




































Global Sustainability Research                                                 ISSN: 2833-986X                                                 
https://doi.org/10.56556/gssr.v2i1.436 

                                                                  

 

Global Scientific Research        10 
 

Knowledge, perceptions and attitude towards open defecation and its health 
implications among residents in Ussa Local government Area, Taraba State, Nigeria 

Simon Alain Inah1*, Shamaki Kuko-Rimam Andenum1, Love Joseph Asor3, Aniekanabasi Jonathan Okon1, 
Darlington Egbe Egbonyi 2, Nelson Chukwudi Osuchukwu1  
 
1Department of Public Health, University of Calabar, Calabar Nigeria  
2Department of Environmental Resource Management, University of Calabar, Calabar Nigeria 
3Department of Adult and Continuous Education, University of Calabar, Calabar Nigeria 
 
Corresponding author: Simon Alain Inah pharmalain2006@gmail.com ; https://orcid.org/0000-0002-0977-6919) 
Received: 17 January, 2023, Accepted: 18 March, 2023, Published: 20 March, 2023 

 

 

Abstract 

Background and Objective: Open defecation is the human practice of defecating in the environment rather than into a toilet. 

Open defecation is a public health menace and causes health problems such as diarrheoa, typhoid, cholera, etc., in areas where 

people defecate places other than toilets or latrines. This study was aimed at determining the knowledge, perception and 
practice of open defecation among residents in Ussa Local Government Area of Taraba State, Nigeria. Material and Methods: 

A cross-sectional study design was adopted and used for this study. Data were generated using a semi-structured questionnaire 

and an observational checklist. Data generated were collated, synthesized and analyzed using SPSS version 20. Results: The 

results obtained in this study showed that 260 (67.7%) had good knowledge of open defecation while 124 (32.3%) recorded 

poor knowledge. Most respondents 202 (53.6%) demonstrated positive perception about open defecation while 182 (46.4%) 

exhibited negative perception. Over two-third of the respondents 302 (78.6%) respondents indicated that they have defecated 

at least once in open space and only 110 (28.6%) have access to a toilet facility. Perceived health problems associated with 

open defecation practice as indicated by the respondents were mainly; malaria 341 (88.8%), typhoid 221 (57.6%) and cholera 

210 (54.7%). It was also observed that 274 (71.4%) households do not have a toilet facility, 200 (69.0%) lack access to 

improved source of water supply, 356 (92.7%) household lack a drainage system, 308 (80.2%) had bushes around their 

surroundings, 256 (66.7%) had odour of excreta in the surrounding and 239 (62.2%) lack a proper waste storage facility and 

exhibit poor waste disposal. Conclusion: Findings in this study showed that respondents had good knowledge and exhibited 
positive perception about open defecation, but majority of the proportion confirmed to have defecated in open fields.  

 

Keywords: knowledge; attitude; open defecation; health implications; residents; Ussa Local Government Area 

 

 

Introduction 

 

Open defecation is the human practice of defecating in the 

environment rather than into a toilet. Open defecation is a 

public health menace and causes health problems such as 

diarrheoa, typhoid, cholera, etc., in areas where people 
defecate places other than toilets or latrines (Clasen, 

Boisson, Routray, Torondel, Bell, Oliver, Ensink, Freeman, 

Jenkins, Odagiri, Ray, Sinha, Suar, & Wolf-Peter, 2014). 

The term is widely used in literatures on water, sanitation, 

and hygiene (WASH) problems in low-income countries. 

Eradicating open defecation is the main aim of improving 

sanitation worldwide and it is an indicator used to measure 

progress towards the Sustainable Development Goal 

(SDG6). Irrespective of availability of toilets, behavioral 

change efforts on human is needed to promote the use of 

toilets. Therefore, people need to be educated and convinced 

to desist from open defecation and use the toilets. The option 

of open defecation may be due to lack of access to toilets or 

cultural practices and these practices are common within 

countries where sanitation infrastructures are not available 
(Clasen et al, 2014).  

Ending open defecation would be an important public health 

intervention and success to healthy living (WHO/UNICEF, 

2014a). It has been reported that extreme poverty and lack 

of sanitation facilities have been linked with open 

defecation. Therefore, eradicating open defecation is 

thought to be an important medium to also eradicate 

poverty. This was due to the publication by the Joint 

Monitoring Programme for Water Supply and Sanitation 

(JMP) in their international year of sanitation 

(WHO/UNICEF, 2014b). Open defecation is a common 

mailto:pharmalain2006@gmail.com
https://orcid.org/0000-0002-0977-6919


Global Sustainability Research 

Global Scientific Research        11 
 

example of poor sanitation. Over the years, the number of 

people practicing open defecation has fallen by 21%, from 

1.3 billion in 1990 to 1 billion in 2012 (WHO/UNICEF, 

2019). These 1 billion people with no sanitation facility 

continued to defecate in gutters, bushes, bodies of water and 
open field, etc. Most people (90%) who practice open 

defecation live in rural areas, but the number of people 

living in urban areas is also increasing (WHO/UNICEF, 

2014a). According to World Bank report in 2015, 39.84% 

of Indian population practice open defecation and it is 

known as the country with the highest number of people 

practicing open defecation (WHO/UNICEF, 2014a). Other 

countries with a high percentage of people practicing open 

defecation are Indonesia (63 million people), Pakistan (40 

million people), Ethiopia (38 million people), Nigeria (34 

million people), Sudan (19 million people), Nepal (15 

million people), China (14 million people), Niger (12 
million people), Burkina-Faso (9.7 million people), 

(WHO/UNICEF, 2014a; (WHO/UNICEF, 2010). 

Open defecation is influenced by a number of reasons which 

include lack of space to build toilets, lack of income, 

seasonal factors, and poverty. The major challenges faced 

by the residents in pursue to end open defecation is the lack 

of human resources base for sanitation. Although people 

living in slums constitute the highest percentage of those 

without the access to toilets, the whole communities suffer 

the effect of open defecation (Spears, 2014). Open 

defecation is a serious public health threat to human health 
especially for children under five years. Fecal-oral route is 

the major cause of diarrhoea disease as well as infections. 

Open defecation was identified by the World Health 

Organization, (WHO) in the year 2014 to be the leading 

cause of diarrhoea deaths and a threat to human health 

globally, due to unimproved sanitation practices (WHO, 

2013). It can also lead to malnutrition and stunted growth in 

children (Spears, Gosh & Oliver, 2017). 

Open defecation perpetuates the vicious cycle of disease and 

poverty and is widely regarded as an insult to personal 

dignity (WHO/UNICEF, 2014b). It causes serious harm 

when done in areas with high population or camping. With 
the insanitary situation in rural areas, open defecation has 

become a challenge and thereby an important public health 

issue and an issue of human dignity when it occurs in 

densely populated areas (O’Reilly, 2016). About 1.1billion, 

people (15% of the global population) practice open 

defecation. On the 19th November, 2013, the United Nations 

General Assembly declared “World Toilet Day”, to 

encourage changes in both human behaviors and policies on 

issues ranging from enhancing water management, creation 

of sanitation facilities, to ending open defecation (Afshan, 

2013). 
Research has also shown that the effect of open defecation 

is one of the most important factors of the groundwater 

sources pollution. The underground water is polluted when 

rain flushes feces that are dispersed in the environment into 

the water body (Tamberkar & Raigire, 2012). 

Approximately, 46million Nigerians (25% of the country’s 

population) practice open defecation, out of which, 

33million live in the rural areas and 130million persons are 

using unimproved sanitation facilities and majority of those 

affected are rural dwellers (UN, 2014). The eradication of 
open defecation is the key strategy for morbidity and 

mortality control, particularly in children under the age of 

five years (5). 

The general objective of this study was to assess the 

knowledge, perception and practice of open defecation 

among residents in Ussa Local Government Area of Taraba 

State, Nigeria. And the specific objectives were to: 

determine residents` knowledge of open defecation in Ussa 

Local Government Area of Taraba State; determine 

residents’ perception of open defecation among respondents 

in the study area; determine the proportion of residents who 

practice open defecation in the study area; identify the 
factors influencing open defecation practice among 

residents in the study area; identify the perceived health 

problems associated with open defecation and assess the 

sanitation facilities and surroundings of residents in the 

study area. 

 

Material and Method 

 

Study Setting 

 

The study area was Ussa Local Government Area of Taraba 
State. It has an area of 1495Km2, and a population of 92,017 

as at 2006 census. This study was carried between March 

and June, 2022. Ussa Local Government Area is located in 

the southern part of Taraba State. It shares boundary with 

Donga Local Government Area by the North, Kurmi Local 

Government Area by the East, Republic of Cameroon by the 

South and Takum Local Government Area by the West. It 

has eight (8) political wards. These are Lissam 1, Lissam 2, 

Kwesati, Lumbu, Fikyu, Kpambo, Kpambo puri, Rufu. Ussa 

is predominantly inhibited by Kuteb people who are mostly 

farmers, local politicians, traders and civil servants.  

 

Study Design 

 

A cross sectional descriptive study design was used for this 

study. This involved the administration of structured 

questionnaires and the used of observational checklist on 

sanitary facilities of respondents. 

 

Study Population 

 

The study population include adults of both gender between 

18years old and above in the study area. 
 

Sampling Procedure 
A multi-stage sampling method was used to select wards, 

households and respondents under the following stages; 

 



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Global Scientific Research        12 
 

Instrument for data collection 

 

The instrument for data collection was an interviewer 

administered structured questionnaire and an observational 

checklist.  
 

Method for Data Analysis 

 

Descriptive statistics was used to analyse the data obtained 

from questionnaire and the observational checklist. The 

responses were coded and analyzed. Data was analyzed 

using Statistical Package for Social Sciences, (SPSS) 

version 20. The results were expressed using descriptive 

statistics. Associations between variables were tested using 

Chi-square statistical test and significance level was set at 

5%. It was interpreted and presented in tables, percentage, 

bar chart, and frequencies. 
 

Ethical consideration 

 

A letter of introduction was obtained from the Department 

of Public Health University of Calabar, Calabar. Ethical 

clearance was also obtained from the Department of Public 

Health Clearance Committee to seek for entry permission 

into the community through the village chiefs and clan heads 

in the study areas. Verbal informed consent was duly sought 

from every respondent. Participation was strictly voluntary; 

respondents were informed that they have the right to 
withdraw from the participation at any time without the fear 

of penalty. The respondents were assured of confidentiality 

and privacy. There was no required indication of names on 

the questionnaire to ensure anonymity. 

 

Results 

 

Socio-demographic characteristics of the respondents 

 

All 384 copies of the questionnaire were returned for 

analysis giving a response rate of 100%. The results 

obtained showed that 202 (52.6%) respondents were 
females, 182 (47.4%) were males, 123 (32.0%) were aged 

between 26-30 years, 241 (62.8%) were married, 130 

(33.9%) had secondary education, 150 (39.1%) were 

farmers and 319 (83.1%) were Christians (Table 1). 

 

Knowledge of open defecation among respondents 

 

Results on knowledge of open defecation showed that 339 

(88.3%) respondents affirmed that they have knowledge of 

the meaning of open defecation out of which 227 (59.1%) 

defined open defecation as the practice of people defecating 

outside and not in designated toilet. A reasonable proportion 

of the respondents 235 (61.2%) indicated that open 

defecation is harmful to human health and highlighted 
possible effects on human health which include; emission of 

offensive odour 200 (85.1%), environmental degradation 

184 (78.3%) and pollution of water bodies 118 (50.2%). 

Most respondents 317 (82.6%) affirmed that the practice of 

open defecation can be avoided (Table 2). On the average, 

260 (67.7%) had good knowledge of open defecation while 

124 (32.3%) recorded poor knowledge. 

 

Table 1: Socio-demographic characteristics of the 

respondents (n=384) 

Variables Number of 

respondents 

Percentage 

Sex   

Male 182 47.4 
Female 202 52.6 

Age (in years)   
18-25  61 15.9 
26-30 123 32.0 
31-35 112 29.2 
36+ 88 22.9 

Marital Status   

Married  241 62.8 
Single 135 35.2 
Divorced  2 0.5 
Separated  2 0.5 
Widow/widower 4 1.0 

Educational status   
No formal education  67 17.4 
Primary 103 26.8 
Secondary  130 33.9 

Tertiary  84 21.9 

Occupation   
Farming 150 39.1 
Fishing 31 8.1 
Trading 71 18.5 
Civil servant  56 14.6 
Artisans 45 11.7 
Unemployed  31 8.1 

Religion    
Christianity 319 83.1 
Islam 53 13.8 
Traditional religion  12 3.1 

 

 

 

 

 



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Table 2: Knowledge of open defecation among respondents  

Variables Number of respondents Percentage 

Have knowledge of the meaning of open 

defecation  

  

Have knowledge  339 88.3 

Do not have knowledge  45 11.7 

Total 384 100 

Meaning of open defecation    

The practice if people defecating outside 
and not in designated toilet 

227 59.1 

The practice if people defecating outside 
and not in designated toilet 

112 29.2 

Do not know 45 11.7 

Total 384 100 

Open defecation is harmful to human 

health 

  

It is harmful 235 61.2 

It is not harmful 104 27.1 

Do not know 45 11.7 

Total 384 100 

Harmful effects of open defecation*    

Causes disease outbreak 51 21.7 
Degrades the environment  184 78.3 

Pollution of water bodies  118 50.2 

Emission of offensive odour 200 85.1 

Practice of open defecation can be 

avoided   

  

It can be avoided   317 82.6 

It cannot be avoided   22 5.7 
Don not know 45 11.7 

Total 384 100 

*Multiple responses 

Fig 1: Knowledge of open defecation among respondents Perception of respondents about open defecation 

0

10

20

30

40

50

60

70

Good knowledge Poor knowledge

260 (67.7%)

124 (32.3%)

%
 o

f 
re

sp
o

n
d

en
ts

Knowledge of open defecation



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Global Scientific Research        14 
 

 

Results on perception of respondents about open defecation 

shows that 45 (11.7%) strongly agreed to the statement that 

open defecation is dangerous to human and community 

health, 67 (17.4%) agree, 113 (29.4%) disagree and 93 
(24.2%) strongly disagree; 58 (15.1%) strongly agree to the 

statement that open defecation is more hygienic than 

defecating in the toilet, 100 (26.0%) agree, 84 (21.9%) 

disagree and 112 (29.strongly disagree; 54 (14.1%) strongly 

agree to the statement that infection can be easily contacted 

through the use of public toilet, 79 (20.6%) agree, 122 

(31.8%) disagree and 106 (27.6%) strongly disagree; 82 

(21.4%) strongly agree to the statement that defecating on 

farmlands increases soil fertility and is beneficial to man and 

environment, 105 (27.3%) agree, 87 (22.7%) disagree and 

69 (18.0%) strongly disagree; 66 (17.2%) strongly agree to 

the statement that open defecation contributes to 
environmental degradation,  111 (28.9%) agree, 105 

(27.3%) disagree and 31 (8.1%) strongly disagree (Table 3). 

On the average, 202 (53.6%) respondents demonstrated 

positive perception about open defecation while 182 

(46.4%) exhibited negative perception.  

 

Practice of open defecation among respondents 

 

Results on practice of open defecation shows that 302 

(78.6%) respondents indicated that they have defecated at 
least once in bushes, gutters, streams or uncompleted 

buildings, out of which 195 (64.6%) respondents always 

defecates in the open space, 68 (22.5%) defecates 

sometimes/occasionally and 39 (12.9%) practice open 

defecation only when traveling/during an emergency. More 

than half of the respondents’ 179 (59.3%) practice open 

defecation during the dry season while 123 (40.7%) practice 

theirs during the wet season (Table 4). 

Of the 384 respondents, 110 (28.6%) have access to a toilet 

facility and pit latrine 71 (64.5%) was identified as the type 

of toilet mostly used. Reasons for not having access to a 

latrine/toilet as indicated by the respondents include; High 
cost of building an improved latrine/toilet 201 (73.4%), lack 

of enough space 42 (15.3%) and 31 (11.3%) felt it’s not a 

priority (Table 4). 

 

 

Table 3: Perception of respondents 

about open defecation (n=384) 

Variables Strongly 

agree 

(%) 

Agree 

(%) 

I don’t 

know 

(%) 

Disagree 

(%) 

Strongly 

disagree 

(%) 

Open defecation is dangerous to human 
and community health  

45 (11.7) 67 
(17.4) 

66 
(17.2) 

113 (29.4) 93 (24.2) 

Open defecation is more hygienic than 

defecating in the  toilet  

58  (15.1) 100 

(26.0) 

30 (7.8) 84 (21.9) 112 

(29.2) 
Infection can be easily contacted 
through the use of public toilet 

54 (14.1) 79 
(20.6) 

23 (6.0) 122 (31.8) 106 
(27.6) 

Defecating on farmlands increases soil 
fertility and is beneficial to man and 
environment 

82 (21.4) 105 
(27.3) 

41 
(10.7) 

87 (22.7) 69 (18.0) 

Open defecation contributes to 
environmental degradation  

66 (17.2) 111 
(28.9) 

71 
(18.5) 

105 (27.3) 31 (8.1) 

 

 

 

 

 

 

 



Global Sustainability Research 

Global Scientific Research        15 
 

 

 

FIG 2: Perception of respondents about open defecation 

 

 

Factors influencing open defecation practice among 

respondents  

 

Factors influencing open defecation practice as indicated by 
the respondents were mainly; low cost 300 (99.3%), requires 

little or no maintenance 281 (93.0%), lack of access to toilet 

facility 274 (90.7%) and convenience 256 (84.8%) (Fig. 3). 

 

Perceived health problems associated with open 

defecation practice  

 

Perceived health problems associated with open defecation 

practice as indicated by the respondents were mainly;  

 

 
 

 

 

 

 

 

 

 

malaria 341 (88.8%), typhoid 221 (57.6%), cholera 210 

(54.7%) and dysentery 87 (22.7%) (Fig. 4).  
 

Assessment of sanitary facilities and general 

surrounding of households 

 

Of 384 household surveyed, 110 (28.6%) households had a 

toilet facility of which 38 (34.5%) were pit latrine without 

cover, 33 (30.0%) were pit latrine with cover and 31 (28.2%) 

were swat flush, 8 (7.2%) were water system closet. Of the 

110 toilet facilities, 58 (52.7%) toilets, were sanitary while 

52 (47.3%) were unsanitary.  Regarding water supply, 290 

(75.1%) households have access to water supply of which 
200 (69.0%) lack access to improved source of water supply. 

In terms of general surrounding, 356 (92.7%) household do 

not have a drainage system, 308 (80.2%) had bushes around 

their surroundings, 118 (30.8%) had stagnant water, 256 

44

45

46

47

48

49

50

51

52

53

Positive perception Negative perception

202 (52.6%)

182 (47.4%)

%
 o

f 
re

sp
o

n
d

en
ts

Perception about open fedecation



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Global Scientific Research        16 
 

(66.7%) has odour of excreta in the surrounding and 239 

(62.2%) do not have a proper waste storage facility and 

exhibit poor waste disposal (Table 5). 

 

 

 
Table 4: Practice of open defecation among respondents 

Variables Number of 

respondents 

Percentage 

Ever defecated in bushes, 

gutters, streams or uncompleted 

buildings 

  

Have defecated  302 78.6 

Have not defecated 82 21.4 

Total 384 100 

Frequency of defecating in the 

open space 

  

Always 195 64.6 

Sometimes/Occasionally 68 22.5 

Only when traveling/during an 
emergency  

39 12.9 

Total 302 100 

Period of the year individuals 

defecate in open space 

  

Wet season  123 40.7 

Dry season  179 59.3 

Total 302 100 

Have access to a latrine/toilet    

Have access 110 28.6 

Do not have access 274 71.4 

Total 384 100 

Type of latrine/toilet   
Water system closet  8 7.2 

Pit latrine  71 64.5 

Swat flush  31 28.2 

Total 110 100 

Reasons for not having access to 

a latrine/toilet 

  

Lack of enough space  42 15.3 

High cost of building an improved 

latrine/toilet   

201 73.4 

Not a priority  31 11.3 

Total 274 100 

 

 



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Fig 3: Factors influencing open defecation practice among respondents  

 

FIG 4: Perceived health problems associated with open defecation practice  

 

 

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0

Convinience

Privacy

Safety and security

Lack of access to toilet facility

Requires little or no maintainance

Low cost

Culture and religious influence

Lack of space to build toilet/latrine

84.8

28.8

22.2

90.7

93.0

99.3

13.6

13.9

% of respondents

Fa
ct

o
rs

 in
fl

u
en

ci
n

g 
o

p
en

 d
ef

ec
at

io
n

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

Cholera Malaria Typhoid Hepatitis HIV/AIDS Diahorrea Cancer Dysentry Do not
know

54.7

88.8

57.6

11.7

4.7

17.4

3.1

22.7

28.4

%
 o

f 
re

sp
o

n
d

en
ts

 

Health problems associated with open defecation



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Table 5: Assessment of sanitary facilities and general surrounding of households 

Variables Number of 

respondents 

Percentage 

(A) Toilet facility    

Availability of toilet facility   
Available 110 28.6 
Not Available  274 71.4 

Total 384 100 

Type of toilet facility available   
Pit latrine with cover 33 30.0 
Pit latrine without cover 38 34.5 
Swat flush  31 28.2 
Water system closet 8 7.2 

Total 110 100 

Sanitary condition of toilet facility   

Sanitary  58 52.7 
Unsanitary  52 47.3 

Total 110 100 

   

Water supply facility    

Availability of water supply facility   

Available 290 75.5 
Not Available  94 24.5 

Total 384 100 

Source of water supply   
Improved 90 31.0 
Unimproved  200 69.0 

Total 290 100 

C) General surrounding    

Availability of drainage system   
Available 28 7.3 
Not Available  356 92.7 

Total 384 100 

Sanitary condition of drainage system   

Sanitary  9 32.1 
Unsanitary  19 67.9 

Total 28 100 

Bush in the surrounding   
Present  308 80.2 
Absent 76 19.8 

Total 384 100 

Proper waste storage and disposal   

Available  145 37.8 
Not available  239 62.2 

Total 384 100 

Odour of excreta in the surrounding    

Present  256 66.7 

Absent 128 33.3 

Total 384 100 

Presence of stagnant water   
Present 118 30.8 
Not present  266 69.2 
Total  384 100 

 

 

 

 

 



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Discussion  

 

The practice of open defecation is a global issue due to its 

implication on human health, dignity and the environment.  

It is mostly prevalent in third world countries including 
Nigeria and significantly fuels the spread of infectious 

diseases, cause the proliferation of neglected tropical 

diseases (trachoma, schistosomiasis, intestinal worms, etc.) 

and increase cases of malnutrition especially amongst the 

rural populace (Ngwu, 2017). Ensuring an open defecation-

free environment requires a strong synergy between the 

community and health professionals. In the light if this, 

understanding their perception about open defecation and 

identifying the factors influencing open defecation practice 

would be a perfect road-map to avert the practice of open 

defecation in Nigeria. 

As documented in the current study, it was observed that 
two-third of the respondents 260 (67.7%) had good 

knowledge of open defecation especially in the aspect of 

defining open defecation, acknowledging that open 

defecation is harmful to human health and highlighting the 

possible effects of open defecation practice which include; 

emission of offensive odour, environmental degradation and 

pollution of water bodies (Table 2). The exhibition of high 

knowledge level of open defecation among respondents 

could be attributed to their routine observation of events and 

practices within their environment, personal/family 

members/friends experiences and access to health 
promotion information. This finding was congruent with a 

recent Ghanaian study where the study participants 

demonstrated high knowledge of open defecation (Asare, 

Gyan &Denteh, 2019). 

More than half of the respondents 202 (52.6%) 

demonstrated positive perception about open defecation 

whiles the remaining 182 (47.4%) exhibited negative 

perception. Respondents’ perception about open defecation 

may be influenced by their belief system, cultural practices, 

superstition, myths and religious affiliations.  Each of these 

perspectives may exert significant level of influence 

(whether positive or negative) on their level of practice. This 
suggests that interventions on achieving an open defecation-

free environment should be tailored towards changing 

behavioural patterns of individuals who frequently practice 

open defecation. This finding was similarly reported by 

Asare, et al. 2019, where respondents perceived open 

defecation as bad practice. However, it is worrisome where 

respondents in the current study believe that defecating on 

farmlands increases soil fertility and felt is beneficial to man 

and environment. This shows pure negligence of the effect 

of open defecation on human health. The low risk perception 

of the adverse effects of open defecation on human health 
may largely account for their negative perception towards 

open defecation practice. 

More than two-third of the respondents 302 (78.6%) 

indicated that they have defecated at least once in bushes, 

gutters, streams or uncompleted buildings, out of which 195 

(64.6%) respondents frequently defecates in the open space 

(Table 4). This finding was similarly reported in other 

studies but the percentage of open defecation was lower than 

that reported in the current study (Verma, 2017; Anuradha, 

Dutta, Raja, Lawrence, Timsi & Sivaprakasam, 2017; 
Panda, Chandrakar, & Soni, 2017). The high prevalence 

reported in the current study suggests that open defection is 

a common practice in the study area with a mix of lifestyle, 

culture and ancestral practices. Open defecation tends to be 

more practiced in the dry season than during the wet season 

(Table 4). The reason may be linked to the fact that wet 

season (especially during heavy rainfall) restrict or limit 

movement and operation of activities. As a result, 

respondents who do not have access to a toilet facility either 

defecate in a polythene bag or bucket and dispose it by 

throwing into the busy or in flowing water. In essence, dry 

season tends to be more favourable to practice open 
defecation than during wet season. It was also documented 

that only one-fourth of the respondents have access to a 

toilet facility and pit latrine was identified as the most type 

of toilet used. Main reasons for not having access to a 

latrine/toilet as indicated by the respondents include; high 

cost of building an improved latrine/toilet, lack of enough 

space and some felt it’s not a priority (Table 4).These 

reasons may be linked to respondents’ socio-economic 

status where the poorer population suffer most from lack of 

access to sanitation facilities. This finding corroborates with 

that of Anuradha et al., 2017, where similar reasons for not 
having access to a latrine/toilet were documented. The 

significant lack of access to toilet facilities confirms the high 

prevalence of open defecation practices among respondents 

in the current study.  Factors influencing open defecation 

practice as indicated by the respondents were mainly; low 

cost, requires little or no maintenance, lack of access to toilet 

facility and convenience. This finding is congruent with 

other studies where similar factors influencing open 

defecation were documented (Asare, et al. 2019; Verma, 

2017). Contrariwise, a Keyanian mixed-method study 

identified culture and poverty as major factors contributing 

to open defecation practice (Busienei, Ogendi & Mokua, 
2019). Unlike the modern toilet facilities, defecating in open 

fields do not require any cost implication or any form of 

maintenance. This is often considered in households when 

building a latrine or toilet facility is less prioritized. Lack of 

access to toilet facility has been identified as a contributory 

factor to open defecation practice. This was evident during 

the sanitary inspection of households conducted in the 

current study where only one-fourth of households had a 

toilet facility (Table 5). In the light of this, communities and 

settlements without access to toilet facilities would 

continuously practice open defecation until a lasting 
solution is provided to address end this practice. Even with 

the availability of toilet facilities, once the users outweigh 

the number of toilet facilities available, open defecation 

would still be practice. Hence, adequate provision of toilet 

facilities can significantly curb open defecation practice. 



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Global Scientific Research        20 
 

Convenience as a factor contributing to open defecation 

could be linked to the fact that available toilet facilities is 

always dark, filthy, smelling, poorly ventilated and lack 

privacy. This was confirmed during the sanitary inspection 

of households where out of 110 households who had a toilet 
facility, toilet facilities in 52 households were unsanitary 

(Table 5). The unhygienic conditions of some toilet facilities 

constantly encourage the practice of defecating in open 

fields. Hence, while it is imperative to ensure the provision 

of toilet facilities for household use, effort should be tailored 

towards constructing user-friendly toilet facilities as well as 

devise an approach to ensure the toilet facilities is constantly 

in hygienic condition. 

Perceived health problems associated with open defecation 

practice as indicated by the respondents were mainly; 

malaria, typhoid, cholera and dysentery (Fig 2). This finding 

supports that of Anuradha et al. 2017, where respondents 
knew at least one disease associated with open defecation 

practice.  A number of health problems are largely 

associated with infected human excreta which contain 

several harmful organisms (Saleem, Buedett & Heaslip, 

2019). The identified health problems often affects a 

significantly proportion of the poorer population who do not 

have access to improved sanitation facilities (Peprah, Baker, 

& Moe, 2015; Njuguna & Muruka, 2017). The diseases are 

usually transmitted via feacal-oral route which arise from 

consumption of contaminated agricultural food products and 

underground water sources. Open defecation also propel 
flies and rodent infestation as well as emission of offensive 

odour which account for why malaria was the most 

identified health problem associated with defecation in open 

fields.  

Regarding sanitary facilities and general surrounding of 

households, more than two-third of the respondents lack 

access to toilet facilities, improved source of water supply, 

drainage system, proper waste storage facility and exhibit 

poor waste disposal and had bushes and odour of excreta 

around their surroundings,  (Table 5). This results showed 

that a significantly proportion of the rural populace still lack 

access to basic sanitation facilities. Lack of these facilities 

increases their vulnerability to contract infectious diseases 

within their vicinity and continually encourage the practice 
of open defecation. A healthy and open defecation-free 

environment can only be achieved if these sanitation 

facilities are adequately provided in rural communities. 

 

Conclusion  

 

Open defecation is still a common practice in rural Nigeria 

especially where there is significant lack or limited access 

to improved sanitation facilities. The drive to protect human 

health and improve environmental sanitation would 

essentially require ending open defecation practice.  

Findings in this study showed that respondents had good 
knowledge of open defecation, exhibited positive perception 

about open defecation, but majority of the proportion 

confirmed to have defecated in open fields. It was also 

observed that basic sanitation facilities in the study area such 

as toilets, access to improved water source, drainage system 

were not available in two-third of the household surveyed. 

Hence, achieving an open defecation-free environment 

would require the collaborative effort of relevant 

stakeholders. 

 

Acknowledgement: We acknowledge all our colleagues in 
the department of Public Health, University of Calabar, 

Nigeria, who contributed to the success of this article. 

 

Funding: none 

 

Conflict of Interest: There is no conflict of interest among 

authors. 

 

 

 

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