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Effect of Cholera Prevention Education on Household Water Treatment Practices in Flood-Prone Communities in Nigeria

Abstract

Cholera remains an important public health concern in Nigeria, particularly in communities where inadequate access to safe water, poor sanitation, overcrowding, and environmental disruptions increase the risk of transmission. Flooding can further increase the risk of waterborne disease by contaminating household and community water sources with human and animal waste and disrupting sanitation and water infrastructure. Household water treatment is therefore an important preventive measure for reducing exposure to contaminated drinking water, particularly during and after flooding. Cholera prevention education provides households with information about cholera transmission, signs and symptoms, sources of water contamination, safe water collection and storage, appropriate household water treatment methods, hygiene, sanitation, and the importance of seeking prompt healthcare when cholera is suspected. Household water treatment practices refer to behaviours used to make drinking water safer at the point of use, including appropriate boiling, chlorination or other approved treatment methods, safe storage of treated water, proper handling of water containers, and protection of treated water from recontamination. In flood-prone communities in Nigeria, household water treatment practices may be affected by inadequate knowledge, limited access to safe water, disruption of water infrastructure, poverty, availability and affordability of treatment materials, and misconceptions about water treatment. Effective cholera prevention education may improve household knowledge and encourage the adoption of appropriate water treatment and safe storage practices. Against this background, this study investigates the effect of cholera prevention education on household water treatment practices in flood-prone communities in Nigeria. The study is anchored on the Health Belief Model, Social Cognitive Theory, and Knowledge-Attitude-Practice framework. The Health Belief Model explains preventive health behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action, providing a basis for understanding households' adoption of water treatment practices. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, social influences, behavioural capabilities, and environmental conditions in shaping household water and hygiene practices. The Knowledge-Attitude-Practice framework provides a basis for examining how improved knowledge and attitudes resulting from cholera prevention education may influence household water treatment practices. Collectively, these theoretical perspectives provide a suitable framework for explaining how cholera prevention education may influence household water treatment practices in flood-prone communities in Nigeria. The study will adopt a quantitative quasi-experimental research design. Primary data will be collected from households in selected flood-prone communities in Nigeria using a structured interviewer-administered questionnaire and an observation checklist for selected household water treatment and storage practices. A multistage sampling technique will be employed to select states, local government areas, flood-prone communities, households, and eligible household representatives. Where feasible, selected communities or household groups will be assigned to intervention and comparison groups. Households in the intervention group will receive structured cholera prevention education covering cholera transmission, flood-related water contamination, safe water sources, appropriate household water treatment methods, safe water storage and handling, hygiene and sanitation, signs and symptoms of cholera, and the importance of prompt healthcare-seeking. Household water treatment practices will be assessed using indicators such as treatment of drinking water, appropriate use of approved treatment methods, correct treatment procedures, regularity of treatment, safe storage of treated water, appropriate handling of water containers, and prevention of recontamination. Descriptive statistics will be used to summarize household sociodemographic characteristics, cholera prevention knowledge, exposure to education, and water treatment practices. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and logistic or multiple regression analysis, will be used to determine the effect of cholera prevention education on household water treatment practices. Appropriate diagnostic tests will also be conducted to assess the reliability of the research instrument, model assumptions, goodness of fit, and robustness of the findings. The study is expected to find that cholera prevention education has a significant positive effect on household water treatment practices in flood-prone communities in Nigeria. Households exposed to structured cholera prevention education are expected to demonstrate improved understanding of waterborne disease transmission and greater adoption of appropriate water treatment and safe storage practices. Education may improve knowledge of flood-related water contamination, encourage regular treatment of drinking water, strengthen correct use of appropriate treatment methods, promote safe storage, and reduce the risk of recontamination. However, education alone may not guarantee sustained household water treatment because flood-prone households may continue to face barriers such as shortages of safe water, limited availability or affordability of treatment materials, disruption of electricity and water infrastructure, poverty, displacement, and environmental contamination. Consequently, cholera prevention education is expected to be most effective when supported by reliable access to safe water, affordable household water treatment materials, appropriate sanitation infrastructure, effective flood-response systems, community health education, and timely public health interventions. The study is expected to contribute to the literature on cholera prevention, household water treatment, water safety, environmental health, flood-related health risks, health education, infectious disease prevention, and public health in Nigeria by providing empirical evidence on the effect of cholera prevention education on household water treatment practices in flood-prone communities. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Nigeria Centre for Disease Control and Prevention, National Primary Health Care Development Agency, state ministries of health, local government health authorities, environmental health agencies, emergency management authorities, water and sanitation programmes, community health workers, development partners, and policymakers regarding strategies for reducing cholera transmission in vulnerable communities. The study will also provide evidence-based recommendations for strengthening cholera prevention education, improving access to household water treatment materials, expanding safe water and sanitation infrastructure, strengthening flood-related disease preparedness, promoting safe water storage, and improving community-based cholera prevention programmes in flood-prone communities across Nigeria.

Keywords: Cholera prevention education, household water treatment practices, flood-prone communities, safe drinking water, water treatment, water contamination, cholera prevention, sanitation, environmental health, health education, flood-related health risks, infectious disease prevention, public health, Nigeria.