Sanitation and hygiene are fundamental determinants of health and play a crucial role in preventing infectious diseases, particularly in rural communities. Understanding community-level knowledge and practices is essential for designing effective interventions. In many areas, factors such as socioeconomic status, literacy levels, and infrastructure availability influence sanitation behavior and hygiene compliance. Assessing the current status of sanitary latrine use, reasons for open defecation, and handwashing practices provides insight into existing barriers and opportunities for improvement. The effects of poor sanitation seep into every aspect of life — health, nutrition, development, economy, dignity and empowerment. Although government agencies are providing the infrastructural support to improve sanitation condition in the developing countries, nevertheless there is a need for collateral personal hygiene and sanitary education to achieve improved outcomes.(2)On October 2, 2019, all the villages in the 36 States and Union Territories of India were declared open defecation-free (ODF). However, recently published data from the National Family Health Survey (NFHS-5) show that none of the 30 States surveyed are open defecation-free. The survey results show that residents in over 25% of rural households defecated in the open.(3)

AIMS AND OBJECTIVES

1. To determine the prevalence of sanitary latrine use and identify reasons for open defecation in study participants.
2. To assess handwashing practices.
3. To examine the association between sociodemographic factors, and sanitation/hygiene practices.
4. To provide recommendations for improving sanitation practicesand community hygiene behavior.

MATERIAL AND METHODS

Study design: A Community based cross sectional analytical study.

Study  setting and study population: The study was carried out inShivdeenpurwa,a  FAP(Family Adoption Programme )village of Dr.B.S.Kushwaha Institute of Medical Sciences, ,Kanpur,UP,India,which is km far from college with a total population of 1510 consisting of 304 households.

Study duration: One month from 20^th December 2025 to 20^th January 2026

Sampling  technique: Purposive sampling was used to collect data for the study,as information from a specific community or population group where sanitation and hygiene practices were  being assessed.

Inclusion criteria:Persons above 18 years of age residing in the village for at least 10 years.

Exclusion criteria:Those who were  notwilling,orlocked houses.

Sample size: A Total of 100 households were selected for the studyrandomly,starting from the first street and first household  of  the village and further households were selected in a consecutive right direction.Only one adult was interviewed per household.

Data collection:Face-to-face interviews were conducted by the investigator after obtaining informed consent from participants.A pre-tested,  semi -structured questionnaire was used to collect information on Sociodemographic details,Latrine availability and usage,type of sanitary latrine,reasons for open defecation,knowledge and practices related to handwashing. Data was collected with the help of epicollect5  in which the questions asked were translated in hindi by the interviewer.

Data analysis:Data were compiled and analyzed using Microsoft Excel and jamovi 2.4.8,  descriptive statistics such as frequencies and percentages were used to explain  demographic and other details.Chi square test was used to describe the association between sanitation and demographic characterstics of study participants.

Ethical consideration:Informed consent was obtained from all participants. Privacy and confidentiality were ensured throughout the study.Permission was obtained from institutional ethical committee of college, as well as Gram Pradhan of village.

RESULTS

Table 1: Demographic distribution of study participants (N=100)

The majority of study participants were in the 30–39 age group (34%), followed by those aged 20–29 years (26%) and 40–49 years (21%). Participants under 20 years and those aged 60 years or older made up only 2% and 4%, respectively. Females represented a significant majority of the study population at 95%, while males accounted for just 5%. All participants were Hindus (100%). In terms of marital status, a significant portion of participants were married, comprising 89%, while only 11% were unmarried. Regarding educational attainment, 38% had no formal schooling. Following this group, 15% had completed middle school, 14% had reached the primary level, and 13% had graduated from high school. A mere 9% of participants were graduates or had pursued higher education, indicating a relatively low level of education among the group. About family structure, the majority of participants lived in nuclear families (67%), followed by those in joint families (26%) and three-generation families (7%). An assessment of socioeconomic status revealed that half of the participants (50%) belonged to the lower-middle class, while 19% were from the lower class. The middle class accounted for 17%, and the upper-middle class comprised 14% of the participants. (See Table 1)

Table 2: Knowledge and practices regarding sanitation (N=100) :

Out of the 100 participants, 83% reported having access to a sanitary latrine in their households, while 17% did not have any access to a sanitary latrine. Regarding the type of latrine used, 83% of participants utilized pour-flush latrines connected to a sewer system, whereas 17% still engaged in open defecation. In terms of the frequency of open defecation, the majority of participants (77%) stated that they never practiced open defecation. However, 7% admitted to practicing it occasionally, and 16% reported doing so regularly. Out of total 17%,11% households do not possess functional sanitary latrine,6% participants admit that they are not comfortable in using sanitary latrine.(See Table 2)

Table 3: Knowledge and practice regarding hygiene (N=100) :

All participants (100%) reported washing their hands before eating, indicating universal awareness of this hygienic practice. With regard to handwashing before cooking, the majority (94%) reported always washingtheir hands, while 6% practiced it sometimes. Similarly, 100% of participants reported always washing their hands after defecation, reflecting excellent adherence to this critical hygiene behavior. Concerning the material used for handwashing, all participants (100%) used soap andwater. None reported using water alone, mud, or ash.

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Table 4:Association  of sanitation with demographic factors(N=100)

*P value</=0.05 is statistically  significant

Fig:1 use of sanitary latrine in terms of age group

Fig 2:use of sanitary latrine in terms of socioeconomic status (N=100)

A statistically significant association was observed between genderand the practice  ofasanitary latrine. A higher proportion of females (81 out of 95) reported availability of sanitary latrines compared to males (2 out of 5). This association was found to be statistically significant(χ² = 6.90, p = 0.009).A statistically significant association was also found between socioeconomic status and the presence of a sanitary latrine (χ² = 9.25, p = 0.026). Participants belonging to the middle andupper-middle socioeconomic classes had 100% availability of sanitary latrines, whereas comparatively lower availability was observed among participants from the lower and lower-middle classes.

A highly significant association was noted between type of latrine and the presence of asanitary latrine (χ² = 100, p< 0.001). All participants using pour-flush latrines had sanitary latrines, while none of the participants practicing open defecation had access to sanitary latrines, which is expected by definition.

DISCUSSION

In  a study  by Rekha hothuretal majority of study population interviewed belongs to age group of 18-29 years (36.9%) and majority interviewed were females 169(71.6%)likewise in this study majority 95% are female reason being at the time of interview mostly females are available at home while males are at workplace.(4)According to Sheethal MP etal  in their study Sanitary latrine was present in 213 houses (82%) and rest 18%  practiced open  air  defecation,similarly in our study 83% houses  posess sanitary latrine while 17% practiced open air defecation.(5)In a study by Ravi Pachori households  washed their hands after toilet  with soap 198 (66%)  and  remaining  by  others  like  as  Ash,  Mud,  Plain Water 102 (34%)in contrast 100 % households  in our study practiced handwashing with soap and water.(6) in a study byVenkateswarlu M among  the  people  practicing  openair  defecation  115 (26.1%)  belong  to  lower  class,  226  (51.2%)  belong  to upper  lower  class,  94  (21.3%)  belong  to  lower  middle class, and 6  (1.4%)  belong  to upper  middle class while in our study half of the participants (50%) belonged to the lower-middle class, while 19% were from the lower class. The middle class and upper-middle class constituted 17% and 14%, respectively.(7)

It is essential to implement targeted educational programs aimed at improving awareness of water, sanitation, and hygiene practices, enhancing access to hygiene facilities, and involving community leaders in promoting behavioral change. Additionally, improving the availability of clean water and sanitation services in Internally Displaced Persons camps is crucial for improving health outcomes and overall well-being among this population (8).

CONCLUSION

The study highlights a high level of sanitation and hand-hygiene practices among the study participants, with 83% households having access to sanitary latrines and universal use of soap and water for handwashing before eating, before cooking, and after defecation. Despite this, 17% of participants still practiced open defecation, either regularly or occasionally, indicating a persistent gap between infrastructure availability and actual utilization.The presence of sanitary latrines was found to be significantly associated with gender, socioeconomic status, and type of latrine. Higher socioeconomic status was associated with universal latrine availability, whereas lower and lower-middle classes showed comparatively poorer access. The significant association with gender suggests differences in sanitation access or reporting within households. As expected, the type of latrine showed a strong association with sanitary latrine availability.

Overall, while the findings reflect the positive impact of sanitation initiatives such as theSwachh Bharat Mission, targeted efforts are still required to address open defecationpractices, particularly among lower socioeconomic groups. Continued behavior change communication, community engagement, and equitable access to sanitation facilities are essential to achieve sustained improvements in sanitation and hygiene practices.

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Limitations of the Study:

1. Cross-sectional study design: As this was a cross-sectional study, a cause–effect relationship between sociodemographic factors and sanitation practices could not be established.
2. Self-reported information: Data on sanitation and hand-hygiene practices were based on self-reporting, which may be subject to social desirability and recall bias, especially for behaviors such as handwashing and open defecation.
3. Small sample size: The study included only 100 participants, which may limit the generalizability of the findings to the wider population.
4. Female-dominated sample: The majority of participants were females (95%), which may have influenced responses related to household sanitation practices and may not fully represent male perspectives.
5. Single-area study: The study was conducted in a single rural area, and findings may not be applicable to other rural or urban settings with different cultural or socioeconomic contexts.

DECLARATION

Conflicts of interests: The authors declare no conflicts of interest.

Author contribution: All authors have contributed in the manuscript.

Author funding: Nill

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