Access to Functional Handwashing Facilities and Associated Factors among South Sudanese Refugees in Rhino Camp Settlement, Northwestern Uganda

Abstract

Background. Hand hygiene in refugee camp settlements remains an important measure against diarrhoeal infections. Refugee settings are characterised by overcrowding and inadequate access to water and hygiene facilities which favour proliferation of faecal-oral diseases. Handwashing with soap and water is therefore an effective way of preventing such diseases. Despite this knowledge, there is limited information about access to functional handwashing facilities in these settings and associated factors in Uganda. Methods. Quantitative data were collected from 312 refugee households in Rhino Camp Settlement, Northwestern Uganda, using a semistructured interviewer-administered questionnaire. A modified Poisson regression was used to obtain prevalence ratios (PRs) and 95% confidence intervals (CIs) for the determinants of access to a functional handwashing facility among refugee households. All analyses were performed using STATA 14.0 statistical software. Results. Of the 312 households, 123 (39.4%) had access to a handwashing facility, but only 72 (23.1%) of households had handwashing facilities that were functional. Duration of stay in the camp exceeding 3 years (adjusted PR = 2.63; 95% CI (1.73–4.00)) and history of receiving home-based education on hand hygiene (adjusted PR = 9.44; 95% CI (1.40–63.86)) were independent predictors of access to a functional handwashing facility. Conclusion. Access to functional handwashing facilities among the refugee households was low. Our findings highlight the need for more and continued handwashing promotional programs, most especially among newly arrived refugees in the camp.

Social and geographic inequalities in water, sanitation and hygiene access in 21 refugee camps and settlements in Bangladesh, Kenya, Uganda, South Sudan, and Zimbabwe

“…Research in urban slums in Kenya found a positive association between household size and water consumption [ 28 ], washing hands, and sanitation access [ 29 ]. However, there are limited published studies looking at the relationship between household size and WASH access in refugee camps and settlements [ 30 ].…”

The Energy Potential of Harvested Wood Fuel by Refugees in Northern Uganda

“…Selection of refugee households was based on the daily use of wood fuel for cooking and residence time in the refugee settlement of at least a year. Data from the interviews were categorised according to household family size, i.e., very small (1-3), small (3)(4)(5), medium (6)(7)(8), large (9)(10)(11)(12), and very large (12)(13)(14)(15), to examine if these influenced the determinants of wood fuel collection and use. In addition, two focus group discussions consisting of 15 members (men, women, youths, elders, village leaders, and cultural leaders) were conducted in each settlement.…”

“…e refuge household sizes had a significant contribution on the demand for wood fuel. Depending on the membership of each household, families were categorised as very small (1-3), small (3-5), medium (6)(7)(8), large (9)(10)(11)(12), and very large (12)(13)(14)(15) because these influenced the amount of food cooked and frequency. e household size categories that had a significant contribution to the collection and use of firewood were the large (9-12), medium (6)(7)(8), and very small (1-3) (P < 0.05) (Table 2).…”

“…Depending on the membership of each household, families were categorised as very small (1-3), small (3-5), medium (6)(7)(8), large (9)(10)(11)(12), and very large (12)(13)(14)(15) because these influenced the amount of food cooked and frequency. e household size categories that had a significant contribution to the collection and use of firewood were the large (9-12), medium (6)(7)(8), and very small (1-3) (P < 0.05) (Table 2). Other significant determinants were the size of the house, refugees' culture, weak enforcement of environmental laws and regulations, and availability of family labour (P < 0.05).…”

“…However, in this study, only two refugee settlements of Imvepi and Palorinya were selected and investigated because of their degazettement status, nationality of refugees from South Sudan, and proximity to forest reserves and wetlands. e establishment of these refugee settlements has come at a cost to the Ugandan government leading to increased outbreak of human diseases from appalling sanitation and nutritional challenges [8,9] and vegetation degradation [10,11] that have stretched the nation's financial resources in treatment, surveillance, and enforcement of forestry policies. Most of the settlements are established on public land, which is near fragile ecosystems like forests, wetlands, grasslands, and water bodies across different regions.…”