02075nas a2200277   4500000000100000008004100001653000900042653001500051653001200066653001300078653002300091653001300114653002200127653001000149100001400159700001600173700001200189700001300201700001400214245015600228856004300384300000800427490000700435520134100442022001401783       2017                            d10aNTDs10aSanitation10aHygiene10aTanzania10aWaterborne disease10aDiarrhea10aRural communities10awater1 aKamara JK1 aGalukande M1 aMaeda F1 aLuboga S1 aRenzaho A00aUnderstanding the Challenges of Improving Sanitation and Hygiene Outcomes in a Community Based Intervention: A Cross-Sectional Study in Rural Tanzania.  uhttp://www.mdpi.com/1660-4601/14/6/602  a6020 v143 a<p>Good sanitation and clean water are basic human rights yet they remain elusive to many rural communities in Sub-Saharan Africa (SSA). We carried out a cross sectional study to examine the impact of a four-year intervention aimed at improving access to water and sanitation and reducing waterborne disease, especially diarrhea in children under five years old. The study was carried out in April and May 2015 in Busangi, Chela and Ntobo wards of Kahama District of Tanzania. The interventions included education campaigns and improved water supply, and sanitation. The percentage of households (HHs) with access to water within 30 min increased from 19.2 to 48.9 and 17.6 to 27.3 in the wet and dry seasons, respectively. The percentage of HHs with hand washing facilities at the latrine increased from 0% to 13.2%. However, the incidence of diarrhea among children under five years increased over the intervention period, RR 2.91 95% CI 2.71-3.11, p &lt; 0.0001. Availability of water alone may not influence the incidence of waterborne diseases. Factors such as water storage and usage, safe excreta disposal and other hygiene practices are critical for interventions negating the spread of water borne diseases. A model that articulates the extent to which these factors are helpful for such interventions should be explored.</p>
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