KENYA—The Ministry of Health has stepped up its efforts to end open defecation, with the goal of making the country Open Defecation-Free by 2030.

Thirty-nine low-income countries, primarily in Sub-Saharan Africa, are making progress toward attaining the United Nations’ Sustainable Development Goal (SDG) goal 6.2, which calls for the elimination of open defecation by 2030.

The great majority of people who practice open defecation live in rural regions and are from the poorest quintile, highlighting the need to focus efforts to eliminate open defecation in rural areas.

Community-Led Total Sanitation (CLTS) is a behavioral strategy that mobilizes communities to build toilets and end open defecation, mostly by instilling sentiments of shame and disgust in the participants.

When a community no longer exhibits visible signs of open defecation and the number of houses with toilets reaches a certain threshold, often ranging from 80% to 100% depending on a country’s specific laws, it is designated as “open defecation-free” (ODF).

Despite substantial advances in sanitation, as of 2022, approximately 8.5% of Kenya’s population was still practicing open defecation.

In response, the ministry is focusing on 15 high-burden counties with open defecation rates over 10%, primarily in the arid and semi-arid regions.

Turkana, Samburu, Tana River, Marsabit, Wajir, West Pokot, Mandera, Garissa, Kwale, Baringo, Isiolo, Narok, Homa Bay, Kilifi, and Kajiado are among the notable counties.

The Kenya Costed Sanitation and Hand Hygiene Roadmap 2023-2030, released this week by the Ministry of Health in collaboration with partners such as UNICEF, the Council of Governors, and county CECs,

The  roadmap aims to encourage behavioral change, improve the design and use of clean latrines, and advocate for safe waste treatment and disposal.

The Ministry also encourages individuals to wash their hands frequently, practice excellent food hygiene, support safe water management, and keep their homes clean.

According to Ministry statistics, about 9.9 million people directly consume water from contaminated surface sources, and five million people defecate openly.

Surprisingly, only 25% of families have soap and water for handwashing.

According to Health DG Patrick Amoth, these habits contribute to diseases such as diarrhea, cholera, typhoid, and other watery illnesses, which disproportionately affect children under the age of five.

While 25% of rural regions have no open defecation, 40% still lack better toilet facilities.

The challenge persists because the majority of fecal sludge treatment facilities are concentrated in metropolitan regions, rendering transportation and treatment services inaccessible to rural residents.

Despite these challenges, 26 counties have reduced open defecation rates to less than 4%, showing improved economic conditions.

Furthermore, 11 counties have a considerable open defecation load, while the rest have a minor burden with rates of less than 2.5%.

Public Health Services permanent secretary Mary Muthoni emphasized that these activities are in line with the greater goal of Universal Health Coverage

The Universal Health Coverage aims to ensure that everyone, regardless of socioeconomic status or geographic location, has access to basic hygienic services.

Although most schools have some type of toilet, roughly 6% of rural schools lack any sanitary facilities, according to a joint report produced by the World Health Organization and UNICEF in 2021.

The research also identifies defects in working latrines and hand-washing stations with soap in a number of healthcare facilities.

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