İzmir/Basmane merkezinde bulunan hanelerde su, sanitasyon ve hijyen belirleyicileri
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Dosyalar
Tarih
2021
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş ve amaç: Ülkemizde kentsel yoksullukla ilişkili ana sağlık sorunlarından biri güvenli su ve sanitasyona erişim eksikliği, yetersiz hijyendir. Su, sanitasyon ve hijyen eksikliği başta çocuklar üzerinde olmak üzere birçok dezavantajlı grupta hastalık yüküne neden olmaktadır. Bu araştırmanın amacı Basmane merkezinde yer alan ve sosyoekonomik açıdan dezavantajlı nüfusun hakim olduğu hanelerde su, sanitasyon ve hijyen (SSH) durumunun ve belirleyicilerinin ortaya konmasıdır. Bunun yanı sıra biri SSH davranışlarının saptanmasına, diğeri de konutların SSH açısından koşullarının değerlendirilmesine yönelik olmak üzere iki ayrı ölçek geliştirilmesi amaçlanmıştır. Gereç ve yöntem: Kesitsel tasarım tipinde olan bu çalışma ölçek geliştirmeye yönelik metodolojik bir tasarım boyutu da içermektedir. Çalışmanın evrenini Basmane Bölgesi merkezinde yer alan Altınordu, Faikpaşa, Etiler, Alireis merkez mahallelerinde yaşayan 2667 hane oluşturmuş, %50 prevalans, %95 güven aralığı ve %6 hata payı örnek büyüklüğü 243 hane olarak hesaplanmıştır. Çalışmanın bağımlı değişkeni olan hanelerde SSH durumunu değerlendirmek için "SSH Davranışları Ölçeği" ve "Hanelerde SSH Koşulları Ölçeği" geliştirilmiştir. Bağımsız değişkenler ise bireye ve haneye yönelik olmak üzere iki başlık altında incelenmiştir. Bireye ait sosyodemografik ve ekonomik değişkenler ile haneye ait sosyoekonomik, yapısal ve enfeksiyon bulgularına dair değişkenler alınmıştır. SSH Davranışları Ölçeği ve bağımsız değişkenleri içeren form, hanehalkının temizlik ve bakımından birinci derecede sorumlu olan kişi tarafından yanıtlanmıştır. Hanelerde SSH Koşulları Ölçeği formu ise araştırıcı tarafından evin içerisi gözlemlenerek doldurulmuştur. Bağımlı değişkeni ölçen iki ölçeğin ortalama puanları ile bağımsız değişkenler arasındaki ilişki için Student T, Mann-Whitney U, ANOVA, Kruskal Wallis testi, lineer ve lojistik regresyon analizleri kullanılmıştır. Ölçeğin güvenilirliğinin belirlenmesinde Cronbach alfa katsayısı hesaplanmış, yarıya bölme ve madde ile toplam arasındaki korelasyon yöntemi kullanılmıştır. Yapı geçerliliği temel bileşenler analizi ile belirlenmiştir. Bulgular: Araştırmaya katılan katılımcıların tamamı kadın olup yaş ortalamaları 40,65±14,35 dir ve %38,6'sı Suriye'de doğmuştur. Her dört haneden birinin aylık gelirinin 900 TL ve daha az olduğu, her üç haneden ikisinde üçten fazla kişinin yaşadığı, %72,6'sının göç ile geldiği IV belirlenmiştir. Her on haneden birinde son üç ayda en az bir kişinin parazit enfeksiyonu, her dört haneden birinde ise ishal görüldüğü saptanmıştır. SSH Davranışları Ölçeği ve Hanelerde SSH Koşulları Ölçeği'nin açıkladığı toplam varyansı ve Cronbach alpha katsayısı sırasıyla %54,3 ve %52,2; 0,784 ve 0,851 dir. Toplam skor ortalamaları ise 42,06±8,74 ve 8,18±4,17 dir. SSH Davranışları etnisite, çocuk sayısı, eşin eğitim durumu, gelir algısı, şebeke suyu kullanımı ile %58,3 oranında açıklanabilmektedir. SSH koşulları sağlama olasılığı 40 yaş üstündeki kişilerde 3,3 kat, ait oldukları etnik grubun Türk olduğunu belirtenler 8,4 kat daha yüksektir. Hanelerde SSH Koşullarını sağlanamama olasılığını eşin sosyal güvencesinin olmadığı durumlarda 3,5 kat, gelir algısı kötü olduğunda 3,6 kat, sıcak suya ulaşımın sadece banyoda olduğu durumlarda 6,8 kat artırmaktadır. Sonuç: Bu çalışma SSH kavramının kullanılması ve belirleyicilerin saptanması açısından Türkiye'deki ilk çalışmadır. Basmanenin sosyoekonomik ve kültürel özelliklerine bakıldığında yoksulluğu temsil eden bir bölge olduğu görülmüştür. Çalışma, SSH davranışları açısından önemli bir yetersizlik olmamasına karşın bölgedeki hanelerde SSH koşullarının yeterli olmadığını ortaya koymuştur. Aynı zamanda SSH davranışları ve koşullarının temel belirleyicilerinin gelir, etnik köken ve suya erişim olduğu gösterilmiştir. Ayrıca, geliştirilen her iki ölçeğin geçerlilik ve güvenilirlik açısından temel kriterleri karşıladığı belirlenmiştir.
Introduction and aim: One of the main health problems associated with urban poverty is the lack of access to safe water and sanitation, insufficient hygiene, in our country. Lack of water, sanitation and hygiene causes disease burden on many disadvantaged groups, especially on children. The aim of this study is to reveal the water, sanitation and hygiene (WASH) status and its determinants in the households in the center of Basmane, which are dominated by socioeconomically disadvantaged populations. In addition, it was aimed to develop two separate scales, one for determining WaSH behaviors and the other for evaluating the conditions of houses in terms of WASH. Materials and methods: This study, which is in the cross-sectional design type, also includes a methodological design dimension for scale development. The population of the study consisted of 2667 households that living in the central of Altınordu, Faikpaşa, Etiler, and Alireis neighborhoods located in the center of Basmane Region, and the sample size of 50% prevalence, 95% confidence limit and 6% sample error was calculated as 243 households. In order to evaluate the WASH status in households, which are the dependent variables of the study, "The Scale of WASH Behaviors" and "The Scale of WASH Conditions in Households" were developed. Independent variables have been examined under two headings as for the individual and the household. Socio-demographic and economic variables belonging to the individual and socioeconomic, structural variables and infection findings belonging to household were taken. The form containing The Scale of WASH Behaviors and the independent variables was answered by the person who is primarily responsible for the cleaning and maintenance of the household. The Scale of WASH Conditions in Household form was filled by the researcher who observing the inside of the house. Student T, Mann-Whitney U, ANOVA, Kruskal Wallis test, linear and logistic regression analyzes were used for the relationship between the mean scores of the two scales measuring the dependent variable and the independent variables. For determining the reliability of the scale, the Cronbach alpha coefficient was calculated and split half and item-total correlations methods were used. Construct validity was determined by principal component analysis. Results: All of the participants in the study are women and their average age is 40,65±14,35 and 38,6% were born in Syria. It has been determined that one in every four households' VI monthly income are 900 TL or less, two of every three households have more than three people and 72,6% of them come by migration. Parasite infection was found one of every ten households and diarrhea was one of every four households in the last three months. The total variance and Cronbach alpha coefficient explained by The Scale of WASH Behaviors and The Scale of WASH Conditions in Households were 54,3% and 52,2%; 0,784 and 0,851, respectively. Total score averages are 42,06 ± 8,74 and 8,18 ± 4,17. WASH Behaviors can be explained with the rate of 58,3% by ethnicity, number of children, educational status of the husband, income perception, use of piped water. The probability of providing WASH conditions is 3,3 times higher in over 40 years of age, and 8,4 times higher in those who state that their ethnic group is Turkish. The probability of not providing WASH conditions in households increases 3,5 times when the husband does not have social security, 3,6 times when the perception of income is poor, and 6,8 times when access to hot water is only in the bathroom. Conclusions: This study is the first study in Turkey in terms of using the WASH concept and finding the determinants. Considering the socioeconomic and cultural characteristics of Basmane, it is seen that a region that represents poverty. The study revealed that although there is no significant deficiency in terms of WASH behaviors, WASH conditions are not sufficient in the households. It has also been shown that the main determinants of WASH behavior and conditions are income, ethnicity, and access to water. In addition, it was determined that both scales developed appropriate the basic criteria in terms of validity and reliability.
Introduction and aim: One of the main health problems associated with urban poverty is the lack of access to safe water and sanitation, insufficient hygiene, in our country. Lack of water, sanitation and hygiene causes disease burden on many disadvantaged groups, especially on children. The aim of this study is to reveal the water, sanitation and hygiene (WASH) status and its determinants in the households in the center of Basmane, which are dominated by socioeconomically disadvantaged populations. In addition, it was aimed to develop two separate scales, one for determining WaSH behaviors and the other for evaluating the conditions of houses in terms of WASH. Materials and methods: This study, which is in the cross-sectional design type, also includes a methodological design dimension for scale development. The population of the study consisted of 2667 households that living in the central of Altınordu, Faikpaşa, Etiler, and Alireis neighborhoods located in the center of Basmane Region, and the sample size of 50% prevalence, 95% confidence limit and 6% sample error was calculated as 243 households. In order to evaluate the WASH status in households, which are the dependent variables of the study, "The Scale of WASH Behaviors" and "The Scale of WASH Conditions in Households" were developed. Independent variables have been examined under two headings as for the individual and the household. Socio-demographic and economic variables belonging to the individual and socioeconomic, structural variables and infection findings belonging to household were taken. The form containing The Scale of WASH Behaviors and the independent variables was answered by the person who is primarily responsible for the cleaning and maintenance of the household. The Scale of WASH Conditions in Household form was filled by the researcher who observing the inside of the house. Student T, Mann-Whitney U, ANOVA, Kruskal Wallis test, linear and logistic regression analyzes were used for the relationship between the mean scores of the two scales measuring the dependent variable and the independent variables. For determining the reliability of the scale, the Cronbach alpha coefficient was calculated and split half and item-total correlations methods were used. Construct validity was determined by principal component analysis. Results: All of the participants in the study are women and their average age is 40,65±14,35 and 38,6% were born in Syria. It has been determined that one in every four households' VI monthly income are 900 TL or less, two of every three households have more than three people and 72,6% of them come by migration. Parasite infection was found one of every ten households and diarrhea was one of every four households in the last three months. The total variance and Cronbach alpha coefficient explained by The Scale of WASH Behaviors and The Scale of WASH Conditions in Households were 54,3% and 52,2%; 0,784 and 0,851, respectively. Total score averages are 42,06 ± 8,74 and 8,18 ± 4,17. WASH Behaviors can be explained with the rate of 58,3% by ethnicity, number of children, educational status of the husband, income perception, use of piped water. The probability of providing WASH conditions is 3,3 times higher in over 40 years of age, and 8,4 times higher in those who state that their ethnic group is Turkish. The probability of not providing WASH conditions in households increases 3,5 times when the husband does not have social security, 3,6 times when the perception of income is poor, and 6,8 times when access to hot water is only in the bathroom. Conclusions: This study is the first study in Turkey in terms of using the WASH concept and finding the determinants. Considering the socioeconomic and cultural characteristics of Basmane, it is seen that a region that represents poverty. The study revealed that although there is no significant deficiency in terms of WASH behaviors, WASH conditions are not sufficient in the households. It has also been shown that the main determinants of WASH behavior and conditions are income, ethnicity, and access to water. In addition, it was determined that both scales developed appropriate the basic criteria in terms of validity and reliability.
Açıklama
Anahtar Kelimeler
Su, Sanitasyon, Hijyen, Basmane, Yoksulluk, Ölçek, Water, Sanitation, Hygiene, Basmane, Poverty, Scale
