The University of Zambia

School of Public Health

Environmental Health Department

Dissertation

AN ASSESSMENT OF SANITATION CONDITIONS IN HOSTELS AT

UNZA-RIDGEWAY CAMPUS AND HOW THEY AFFECT UTILIZATION
OF SANITATION FACILITIES BY UNDERGRADUATE STUDENTS.

By

GEOFFREY MUTONDO SANDANDO

Computer No. 2017003752

Course Code: EHS 5164

Submitted In Partial Fulfillment of the Requirements for the Award of the Bachelors of
Science Degree in Environmental Health
(BSc. EH)

2022
DECLARATION
I SANDANDO MUTONDO GEOFFREY do hereby declare that this work being submitted to
the University of Zambia in partial fulfillment for the award of bachelors’ degree in
Environmental Health in the 2021-2022 academic year to my best of knowledge has not been
submitted either wholly or partially by anyone for any other degree.

DEDICATION

I would like to dedicate this study to my family, my daughter Keke, friends and all the higher
learning institution in Zambia, especially Unza.

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ACKNOWLEDGEMENT

First and foremost, thanks and praises to God, the almighty, for his relentless showers of
blessings throughout the period of my study and for successfully completing this research report.

I would like to express my deep and sincere gratitude to my lecturer and supervisor, Ms. Mubita,
firstly, for helping me and my classmates to learn how to analyze research data using STATA.
Secondly, for the guidance she rendered in the development of this research.

I am extremely grateful to the Dean of Student Unza-Rudgeway campus for giving me an

opportunity to conduct this research at the institution.

I cannot express enough thanks to my classmates, for their support and encouragement during
my whole study period and in the development of this work. I offer my sincere appreciation for
giving me moral and material support. Your commitment and positive attitude towards school
work is utterly good and quite exemplary. The completion of this report could have not been
accomplished without your support.

Lastly, special thanks goes to my parents, for their love, prayers, care and sacrifice for educating
and preparing me for the future. To my brothers and sisters, your support and encouragement
when the times got rough is much appreciated and duly noted. My heartfelt thanks.

Table of contents

ii
DECLARATION....................................................................................................................................i
DEDICATION.......................................................................................................................................i
ACKNOWLEDGEMENTS...................................................................................................................ii
Table of contents..................................................................................................................................iii
CHAPTER ONE....................................................................................................................................1
1.0 INTRODUCTION...........................................................................................................................1
1.1 Background information..............................................................................................................1
1.2 Statement of the problem.............................................................................................................2
1.3 Justification of study....................................................................................................................3
1.4 RESERCH QUESTION AND OBJECTIVES.................................................................................4
1.4.1Research questions....................................................................................................................4
1.4.2 General objectives…………………………………………………………………………………………………………………4

1.4.3 Specific objectives....................................................................................................................4

1.4.4 Definition of terms........................................................................................................................4
CHAPTER TWO...................................................................................................................................5
2.0 LITERATURE REVIEW................................................................................................................5
2.1 Introduction…………..……………………………………………………………………………………………………………….5
2.2 Similar studies………...............................................................................................................…..5
2.3 The 2030 vision for wash.............................................................................................................5
2.4 Sanitation adequacy, cleanliness and privacy..............................................................................7
2.4.1 Sanitation adequacy and privacy ……………………………………………………………………………….7
2.4.2 Cleanliness …………………………………………………………………………………………………………………….7
2.5 Constraints to successful sanitation………………..……………………………………………………………………….7

2.6 Health impact of sanitation………………………………………………………………………………………………………8

2.6.1 Increased health issues………………………………………………………………………………………………….………8

2.6.2 Increase in diseases……………………………………………………………………………………………………….………8

2.6.3 Decease schooling…...................................................................................................................9

2.6.4 Downturn in economic opportunity………………………………………………………………………………………9

2.6.5 Inadequate WASH affects children’s health, well-being and cognitive performance……………..9

2.7 Benefit of sanitation…………………………………………………………………………………………………………………9

2.8 The role of the health inspector in improving sanitation………………………………………………………..10

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CHAPTER THREE.............................................................................................................................11
3.0 METHODOLOGY........................................................................................................................11
3.1 study design...............................................................................................................................11
3.2 Study Variables....................................................................................................................11
3.3 Study area and setting................................................................................................................12
3.4 Target population.......................................................................................................................13
3.4.1 Study population ……………………………………………………………………………………………………..13
3.4.2 Inclusion and exclusion criteria …………………………………………………………………………………………13
3.5 Sample size................................................................................................................................12
3.6 Sampling procedure...................................................................................................................13
3.7 Data collection tools and techniques..........................................................................................15
3.7.1 Plans for data processing and analysis....................................................................................15
3.7.2 Pre-testing of data collection tools..........................................................................................15
3.8 Ethical considerations................................................................................................................16
CHAPTER FOUR...............................................................................................................................16
4.0 RESULTS......................................................................................................................................16
4.1 Demographic characteristics of respondents..............................................................................16
4.1.1 Number of students per room.................................................................................................17
4.2 Student perception of sanitation facilities .................................................................................18
4.3 students knowledge on importance of sanitation........................................................................18
4.4 Association between the independent variables and the dependent variable..............................19
5.0 DISCUSSION OF THE FINDINGS..............................................................................................19
5.1 Demographic characteristics......................................................................................................20
5.2 Student perception of sanitation facilities..................................................................................20
5.3 students knowledge on importance of sanitation........................................................................20
5.4 Association between the independent variables and the dependent variable……………………….20

5.5 Study limitations........................................................................................................................21

6.0 Conclusion.....................................................................................................................................21
6.1 Recommendations.........................................................................................................................21
REFERENCES....................................................................................................................................22
APPENDICES.....................................................................................................................................23

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Annex 1: Standards of sanitation in Zambia....................................................................................24
Annex 2: Questionnaire...................................................................................................................25

v
CHAPTER ONE

1. INTRODUCTION
1.1. Background

Sanitation and hygiene are critical to health, survival, and development. Many countries face
challenges in providing adequate sanitation for their entire populations, leaving people at risk for
diseases related to water, sanitation, and hygiene. Throughout the world, an estimated 1.7 billion
people lack basic sanitation (CDC, 2022).

Cultural differences influence the way people generally perceive sanitation. For this reason, the
concept of sanitation is difficult to define (Minh and Hung, 2011). WHO defines sanitation as the
provision of facilities and services for the safe disposal of human feces and urine (WHO and
UNICEF, 2010).

The United Nations Sustainable Development goal (SDG) is for everyone to have adequate and
equitable sanitation and basic hygiene for all by the year 2030.

According to the World Health Organization and UNICEF, nearly one third of schools around
the world still lack basic water, sanitation, and hygiene services (WASH). For girls, appropriate
WASH facilities are especially important in ensuring their safe and healthy participation in
school and has been associated with improved girl’s attendance.

Higher learning institutions are equally not spared from the intricacy of poor sanitation. One
important function of those in charge of the environment on the campus which has been
neglected at most universities and colleges is general sanitation. This oversight has been well
illustrated by Dr. James Frederick Rogers in his book "Safety in Sanitation in Institutions of
Higher Education”. According to a study which was done by Nina Hartmuth at Adama
University, Ethiopia, about the hygiene behavior of students in relation to sanitation, it was
found that 86% of the female respondents thought the numbers of toilets are not sufficient for the
students whereas only 45% of the male respondents indicated that the number of toilets available
are not sufficient. It was also found that the ratio of toilets to the number of students is 1:20 for
female dormitories, 1:15 for male dormitories. The study also indicated that most of the
interviewed students were not satisfied with the existing toilets. Poor Sanitation in higher

1
learning institutions remains a matter of great public health concern, particularly for Zambian
universities.

Lack of adequate and substantial literature on the perceived sanitation conditions in higher
learning institutions in Zambia shows that few studies have been done in this area. Most studies
done in Zambia focus on primary and secondary schools. This leaves behind a great gap and an
interesting area of study.

This study will assess the factors which affect utilization of sanitation facilities in resident halls
(hostels) by undergraduate students at UNZA-ridgeway campus. It will assess whether or not
such factors affect how students use the provided sanitation facilities for defecation and
urination.

The global effort to achieve sanitation and water for all by 2030 is extending beyond the
household to include institutional settings, such as schools, healthcare facilities and workplaces.
This has been reinforced by global education for all strategies highlighting how water, sanitation
and hygiene (WASH) in schools improves access to education and learning outcomes,
particularly for girls, by providing a safe, inclusive and equitable learning environment for all
(WHO,2022).

1.2. Problem statement

According to Wolf and Guy, a key justification for investment in water, sanitation and hygiene
(WASH) is to reduce the burden of diseases transmitted by the faecal-oral route, most notably
diarrhea (Wolf and Guy, 2011). Inadequate sanitation is a major global driver of disease and loss
of life, contributing to 432,000 diarrheal deaths annually (WHO 2018). Globally 3.6 billion people
lack access to safely managed sanitation services (The World Bank, 2021). Access to good
sanitation facilities has been a perennial challenge in many universities including University of
Zambia-Ridgeway campus where poor sanitation and hygiene has long been recognized as a
major Public Health concern. Speaking after a tour of some UNZA hostels, Minister of Water,
Development, Sanitation, and Environmental Protection who is also a Munali Member of
Parliament, Hon. Mike Mposha, said the water and sanitation situation at the University was
worrisome and that it needed urgent attention (UNZA News and Events, 2022). This challenge is

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perpetual owing to the fact that the WASH concern has been greatly marginalized and people
have argued that universities are higher learning institutions which enroll adults capable of
making good and sound decisions with regards to water, sanitation and hygiene. Maintaining
good sanitation is however, a matter of behavior and a sense of responsibility students have
towards public facilities.

Improved hygiene and sanitation practices in educational settings are effective for the prevention
of infections, controlling the transmission of pathogens, and promoting good health. The United
Nation’s Sustainable Development Goals include the target of ensuring access to water and
sanitation and hygiene (WASH) for all; very few studies have assessed comprehensive university
WASH service in Zambia. To the researchers knowledge, many studies have been conducted on
water, sanitation and hygiene (WASH), unfortunately, the focus is mostly on primary and
secondary schools with a concentration to understand the perceived conditions of sanitation
facilities and sanitary challenges, as a result, not much is known about the perceived sanitation
conditions in universities and how they affects students utilization of sanitation facilities.
Therefore, this study will assess the sanitation conditions at UNZA-ridgeway campus and how
they affect student’s utilization of the sanitation facilities.

1.3. Justification of the study

Most literature available on sanitation in learning institutions is on studies done in primary and
secondary schools. Few information is available from previous studies which explain sanitation
conditions in universities and how they affects students’ utilization of sanitation facilities.

The purpose of this study is to assess sanitation conditions at UNZA-ridgeway campus and how
they affects student’s utilization of sanitation facilities.

The findings of this study will be helpful in establishing the state of sanitation conditions at
UNZA-ridgeway campus, which of the following variables; adequacy, privacy and cleanliness
has been overlooked and marginalized and what measures need to be intensified to mitigate the
perceived sanitation challenges.

To the researchers’ knowledge, not much information is available on this subject. The findings of
this study will therefore add information to the body of knowledge on the sanitation status quo at
UNZA-ridgeway campus and also pave way for further studies.
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Furthermore, the findings of this study could also be used in policy making with regards to
sanitation in higher learning institutions and provide an opportunity for interested stakeholders
who wish to support and advocate for good sanitation in higher learning institutions.

1.4 Research Question And Objectives

1.4.1 Research question

What factors affect student’s utilization of sanitation facilities in hostels at Unza-Ridgeway

Campus?

1.4.2 General objective

To assess sanitation conditions at UNZA-Ridgeway campus and how it affect student’s

utilization of sanitation facilities.

1.4.3 Specific objectives

1. To assess the adequacy of sanitation facilities in hostels and how it affects utilization of
sanitation facilities.
2. To ascertain the privacy of sanitation facilities in hostels and how it affects utilization of
sanitation facilities.
3. To assess the cleanliness of sanitation facilities in hostels and how it affects utilization of
sanitation facilities.
1.4.4 Definition of terms

Hygiene: Conditions or practices conducive to maintaining health and preventing disease,

especially through cleanliness

Sanitation: the provision of facilities and services for the safe disposal of human urine and
faeces- maintenance of hygienic conditions through services such as garbage collection and
waste water disposal.

Sanitary: concerned with keeping things clean and healthy especially by providing a sewage
system and a clean water supply

Sanitary facilities: includes wash basin, sink, bath shower, urinal or water closet.

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Privacy: the state of being alone, or the right to keep one's personal matters and relationships
secret.
Cleanliness: refers to the healthy practice of keeping yourself and your environment free of dirt,
germs, dust, mud, and unwanted matter.
Adequacy: the fact of being enough or satisfactory for a particular purpose.

CHAPTER TWO

2.0 LITERATURE REVIEW

2.1 Introduction

Worldwide, one in three people do not have access to safe drinking water, two out of five people
do not have a basic hand washing facility with soap and water, and more than 673 million people
still practice open defecation (UN, 2021). Sanitation is access to and use of excreta and
wastewater facilities and services that ensure privacy and dignity, ensuring a clean and healthy
living environment for all. Improved sanitation facility hygienically separates human excreta
from human contact.

This chapter will review the key concepts related to this study. It will particularly discuss studies
related to sanitation in learning institutions, determinants of good sanitation, utilization of
sanitation facilities and also review the various factors that can act as barriers to utilization of
sanitation facilities. It will further discuss the benefits of good sanitation and the role of health
sectors in improving sanitation.

2.2 Similar studies

According to a study by Grossi et al (2016), access to sanitation facilities is hindered by poor

building materials, lack of privacy, insufficient maintenance and cleanliness, poor illumination
and cold temperatures. Avoidance of toilet is common when sanitation facilities are reported to
be dirty, overcrowded and smelly.

Maria (2010) in her study in a school in South Africa reported that students could not
use toilets since they were in a bad state. Some of the toilets had no doors to provide privacy

5
while the remaining ones had badly rusted corrugated iron sheets and broken doors thus
passersby could see into the toilets.

Priscilla and Prof Paul, (2014) in their paper alluded to the fact that, the adequacy of sanitary
facilities is a critical issue in a girl’s life. Studies have shown that most aspects of a girl’s life are
affected by lack of sanitary facilities thus lowering the girl’s esteem and confidence.

Korima Begum et al (2021) conducted a study in a public university named Shahjalal University
of Science and Technology located in a divisional city of Bangladesh based on the Integrated
Behavioral Model for Water, Sanitation, and Hygiene (IBM-WASH). The results of this study
suggest that despite the rapid expansion of on-campus university education, hygiene practices in
public universities are remarkably poor due to a variety of dynamic and interconnected factors
situated in different (individual, contextual, socio-psychological) levels.

Wolf and Guy, (2011) made mention in their book that, a key justification for investment in
water, sanitation and hygiene (WASH) is to reduce the burden of diseases transmitted by the
fecal-oral route, most notably diarrhea.

2.3 The 2030 vision for WASH in school

The 2030 Agenda for Sustainable Development was agreed by all 193 Member States of the
United Nations (UN) General Assembly, which resolved to end poverty in all its forms, take bold
and transformative steps to shift the world onto a sustainable and resilient path, and ensure that
no one will be left behind. The 2030 Agenda established 17 SDGs and 169 global targets
addressing the social, economic and environmental dimensions of sustainable development in an
integrated manner.

SDG6 aims to ‘ensure available and sustainable management of water and sanitation for all’ and
includes targets for universal access to drinking water, sanitation and hygiene for all by 2030.
The term ‘universal’ implies all settings, including households, schools, healthcare facilities,
workplaces and public places, and ‘for all’ implies services that are suitable for men, women,
girls and boys of all ages, including people living with disabilities.

SDG4 aims to ‘ensure inclusive and quality education for all and promote lifelong learning’ and
includes targets for access to pre-primary, primary and secondary education, improved learning

6
outcomes and effective learning environments for all, including, among other things, providing
access to basic drinking water, sanitation and hygiene services in all schools.

2.4 Sanitation adequacy, cleanliness and privacy

In several countries, especially in middle-income economies, the national requirements and

international standards are not met with regard to water waste disposal, as
some schools may not be connected to a sewage system and do not provide any other safe
collection method (Adams et al., 2009). Surveys also report inadequate numbers, locations and
functionality of sanitation facilities and issues with overcrowding, sometimes as a consequence
of overcrowded school premises.
2.4.1 Sanitation adequacy and privacy
Sanitation facilities may be inadequate because of lack of privacy, this was frequently reported
by pupils (Adams et al., 2009). Privacy is affected by a lack of separated toilets for boys and
girls and/or for pupils and teachers, missing or damaged doors, missing or malfunctioning locks
for cubicles, missing partitions between latrines or urinals or partition sizes inadequate to the
need of pupils who are afraid of being spied on or bullied by other pupils. Lack of privacy, poor
illumination and a lack of supervision caused by the distance of the facilities (outside the
building or on another floor) also facilitate bullying. Children also reported avoiding going to the
toilet because they feared harassment from other students.
2.4.2 Cleanliness

According to a study which was done by Kweyu, R.M., Antwi-Agyei, P. et al (2020), on

“Barriers and opportunities for cleanliness of shared sanitation facilities in low-income
settlements in Kenya”, unclean toilets, high number of users, and high fill up rates of pit latrines
were cited as the main challenges in sharing of sanitation facilities. Unclean toilets resulted from
improper use or disposal of human faecal matter, often on the slab which discouraged others
from using the toilets.

2.5 Constraints to Successful Sanitation

The lack of national policies is a major constraint to success in sanitation. Governments in

general and health ministries in particular cannot play their key roles as facilitators and
regulators of sanitation without policies that support the transformation of national institutions

7
into lead institutions for sanitation (Valdmanis V., 2011). Policies that increase focus on learning
institutions, household behaviors and community action, that promote demand creation, and that
enable health systems to incorporate sanitation and hygiene. Other constraints to success in
sanitation are population growth and increasingly high population densities in urban and peri-
urban areas of developing countries (IRC, 2010).

2.6 Health Impacts of Sanitation

Lack of sanitation leads to disease, as was first noted scientifically in 1842 in Chadwick's
seminal “Report on an inquiry into the sanitary condition of the labouring population of Great
Britain”. The diseases associated with poor sanitation are particularly correlated with poverty
and infancy and alone account for about 10% of the global burden of disease (Pruss A.,et al,
2015). At any given time close to half of the urban populations of Africa, Asia, and Latin
America have a disease associated with poor sanitation, hygiene, and water (WHO, 2010).

The effects of poor sanitation can cause a wide range of issues from health and well-being
related to economic and societal issues. Health risks are often exacerbated by poor sanitation and
hygiene practices and many preventable health problems and diseases can be avoided with a little
education and the right environment and products (clean water, soap, water filters, composting
toilets, grey water systems, etc).

2.6.1 Increased health issues

There are many water borne diseases and pathogens that are harmful to humans that thrive in
unsanitary conditions that are brought about by untreated water and issues related to open
defecation. In some countries the cost of treating water borne diseases like diarrhoea and worm
infections can represent up to a third of household incomes. This can be avoided with some safe
hygiene practices, access to clean water and water sanitation solutions like composting toilets.

2.6.2 Increase in diseases

Diarrhoea, cholera, dysentery, typhoid and polio can all be and are transmitted by contaminated
water. Communities where there’s a high density of people combined with poor sanitary

8
conditions means these horrific diseases can race through communities causing ill-health,
ongoing health problems and death in severe cases.

2.6.3 Decrease in schooling

Many children can’t attend school because of diseases and issues relating to poor sanitation. By
simply not having the right toilet facilities at schools girls are less likely to be able to attend
which impacts the broader community for many years into the future.

2.6.4 Downturn in economic opportunity

Communities that suffer ill health and poor sanitation related issues are more likely to spend less
time working because of health related issue and be required to spend more money on healthcare
related to this. The investment of proper sanitation helps to create economic returns, can create
jobs and contributes to the overall economy of the community.

2.6.5 Inadequate WASH affects children’s health, well-being and

cognitive performance.

The studies undertaken, although limited in number, indicate a clear association between
children’s health and WASH conditions in schools. A significant number of pupils avoid using
WASH facilities, with consequences on health, well-being and cognitive performance.
Inadequate WASH in schools may result in dehydration, urinary infections and constipation and,
in some countries, parasitic infections. The evidence shows that toilet avoidance is fostered not
only by insufficient and inadequate facilities but also by a lack of awareness among both
teachers and children concerning the importance of WASH and the consequent school policies
for drinking and toilet visits. Available studies also reported a beneficial effect of hygiene
interventions, with a significant reduction of absenteeism due to infections during and/or after
the intervention (WHO Regional Office for Europe, 2010).

2.7 Benefits of Sanitation

Improved sanitation generates both social and economic benefits. The economic benefits of
improved sanitation include lower health system costs, fewer days lost at work or at school

9
through illness or through caring for an ill relative. In total, the prevention of sanitation and
water related diseases could save some $7 billion per year in health system costs (Hutton G.,et al,
2011). Furthermore, in much of the developing world at any one time around half the hospital
beds are occupied by people with diarrhoeal diseases (UNDP, 2010). Expressed at a national
scale, poor sanitation and hygiene costs the Lao People's Democratic Republic 5.6% of its GDP
per year and studies in Ghana and Pakistan suggest that general improvements in environmental
conditions could save 8%–9% of GDP annually (World Bank 2014).

The benefits of improved sanitation extend beyond reducing the risk of diarrhoea and other
sanitation-related diseases:

 Improving sanitation and hygiene will reduce the spread of intestinal worms,
schistosomiasis and trachoma, which are neglected tropical diseases that affect millions
of people. Poor sanitation is also linked to an increased risk of the transmission of
diseases, including ranging from cholera, diarrhoea, dysentery, hepatitis A, typhoid to
polio.
 Unsanitary living conditions can also exacerbate stunting in children. Hence, proper
sanitation facilities will help reduce the severity and impact of malnutrition.
 It will also promote the dignity and boost safety, particularly among women and girls,
who are especially affected by inadequate sanitation mainly due to gender-related
differences (cultural and social factors) as well as sex-related differences (physiological
factors).
 The provision of separate sanitary facilities for girls will also promote their school
attendance, (WHO 2011).
 Improved sanitation also facilitates the potential recovery of water, renewable energy and
nutrients from faecal waste. A WHO study in 2012 suggested that improved sanitation
will also lower health costs, boost productivity and contribute to fewer premature deaths.
2.8 The Role of the Health Sector in Improving Sanitation

In many countries, Environmental Health Officers are responsible for ensuring the sanitary
condition and hygienic emptying of toilets, and have the power to sanction dissenting households
with fines and court action (Terefe B, 2014). Sanitation promotion is one of the most important
roles the health sector can have in environmental health planning, because behaviours must be

10
changed to increase householders' demand for and sustained use of sanitation, especially in rural
areas where the pressure for change is lower. Promotion alone by the health sector may be
insufficient, however, to ensure sanitation adoption and maintenance a “carrot and stick”
approach may be needed in which sanitation coverage is increased through a combination of
community-based promotion and enforcement of national or local legislation that every house
must have a toilet (Welle K, 2010).

CHAPTER THREE

3.0 RESEARCH METHODOLOGY

This section will describe the methods that was used to achieve the general and specific
objectives of this study. It includes study design, study variable, study area and setting, target
population, study population, the sampling procedures as well as the data collection methods and
procedures. It will also include how the collected data was analyzed and interpreted to provide
meaning to the research data.

3.1 Study Design

This study was a descriptive Cross sectional study. Quantitative methods were used to assess
factors affecting utilization of sanitation facilities by undergraduate students in halls of residence
at Unza-Ridgeway campus. Interviews using a well-structured questionnaire were used to
ascertain the adequacy, cleanliness and privacy of the sanitation facilities, furthermore, to assess
the satisfaction of students with the status quo of sanitation conditions. A cross sectional study
design was suitable for this particular study because different variables were studied at the same
time in order to develop a well-rounded understanding of the potential relationship of the
variables and the utilization of the sanitation facilities.

3.2 Research Variables

Table1: Table of research variables

Variables Indicators Scale of Data Source of data
measurement collection

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 technique
Dependent Variable
Sanitation in Conditions of sanitary Adequate/Not Questionnaire Students
hostels facilities. Adequate Checklist
Clean/not clean
Private/not
private
Independent variables
Adequacy of Number of facilities Adequate/Not Questionnaire Students
sanitation (toilets, urinals) Adequate Checklist
facilities in
hostels
Cleanliness Evidence of urine or Clean/slightly Questionnaire Students
faeces. dirty/very dirty Checklist
Privacy Presence of lockable Very Questionnaire Students
doors private/Private/Not Checklist
private
Satisfaction Conditions of Satisfied/Not Questionnaire Students
sanitary facilities. satisfied Checklist

3.3 Study Area and Setting

This study was conducted at Unza-Ridgeway campus. Unza-Ridgeway campus is situated in
Lusaka urban area of Lusaka province about 4.8km from the Central Business District (CBD).

Unza-Ridgeway campus is Zambia's first Medical School which was established in 1965, with its
first intake in 1966. It obtained its establishment as an independent School of the University
Zambia in 1970. Its scope of academic instructional include not only the Medicine Program, but
also Pharmacy, Nursing Sciences, Biomedical Sciences, Physiotherapy, Environmental Health
and Public Health.

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According to the Office of Prime Minister (Student Union), Unza-Ridgeway campus has 9
hostels with a total of 215 and 142 rooms for male and female undergraduate students
respectively. The institution has a total of 357 rooms.

3.3.1 Study Population

The study population and sampling frame was the total number of undergraduate students
occupying bed spaces from the various hostels in both Unza-ridgeway campus and the other
hostel from the Department of Nursing Sciences (DNS) situated in University Teaching Hospital
(UTH).

3.3.1.1 Inclusion and Exclusion Criteria

The study included;

 All accommodated undergraduate students who were residents in a particular hostels.

 All non-accommodated undergraduate students who were residents in a particular hostel.
The study will exclude;

 All accommodated undergraduate students who were residing in rooms at a certain floor
where no physical inspection of sanitation facilities was conducted.

3.4 Sample Size calculation

The sample size was calculated using Kothari, (2004) sample size calculation formula for a finite
population. The formula for the sample size calculation according to Kothari is given below, it
was used at the confidence interval of 95% with significance level of 5%.

N
n=
1+ N ( e ) 2

Where;

n = Sample size

N = Population size

13
e = Margin of error (0.05)

357
n=
1+357 ( 0.05 ) 2

n = 189

357 students were used in the sample size calculation because the number represents
the total number of undergraduate rooms in halls of residence for the whole institution.

3.5 Sampling Procedure

Stratified random sampling method was used to divide the halls of residence into strata of male
and female.

To ensure that the number of units selected for the sample from each stratum is proportionate to
the number of males and females in the population, the desired sample size (n) was multiplied by
the proportion of units in each stratum.

3.5.1 Proportionate stratification

215
males : x 100=60 %
357

142
females: x 100=40 %
357

To calculate the number of male and female students required in the sample, the proportions
calculated above was multiplied by the sample size.

60
males : x 189=113
100

40
females: x 189=76
100

This meant that 113 male students and 76 female students were interviewed from the sample size
of 189 students.

14
A simple random method was then be used to select room numbers to be used based on the
rooms available in a particular hostel. For rooms having more than one bed space, data was
collected from each student occupying a bed space.

The stratified sampling technique made equal the representations for males and females in the
case of selecting a single sex hall as one of the sample halls for the study. A stratified sample
was also used to identify the halls by their populations to give weights to them.

3.6 Data Collection Tools and Techniques

A structured questionnaire was used to collect the relevant data that will be used to answer the
research question and achieve the objectives of the study. The questionnaire was divided into 4
sections (Section A, B, C and D); section A contained information to assess the Demographic
Characteristics, Section B assessed knowledge levels, section C assessed sanitation facilities and
section D assessed perception of sanitation facilities.
3.7 Data analysis

Data was entered and coded by means of a computer software called statistical package for social
scientist (SPSS). The data set from SPSS was then exported to another computer software called
STATA for analysis. STATA obtained descriptive statistics such as proportions and
percentages. Measures of central tendency was used to give a summary of the data set and its
distribution. STATA was also ran a Pearson’s Chi-square test to determine the factors which
affect utilization of sanitation facilities by undergraduate students in hostels. Data from
questionnaires was coded and categorized accordingly. During data processing the information
was checked for completeness and internal consistency. Processing the data enabled the findings
to be presented in organised and simplified form such as frequency tables, charts and graphs.

3.8 Pretesting of Data Collection Tools

A pre-testing was done prior to the main study in order to provide a platform to identify errors
and to make some revisions to data collection tools and data collection procedures to ensure that
appropriate questions were asked and that questions did not make respondents uncomfortable or
get confused. The pre-test was also an opportunity to train the research assistants who were
engaged in data collection procedures. The pre-test was conducted at Unza-Great East (GERC)
because it has similar setting with Unza-Ridgeway Campus. This ensured the feasibility of the
data collection tools.

15
 3.9 Ethical Consideration
Permission to conduct a study at Unza-Ridgeway campus was obtained from the office of the
Dean of Student Association (DOSA). The researcher vividly to explained the purpose of the
research the participants and protected their identity and confidentiality. Assurance was given to
the participants who participated in the study that the information collected would be kept
confidential. The consent form was filled in by the participants to confirm their voluntary
participation. The participants were free to withdraw from the study at any time they felt like.

CHAPTER FOUR

4.0 RESULTS

This chapter provides description of results of the research on factors affecting utilization of
sanitation facilities by undergraduate students in halls of residence (Hostels). It describes the
socio-demographic characteristics of the respondents and show association between dependent
variable and the independent variables.

4.1 Demographic characteristics of respondents

A total of 189 students participated in the study. The study comprised both male and female
students, 113 (60%) and 76 (40%) respondents respectively. A large proportion of respondents,
70 (37%) indicated that they lived 4 in a room, while smallest proportion 2 (1%) lived 8 in a
room.

Characteristic (N=189) Frequency Percentage (%)

Gender
Male 113 60
Female 76 40
Hostel
New Hostel 14 7
Nkwazi 14 7
Nkomesha 29 15
Elizabeth Mumba 72 38
KK1 11 6
KK2 15 8
KK4 10 5
KK5 24 13

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 Number of bed spaces
1 58 31
2 115 61
3 16 8
Number of students per room
1 16 8
2 32 17
3 37 20
4 70 37
5 6 3
6 25 13
7 1 1
8 2 1
Table 2: Social demographic characteristics of respondent

4.1.1 Number of students in a room per hostel.

The pie charts below show the percentage of the number of students living in each room per
hostel. New hostel and nkwazi have the most populated rooms with over 60% of the rooms
having 6 students

Figure 1: Number of students in a room per hostel.

New Hostel Nkwazi Nkomesha

7.143% 21.43% 3.448%
13.79%
21.43%
7.143%
64.29%7.143% 71.43% 55.17% 27.59%

Elizabeth Mumba KK1 KK2

4.167%
6.944% 18.18%
18.18% 20%
29.17% 9.091%
. 46.67% 6.667%
45.83% 9.091%18.18%
13.89% 27.27% 26.67%

KK4 KK5

25%20.83%
50% 50%
25%
29.17%
17

1 2
 3 4
5 6
7 8
Graphs by Hostel

4.2 Student’s perception of sanitation facilities

Students were questioned on their perception of adequacy, cleanliness and privacy of sanitation
facilities in their respective hostels, the responses are recorded in table 2 below. A large
proportion indicated that the sanitation facilities were not adequate (38%), Clean (40%) and
private (62%).

Table 3: Student’s perception of sanitation facilities

Variable Characteristic Frequency Percentage (%)

Adequacy Adequate 56 30
Not adequate 71 38
Convenient 62 33
Cleanliness Clean 75 40
Slightly clean 79 42
Dirty 35 35

Privacy Private 117 62

Very private 17 9
Not private 55 29

4.3 Student’s knowledge on importance of sanitation/Orientation on sanitation

Students were questioned to find out their knowledge on the importance of sanitation and if they
were educated on the importance of sanitation during campus orientation. The results are in table
3 below.
Variable Characteristic Frequency Percentage (%)

18
 Importance of sanitation Yes 179 95
No 10 5

Orientation on Sanitation Yes 41 32

No 147 78

Table 4: Students knowledge on importance of sanitation/Orientation on sanitation.

4.4 Association between dependent variable and the independent variables.

The results in table 4 below shows that a bigger proportion of males (66%) and females (71%)
indicated that cleanliness affected utilization of sanitation facilities. The results show association
between all the three variable which were studied, adequacy (P=0.00), cleanliness (P=0.008) and
privacy (P=0.009). A value of P < 0.05 was considered to be significant and association between
the studied independent variable and dependent variable holds.

Table 5: Association between dependent variable and the independent variables.

Variable Male Percentage Female Percentage% Pearson Chi-squared P-value

%
Adequacy 10 9 14 18 33 0.00

Cleanliness 75 66 54 71 17.4 0.008

Privacy 28 25 8 11 17 0.009

Gender 113 60 76 40 34.9 0.00

5.0 DISCUSSION
The discussion will give insight on the results obtained from the study with regards to the
demographic characteristics of participants, their perception on sanitation facilities, their
knowledge on the importance of good sanitation and if they were educated about sanitation

19
during campus orientation. The discussion will also include insight on the established association
of the participant’s perception of sanitation facilities and its utilization.

5.1 Demographic characteristics

A total of 189 students participated in the study. The study comprised both male and female
students, 113 (60%) and 76 (40%) respondents respectively. A large proportion of respondents,
70 (37%) indicated that they lived 4 in a room, while smallest proportion 2 (1%) lived 8 in a
room. A large proportion (61%) shows that majority of rooms have 2 bed spaces each. The
results show that a large proportion of participants (37%) live 4 per room. This indicates an
increment in the number of students in halls of residence than they were initially built to
accommodate. This increase has impacted the adequacy of sanitation.

5.2 Student’s perception of sanitation facilities

Students were questioned on their perception of adequacy, cleanliness and privacy of sanitation
facilities in their respective hostels. A large proportion of 38% of participants indicated that the
sanitation facilities were not adequate, 40% said they were Clean and 62% indicated that the
facilities were private (62%). The results on adequacy coincide with the findings in the
demographic characteristics of the participants. Considering the results in table 4, females are
more affected by the adequacy of sanitation facilities. 18% of the entire female population and
only 9% of the males are affected by adequacy of sanitation facilities.

5.3 Student’s knowledge on importance of sanitation and Orientation on

sanitation
The results in table 3 show the responses of participants regarding their knowledge on the
importance of good sanitation and whether or not they were oriented on sanitation during campus
orientation. Though a large proportion of respondents (95%) know the importance of good
sanitation, results show that only a few respondents (32%) were educated on sanitation during
campus orientation. The results show a great gap which has to be bridged.

5.4 Association between dependent variable and the independent variables.

The results in table 4 shows that a bigger proportion of males (66%) and females (71%) indicated
that cleanliness affected utilization of sanitation facilities. The results show association between
all the three variable which were studied, adequacy (P=0.00), cleanliness (P=0.008) and privacy

20
(P=0.009). A value of P < 0.05 was considered to be significant and association between the
studied independent variable and dependent variable holds.

Despite having reasonable knowledge on the importance of sanitation, the sanitation and hygiene
practices of the students are remarkably low. This has greatly impacted on the cleanliness,
privacy and adequacy of sanitation facilities. A broad array of interconnected factors influenced
utilization of sanitation facilities. These include gender, perceived cleanliness, adequacy and
privacy of sanitation facilities. The perceived cleanliness of sanitation facilities emerged as the
underpinning factors that determined the utilization of sanitation facilities. 66% males and 71%
females indicated that cleanliness hindered them from using the sanitation facilities. The finding
of this study coincide with a study that was done by Grossi et al (2016). According to their study
access to sanitation facilities is hindered by poor building materials, lack of privacy, insufficient
maintenance and cleanliness, poor illumination and cold temperatures. Avoidance of toilet is
common when sanitation facilities are reported to be dirty, overcrowded and smelly.

5.5 Limitations of study

The biggest limitation of the study was resource and time. The study was unable to carry out the
physical examination of sanitation facilities using a structured checklist due to lack of money and
limited time because the study was conducted during the examination period. Therefore the
finding of this study are entirely dependent on the perception of the participants with regards to
cleanliness, adequacy and privacy.

6.0 CONCLUSION

The results of this study suggest that despite the high knowledge levels on the importance of
good sanitation, utilization of sanitation facilities is greatly affected by cleanliness, privacy and
adequacy. This is especially true for females who sometimes choose to use sanitation facilities
not situated in their halls of residence. Therefore, multi-level interventions including regular
supply of WASH-related materials and agents, improving quality cleaning services, close
monitoring of cleaning activities, promoting good hygiene behaviour at the individual level and
introducing gender-sensitive WASH infrastructure may be beneficial to advance improved
sanitation and hygiene practices among university students.

6.1 Recommendations

21
1. Facilitate education on good sanitation practice during on-campus orientation.
2. Frequent cleaning and maintenance of sanitation facilities.
3. Provide more accommodation facilities for students to avoid overcrowding in rooms.
4. Conduct health promotion programs to initiate behavior change among students.

Reference

1. Adams J, Bartram J, Chartier Y, Sims J (2009). Water, sanitation and hygiene standards
for schools in low-cost settings. Geneva: World Health Organization

2. Adams J. Simms J. Chartier Y. Bartram J. Organization W. H., 2009. Water, Sanitation

and Hygiene Standards for Schools in Low-Cost Settings World Health Organization,
Geneva, Switzerland.

3. Breman JG, Measham AR, et al., 2016. Disease control priorities in developing
countries, 2nd ed. New York: Oxford University Press.

4. Chadwick E, 2014. Report on an inquiry into the sanitary condition of the labouring
population of Great Britain. London: Her Majesty's Stationery Office; 1842. 279.

5. Cairncross S, Valdmanis V., 2010. Water supply, sanitation, and hygiene promotion. In:
Jamison DT.

6. Deroo L. Walter E. Graham J. 2015. Monitoring and evaluation of WASH in schools

programs: lessons from implementing organizations. Water Sanitation and Hygiene for
Development.

7. Ferriman A. 2011. BMJ readers choose the ‘sanitary revolution’ as greatest medical
advance since 1840. BMJ.; 334:111.

8. Greed, C., 2019. "Join the queue: Including women's toilet needs in public space", The
Sociological Review Monographs, 67, 4.

9. Hutton G, Haller H. 2008. Evaluation of the costs and benefits of water and sanitation
improvements at the global level. Geneva: World Health Organization.

22
10. Kabir, A., Roy, S., Begum, K., Kabir, A. H., & Miah, M. S. 2021. Factors influencing
sanitation and hygiene practices among students in a public university in Bangladesh.

11. Lundblad B, Hellström AL., 2005. Perceptions of school toilets as a cause for irregular
toilet habits among schoolchildren aged 6 to 16 years. J School Health.

12. Mangold, Walter S. 2013. “Minimum Essentials of Campus Sanitation.” The Sanitarian
3, no. 8: 156–69.

13. Peterson, P., 2018. "Creating Bathroom Access & A Gender Inclusive Society," Haas
Institute for a Fair and Inclusive Society, Berkley: University of California.

14. Terefe B, Welle K. 2008. Policy and institutional factors affecting formulation and
implementation of sanitation and hygiene strategy. A case study from the Southern
Nations Region (‘SNNPR’) of Ethiopia. Addis Ababa.

15. UNDP, 2006. Human Development Report 2006: Beyond scarcity – Power, poverty and
the global water crisis. New York: United Nations Development Programme; 440.

16. World Bank, 2010. Environmental health and child survival: epidemiology, economics,
experience. Washington, DC: World Bank; 2008. 135.

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APPENDICES
Sanitation Standards in Zambia

Public Health Act Cap 295 (Drainage and Latrine) Regulation No18A, of the laws of Zambia
(GRZ 1995) sets standards of latrine accommodation in schools as follows:

 Water closet and pit latrine for school girls ‘guidelines indicate that 1 closet or seat for
every 10 or part of 10 for the first 30 must be provided.
 In the case of over 30 pupils and fewer than 50, 4 closets or seats must be provided.
 If there are over 50 pupils and under 70, 5 closet or seat or seat must be provided.
 If there are over 70 pupils and under 100, 6 closets or seat must be provided.
 If the pupil population is over 100 1 closet or seat must be provided for every 25 or part
of 25.
 1 closet or seat for every 20 or part of 20 for the first 100.
 Boys sanitary block be provided with 1 urinal for every 20 males or part of 20.

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QUESTIONNAIRE TO STUDENTS TO ASSESS THE FACTORS AFFECTING
UTILIZATION OF SANITATION FACILITIES IN HOSTELS.
FOR OFFICIAL
Date….../….../2022 USE ONLY
Questionnaire No:

SECTION A: DEMOGRAPHIC CHARACTERISTICS

Tick √ appropriately

1. Gender
1. Male
2. Female

2. What hall of residence (Hostel) do you belong?

1. New hostel
2. Nkwanzi hostel
3. Nkomesha
4. Elizabeth Mumba
5. KK1
6. Kk2
7. Kk3
8. Kk4
9. Kk5

3. How many bed spaces are in your room?

1. 1
2. 2
3. 3
4. 4
5. 5
6. 6
4. How many students live in your room?

25
 1. 1
2. 2
3. 3
4. 4
5. 5
6. 6

SECTION B: KNOWLEDGE ON SANITATION

5. Do you know anything about sanitation?

1. Yes
2. No
6. Do you know the importance of good sanitation?
1. Yes
2. No
3. I don’t know
7. Did you have an opportunity to be taught or educated on sanitation during campus
orientation?
1. Yes
2. No
8. How do you or would you maintain good sanitation in hostels?
1. Cleaning floors
2. Throwing any waste outside the hostels
3. Using an appropriate sanitary facility and keeping it clean
4. I don’t know
9. What examples of disease do you know that is associated with poor sanitation?
1. TB
2. Diarrhoeal diseases
3. HIV/AIDS
4. I don’t know

26
SECTION C: SANITATION FACILITIES
10. What type of toilets facility do you use in halls of residence?
1. Pit latrine
2. Water closet (Flush toilet)
3. Other specify__________________
11. How many of these toilets are provided in your hostel (Your particular floor/level)?
1. 1
2. 2
3. 3
4. 4
5. 5
6. 6
7. 7
8. 8
12. Are urinals provided in your hostels? (for males only)
1. Yes
2. No
13. If your answer is yes above, how many urinals are provided in your hostel (Your
particular floor/level)?
1. 1
2. 2
3. 3
4. 4
5. 5
6. 6
14. Are pad bins provided in your hostel? (for females only)
1. Yes
2. No
15. If your answer is yes above, how many pad bins are provided in your hostel (Your
particular floor/level)?
1. 1
2. 2
3. 3
4. 4

27
SECTION D: PERCEPTION OF SANITATION FACILITIES
16. What is your perception on the adequacy of sanitation facilities in your hostel?
1. Adequate
2. Not adequate
3. Convenient
17. What is your perception on the cleanliness of sanitation facilities in your hostel?
1. Clean
2. Slightly clean
3. Dirty
4. Very dirty
18. What is your perception on the privacy of sanitation facilities in your hostel?
1. Private
2. Very private
3. Not private
19. What challenge do you experience when using sanitation facilities in your hostel?
1. Flooding
2. Low water
3. Slipping
4. Leakages
5. Other specify_______________________________________
20. What do you think discourages people from utilizing sanitation facilities in hostels?
1. Privacy
2. Cleanliness
3. Adequacy
4. All above
21. How satisfied are you with the sanitation of your hostel?
1. Satisfied
2. Very satisfied
3. Not satisfied
22. What is your attitude towards using the sanitation facilities?
1. I do not have any problem using them
2. I hate going there but I have no choice
3. Sometimes I use sanitation facilities not situated in hostels
4. Sometimes I avoid going there
5. I avoid going there altogether
23. If your answer is 3 above, where do you go?
1. Class sanitation facilities
2. Boarding houses nearby
3. UTH

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 4. Other, specify……………………………………..
24. Do you experience episodes of water supply interruptions?
1. Yes
2. No
25. If your answer is yes above, how long does water go in a day?
1. Less than an hour
2. More than an hour
3. Whole day

Thank you.

29