PDF(Pubmed)
Abstract：
Open defecation continuously remains a major global sanitation challenge, contributing to an estimated 1.6 million deaths per year. Ghana ranks second in Africa for open defecation and had the fourth-lowest sanitation coverage in 2010. Evidence indicates that about 32% of the rural Ghanaian population still practice open defecation due to lack of access to basic sanitation facilities, drifting the country from achieving universal access to sanitation by 2030. Women, particularly those in rural areas, are disproportionately affected by open defecation, facing heightened health risks, harassment, and a loss of dignity. Even though previous studies on open defecation in Ghana exist, they lack national representation and neglect women in rural residents who are disproportionally affected by the repercussions of open defecation. Examining that rural women will contribute to heightening their own vulnerability to health risks by practising open defecation is essential to bridging the literature gap on open defecation practices among rural women. The study investigated determinants of open defecation among rural women in Ghana using data from the female files of the 2003, 2008 and 2014 Demographic and Health Surveys (DHS). A total of 4,284 rural women with complete information on variables of interest were included in the study. The outcome variable was \'open defecation\', whilst 14 key explanatory variables (e.g., age, education, wealth status, among others) were used. Two logistic regression models were built, and the outputs were reported in odds ratio. Descriptively, 42 in every 100 women aged 15 to 49 practiced open defecation (n = 1811, 95% CI = 49-52). Open defecation (OD) significantly correlated with educational attainment, wealth status, religion, access to mass media, partner\'s education, and zone of residence. The likelihood of practicing open defecation reduced among those with formal education [aOR = 0.69, CI = 0.56-0.85], those whose partners had formal education [aOR = 0.64, CI = 0.52-0.80], women in the rich wealth quintile [aOR = 0.12, CI = 0.07-0.20], the traditionalist [aOR = 0.33, CI = 0.19-0.57], and those who had access to mass media [aOR = 0.70, CI = 0.57-0.85]. Residents in the Savannah zone had higher odds of openly defecating [aOR = 21.06, CI = 15.97-27.77]. The prevalence of open defecation is disproportionately pro-poor, which indicates that impoverished rural women are more likely to perform it. Public health initiatives should aim to close the rich-poor divide in OD practice among rural women.
摘要：
露天排便仍然是全球卫生面临的主要挑战，估计每年有160万人死亡。加纳的露天排便在非洲排名第二，2010年的卫生覆盖率排名第四。证据表明，由于缺乏基本的卫生设施，加纳农村人口中约有32％仍在露天排便，使该国无法在2030年前实现普遍获得卫生设施。女人,特别是那些在农村地区，不成比例地受到开放式排便的影响，面临更高的健康风险，骚扰,失去尊严。尽管以前在加纳有关于露天排便的研究，他们缺乏国家代表性，忽视了农村居民中受到露天排便影响的妇女。审查农村妇女通过露天排便将有助于增加自己对健康风险的脆弱性，对于弥合农村妇女露天排便做法的文献差距至关重要。该研究使用来自2003年，2008年和2014年人口与健康调查（DHS）女性档案的数据，调查了加纳农村妇女排便的决定因素。共有4,284名农村妇女拥有有关感兴趣变量的完整信息。结果变量为“开放性排便”，而14个关键解释变量(例如，年龄,教育,财富地位,其中一些)被使用。建立了两个logistic回归模型，输出以比值比报告。描述性的,每100名年龄在15至49岁之间的女性中有42人进行了开放式排便（n=1811，95％CI=49-52）。开放式排便(OD)与受教育程度显著相关，财富地位,宗教,进入大众媒体，合作伙伴的教育，和居住区。在受过正规教育的人群中，进行开放式排便的可能性降低[aOR=0.69，CI=0.56-0.85]，伴侣接受过正规教育的人[aOR=0.64，CI=0.52-0.80]，富裕财富五分之一的女性[aOR=0.12，CI=0.07-0.20]，传统主义者[AOR=0.33，CI=0.19-0.57]，和那些接触大众媒体的人[aOR=0.70，CI=0.57-0.85]。萨凡纳地区的居民公开排便的可能性更高[aOR=21.06，CI=15.97-27.77]。露天排便的患病率不成比例地有利于穷人，这表明贫困的农村妇女更有可能做到这一点。公共卫生举措应旨在缩小农村妇女在OD实践中的贫富差距。
