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Effect of Open-Defecation Prevention Education on Toilet Use Practices among Rural Households in Nigeria

Abstract

Open defecation remains an important environmental and public health concern in some rural communities in Nigeria, where inadequate access to improved sanitation facilities, poverty, cultural practices, limited sanitation awareness, and poor maintenance of toilets may influence household sanitation behaviours. Defecating in open spaces may contaminate soil and water sources and increase exposure to faecal pathogens, thereby contributing to diarrhoeal diseases, intestinal infections, and other sanitation-related health problems. Open-defecation prevention education provides an opportunity to improve household knowledge of the health and environmental consequences of open defecation and promote consistent use and maintenance of appropriate toilet facilities. Against this background, this study investigates the effect of open-defecation prevention education on toilet use practices among rural households in Nigeria. The study will be anchored on the Health Belief Model, Social Ecological Model, and Social Cognitive Theory. The Health Belief Model explains how household members' perceptions of susceptibility to sanitation-related diseases, perceived severity of open-defecation-related health risks, perceived benefits of toilet use, perceived barriers, and cues to action may influence sanitation behaviours. The Social Ecological Model emphasizes the influence of individual, household, community, environmental, cultural, infrastructural, and institutional factors on sanitation practices. Social Cognitive Theory emphasizes observational learning, behavioural modelling, self-efficacy, reinforcement, and environmental influences in developing and maintaining appropriate toilet-use practices. Collectively, these theoretical perspectives provide a suitable framework for explaining how open-defecation prevention education may influence toilet use practices among rural households in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise rural households in selected communities across Nigeria, with eligible respondents being adults who are primarily responsible for household sanitation decisions and practices. A multistage sampling technique will be used to select geopolitical zones, states, local government areas, rural communities, households, and eligible respondents. Open-defecation prevention education will be assessed using indicators such as exposure to sanitation education sessions, frequency and duration of education, knowledge of health risks associated with open defecation, awareness of faecal-oral disease transmission, knowledge of the benefits of toilet use, toilet construction and maintenance information, handwashing education, child faeces disposal education, community sanitation participation, and awareness of sanitation regulations. Toilet use practices will be assessed using indicators such as regular use of household toilets, avoidance of open defecation, proper toilet use by household members, safe disposal of children's faeces, toilet cleanliness, toilet maintenance, availability of water or handwashing facilities near toilets, safe disposal of toilet waste, use of toilets by children and visitors, and consistency of toilet use during different times or circumstances. Data will be collected using structured questionnaires, household sanitation observation checklists, toilet inspection records, community sanitation programme records, and relevant environmental health documents. Descriptive statistics will be used to summarize household characteristics, sanitation facilities, exposure to education, sanitation knowledge, and toilet-use practices. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the effect of open-defecation prevention education on toilet use practices. Where a quasi-experimental design is adopted, toilet-use practice scores before and after the educational intervention may be compared with those of a comparison group to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that open-defecation prevention education has a significant positive effect on toilet use practices among rural households in Nigeria. Households exposed to structured and community-based sanitation education are expected to demonstrate more consistent toilet use and reduced reliance on open defecation than households without comparable exposure. Education may improve household understanding of the relationship between poor sanitation and disease transmission and encourage regular toilet use, proper disposal of children's faeces, toilet maintenance, and handwashing after toilet use. Community-based education may also strengthen collective responsibility for sanitation and encourage households to maintain hygienic environments. However, inadequate toilet facilities, poor water availability, poverty, damaged or poorly maintained toilets, cultural practices, limited household space, and weak community sanitation infrastructure may reduce the effectiveness of education alone. The study therefore expects practical, culturally appropriate, community-supported, and continuous open-defecation prevention education, combined with improved access to functional sanitation facilities, to contribute significantly to improved toilet use practices among rural households in Nigeria. The study is expected to contribute to the literature on open-defecation prevention, sanitation education, household toilet use, environmental sanitation, water sanitation and hygiene, environmental health, community health promotion, diarrhoeal disease prevention, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Federal Ministry of Environment, Federal Ministry of Water Resources and Sanitation, National Primary Health Care Development Agency, state ministries and agencies responsible for health and sanitation, local government authorities, environmental health officers, community health workers, development partners, and policymakers regarding strategies for improving rural sanitation. The study will also provide evidence-based recommendations for strengthening sanitation education, expanding access to functional household toilets, improving water and handwashing facilities, promoting community-led sanitation initiatives, strengthening monitoring of open-defecation prevention programmes, and supporting sustainable sanitation practices among rural households across Nigeria.

Keywords: Open-defecation prevention education, toilet use practices, rural households, sanitation education, environmental sanitation, water sanitation and hygiene, environmental health, community health promotion, Nigeria, public health.