi-urban communities in Orlu, Imo State, Nigeria.
Occupational Diseases and Environmental Medicine.
5(1):88 – 105
Ekong IE. (2015). An assessment of environmental
sanitation in an urban community in Southern Nigeria.
African Journal of Environmental Science and
Technology. 9(7): 592 – 599.
Fonyuy B E. (2014). The knowledge of hygiene and
sanitation practices in the collection, treatment and
preservation of portable water in Santa North West
Cameroon. Journal of Biosafety and Health Education.
2(2): 1 – 6.
Ghana Statistics Service. (2012). Population and Housing
Census Report.
Ghana Statistics Service. (2014). District analytical report
on Population and Housing Census.
Gwatkin DR, Guillot M. (2000). The burden of diseases
among the global poor: Current situation, future trends
and implication for strategy. Washington DC.
Isah EC, Okojie OH. (2007). Environmental sanitation in
urban community in Benin in city, Edo state, Nigeria.
Postgrad Medical Journal. 14 (1): 12 - 55
Jody MH, Harold R H, Audrey N, Tomera R. (1987).
Analysis and synthesis of research environmental
behaviour on responsible: Meta – analysis. The Journal
of Environmental Education. 18(2): 1 – 8
Safo-Adu et al. 137
Little RJA, Rubin DB. (1989). Statistical analysis of missing
data. New York. John Willey and Sons.
Mohd G, Malik I. (2017). Sanitation and hygiene
knowledge, attitude and practices in urban setting of
Bangalore: Across sectional study. Journal of
Community Medicine and Health Education. 7(4): 540
– 545
Mohd G. Malik I. (2017). Sanitation and hygiene
knowledge, attitude and practices in urban setting of
Bangalore: Across sectional study. Journal of
Community Medicine and Health Education. 7(4): 540
– 545
Nsiah-Gyaaba K. (2004). Urbanization process –
environmental and health effects in Africa. Sunyani,
Ghana:
Pruce A, Mariotti SP. (2000). Preventing Trachoma
through Environmental Sanitation. A review of
Evidence Base. Bull. 78, 58 – 66
Rubin DB. (1987). Multiple imputation for non-response in
surveys. New York. John Willey and Sons.
Sah RB, Baral DD, Ghimire A, Pokharel PK. (2013).
Knowledge and practice of water and sanitation
application in Chandragadhi VDC of Jihapa District.
Health Renaissance, 11(3):241 – 245.
Sedgwick P. (2014). Prospective cohort studies:
advantages and disadvantages. BMJ. 348 (1): 2276 –
2276.
Sheetal MP. Shashikantha S.K. (2016). A cross study on
the coverage and utilization of sanitary latrine in rural
field practice area of a tertiary care hospital in Southern
Kernataka, India. International Journal community
Medicine. 3(1), 1540 – 1543.
Status of Sanitation and Hygienic Conditions in Urban Communities in Gomoa East District, Ghana
Shyamsunder P. (2002). Poverty – Environmental
Indicators. World Bank Environmental Departmental
Economic Series Paper No. 85.
UNICEF, WHO (2006). Core questions on drinking water
and sanitation for households. Geneva, Switzerland.
UNICEF, WHO (2017). Progress on Drinking Water,
Sanitation and Hygiene Report, New York
Vach W. (1994). Logistic regression with missing values in
covariates. New York. Springer-Verlag.
WHO. (2016). World Health Statistics: Monitoring Health
for sustainable Development Goals, Geneva.
Accepted 28 June 2019
Citation: Safo-Adu G, Ngman–Wara E, Azure JA (2019).
Status of Sanitation and Hygienic Conditions in Urban
Communities in Gomoa East District, Ghana. International
Journal of Public Health and Epidemiology Research, 5(2):
108-115.
Copyright: © 2019 Safo-Adu et al. This is an open-access
article distributed under the terms of the Creative
Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium,
provided the original author and source are cited.