Faculty of education - University Of Nigeria Nsukka [PDF]

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Dangbin, Joseph Philip PG/Ph.D/12/63001

Water Hygiene Knowledge, Attitude, Practice and an Enhancement Strategies among Women Attending Antenatal Care in Plateau State, Nigeria

Department of Human Kinetics and Health Education

Faculty of education

Digitally Signed by: Content manager’s Name

Ebere Omeje DN : CN = Webmaster’s name O= University of Nigeria, Nsukka OU = Innovation Centre

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Title Page

Water Hygiene Knowledge, Attitude, Practice and Enhancement Strategies among Women Attending Antenatal Care in Plateau State, Nigeria

A Thesis Report Submitted to the Department of Human Kinetics and Health Education, University of Nigeria, Nsukka in Fulfillment of the Requirements for the award of Doctor of Philosophy (Ph. D) Degree in Public Health Education

By

Dangbin, Joseph Philip PG/Ph.D/12/63001

May, 2016

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Approval Page

This Project has been approved for the Department of Human Kinetics and Health Education, University of Nigeria, Nsukka

By

Tr. Professor E.S. Samuel (Project Supervisor)

Internal Examiner

External Examiner

Tr. Professor E. S. Samuel Head of Department

Prof. Uju Clara Umo Dean Faculty of Education

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Certification Dangbin, Joseph Philip a Postgraduate student of the Department of Human Kinetics and Health Education with registration number PG/Ph.D/12/63001, has satisfactorily completed the requirements for the degree of Doctor of Philosophy (Ph.D) in Public Health Education. The work embodied in this thesis report is original and has not been submitted in part or in full for any other Diploma or Degree of this or any other University.

Dangbin, Joseph Philip (Student)

Date

Tr. Professor .E. S. Samuel Supervisor

Date

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Dedication This thesis is dedicated to the memory of my late parents Mr. and Mrs. Dangbin.

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Acknowledgements This work would not have been possible without the contributions of notable individuals. In line with the above, the investigator would like to specially acknowledge the efforts of those who contributed in one way or the other to the successful completion of this study. Special thanks go to you my Supervisor Tr. Prof. E. S. Samuel for his support, guidance encouragement and tireless efforts in reading and correcting the manuscript of this work. God reward you abundantly. The researcher also wishes to thank and appreciate the following for validating the research instruments for this study: Dr. D. O. Dike; Dr. (Mrs.) C, N. Ogbuji; Dr. J. E. Umeifekwem; Dr. G. C. Nji; Dr. F. C. Ugueze; Dr. C. C. Igbokwe and Dr. A. A. Jatau. Moreover, the investigator is grateful to the following panel members at proposal: Professor O. A. Omeakuka; Dr. (Mrs.) C. N. Ogbuji and Dr. D. A. Aniodo. The researcher is also appreciative of the following members of panel at Faculty Seminar: Professor (Mrs.) E. U. Anyakoha, Dr. F. M. Onu; Dr. C. C. Igbokwe and Dr. R. E. Ozioko. Worthy of mention also were the contributions of the administrative Head of the health facilities consulted and their midwives who granted permission to access the information required for this study. Also, appreciation must be made to those who responded to all the instruments. This acknowledgement would be incomplete without appreciating and mentioning Mrs. R. Telfim of Plateau State Ministry of Health, Jos who released the figure of population used in this study. Above all, the researcher exalts the name of God Almighty for his grace over me while this study lasted.

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Table of Contents Title Page

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Approval Page

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Certification Page

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Dedication

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Acknowledgements

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Table of Contents

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List of Tables

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List of Figures

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Abstract

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CHAPTER ONE:

Introduction

Background to the Study

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Statement of the Problem

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Purpose of the Study

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Research Questions

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Hypotheses

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Significance of the Study

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Scope of the Study

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CHAPTER TWO: Conceptual Framework

Review of Related Literature 19

Water Hygiene

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Knowledge

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Attitude

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Practice

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Measurement of knowledge, attitude and practice

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Enhancement strategies

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Demographic factors associated with water hygiene

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Schematic representation of conceptual framework

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Theoretical Framework Social Cognitive Theory (SCT)

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Theory of Change of Attitude (TCA)

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Stages of Change /Transtheoretical Model (TTM)

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Schematic representation of theoretical framework

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Empirical Studies

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Summary of Literature Reviewed

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CHAPTER THREE:

Methods

Research Design

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Area of the Study

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Population of the Study

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Sample and Sampling Techniques

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Instruments for Data Collection

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Validity of the instruments.

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Reliability of the instruments.

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Method of Data Collection

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Method of Data Analysis

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CHAPTER FOUR:

Results and Discussions

Results

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Discursion

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CHAPTER FIVE:

Summary, Conclusion and Recommendations

Summary

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Conclusions

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Recommendations

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References

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Appendices

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Appendix A

Letter of introduction

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Appendix B

Letter to the respondents

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Appendix C

Water hygiene knowledge, attitude and practice questionnaire (WaHKAPQ)

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Women attending antenatal care focus group discussion guide (WaHFoGuDi)

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Water hygiene enhancement strategy questionnaire (WaHESQ)

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Appendix D Appendix E

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Appendix F

List of local government areas in senatorial zones of Plateau State 184

Appendix G

List of Plateau state senatorial zone antenatal care facilities

Appendix H

Population of women who attended ANC in 2014 in Plateau State 201

Appendix I

List of the antenatal care facilities and the stratum sample size

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Appendix J

List of antenatal care facility ant grand total

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Appendix K

List of antenatal care facility sampled by category and location

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Appendix L

List of sampled ANCF

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Table

List of Tables

1. Percentage Responses on the Water Hygiene Knowledge of Women attending ANC in Plateau State

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2. Percentage Responses on the Water Hygiene Attitude of Women attending ANC in Plateau State

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3. Percentage Responses on the Water Hygiene Practices of Women attending ANC in Plateau State

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4. Percentage Responses on the Water Hygiene Knowledge of Women attending ANC based on Level of Education in Plateau State

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5. Percentage Responses on the Water Hygiene Knowledge of Women attending ANC based on Location in Plateau State

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6. Percentage Responses on the Water Hygiene Attitude of Women Attending ANC based on Level of Education in Plateau State

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7. Percentage Responses on the Water Hygiene Attitude of Women Attending ANC based on Location in Plateau State

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8. Percentage Responses on the Water Hygiene Practises of Women attending ANC based on Level of Education in Plateau State

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9. Percentage Responses on the Water Hygiene Practises of Women attending ANC based on Location in Plateau State

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10. Mean Responses of Experts on Water Hygiene Knowledge Enhancement Strategies

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11. Mean Responses of Experts on Water Hygiene Practice Enhancement Strategies

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12. Mean Responses of Experts on Water Hygiene Attitude Enhancement Strategies

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13. Summary of Chi-square Analysis Testing the Null Hypothesis regarding Water Hygiene Knowledge of Women Attending ANC according to Level of Education in Plateau State

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14. Summary of Chi-square Analysis Testing the Null Hypothesis regarding Water Hygiene Knowledge of Women Attending ANC according to Location

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15. Summary of Chi-square Analysis Testing Water Hygiene Attitude of Women Attending ANC according to Level of Education in Plateau State

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16. Summary of Chi-square Analysis Testing Water Hygiene Attitude of Women Attending ANC according to Location in Plateau State

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17. Summary of Chi-square Analysis Testing the Null Hypothesis regarding Water Hygiene Practices of Women Attending ANC according to Level of Education

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18. Summary of Chi-square Analysis Testing the Null Hypothesis regarding Water Hygiene Practices of Women Attending ANC according to Location

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List of Figures Figure 1. Conceptual Framework of Enhancement Strategies of Water Hygiene

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Figure 2. Theoretical Framework: Schematic representation of theoretical framework of Water Hygiene KAP

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Abstract In some cases in Plateau State, water was got from source closest to the user irrespective of its quality. Moreover, fetched water was mixed with stored one, which is troubling and point to problems among others. Therefore, the aim of this study was to investigate the water hygiene KAP of women attending ANC in Plateau State and the outcome used to proffer water hygiene KAP enhancement strategies. To achieve the main purpose, the study determined water hygiene KAP of women attending ANC in Plateau State using ten research questions and six hypotheses tested at 0.05 level of significance. Descriptive survey research design was used for the study. The population for the study consisted of 150,913 (all the women who attended ANC in Plateau State in 2014). The sample size for the study was 777 drawn from the population using multi stage sampling procedure. Two types of instruments (WaHKAPQ & WaHESQ) used for the study were validated by five experts from the Department of Human kinetics and Health Education and Measurement and Evaluation, University of Nigeria, Nsukka. The Cronbach Alpha reliability index of WaHKAPQ was .80 and WaHESQ, .89. The research questions were answered using descriptive statistic of frequencies, percentages and means. The Chi-square statistic was used to test all the null hypotheses at 0.05 level of significance. The findings of the study revealed that majority (61.6%) of women who attended ANC possessed correct knowledge regarding water hygiene, water collection (75%), water source protection (74.8%) and water transportation (74.2%) while more than half of women possessed correct knowledge regarding water storage (58.3%) and about half of women possessed correct knowledge regarding PoU of water (49.2%) whereas over 30 per cent of women possessed correct knowledge regarding water purification (37.1%). Also, more than half (56.4%) of women expressed positive attitude regarding water hygiene while majority of the women expressed positive attitude regarding water source protection (76.7%) and water storage (70.2%) whereas over one half of the women displayed positive attitude towards water purification (58.5%), water transportation (51.8%) and PoU of water (50.5%) while 30.6 per cent of women expressed positive attitude regarding water collection (30.6%). Also, the finding showed that women attending ANC practised: water hygiene (overall always = 32.7%, sometimes = 23.7%, rarely = 22.9%); water source protection (always = 49.9%, sometimes = 32.6%, rarely = 10.4%); water collection (always = 40.7%, sometimes = 25.6%, rarely = 16.3%), water storage (sometimes = 40.5%, always = 38.6%, rarely = 8.9%); water purification (always = 37.7%, sometimes = 33.7%, rarely = 20.3%), transportation of water (always = 34.2%, sometimes = 20.1%, rarely = 15.7%) and point-of-use (PoU) of water (sometimes = 32.7%, always = 29.5%, rarely = 17.2%). The findings further showed that there was no significant difference with regard to practices of water hygiene of women who attended ANC based on location (overall χ 2 = 2.077, P-value .586 > .05), storage of water ( χ 2 = 1.638 > P = .672, df = 3), transportation of water ( χ 2 = 2.107 > P = .551, df = 3), water collection ( χ 2 = 3.25 > P = .422, df = 3), PoU of water ( χ 2 = 1.999 > P = .591, df = 3), water source protection ( χ 2 = 1.584 > P = .673, df = 3) and purification of water ( χ 2 = 1.884 > P = .607, df = 3). In addition, the findings of the study also showed that the enhancement strategies of water hygiene KAP were adjudged very appropriate with cluster means of 2.55 with SD of 559, which fell between 2.49 – 3.00; means of 2.62 with SD = .515, which fell between 2.49 – 3.00 and 2.65 with SD = .496, which fall between 2.49 - 3.00 among others. Based on the findings of the study, it was recommended among others that women attending ANC should practise the items contained in the water hygiene enhancement strategy aspects of the strategies on attitude towards water hygiene. This becomes necessary so as to influence all women attending ANC in both rural and urban areas express positive attitude towards water hygiene.

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CHAPTER ONE Introduction Background to the Study Water hygiene knowledge, attitude, practice (KAP) and enhancement strategies are key to ensuring the sustenance of good health, wellbeing, comfort and survival of man, including women attending antenatal care (ANC). This is because water has impurities that affect it in the environment. These impurities are often ingested as a result of man’s inability to embark on correct water hygiene, which results to dire consequences. For instance, in many homes, water related diseases have been one of the leading causes of mortality and morbidity in developing countries (World Health Organization and United Nation International Children Fund [WHO/UNICEF], 2000). In addition, WHO (2004) further revealed that approximately 88 per cent of water related diseases were attributable to unsafe water use, inadequate sanitation and hygiene. Furthermore, the consequences of inappropriate water hygiene according to UNICEF/WHO (2009) led to diarrhoea that killed 1.5 million children of less than five years of age annually more than deaths from acquired immune deficiency (AIDS), malaria and measles combined globally. According to Craun, Brunkard, Yoder, Roberts, Carpenter, Wade,…Roy (2010), from 1971 to 2006, 54 per cent of reported water related disease outbreaks were due to the use of untreated water. Jones (2011) showed that 37 per cent of people not using improved source of water lived in sub-Saharan Africa, which included Nigeria and Plateau State. Jones further pointed that poor practices of water hygiene were on the increase and accounted for 2.2 million children deaths of less than 5 years of age. The scourge of water related diseases had been on the increase. Nigeria Center for Disease Control – NCDC reported an increase in water borne diseases with 9,006 cases and 106 deaths in the first quarter of 2014 (Leo, Sadiq, Alao, Auwal, Liman & Mohammed, 2014). When untreated water was ingested, cholera occurred (Igomu, 2011). It may be in this regard that in 2013, Plateau State government reported 130 cases of cholera disease and 11 deaths (Sadiq, Auwal & Joseph, 2013). Therefore, the ingestion of untreated water can lead to many health problems such as gastrointestinal illness, reproductive problems and neurological disorders (Center for Disease Control [CDC], 2013). Moreover, infants, young children, pregnant women, the elderly and patients with compromised immune system due to AIDS, chemotheraphy or transplant medications may be especially susceptible to illness (United States Environmental Protection Agency [USEPA], 2013). Thus, safe water supports

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life. The above statistics lend credence to the importance of the ingestion of safe water if good health is desired. Water is an important ingredient necessary to all forms of life. Mathur (2007) viewed water as a great cleaning agent that is used both externally and internally. Moshby (2009) defined water as a chemical compound, which one molecule contains one atom of oxygen and two atoms of hydrogen. Leeds (2014) conceived water as a compound that is made of two parts, hydrogen and one part oxygen. Quotes (2015) posited that water is the fluid which decends from the clouds in rain and which forms rivers, lakes, seas and oceans. Water as used in this study refers to any clear, colourless, odourless, pleasant tasting liquid that is necessary for all forms of life. Thus, it may imply that water is a transparent fluid which forms the world's streams, lakes, oceans and rain that is a major chemical constituent of the fluids of living things. Furthermore, water can be used for domestic, irrigation, commercial, industrial and hydroelectric power purposes (Heaton, 1999). Domestic water includes water used for normal household purposes such as drinking, food preparation, bathing and personal hygiene, dish washing, laundry, general household cleaning, watering of lawns and gardens. Water is used for irrigation, which involves the supply of an area of land through pipes or channels with water to grow crops. Commercial and industrial water is used for manufacturing of goods, while water is also used for the generation of electricity, known as hydro-electricity. Water is required in the human body for the maintenance of vital physiological and biochemical processes such as digestion, respiration, excretion and circulation. Water used for these purposes need to be clean, clear and free from harmful substances, minerals, chemicals and microorganisms. This implies that water introduced into the human body must be safe. The consumption of safe water does not cause illness or health problems but maintains health. Safe water ought to be free from dirts, wastes, feaces and germs. Also, it must be free from poisonous chemical compounds or the presence of chemicals, which must be below permitted level and minerals therein not exceeding tolerant level. It must also be tasteless, colourless, odourless, and drinkable. Unfortunately, water often contains particles, dirts, microorganisms, bacteria of cocci, bacilli or flagella, coliforms, viruses, algae, Escherichia coli, Pseudomonas aeruginosa, Campylobacter spp, Salmonella spp, protozoas of Crysptosporidium and giardia lamblia thus making it unclean. In other to make water clean and safe for use, measures of hygiene like purification of water among others become important.

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Hygiene is a term that refers to practices that help maintain sound health and prevent disease. Pugh, Warner, Filardo, Binns, Francis, Lukens,…Cradle (2000) defined hygiene as any practice of cleanliness that promotes health and wellbeing especially of a personal nature. Rand and Frazier (2007) referred to hygiene as including practices that relate to personal hygiene, food hygiene; environmental hygiene and keeping household environment free of excreta and solid wastes, as well as keeping drinking water supplies safe and free from contaminants. It involves regular washing of the body, clothing, hair, brushing of teeth and caring for the gums (Ilika & Obanu, 2009). In addition, Center for Disease Control (CDC, 2014) referred to hygiene as behaviors that can improve cleanliness and lead to good health such as frequent hand washing, face washing and bathing with soap and water. Nyanghura (2014) viewed hygiene as any personal effort to make oneself clean. Hygiene as used in this study refers to keeping water odourless, tasteless, colourless and free from microorganisms to prevent illness or disease in other to promote sound health when used. It involves all the practices that help people stay healthy. This implies that hygiene is an embodiment of cleanliness of the human body, food, kitchen, environment and keeping water clean. The focus of this study was water hygiene. Water hygiene eliminates or removes impurities and microorganisms from water to keep it safe for use. According to Business (2015), water hygiene is a process for enhancing the quality of water so that it meets the quality criteria for its fitness for intended use. To achieve correct water hygiene, Mintz, Reiff and Tauxe (1995) revealed that one needs to have container with single opening five to eight centimeters in diameter with strong, tightly fitting cover that makes it easy to fill and add disinfectant but difficult to immerse hands or utensils. In addition, Sobsey (2002) pointed that water carrying vessels should be between 10-25 liters capacity, rectangular or cylindrical with one or more handles and flat bottoms for portability and ease of storage among others. In the context of this study, water hygiene refers to the use of various ways to eliminate impurities, odour, taste, colour and pathogens from water in order to keep it suitable for use to prevent disease and promote sound health when used. In order to eliminate impurities, filtration, disinfection, aeration, coagulation, flocculation and sedimentation are important (Joint Departments of the Army and Air Force United States of America (JDAAUSA, 1985). Therefore, for any water hygiene to be effective, the multiple barrier principles identified by JDAAUSA (1985) as ways for the removal of contaminants in raw water is necessary. Filtration is the process where liquid is passed through a medium that helps to remove smaller particles in it. JDAAUSA (1985) defined filtration as the separation of larger

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particles from water by passing it through a porous medium, usually sand, granular coal or granular activated carbon. CDC (2015) viewed filtration as the process of removing impurities from water by means of physical barrier, chemical or biological processes. In this study, filtration refers to the process of passing water through a porous medium to remove impurities from it. Various types of filtration media include slow sand, pressure sand, diatomaceous earth, porous stone or ceramic, paper or cloth and charcoal, membrane filters and depth filters among others. Filtration media is better enhanced to purify water when such is disinfected. To disinfect requires cleaning a substance with something to inactivate or kill microorganisms. According to Chlorine Chemistry Council (2003), disinfection is a means of destruction of harmful microorganisms usually by the use of bactericidal chemical compounds. Lenntech (2014) conceived disinfection as the removal, deactivation or killing of pathogenic microorganisms in water. Disinfection as used in this study means the deactivation or killing of pathogenic microorganisms in water using chemical or physical disinfectants to make it suitable for use. Disinfection thus destroys organic contaminants from water, which serve as nutrients or shelters for microorganism. Moreover, disinfectants do not only kill microorganism but also have residual effect, which means that they remain active in the water after disinfection. In addition, disinfection can be attained by means of chemical and physical disinfectants. The chemical disinfectants for water include the use of chlorine, chlorine dioxide, calcium hypochlorite, ozone, halogens of bromine, iodine, bromine chloride, copper, silver, kaliumpermanganate, fenols, alcohols, hydrogen peroxide, and several acids and bases. Ultraviolet light such as electronic radiation, gamma rays, sounds and heat as in boiling of water can all be used for disinfection of raw water. Aeration implies the exposure of water to surface air. As conceived by Hofkes and Huissman (1987) aeration is the blending of water with air in order to increase oxygen content in water; increase the pH in water by reducing its carbon dioxide content; remove iron, magnesium, hydrogen sulphate, methane, various volatile and organic compounds responsible for flavour and smell in water. As pointed by Paulson (2012), aeration is used to mix, circulate or dissolve air into a liquid or other substance(s). Aeration as used in this study refers to the process of exposure of water to air so as to remove volatile substances in water such as odour. It may follow that aeration could be used for the oxidation of substances such as iron and manganese; removal of carbon dioxide; taste and odour producing substances such as hydrogen sulfide; volatile organic compounds; removal of compounds suspected to

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be carcinogenic such as methane, and increase pH. Aeration gives better results when sedimentation is attained. Sedimentation may mean the process where fluid is allowed to move slowly, causing heavy floc particles to settle to the bottom. According to CDC (2015), sedimentation is a process where floc particles are caused to settle to the bottom of water supply due to its weight. Sedimentation in this study refers to the settling under gravity of dirt particles in raw water. Sedimentation implies the movement of solid particles to settle downward through the force of gravity, centrifugal force or electromagnetism. In the case of water, heavy particles (flocs) settle to the bottom and clear water is left above to be filtered. For sedimentation to be achieved in causing flocs formation, coagulation is important. Coagulation is a process in the formation of small particles in raw water. LeChevallier and Au (2004) submitted that coagulation is the addition of a substance that forms hydrolysis products that cause particle destabilization and interparticle collisions in water. Environmental Protection Agency (EPA, 2011) conceived coagulation as a process by which dirt and other small suspended solid particles are chemically bound, forming flocs using coagulant so that they can be removed from water. Coagulation in this study refers to the process that involves addition of iron or aluminum salts such as aluminum sulphate, ferric sulphate, ferric chloride or polymers to raw water in other to bring dirt particles close together. Thus, it implies that the process of coagulation require having positive charge of the chemicals (coagulant) neutralizing negative charge of dissolved and suspended particles in raw water. When this reaction occurs, the particles bind together or coagulate. Large coagulates is formed through floculation. Flocculation could be any physical process in the formation of solids into large mass. LeChevallier and Au (2004) defined flocculation is the physical process of producing interparticle contacts that lead to the formation of large particles. EPA (2011) posited that flocculation is the physical process of growing particles (flocs) in water. CDC (2015) conceived flocculation as the binding of dirt particles with chemicals to form larger particles called floc. In this study, flocculation is the physical process which leads to the production of larger interparticle formation of flocs in raw water. It implies that flocculation join together small particles into larger, settleable and filterable particles. It occurs when alum, potash ash, magnesium hydroxide, ferric sulfate or ferrous sulfate are added to water and colloidal particles of minerals, clay, silt, organic debris and microscopic organisms ranging in size from about 0.001 to 1.0 micrometer to form tiny sticky particles called floc which attract the dirt particles. Flocculation is an important technology for larger scale water treatment, which

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requires a degree of skill, technical competence and knowledge. From the foregoing discourse on water, water hygiene and water hygiene knowledge and practice appeared to be an important means to achieving correct water hygiene for the maintenance of sound health. The right knowledge of hygiene of water when practiced influences correct water hygiene. Adequate knowledge, positive attitude and correct practises of hygiene have been identified by WHO (2004) as important measures that yield correct knowledge of water hygiene. Knowledge as defined by Carter and Winifred (2005) is accumulated facts, truths, principles and information to which the human mind has access. Comfort (2005) viewed knowledge as the sum of our conceptions, views and predispositions which have been established and tested. Knowledge in the present study refers to facts, truths, principles or information that people have acquired with regard to water hygiene. This may imply that if correct facts, truths, principles or information are applied to water hygiene, the right knowledge of water hygiene occur. Knowledge of water hygiene could be an important ingredient in forestalling water related diseases. Knowledge of water hygiene as depicted by Clarke (2001) refers to the facts and principles accumulated by people with regard to water hygiene. In this study, water hygiene knowledge refers to the facts, truths, principles or information that help people to eliminate impurities, odour, taste, colour and microscopic organisms in water so as to keep it suitable for use to prevent disease and promote sound health. This implies that if knowledge of water hygiene is compromised, the presence of pathogen, toxic chemicals and particles found in such water when ingested can cause disease affecting man’s health like diarrhoea among others. Whereas water related diseases may stem from incorrect knowledge of water hygiene. In Plateau State, observation has shown that domestic water was collected from unhygienic sources such as streams, rivers and shallow wells that may be unsafe. Moreover, all and sundry including women attending ANC chose wide opened containers without lid to fetch and store domestic water. This implies incorrect knowledge of water hygiene that can have implications on health. In this regard, there is the need for all including women attending ANC have correct knowledge of water hygiene facts; truths, principles or information if they must enjoy safe water devoid of disease causing organisms even in Plateau State. In Plateau State, water was got from source closest to the user irrespective of its quality. This implied incorrect water hygiene attitude. They also fetched and mixed stored water with freshly fetched one implying incorrect practises of water hygiene. The situations above concerning water hygiene KAP even of women attending ANC is troubling and point

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to problems, which justify the study. From the foregoing discourse on water; water hygiene and practices of water hygiene, it follows that knowledge of water hygiene, attitude and practices are very important for the maintenance of safe water that when ingested leads to sound health. However, women attending ANC are at liberty to express their feeling. When feelings or disposition are expressed, attitude is expressed. Attitude according to Kerlinger (2002) is an organized predisposition to feelings, perception and behaviour towards a referent or cognitive object. Mudary (2003) viewed attitude as a feeling tone directed towards a person, object or idea. Luthans (2007) defined attitude as persistence tendency to feel and behave in a particular way towards some object. Attitude in the context of this study refers to predisposition women have concerning water hygiene. Therefore, the disposition women attending ANC may have could be either positive or negative. Thus, when positive or negative disposition towards water hygiene occurs, attitude towards water hygiene is observed. When attitude to water is expressed, attitude towards water hygiene has occurred. Hogg and Vanghan (2005) viewed attitude as a person’s expression of any relatively enduring organization of beliefs, feelings and behavioural tendencies. The view of Hogg and Vanghan concerning attitude may imply that when attitude is directed to water hygiene, attitude to water hygiene has occurred. Therefore, in this study; attitude to water hygiene refers to the feeling women attending ANC have toward water impurities, odour, taste, colour and microscopic organisms in water. This implies that attitude of water hygiene can be expressed by the manifestation of liking or disliking the condition of water as it concerns one. Moreover, when positive attitude towards water hygiene is expressed, Morankola and Okanlawon (2003) opined that it leads to good practice toward health. Practice is opined as product of the application of what one knows. Grove (1993) viewed practice as the application of knowledge. Brown (1993) conceived the term practice as carrying or performing an act habitually or consistently. Funks and Wagnalls (2003) submitted that practice is any customary action or proceeding regarded as individual’s habit. Gillard (2003) viewed practice as having to do something usually repeatedly, habitually, regularly, often and customarily. Practice in this study refers to the actions or ways women attending ANC handle water to keep it safe. Therefore, it implies that any action women take concerning water hygiene may be termed water hygiene practice. Water hygiene practice may mean habitual actions taken to keep water clean. The right practice of water hygiene as described by Mintz, Reiff and Tauxe (1995) involved the removal of pathogens from water and preventing recontamination. Pugh et al. (2000) posited

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that it is the action of cleanliness that promotes health and wellbeing through safe water. In this study, practice of water hygiene refers to habitual actions or ways by which women attending ANC take to keep water safe from impurities and or microorganisms. Thus, it implies that practice of water hygiene can be performed consistently. Moreover, it can be practiced by women attending ANC who may be reffered to as respondents. The respondents in this study were women attending ANC. They consisted of all women who attended ANC and received some hygienic orientation in health facilities in Plateau State in 2014 here-in-after referred to as women attending ANC. It was expected that women attending ANC mostly were involved in fetching water, using same to cook, serving water at family meals and for other domestic purposes. On the basis of their interactions with water, they were able to present their experiences concerning water hygiene as adult members of the family. Although women who attended ANC were involved and interacted with water more often than not, they had poor access to safe water which affected their health and family members. No wonder, Ilahi and Grimard (2000) noted that poor access and interaction with safe water resulted to reduced market-oriented activities of women, which implies could increase the total work burden of women including those attending ANC. Antenatal care helps women attending ANC through normal pregnancies. WHO (2002) posited that ANC is the care women receive throughout pregnancy. Akinsola (2006) defined ANC as the care given to women immediately pregnancy has been confirmed at about the third month. Okereke (2006) asserted that it is a specialized care given to women who conceive to ensure survival of both the woman and her baby. In this study, ANC refers to the care given by health professionals to women who are conceived throughout pregnancy to six weeks after delivery. The onset of ANC commences from the time pregnancy is diagnosed until six weeks after delivery. Good ANC increases the chance of using skilled attendant at birth and contributes to good health and economy throughout life cycle. The economic status of women attending ANC may influence water hygiene KAP. Economic status influences water hygiene. Phaswana-Mafuya and Shukla (2005) implicated safe hygienic practices as rich people's affair. In another research conducted in Ethiopia, discrimination experience was associated with the economic status of one third of the respondents at water source and being forced to go far distance to fetch water for their family use (Tibebu & Belachew, 2007). Appropriate knowledge is a factor of water hygiene. Knowledge has been implicated as a factor of water hygiene. Lian, Phing, Chat, Shin Baharruddin and Che Jalil (2010) implicated age groups with no significant difference in terms of knowledge level but associated schools in the influence on knowledge.

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Bhattacharyal, Joon and Jaiswal (2011) implicated all households with the storage of drinking water in containers. Furthermore, they also associated mothers with the thought that unsafe water was not responsible for diarrhoea but spicy foods. Concerning the status of knowledge of water hygiene of people, Sibiya and Gumbo (2013) implicated majority of the respondents with having no knowledge when it comes to water based diseases and its prevention. Level of education is associated to water hygiene KAP. Chipeta (2004) implicated mothers’ low education as responsible for morbidity of children due to diarrhoea while more girls showed higher positive rate on knowledge of water hygiene (Nematian, Nematian, Gholamrezanezhad, Asgari, 2004). Mpazi and Mnyika (2005) implicated level of education as responsible for female’s low knowledge concerning difference in water source of shallow and deep well. Moreover, Kaiko (2012) indicated that male were knowledgeable and have positive attitudes about methods of water hygiene. Findings from researches showed that location is a factor associated with water hygiene KAP. No wonder, Church World Service (CWS, 2008) implicated those in rural than urban areas of inappropriate water hygiene KAP. Oswald, Hunter, Lescano, Cabrera, Leontsini, Pan…Gilman (2008) showed that due to difficulty in accessing water, those in rural settings re-use water for cooking and domestic activities daily. Adams, Bartam, Charter and Sims (2009) found that rural students’ inadequate water supply to them was responsible for the poor hygiene conditions in schools. In addition, they added that rural students lacked water hygiene knowledge in schools, and again completely lacked adequate drinking water. UNICEF.Org (2012) pointed that more students in rural than urban areas preferred and drank water from school faucets. Whereas respondents’ location has implication on households water use, households has influence on water quality. Households have been implicated in influencing their water quality in diverse ways. Suthar (2011) implicated water sample collected from households to be contaminated. Suthar further associated potable water samples from towns and villages which showed E.coli contamination. In this study, the demographic variables that were used for the study involved location and level of education. Whereas location and level of education have been implicated as factors of water hygiene KAP; it was used to produce the enhancement strategies in this study. Measures that facilitate improvements in water hygiene KAP are referred to as enhancement strategies. Bostrom and Roache (2007) defined enhancement as making efforts to improve beyond normal state. Brey (2008) conceived enhancement as modification of

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human minds and bodies that equips them with supernormal abilities. Enhancement in this study refers to improvement aimed at promoting water hygiene KAP. It implies that enhancement may be improvement rules that are aimed at refining behaviour or knowledge, dispositions or practices. In this regard, an existing state of doing things can be improved upon. Therefore, well planned practices of water hygiene can be achieved through water hygiene enhancement strategies. A strategy is anything you do to achieve a target. Strategy as conceived by Mintzberg (1987) is a plan. United Nations Emergency Scientific and Cultural Organization (UNESCO, 1998) posited that strategies are actions that stimulate interests, feelings, aspirations, beliefs, convictions and goals that one holds as this forms a basis for his practices in life. Jonas (2000) referred to strategy as that which is not the mission but the plan that allows the mission to be accomplished. Nickols (2012) refers to strategy as any complex web of thoughts, ideas, insights, experiences, goals, expertise, memories, perceptions and expectations that provide general guidance for specifications in pursuit of particular ends. Strategy in this study refers to the application of conscious and purposeful action plans or rules that allow improvement to practices of water hygiene KAP. The strategy used in this study was to elicit interests, action plans, ideas and thoughts from women attending ANC concerning KAP of water hygiene. Enhancement strategy which was necessary and effective in improvement of water hygiene involved communication strategy. Communication strategy mean information plan targeted to addressing a specific event, issue or concern. As conceived by Scotland and Northern Ireland Forum for Environmental Research (SNIFFER, 2010), communication strategies are ways by which messages are targeted to influence specific issue, event, situation or audience. In this study, strategies as presented by SNIFFER was adapted and used to formulate strategies for KAP of water hygiene through the use of community mobilization; entertainment education and advocacy strategies. Advocacy has to do with getting influential people, government, business, schools or some other large institution to correct an unfair or harmful situation that affect people in the community. UNICEF (2010) defined advocacy as deliberate process, based on demonstrated evidence, to directly and indirectly influence decision makers, stakeholders and relevant audiences to support and implement actions that contribute to the fulfillment of children’s and women’s rights. Pathfinder International (PI, 2011) conceived advocacy as any strategy that influence policymakers to make a policy change (create supportive policies, reform or remove harmful policies, ensure the funding and implementation of supportive policies). In

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this study, advocacy is a planned and organized set of actions or plans to influence people to correct an unfair or harmful situation that affect them. Other than advocacy, community mobilization is another way by which communication strategy influence people. For desired practices to be adopted as the norm among the people, community mobilization is essential. Mosquera, Obregon and Lopez (2008) conceived community mobilization as the process through which action is stimulated by a community itself or by others. UNICEF/India (2012) defined community mobilization as any way to initiate dialogue among community members to deal with critical issues of sanitation and hygiene and also provide a platform for the community to participate in decisions that affect their daily lives. Community mobilization in this study refers to means by which one can initiate dialogue among community members to deal with critical issues of hygiene and also provide a platform for the community to participate in decisions that affect their daily lives. Another water hygiene KAP strategy is entertainment education. Entertainment education (EE) is any entertainment that presents to individuals how they can live improved, safer, healthier, and happier lives. Singhal and Rogers (2002) conceived EE as the intentional placement of educational content in entertainment messages. Khalid and Ahmed (2014) defined EE is the process of purposely designing and implementing a media message to both entertain and educate, in order to increase audience member’s knowledge about an educational issue, create favourable attitudes, shift social norms and change overt behaviour. EE according to Singhal (2015) is the process of designing and implementing a media message to both entertain and educate to increase audience members' knowledge about an educational issue, create favorable attitudes, and change overt behavior. EE in this study refers to intentional inclusion of practical content in entertainment messages to entertain and educate people in order to increase members’ knowledge, influence attitudes, norms and behaviour. In this regard, to understand how EE translates to adoption of improved practices of water hygiene; appropriate health theories and models explain these scenarios. This study is anchored on three theories – the social cognitive theory (SCT), theory of changing attitude (TCA) and the stage of change (transtheoretical) model (TTM). The SCT which was propounded by Bandura in 1986 assumes that learning occur when there is interrelation between behavoural, environmental and personal factors. The SCT suggests how knowledge of women attending ANC may influence water hygiene. The theory of changing attitude (TCA) was developed by Zanna and Rempel in 1988. TCA is predicated on the tenets of cognition, affect and past. The theory suggests that attitude is not something stable

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but something that might change based on internal or external cues. This theory suggests its influence by cognition (a source of information concerning water hygiene), the affect (one’s feelings as experienced in interaction with water) and the past (one’s previous experiences in interaction with water) that influence water hygiene KAP. The TTM was propounded by Prochaska and Diclemente in 1983 as a theoretical model of behavior (practice) change. The tenets are precontemplation, contemplation, preparation, action and maintenance. It suggests that for any water hygiene practice to occur, women attending ANC may go through the stages. Gold (2013) suggested that for any change to be stable, the stage of successful, sustained lifestyle modification (practices) has to be attained. Applied to this study, the transtheoretical theory suggests that women attending ANC can begin their practices of water hygiene at any point and when they become stable, there is sustained modification of lifestyle. However, the modification in practices of water hygiene may be of public health significance even in Plateau State. This study was conducted in Plateau State, Nigeria. Situated in the middle belt region of the country, Plateau State shares common boundaries with the States of Bauchi, from the north; Taraba from the east; Nassarawa from the south; and Kaduna from the western part. It was located in the middle belt region and one of the 36 States in Nigeria. Plateau State has an area of 26,899 square kilometers with three senatorial zones of northern, central and southern zones and 17 local government areas, with the State capital in Jos. Nigeria Information and Guide (2014) noted that Plateau State got its name from the Jos plateau, a mountainous area with captivating rock formations. It is a source of minerals and many rivers to northern Nigeria due to volcanic activities million years ago. The rivers serve as sources of water for most people including women attending ANC. It was expected that those attending ANC receive health education during their visits to the health facilities, which enables them to appreciate the need for hygiene, safety and good health for themselves, their foetus and other members of their family. In addition, it helps women attending ANC to strengthen the realization of the goal of safe delivery and good health as desired by ANC to its attendees. Regrettably, it was observed that some women attending ANC often preferred and collected water for domestic use from sources closest to them irrespective of its quality, which implied negative attitude regarding water hygiene. Again, they chose wide opened containers to collect safe water for domestic use implying incorrect water hygiene knowledge. Also, women attending ANC were observed to have collected and transported safe water in wide opened container for domestic use, which implied poor water hygiene practice. Thus, the

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expression and display of KAP of women attending ANC in the State as it concerned safe water use was worrisome. It was obvious that the water situation in the State was plagued with concerns. No wonder, Chollom et al. (2013) revealed that contaminants in the water used in the State posed serious hazard to human health. This implied that it affected all and sundry, especially women attending ANC because of their condition. Moreover, the State authorities paid lip service to issues of safe water. This was because the existing water treatment facilities were not maintained as large sums of monies was voted and publicized over the media with plausible intended water projects completed only on paper but not on ground for the people to benefit. The consequences involved the collection and use of water from all sources whether safe or unsafe. Moreover, the way and manner water was collected, transported, stored and used by women attending ANC seemed troubling. It was against this background that the water hygiene KAP among women attending ANC was determined and the outcome used to proffer water hygiene enhancement strategies in Plateau State. Statement of the Problem Striving to get safe water requires scaling up safe water sources and ensuring that portable water reaches the homes in safe or hygienic state and used in such state by all and sundry including women attending ANC. To achieve this, government of Plateau State proposed the expansion of the existing water treatments facilities in the State. The effort of the State government was further enhanced by the drilling of boreholes across the State by foreign Non-governmental organizations. Radio jingles on water use and handling by government was an attempt to ensure that safe water was used in homes in the State to promote sound health and wellbeing. Regrettably, people including women who attended ANC and received hygienic orientation in health facilities of Plateau State collected water from different sources such as streams, rivers, surface water and shallow wells. Some collected water with wide opened containers. In addition, the surroundings of the wells and boreholes which water for domestic use was got appeared unhygienic. Stray animals used spilled water around the drinking water source. Furthermore, freshly collected water was mixed with stored water for use. Moreover, water was scooped from stored container at home. Women who attended ANC allowed little children scooped from stored water before use. They preferred and got water from any source closest to them for domestic use irrespective of its quality. Despite the State government lofty efforts to avail safe water to the citizens for use; the projects were only completed on paper as the ongoing water project facilities were not

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completed and existing ones not maintained. This accounted for the collection of safe water for domestic purposes from nearest sources such as streams, rivers, and wells, which were sometimes unsafe. Also, domestic water was sometimes collected and transported by women who attended ANC and received hygienic orientation in health facilities in opened containers without lid, implying incorrect practices of water hygiene. Moreover, women who attended ANC and received hygienic orientation in health facilities perceived stored domestic water in opened containers as positive attitude towards water hygiene. Again, they chose wide opened containers like basins to collect domestic water implying incorrect knowledge of water hygiene. Also, the way and manner water was collected, transported, stored and used by women who attended ANC and received hygienic orientation in health facilities seemed troubling. In addition, diseases such as hepatitis, typhoid fever and abdominal discomfort were often diagnosed in the State. Furthermore, literature reviewed revealed a study conducted on knowledge and practice of water purification in Lamingo community. Such study did not cover the entire State neither was it particular to women who attended ANC and received hygienic orientation in health facilities nor their attitude or provision of enhancement

strategies, which was worrisome. The inadequate data on water hygiene KAP of women who attended ANC and received hygienic orientation in health facilities of Plateau State was the gap this study filled. Based on existence of the aforementioned in the State, this study determined the water hygiene KAP among women attending ANC in Plateau State and the outcome used and proffered the water hygiene enhancement strategies. Purpose of the Study This study determined the water hygiene knowledge, attitude, practice (KAP) and enhancement strategies among women attending ANC in Plateau State. Specifically, the study sought and determined: 1. water hygiene knowledge of women attending ANC in Plateau State; 2. water hygiene attitude of women attending ANC in Plateau State; 3. water hygiene practices of women attending ANC in Plateau State; 4. water hygiene knowledge of women attending ANC based on level of education in Plateau State; 5. water hygiene knowledge of women attending ANC based on location in Plateau State; 6. water hygiene attitude of women attending ANC based on level of education in Plateau State; 7. water hygiene attitude of women attending ANC based on location in Plateau State;

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8. water hygiene practices of women attending ANC based on level of education in Plateau State; 9. water hygiene practices of women attending ANC based on location in Plateau State; and 10. enhancement strategies of water hygiene KAP of women attending ANC in Plateau State. Research Questions In order to guide this study, the following research questions were posed: 1. what is the water hygiene knowledge of women attending ANC in Plateau State? 2. what is the water hygiene attitude of women attending ANC in Plateau State? 3. what is the water hygiene practices of women attending ANC in Plateau State? 4. what is the water hygiene knowledge of women attending ANC based on level of education in Plateau State? 5. what is the water hygiene knowledge of women attending ANC based on location in Plateau State? 6. What is the water hygiene attitude of women attending ANC based on level of education in Plateau State? 7. What is the water hygiene attitude of women attending ANC based on location in Plateau State? 8. What is the water hygiene practices of women attending ANC based on level of education in Plateau State? 9. What is the water hygiene practices of women attending ANC based on location in Plateau State? 10. What are the enhancement strategies of water hygiene knowledge, attitude and practice of women attending ANC in Plateau State? Hypotheses The following null hypotheses were postulated and tested at .05 level of significance. 1. There is no significant difference in the water hygiene knowledge of women attending ANC based on level of education in Plateau State. 2. There is no significant difference in water hygiene knowledge of women attending ANC based on location in Plateau State. 3. There is no significant difference in the water hygiene attitude of women attending ANC based on level of education in Plateau State.

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4. There is no significant difference in water hygiene attitude of women attending ANC based on location in Plateau State. 5. There is no significant difference in the water hygiene practice of women attending ANC based on level of education in Plateau State. 6. There is no significant difference in water hygiene practice of women attending ANC based on location in Plateau State. Significance of the Study The present study determined the water hygiene KAP of women who attended ANC in Plateau State. The study of this nature would be useful in several ways. Data generated on knowledge of water hygiene would be beneficial to health educators, environmental inspection officers (EHOs), midwives, researchers, women attending ANC and their family members. The result of the study showed that majority of the respondents’ possessed correct knowledge regarding water hygiene. Health educators would find this result useful as they use the aspect of incorrect knowledge regarding water hygiene useful in sensitizing and teaching students on water hygiene issues. The attempt to sensitize and teach students with the findings would create awareness in them concerning water hygiene, which ought to influence the students to better exercise appropriate water hygiene measures when it comes to water issues wherever they find themselves. When students are sensitized and taught, they are better prepared to make informed decisions concerning water related issues wherever they find themselves. Moreover, health educators will utilize the result of the findings on knowledge of water hygiene as a guide to identify which area has incorrect knowledge of water hygiene and emphasize the dangers when teaching. Additionally, EHOs will use the knowledge of the incorrect water hygiene to establish the most critical areas concerning water that attention needed to be drawn to among the populace including women attending ANC so as to avoid water contamination and live devoid of health problems from unsafe water that affects health when used. Data generated on majority of women possessing correct knowledge of water hygiene, which implies that some possessed incorrect knowledge of water hygiene would be useful to researchers and midwives. This finding would serve as a resource of literature as well as serving as empirical data concerning research issues when the finding is quoted. The midwives would use the findings to understand the magnitude or otherwise of the water hygiene issues of women attending ANC. As the midwives acquired this knowledge, they would in turn use it to teach women attending ANC when it comes to issues of water hygiene

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and the need to enhance knowledge of water hygiene. As the teaching to women attending ANC is done by the midwives using the finding, women attending ANC are better handled; and this leaves them better informed, consequently, benefiting better. Within the field of water and allied profession, findings from knowledge of water hygiene based on level of education would generate data that will be useful to academics when they are conducting researches, planning workshops or seminars for their clients on water hygiene. It may also improve the education system because learning and teaching of women attending ANC would be enhanced by using the findings in future. Findings on attitude towards water hygiene would be useful to women attending ANC and their family members. Through the findings on attitude towards water hygiene negative attitude towards water hygiene, which women attending ANC and their family members had would be modified or altered after their negative effects are exposed. Additionally, the change or modification in the negative attitude towards water hygiene of women attending ANC and their family members would curtail the negative attitude towards water hygiene thereby promoting the health and wellbeing of women attending ANC and their family members when they understand the consequences of the expression of negative attitude towards water hygiene. Health educators on the other hand would use the findings on the attitude towards water hygiene of women attending ANC and publicize it as a means for sensitizing the vulnerable groups. As attitude towards water hygiene are published in reputable journals, they would enrich global data on the subject matter. When this is done, it would help to expand the literature on such aspects and also sensitize the public in general and women attending ANC in particular on the attitude towards water hygiene that are inimical to health. This study generated findings on water hygiene practice. Results from water hygiene practice would unveil those practices regarding water hygiene that women attending ANC exhibited in Plateau State. As the practices regarding water hygiene of women attending ANC were unveiled, it could be used as a weapon for making strong case for the need of education concerning correct practices regarding water hygiene. Based on the results of the practices of water hygiene of women attending ANC, Nigeria’s consumer policy makers may see the need to formulate policies that would make the teaching of water hygiene mandatory to all and sundry including women attending ANC. Data generated from enhancement strategies revealed the impact appropriate strategies would have on women attending ANC and perhaps the populace. The revelation would be useful across gender irrespective of their occupation, social status and economic

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standing. It would again help women who would put to practice the various enhancement strategies so as to live healthy as they interact with water. As this is done, it will promote, maintain and preserve their health and those of their family members; thus making them healthy including their fetuses. Furthermore, the social cognitive theory; theory of change attitude and transtheoretical model of change were used in this study. To give this study theoretical significance, the social cognitive theory, theory of changing attitude and the stage of change (transtheoretical) model were the theories of anchor. These theories were based on the premises that suggested how and why women who attended ANC possessed correct or incorrect knowledge of water hygiene; why attitude towards water hygiene was expressed by women who attended ANC and why women who attended ANC were involved in the practice of certain practices of water hygiene. Scope of the Study This study was delimited to Plateau State, Nigeria, with three senatorial zones and seventeen local government areas. The study also covered water hygiene KAP and enhancement strategies among women who attended antenatal care in Plateau State. The study was also delimited to the various components of water hygiene hygiene, which included water storage, water transportation, and water collection, point-of-use (PoU) of water, water source protection and water purification. The components of water hygiene were determined in relation to demographic variables such as location and level of education. Furthermore, the study was delimited to theories such as Social Cognitive Theory (SCT), Transtheoretical Model of Change (TTM) and theory of Changing Attitude (TCA) which were relevant to water hygiene KAP in Plateau State. The study also covered women who attended antenatal care in Plateau State.

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CHAPTER TWO Review of Related Literature Literatures abound on water hygiene knowledge, attitude and practice (KAP) and enhancement strategies. Moreover, some of the literature had bias to Nigeria but others were from other countries. In order to properly give focus to this study, related literature on water hygiene KAP and enhancement strategies among women attending ANC was reviewed and presented under the following sub-headings: Conceptual Framework; •

water hygiene;

•

knowledge, attitude and practice;

Measurement of knowledge, attitude and practice; Enhancement strategies; Demographic factors associated with water hygiene knowledge, attitude and practice; Theoretical Framework; •

Social Cognitive Theory (SCT);

•

Theory of Change Attitude (TCA);

•

Stages of change model (transtheoretical) (SCM);

•

Schematic representation of theoretical framework;

Empirical Studies, and Summary of Review of Related Literature. Conceptual Framework This section presents the various concepts of water hygiene, knowledge, attitude and practice, components of water hygiene. It also includes enhancement strategies and factors associated with water hygiene knowledge, attitude and practice. Water hygiene. Water is an important ingredient necessary to all forms of life. Mathur (2007) viewed water as a great cleaning agent that is used both externally and internally. Leeds (2014) conceived water as any compound that is made of two parts of hydrogen and one part oxygen. Lennthech (2014) refers to water as any substance that makes up the larger part of an organism's body, which consists of two tiny atom of hydrogen and one of oxygen. Water as used here-in-after refers to any colourless, odourless, tasteless pleasant tasting liquid that is necessary for all forms of life. It implies that water as cleaning agent may be from diver’s sources. Water for safe use ought to be free from impurities, dirts, pathogens and dissolved or suspended particles. Water for safe use is important as it can be

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used for the removal of dirts and impurities implying its use for hygienic purposes. Water used for hygienic purposes therefore depends on its chemical configurations of hydrogen and oxygen compounds that give the special characteristics it possesses. The special characteristic water possesses is essential as a universal solvent as well as important fluid in living organisms. In this regard, water can be used for domestic, irrigation, commercial, industrial and hydroelectric power purposes (Heaton, 1999). Domestic water includes water used for normal household purposes such as drinking, food preparation, bathing and personal hygiene, dish washing, laundry, general household cleaning, watering of lawns and gardens. Irrigation use involves the supply of an area of land through pipes or channels with water to grow crops. Commercial and industrial water is used for manufacture of goods, while hydroelectric is used for the generation of electricity. This implies that the use of water cannot be over emphasized. Water is required in the body for vital physiological and biochemical processes such as digestion, respiration, excretion and circulation. Water used for these purposes need to be clean, clear and free from harmful substances, minerals, chemicals and microorganisms. This implies that water must be safe. Consumption of safe water does not cause illness or health problem but maintains health. Safe water ought to be free from dirts, wastes, feaces and germs; it must be free from poisonous chemical compounds or the presence of chemicals, which must be below permitted level and minerals must not exceed tolerant level; it must be tasteless, colourless, odourless, and drinkable. Regrettably, water which ought to be free from microorganisms,

bacteria of cocci, bacilli or flagella, coliforms, viruses, algae,

Escherichia coli, Pseudomonas aeruginosa, Campylobacter spp, Salmonella spp, protozoas of Crysptosporidium and giardia lamblia when mixed with water constantly make it unsafe for use unless hygienic activities are administered to it. Hygiene is a term that refers to personal practices that help maintain sound health and prevent disease. Purgh, Warner, Filardo, Binns, Francis, Lukens et al. (2000) defined hygiene as any practice of cleanliness that promotes health and wellbeing, especially of a personal nature. Rand and Frazier (2007) referred to hygiene as including practices that relate to personal hygiene, food hygiene, environmental hygiene and keeping household environments free of excreta and solid wastes, as well as keeping drinking water supplies safe and free from contaminants. It involves regular washing of the body, washing of one’s clothing, washing the hair, brushing the teeth and caring for the gums (Ilika & Obanu, 2009). The term hygiene is used to refer to behaviours and measures which are used to break the chain of infection transmission in the home and community (Pruss-Ustiin & Bartram,

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2008). Hygiene as conceived by Center for Disease Control-CDC (2014) is behavior that improve cleanliness and lead to good health such as frequent hand washing, face washing, and bathing with soap and water. Nyanghura (2014) viewed hygiene as any personal effort to make oneself clean. Hygiene here-in-after refers to keeping water clean to prevent illness or disease in other to promote sound health. It involves behaviours to improve cleanliness or all the practices that help people stay healthy. All of the following contribute in some way, to reducing the burden of water borne infectious diseases circulating in the community: hand hygiene and personal hygiene, safe disposal of faeces, ensuring safe water at the point-of-use (PoU), menstrual hygiene, food hygiene (cooking, storing, preventing cross-contamination), respiratory hygiene, general hygiene (laundry, surfaces, toilets, baths, sinks), the disposal of solid waste and the control of waste water and rain water. Therefore many types of hygiene exist. The focus of this study is water hygiene. Water hygiene or water treatment means eliminating or removing impurities and microorganisms from water to keep it safe for use. Water treatment is a process of making water suitable for its application or returning its natural state (Science, 2014). In the context of this study, water hygiene refers to the use of water treatment measures to eliminate impurities, odour, taste, colour and microscopic organisms to keep it suitable for use to prevent disease and promote sound health. Therefore, the correct use of water hygiene rid water of impurities of solid particles, chemicals, odour, colour, taste; pathogens of bacteria cocci, bacilli or flagella; coliforms; viruses; algae; Escherichia coli; Pseudomonas aeruginosa; protozoan parasites of Crysptosporidium and giardia lamblia to keep it suitable for use. In other to eliminate impurities, microscopic organisms and others in water for safe use; filtration, disinfection, aeration, coagulation and flocculation and sedimentation treatments are needed. Filtration is the process where liquid is passed through a medium that helps to remove smaller particles in it. JDAAUSA (1985) defined filtration as the separation of larger particles from water by passing it through a porous medium, usually sand, granular coal or granular activated carbon. CDC (2015) posited filtration as the process of removing impurities from water by means of physical barrier, chemical or biological processes. In this study, filtration refers to the process of passing water through a porous medium to remove impurities from it. Various types of filtration media include slow sand, pressure sand, diatomaceous earth, porous stone or ceramic, paper or cloth and charcoal, membrane filters, depth filter, among others.

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Disinfection requires cleaning a substance with something to inactivate or kill microorganisms. According to Chlorine Chemistry Council (2003), disinfection is a means of destruction of harmful microorganisms usually by the use of bactericidal chemical compounds. Lenntech (2014) conceived disinfection as the removal, deactivation or killing of pathogenic microorganisms in water. Disinfection as used in this study means the deactivation or killing of pathogenic microorganisms in water using chemical or physical disinfectants to make it suitable for use. Disinfection destroys organic contaminants from water which serve as nutrients or shelters for microorganism. Moreover, disinfectants do not only kill microorganism but also have residual effect, which means that they remain active in the water after disinfection. Disinfection can be attained by means of chemical and physical disinfectants. The chemical disinfectants for water include chlorine, chlorine dioxide, chlorine or calcium hypochlorite, ozone, halogens of bromine, iodine; bromine chloride; cupper, silver, kaliumpermanganate, fenols, alcohols, hydrogen peroxide, and several acids and bases. Ultraviolet light such as electronic radiation, gamma rays, sounds and heat as in boiling of water are all used for disinfection of water. Therefore, when microorganisms are not removed from drinking water, such water usage will cause women attending ANC to fall ill sometimes affecting their unborn fetus. Aeration implies the exposure of water to surface air. As conceived by Hofkes and Huissman (1987) aeration is the blending of water with air in order to increase oxygen content in water; increase the pH in water by reducing its carbon dioxide content; remove iron, magnesium, hydrogen sulphate, methane, various volatile and organic compounds responsible for flavour and smell in water. As posited by Paulson (2012), aeration is used to mix, circulate or dissolve air into a liquid or other substance. Aeration as used in this study refers to the process of exposure of water to air so as to remove volatile substances in water such as odour. It may follow that aeration may be used for the oxidation of substances such as iron and manganese; removal of carbon dioxide; taste and odour producing substances such as hydrogen sulfide; volatile organic compounds; removal of compounds suspected to be carcinogenic such as methane, and increase pH. Sedimentation may mean the process where fluid is allowed to move slowly, causing the heavy floc particles to settle to the bottom. According to CDC (2015), sedimentation is a process where floc particles are caused to settle to the bottom of water supply due to its weight. Sedimentation in this study refers to the settling under gravity of dirt particles in raw water. Sedimentation implies the movement of solid particles to settle downward through the force of gravity, centrifugal force or electromagnetism. In the case of water, heavy particles

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(flocs) settle to the bottom and clear water is left above to be filtered. Sedimentation implies the movement of solid particles naturally to settle downward through the force of gravity, centrifugal force or electromagnetism. Microorganisms are often attached to suspended material in water so removing these particles can also help to reduce the biological contaminants. Turbid water looks cloudy, dirty or muddy and is caused by sand, silt and clay that are floating in the water. Turbid water usually has more pathogens so drinking it increases your chances of becoming sick. Sedimentation simply let water settle for some time. This can be done in a small container such as a bucket or pail. The sedimentation process can be quickened by adding special chemicals or native plants, also known as coagulants, to the water. Coagulants help the sand; silt and clay join together and form larger clumps, making it easier for them to settle to the bottom of the container. Sedimentation removes small particles that are suspended in water and make it cloudy. Therefore, when biological contaminants that attach to water are lowered through sedimentation, women attending ANC danger of infection is reduced as heavy particles (floc) settle to the bottom and clear water is left above to be filtered for use. Coagulation may mean the process in the formation of small particles in raw water. LeChevallier and Au (2004) posited that coagulation is the addition of a substance that forms hydrolysis products that cause particle destabilization and interparticle collisions in water. EPA (2011) conceived coagulation is a process by which dirt and other small suspended solid particles are chemically bound, forming flocs using coagulant so they can be removed from water. Coagulation in this study refers to process that involves adding iron or aluminum salts such as aluminum sulphate, ferric sulphate, ferric chloride or polymers, to the water in other to bring particles close together. It implies that the process of coagulation require having positive charge of the chemicals (coagulant) neutralizing negative charge of dissolved and suspended particles in the water. When this reaction occurs, the particles bind together or coagulate. In addition, it can mean that for coagulation to occur, inorganic chemical ought to be introduced into raw water to be neutralized by aluminum and iron (III) ions to form filtrate. These precipitates combine into larger particles through induced mixing to form flocs and the process called flocculation. Flocculation may be physical process of the formation of solids into large mass. LeChevallier and Au (2004) defined flocculation is the physical process of producing interparticle contacts that lead to the formation of large particles. EPA (2011) posited that flocculation is the physical process of growing particles (flocs) in water. CDC (2015) conceived flocculation as the binding of dirt particles with chemicals to form larger particles

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called floc. In this study, flocculation is the physical process which leads to of production of interparticle formation of flocs in raw water. It implies that flocculation join together small particles into larger, settleable and filterable particles. It occurs when alum, potash ash, magnesium hydroxide, ferric sulfate or ferrous sulfate are added to water and colloidal particles of minerals, clay, silt, organic debris and microscopic organisms ranging in size from about 0.001 to 1.0 micrometer to form tiny sticky particles called floc which attract the dirt particles. It is an important technology for larger scale water treatment. Based on above, flocculation is a means to improve the quality of water. Water is an important part of our life that occurs in diverse major sources. House, Reed and Shaw (n. d.) viewed major sources of water to involve the rainwater, surface water and groundwater. Heran (2014) identified various major sources of water to include the lakes and rivers; the rain water, glacier and ground water. Rain water may mean water that falls from the sky in drops. According to Paraskh (n. d.) rain water collects on the earth in the form of surface water and underground water. It implies a source of water supply to the earth surface. This water moves across the ground in the form of streams or rivers, or remains in one place in the form of ponds or lakes and could sink underground to form underground water. This source of water may collect on the surface to form the rivers, seas, oceans and found in the ground water in the form of lakes and so on. Therefore, collecting rainwater from either an existing roof structure or a ground catchment area can provide a useful supplementary source of water even if it is not used as the main supply. In this regards, the process of water collection, storage, transportation as well as PoU of rain water if not properly handled can trigger contamination by microorganism. While microorganisms are mixed with water, its use and ingestion by all and sundry including women attending ANC can become disease and this affect their health and that of the fetus. Surface water accumulates mainly as a result of direct runoff from precipitation (rain or snow). It may be any means of water that is found on the surface of the ground. According to Haney (1997), surface water is any water that occurs as in rivers, streams, ponds, lakes, and wetlands. Rawat (2007) explained that surface water is that precipitation that does not enter the ground through infiltration or is not returned to the atmosphere by evaporation, flows over the ground surface and is classified as direct runoff. Direct runoff is water that drains from saturated or impermeable surfaces, into stream channels, and then into natural or artificial storage sites (or into the ocean in coastal areas). The amount of available surface water depends largely upon rainfall. When rainfall is limited, the supply of surface water will

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vary considerably between wet and dry years. Surface water supplies may be further divided into river, lake, and reservoir supplies. Dams are constructed to create artificial storage. Canals or open channels can be constructed to convey surface water to the project sites. The water is also conveyed through pipes by gravity or pumping. In general, the surface sources are characterized by soft water, turbidity, suspended solids, some colour and microbial contamination. In this regards, nearly all surface water features in the form of streams, lakes, reservoirs, wetlands, and estuaries interact with ground water. The occurrence of water in diverse means of streams, lakes, reservoirs and so on if not hygienically handled makes water full of pathogens affection all who use it including women attending ANC. Streams are small rivers. The stream run and empties its content into larger rivers. As the stream runs down into a larger river, it may pass through or close to human settlements. The settlements may use such as their source of domestic water. Depending on the activities of the settlements around the stream, it may become contaminated. Without adequate treatment of such water, using it affects health. Water that is surrounded by land may be called lake. A lake is a sizable water body surrounded by land and fed by rivers, springs or local precipitation (Shiklomanov, 1999). Lakes provide us with a wide range of practical benefits. Much of our domestic, agricultural and industrial water requirements come from surface water, and much of this surface water is contained in lakes. Lakes also provide us with avenues of transportation, recreational opportunities, and centres of biodiversity and natural ecosystems. Groundwater may be obtained in several ways. Ground water as conceived by Rawat (2007) is that water that drains downward (percolates) below the root zone reaching a level at which all the openings or voids in the earth's materials are filled. This water replenishes the soil moisture, or is used by growing plants and returned to the atmosphere by transpiration. It is referred to as the zone of saturation. Ground waters are generally characterized by higher concentrations of dissolved solids, lower levels of colour, higher hardness as compared with surface water, dissolved gasses and freedom from microbial contamination. However, groundwater may be affected by both human and natural contaminants. The human contaminants include unhygienic activities such as collection of water in unclean containers; storage in contaminated containers; storage of agrochemicals in the same place with drinking water and so on. Therefore, if the maintenance requirement of groundwater in terms of safe handling, treatment, protection is not well handled; contaminated ground water could affect the health of people and even that of women attending ANC and their fetus. Based on the

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above, if groundwater is to be used by all and sundry including women attending ANC, ground water must be made safe. Water is a clear sparkling, colourless, odourless and tasteless fluid that contains two hydrogen and one atom of oxygen. Water is useful and important in so many ways. The importance of drinking water according to Srivastava (2014) includes water being able to maintain electrolyte balance; being universal solvent and regulating the body temperature. In addition, Zelman (2014) indentified the followings: drinking water helping to maintain balance of body fluids; helping to control calories; help in energizing muscles; water helps skin keeps looking good; water helps, and water helps to maintain normal bowel function. It implies that it is an essential resource that is vital for physiological and biochemical processes. In addition it can be an excellent solvent; it is important in the movement of molecules through biological membranes; it takes part in many chemical reactions; it acts as a lubricant (to reduce friction between moving surfaces; thermal properties of water are wellsuited to support life; as well as other biologically useful properties of water that include cohesion, adhesion and surface tension. The importance of water cannot be overemphasized. According to Srivastava (2014), the total volume of water in the body if decreased by one per cent, your thirst instinct triggers. In addition, that a five (5) per cent reduction leads to decreased muscle strength and endurance, and a 20 per cent reduction causes death. Therefore, many of the processes within the body rely heavily on water, so it is important that clean and safe water is enough and essential nutrient in your diet including those of women attending ANC. Zelman (2014) posited that through the posterior pituitary gland, your brain communicates with your kidneys and tells it how much water to excrete as urine or hold onto for reserves. The process of burning calories requires an adequate supply of water in order to function efficiently and water helps the body metabolize and burn fat. Water plays a major role in how every single cell, tissue and organ in our body operates and is important to almost every bodily function. In this regards, it implies that water contains no calories, fat, or cholesterol and is low in sodium. It is nature's appetite suppressant, and helps the body to metabolize fat. Without enough water, the kidneys will not function properly. As a result, some of their workload is pushed off onto the liver, in turn preventing the liver from operating at peak levels to act on fats. When less water is in the kidney, metabolizing fat that is the primary function of the liver is hampered. Therefore, the liver cannot function at peak levels when taking on the added workload from the kidneys. In which case, less body fat is metabolized and more is

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stored. If the liver does not have sufficient water, it cannot reach total productivity and will not metabolize fat efficiently, leading fat to store in the body. This leads to either weight gain or reaching a plateau of weight loss. In other for women attending ANC to regulate their weight, they need to increase their ability to metabolize excess fat in other to maintain adequate weight. This can be done when they drink adequate clean and safe water to improve their kidney and liver functions, which regulates their weight and invariably the weight of their fetus, thus giving them adequate weight. Human body is regulated by water. Srivastava (2014) submitted that water helps one;s body stay cool by regulating the body’s temperature that is 98.6 degrees Fahrenheit through sweat. This means that our bodies can control over-heating through perspiration from sweat glands in the skin and from evaporation which produces a cooling effect. Blood is also routed into areas close to the surface of the skin where it can be cooled and then carried back to the interior of the body. Conversing in a cold environment, the skin maintains proper body temperature by shunting the blood away from the exterior surface thereby conserving heat within the body. The movement of water within our cellular systems also transports vital blood plasma which is 92 per cent made of water. Blood plasma play a critical role in buffering the body’s pH, circulating antibodies from the immune system, and regulating osmotic balance which all helps to maintain proper body temperature. When women attending ANC ventures out in the sun as they are required to embark on some forms of exercise, the internal temperature of your body shoots up and immediately starts to sweat. Sweating is just the body’s way of cooling itself down through the release of water in the form of sweat. Since sweat evaporates from the surface of your skin, removing excess heat and cooling you down through sweat is of importance to women attending ANC as a means of cooling down. Water’s importance can be noticed on the skin. No wonder it helps keep skin looking good (Zelman, 2014). This implies that inadequate water in the form of dehydration makes your skin look drier and wrinkled, which can be improved with proper hydration. In the event that one is adequately hydrated, the kidney strikes a balance by taking over and excreting excess fluids. Therefore, in other to maintain a healthy skin, women attending ANC ought to hydrate their selves with adequate amount of water every day so as to have good skin and adequate water supply to her fetus. Water helps maintain normal bowel function. In other to maintain normal bowel function, Kim (n. d.) posited that the mucosal lining of the large intestine lined with tiny pits that open into long tube-like intestinal glands are lined with specialized cells that absorb

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water, and other specialized cells (goblet cells) that release mucous into your large intestine to lubricate your stools and to protect the lining of your large intestine against acidic substances and potentially harmful gases. Therefore, adequate hydration keeps things flowing along your gastrointestinal tract and prevents constipation. When you do not ingest enough fluid, the colon pulls water from stools to maintain hydration, and the result is constipation. Thus, it implies that all including women attending ANC are required to ingest adequate water every day in other to forestall dehydration that will affect the function of their bowel, which may affect their health. Water is an excellent solvent. Srivastava (2014) posited that water is a universal solvent. The submission by Srivastava implies that many different types of materials can dissolve in water forming solutions. It may imply that water is the solvent that dissolve many essential molecules and other particles round the body. It further means that due to water polar nature, it allows other charged and polar molecules to mingle with it thereby dissolving it. In this regard, carbonates, hemoglobin, various proteins and other molecules in the body use water as a solvent. The solute is circulated in the body with the help of blood that transfers nutrients, oxygen, carbon dioxide and waste products from one cell to another with nutrients. As the solute is supplied to various parts of the body, women attending ANC need such nourishment even unto the developing fetus. In the course of the above, women attending ANC and their fetus are supplied nourishments as the solute occur and circulate due to the presence of blood that leaves them healthy. Water is an important resource in biochemical processes in the human body. The use of water for biochemical processes according to Srivastava (2014) involves the use of water to maintaining the right balance of electrolytes in one’s body. The submission by Strivastava implies that the electrolytes in the body are electrically charged ions such as sodium or chloride ions, which need to be stored at certain levels to maintain the correct water content of your cells. Therefore, without water in the body, electrolytes ability to supply all types of information to your brain in the form of electrical signals called nerve impulses will be hampered. They also help regulate muscle activity, which would be incapacitated if safe water is absent in such body. Moreover, in other to maintain proper electrolyte levels, water plays an important role as its presence enables water to gush in and out of the cells so that these ions stay in equilibrium. In the light of the importance of water in enabling the biochemical processes of the body to be functional, it is a necessity for women attending ANC to ingest adequate water every day so as to enjoy balance in biochemical processes that enhance health and growth of her fetus.

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Water is needed for most body functions that include the followings: maintain the health and integrity of every cell in the body; keep the bloodstream liquid enough to flow through blood vessels; help eliminate the byproducts of the body’s metabolism, excess electrolytes (for example, sodium and potassium), and urea, which is a waste product formed through the processing of dietary protein; regulate body temperature through sweating; moisten mucous membranes such as those of the lungs and mouth; lubricate and cushion joints; reduce the risk of cystitis by keeping the bladder clear of bacteria; aid digestion and prevent constipation; moisturize the skin to maintain its texture and appearance; water takes part in many chemical reactions; drinking enough water maintain hydration in the body; carry nutrients and oxygen to cells, and serve as a shock absorber inside the eyes, spinal cord and in the amniotic sac surrounding the fetus in pregnancy. Two third constituent of human body is dependent on water. As a matter of importance, body cannot carry out and sustain its functions without water. Water controls the functioning of different anatomical units comprising human body. Also described as universal solvent, it forms the foundation of different biological activities. Water serves as a major agent of detoxification. It is said to regulate temperature and that of metabolism is facilitated through water. Water provides for effective lubrication in the body. Besides being the basis of saliva and fluid guarding the joint system, water prevents human body from diseases of different kinds. Each and every human cell needs water for its sustenance, be it the blood cell or neuron the smallest unit of the nervous system. Water has its part to play in the transportation of nutrients. As far as the absorption of nutrients is concerned, water has its role to offer. It also exist in various components. Experts have indentified various components and forms of water hygiene. Water hygiene components identified by WHO (1997) involve water storage, water disinfection with chlorine, boiling, and solar water disinfection. Moreover, AIDS Support and Technical Assistance Resources-One (AIDSTAR-One, 2012) outlined water hygiene components at PoU water treatment that has the forms as chlorination, flocculation, filtration and chlorination, solar disinfection, boiling; PoU safe water handling and PoU safe water storage. The PoU water storage involves the use of water carrying containers as in jerry cans, Oxfam buckets, CDC containers, bucket with lid and tap, and modified clay pot can keep water safe if properly used. In this study, the components of water hygiene of water disinfection in the forms of solar water disinfection, chlorination, boiling, coagulation and flocculation; in addition, the components of aeration, sedimentation and filtration will be used in this study.

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The use of the outlined components becomes necessary because most of the components are simple to use and least expensive methods of water purification. One form of water disinfection is chlorination. According to AIDSTAR-One (2012), chlorination is the process of disinfecting water by mixing it with chlorine. WHO (2012) posited that chlorination of raw water takes place where few milligrams of chlorine is added per liter of water and waiting about 30 minutes to kill almost all bacteria and viruses. This implies that in other for women attending ANC to use chlorine to treat water, such water must be devoid of turbidity. In addition, the water should be free from organic and inorganic compounds that interfere with the chlorine’s effectiveness. Chlorination should be applied in a protected water container (a narrow neck container with a spigot) to prevent recontamination. Various forms of chlorine exist in a solid, powder form (calcium hypochlorite) or a liquid form (sodium hypochlorite). Commercially, chlorine is available in tablets, solution, and powder. Chlorine’s effectiveness as a disinfectant reduces over time depending on the storage situation. Therefore, women attending ANC should store chlorine products as recommended by the manufacturers and should check the expiration date before use. Chlorine should be added in sufficient quantities, as specified by the product. To destroy all germs, chlorine should have contact time of at least 30 minutes from the time it is added to the water to the time the water becomes potable. Adding too much chlorine in water may adversely affect the taste. Chlorine when added to water has a residual action quality, meaning it persists in water for some time (called residual chlorine) and kills germs (if contaminated later). This quality makes chlorine a potent water disinfectant. The residual action of chlorine is important to women attending ANC because their condition is characterized by frequent visits to convenience, vomiting and so on. In an attempt to clean up after the visit to rest room with safe water; recontamination of safe water may occur that the residual chlorine protection may be helpful. Flocculation is a water treatment process that thickens small particles (organic and inorganic) into a semisolid mass which then settles as sediment at the bottom of the container and finally is separated from water through straining with a clean cloth. WHO (n. d.) conceived flocculation as the slow and gentle mixing of the water to encourage the flocs to form and grow to a size which will easily settle out while the clear water is collected at the top that gives women attending ANC clear water. The mixing is often done in a chamber. Benefits of flocculation even to women attending ANC include proven reduction of bacteria, viruses, and protozoa even in turbid water; removal of heavy metals and pesticides; residual protection against contamination; proven health impact; sachets are easily transported due to

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their small size and long shelf life. Flocculation is important to women attending ANC because it will help them remove the turbidity in their water as well as micro organisms that could affect their health and unborn fetus. Filtration is a physical water treatment option, not a chemical treatment option like those previously mentioned. Lenntech (2009) viewed filtration as the process of separating suspended solid matter from a liquid by causing the latter to pass through the pores of some substance called filter. The liquid which has passed through the filter is called the filtrate. In other to filter water, women attending ANC at point-of-use (PoU) allow raw water pass through porous medium (such as paper, cloth, cotton-wool, asbestos, slag- or glass-wool, unglazed earthenware, sand, or other porous material). When water flows through the filter, impurities come into contact with the surface of the particles in the filtering medium and are trapped. In some filters, women attending ANC may deposit granulated activated carbon to remove chemical impurities. As this is done, there is removal of bacteria and protozoa in water, which results to reduction or elimination of diarrheal disease incidence due to unsafe water. Therefore, when filtration is not administered to raw water with suspended particles; microorganisms are not removed from drinking water, which the ingestion of such water will cause women attending ANC to fall ill sometimes affecting their unborn fetus. Boiling is the most certain way of killing all microorganisms. Block (2001) posited that boiling is one of the most effective water treatment methods to kill or deactivate all classes of waterborne pathogen, including bacterial spores and protozoan cysts that have shown resistance to chemical disinfection and viruses that are too small to be mechanically removed by microfiltration. For boiling to be enough to destroy pathogens in water, WHO recommends bringing water to a rolling boil as an indication that a disinfection temperature has been achieved (WHO, 2008). When water boils, it destroys various pathogens such as viruses, spores, cysts, and worm eggs (CDC/USAID, 2009). In this study, disinfection of water by boiling refers to the hitting of water to a rolling boil for at least one minute in other to destroy the pathogens in such water. From the foregoing, when water is allowed to boil; pathogens therein are destroyed. Therefore, raw water is made safe to drink when allowed to cool in a safe container. In other for women attending ANC to disinfect water through boiling, water has to be heated until it reaches the boiling point. In addition, it should be stored in the same container in which it was boiled, handled carefully, and consumed within 24 hours to prevent recontamination. Therefore, when women attending ANC boil their water; they drink water that is devoid of microorganisms that can damage their health. No

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wonder, CDC/USAID submitted that boiling water to a rolling boil is noted to protect against cholera. Another method of PoU water treatment is solar water disinfection-SODIS. According to Akvopedia.org (2013), SODIS is a simple water treatment method that uses solar radiation (Ultra violet- UV light and temperature) to destroy pathogenic bacteria and viruses present in water. SODIS as posited by Wegelin and Meierhofer (n. d.), is any solar water purification method that is required to improve the microbiological quality of drinking water. In this study, SODIS refers to household water purification in which solar energy is used to make biologically contaminated water safe to drink. Women attending ANC are expected to disinfect small quantities of water with low turbidity using this method because it is cost effective. In other for raw water purification occurring, sunlight that produces highly reactive forms of oxygen (oxygen free radicals and hydrogen peroxides) in the water that destroys pathogens when allowed for six hours in bright sunlight. These reactive molecules contribute in the destruction process of the microorganisms. Under normal conditions (rivers, creeks, wells, ponds, tap) water contains sufficient oxygen (more than 3 mg oxygen per litre) and does not have to be aerated before the application of SODIS. Solar disinfection can be done as when contaminated water is filled into transparent plastic bottles and exposed to full sunlight for six hours in sunlight or two days in cloudy weather. As water is exposed to sun, the pathogens are destroyed during the exposure by the UV radiation, which causes damage to DNA and kills living cells of micro organisms in water. Therefore, when women attending ANC ought to use this cost effective means of water purification to have safe water that when used keeps them healthy and their family members. The UV (wavelength 320-400nm) reacts with oxygen dissolved in the water and produces highly reactive forms of oxygen (oxygen free radicals and hydrogen peroxides) that are believed to also damage pathogens. In addition, if the infrared radiation of UV light heats the water, it causes pasteurization when the temperature is raised to 70-75 degrees Celsius that kills the micro organisms. If the water temperature rises above 50°C, the disinfection process is three times faster. Therefore, women attending ANC require utilizing this cheap method of water treatment in other to cut down cost compared to other methods of treatments. While it is only possible where enough solar radiation exists, this method can be an appropriate water treatment option for households when economic and sociocultural conditions in the community are not amenable to other treatment or disinfection alternatives, such as chlorination or filtration. In this regards, when women attending ANC fail to use SODIS; they may suffer from viruses, bacteria, and protozoa leading to diarrheal disease

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incidence that affect their health and of their foetus. However, if women attending ANC disinfect their water using SODIS, recontamination of water is unlikely because water is often served from bottles and they live healthy. In other to effectively use SODIS, water turbidity levels greater than 30 NTU should first be filtered through a cloth or sedimented (Sommer, Marino, Solarte, Silas, Dieroll, Valient,…Wegelin, 1997). Bottles used for SODIS should not exceed 10 cm in water depth. 1-2 litre volume PET bottles do not exceed this depth when they are horizontally placed in the sunlight (Swiss Federal Institute for Environmental Science and Technology / Department of Water and Sanitation in Developing Countries (EAWAG/SANDEC, 2002). PET soft drink bottles are often easily available and thus most practical for the SODIS application. Basically the SODIS is suitable for batches of 1-2 litres per bottle (Akvopedia.org, 2013). In addition, that the system is not useful for treating large volumes of water because several are bottles needed for a large family. Moreover, that bottle will melt and deform if the temperature reaches 65°C. In other to use SODIS treatment method, bottles made of PET (Polyethylene terephthalate) such as the plastic bottles in which soft drink beverages are sold is recommended. The handling is much more convenient in the case of PET bottles. Polycarbonate container blocks all ultra violet A (UVA) and ultra violet B (UVB) rays, and therefore should not be used. Glass also blocks UV rays and therefore would be ineffective. Further, SODIS efficiency depends on the physical condition of the plastic bottles. Transparent plastic bottles with scratches and other signs of wear reduce the efficiency of SODIS. Also, heavily scratched or old blind bottles should be replaced. In addition, it is to be noted that the intensity of the UV radiation decreases rapidly with increasing water depth. Water that was previously disinfected can be recontaminated by unhygienic handling, during transportation, during storage, and by utensils used at the PoU. Evidence by CDC/USAID (2009) suggests that safe storage containers are effective at preventing contamination of drinking water during transport and storage. According to CDC (2014), before filling storage container with safe water, the following steps are important: wash the storage container with dishwashing soap and water and rinse completely with clean water; sanitize the container by adding a solution made by mixing one teaspoon of unscented liquid household chlorine bleach in one quart of water; cover the container and shake it well so that the sanitizing bleach solution touches all inside surfaces of the container; wait at least 30 seconds and then pour the sanitizing solution out of the container; let the empty sanitized container air-dry before use or rinse the empty container with clean, safe water that already is

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available. According to WHO (2014), every year millions of diarrhoeal deaths related to unsafe water occur. Women attending ANC can avoid the following poor water storage practices to avoid suffering from diarrhoeal deaths to their self and family members as they store water devoid of: using storage containers that cannot be sealed tightly; using containers that can break, such as glass bottles; using containers that have ever been used for any toxic solid or liquid chemicals (includes old bleach containers), and using plastic or cardboard bottles, jugs, and containers used for milk or fruit juices. Therefore, as you store water, label container as "drinking water" and include storage date; replace stored water that is not commercially bottled every six months; keep stored water in a place with a fairly constant cool temperature; do not store water containers in direct sunlight, and do not store water containers in areas where toxic substances such as gasoline or pesticides are present. Several safe water storage containers have been identified. Latagne and Gallo (n. d.) identified the Oxfam bucket; jerry cans; CDC containers; bucket with lid and tap, as well as the modified clay pot. The Oxfam bucket was designed to provide safe storage option to organizations working on water safety in the home or refugee camps. In other to ensure that safe water poured into the CDC container keeps water safe, the lid of the CDC container snap on to prevent entry of hands or objects into the container; which promotes the health of those who drink from such source. The jerry cans on the other hand was initially manufactured and used to hold vegetable cooking oils. The 20-liter jerry cans can be cleaned and used to transport and store safe water. The jerry cans are a good option for safe storage and easy to carry on the head. The opening is too small to allow hands or utensils into the safe water. A hole can be drilled into the plastic to add a tap, which offers easier access to the treated water and a handwashing station in the home. The CDC container on the other hand was designed to handle up to 20-liter of water. On the other hand, the bucket with lid and tap is a bucket that was designed to hold five gallon or 19-liter of fluid. The bucket is widely available and often used for safe water transport and storage. The bucket can be modified for safe storage by ensuring there is a tight-fitting lid, drilling a hole through the plastic and installing a sturdy tap, and placing a label with instructions for water treatment on the bucket. Additionally, it is important to teach people to use the tap instead of dipping into the bucket. Due to the cooling characteristics of the modified clay pots, they are the preferred storage container in many cultures because as water evaporates through the clay; the water inside the container is cooled. In some rural areas, safe water is transported in clay pots, but in most areas water is transported in plastic containers and then stored in clay pots.

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Experts have identified practices that can be used to forestall contamination of stored water. The United Nations Children’s Fund (2008) revealed that treated water should be stored in narrow-mouthed plastic, ceramic, or metal containers that serve as physical barriers to recontamination, especially if using water treatment options that do not leave residual protection. The following characteristics according to AIDSTAR-One (2012) have been identified to relate with water storage containers: it should have a small opening with a lid or cover that discourages users from placing potentially contaminated items such as hands, cups or ladles into the stored water; it should have a spigot or small opening to allow stored water easy and safe access to the water without requiring the insertion of hands or objects into the container; the storage container should be of appropriate size for the household/facility with permanently attached instructions for using the treatment method and for cleaning the container. If containers with the characteristics above are not available, efforts should be made to educate households to access water from the container by pouring the water rather than dipping into the container with a possibly contaminated object. Moreover, that treated water in a narrow-neck container with tight fitting lid can be used for up to seven days. If the water is stored in wide-neck container or without tight fitting lid, it can be used for only 24 hours. Care should be taken to avoid using any container to store drinking water that was previously used to transport toxic materials (such as pesticides or petroleum products). Knowledge. Knowledge has been viewed as an important means of acquisition of facts and principles that may yield to correct practices. Adequate knowledge, positive attitude and correct practices of hygiene have been identified by WHO (2004) as important measures that yield correct knowledge of water hygiene. Knowledge as defined by Carter and Winifred (2005) is accumulated facts, truths, principles and information to which the human mind has access. Comfort (2005) viewed knowledge as the sum of our conceptions, views and predispositions which have been established and tested. Knowledge in the present study refers to facts, truths, principles or information that people have acquired with regard to water hygiene. This may imply that if correct facts, truths, principles or information is administered to water hygiene, water hygiene knowledge occurs. Water hygiene knowledge as depicted by Clarke (2001) is a body of facts and principles accumulated by people with regard to water hygiene. In this study, water hygiene knowledge refers to facts, truths, principles or information that women attending ANC use to ensure that impurities, odour, taste, colour and microscopic organisms in water is eliminated so as to keep it suitable for use to prevent disease and promote sound health. This implies

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that if water hygiene knowledge is compromised by women attending ANC, the presence of pathogens, toxic chemicals and particles that are found in water will cause disease. Thus, where water hygiene knowledge involve the use of correct facts, truths, principles or information of water treatment measures of sedimentation, disinfection, filtration, coagulation and flocculation as well as aeration on water; safe water for use devoid of disease causing organisms ensue. However, people are at liberty to express their feeling or disposition towards water, water hygiene and its use. In this regard, when water hygiene knowledge dispositions or feelings may be expressed in terms of water filtration, disinfection among others; this brings about water hygiene attitude. People’s predispositions exert influence on attitude. Kerlinger (2002) perceived attitude as an organized predisposition to think, feel, perceive and behave towards a referent or cognitive object. Mudary (2003) viewed attitude as a feeling tone directed towards a person, object or idea. Hogg and Vanghan (2005) viewed attitude as a person’s expression of any relatively enduring organization of beliefs, feelings and behavioural tendencies. Luthans (2007) defined attitude as persistence tendency to feel and behave in a particular way towards some object. Ruoho (2011) categorized attitude into three components that are responsible for overall evaluation of an object as cognitive (thinking); affective (feeling, emotion), and behavioral information components. Attitude in the context of this study refers to predisposition or feeling women attending ANC have of favour or disfavour and positive or negative response to water hygiene. In this regards, it could imply that when women attending ANC’s attitude is expressed as a complex mental process, the cognitive component is expressed. Whereas, when their feeling about an object is displayed, the affective component is expressed. While, as the behavoural component is expressed as they put up some practices in relation to what they have learnt and feel. Additionally, attitude tends to persist unless something is done to change them. Therefore, attitude can be directed towards some object about which a person has feeling, beliefs and dispositions. In this direction, any disposition women attending ANC have with regard to water hygiene is referred to as water hygiene attitude. Attitude. Water hygiene attitude refers to the predisposition or feeling women attending ANC have towards keeping water clean. In this study, water hygiene attitude refers to the feeling women attending ANC have toward eliminating impurities, odour, taste, colour and microscopic organisms in water to keep it suitable for use to prevent disease and promote sound health. In this regard, water hygiene attitude manifest in conscious experience, verbal

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reports and gross behaviour. Therefore, when women attending ANC display positive dispositions displaying correct skills of treating water before drinking or drinking treated water; and the negative dispositions of drinking untreated water without sedimentation, disinfection, filtration, coagulation and flocculation; water hygiene attitude has occurred. In this direction, when correct water hygiene attitude is expressed, Morankola and Okanlawon (2003) opined it leads to good practice toward health. Practice. Practice is opined as products of the application of knowledge. Grove (1993) viewed that practice is the application of knowledge. Funks and Wagnall (2003) submitted that practice is any customary action or procedure regarded as individual’s habit. Gillard (2003) viewed practice as having to do something usually repeatedly, habitually, regularly, often and customarily. Practice in this study refers to the application of water hygiene rules in other to keep water safe. Therefore, it implies that practices of water hygiene may be termed water hygiene practice. Water hygiene practice may means a habit or custom of keeping water clean. In this study, water hygiene practice refers to practical action or ways of eliminating or removing impurities and microorganisms from water to keep it safe for use. Practices or activities of water hygiene practice according to Class 1 Water Treatment Plant Operator Program Manual (2003), include filtration, disinfection, aeration, coagulation and flocculation, and sedimentation. EPA (2012) posited that water filtration removes impurities from water by means of fine physical barrier. Lenntech (2014) conceived water disinfection as a means of removal, deactivation or killing of pathogenic microorganisms in water (by chlorination and others); chlorination is chemical disinfection method that uses chlorine or chlorinecontaining substances for the oxidation and disinfection of water. In addition, coagulation removes dirt by ensuring that suspended dirt particles in water form tiny sticky particles called floc that attract the dirt particle and sink to the bottom during sedimentation and so on. Aeration is the processes by which water is brought into contact with air for the purpose of transferring volatile substances to or from water. This study was concerned with water hygiene KAP bordering on water disinfection; water filtration; sedimentation, coagulation and flocculation treatments as it concerned women attending ANC in Plateau State. Antenatal care helps women through normal pregnancies. WHO (2002) posited that ANC is the care women receive throughout pregnancy and six weeks after delivery. Akinsola (2006) defined Antenatal care as the care given to women immediately pregnancy has been confirmed at about the third month. Okereke (2006) asserted that it is a specialized care given

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to women who conceived to ensure survival of both the woman and her baby. In this study, ANC refers to safety care administered by health professionals to women who are conceived and their fetuses from conception to six weeks after delivery. The onset of ANC commences from the time pregnancy is diagnosed until six weeks after delivery. Good ANC increases the chance of using skilled attendant at birth and contributes to good health throughout life cycle. Women attending ANC are those attending ANC and receiving care from health professionals. Good care accorded women attending ANC is important for the health of the woman attending ANC and the development of the fetus. WHO recommends a minimum of four visits for women attending ANC as follows: first visit on confirmation; second visit 2028 weeks; third visit, 34-36 weeks and fourth visit before expected date of delivery or when the pregnant woman needs to consult health worker. Economic factor is a factor of water hygiene KAP. The economic status of women attending ANC may influence water hygiene KAP. According to United Nations Population Fund (UNFP, 2014), the primary objective of antenatal care is to establish contact with the women, and identify and manage current and potential risks and problems. The Fund added that this creates the opportunity for the woman and her health care provider to establish a delivery plan based on her unique needs, resources and circumstances. Moreover, that the delivery plan identifies her intentions about where and with whom she intends to give birth and contingency plans in the event of complications (for example: transport, place of referral). Furthermore, that at least three antenatal visits are recommended, ideally with the first visit early in the pregnancy. This number may vary based on national policies. In addition, appropriate antenatal care should include assessment of maternal health; detection and management of complications; observation and recording of clinical data; maintenance of maternal nutrition; health education and prevention of major diseases. Assessments of maternal health in ANC not only determine the pregnant woman’s overall health status, but also identify factors which may adversely affect pregnancy outcome. Women attending ANC are females of child bearing age who are mostly married. These women may or may not be educated. They may be public servants or not. However, they are conceived or have foetus growing inside their body. Their conceived status gives them unique characteristics, which they have over others. During early pregnancy, most women experience extreme tiredness and nausea as well as vomiting combined sometimes with care of other children. In the later stages of the pregnancy, back ache and tiredness are common symptoms (Dolbash & Dolbash, 1998). As women, they are expected to cook; serve

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food and water to the family, even onto their babies. In addition, they fetch, store and have water for the family. Therefore, their knowledge, attitude and practices in handling domestic chores especially of water may have some implications on their own health and that of their family members. Pathetically, women attending ANC level of education regarding self care including hygiene during pregnancy is unsatisfactory (Stekelenburg et al., 2004). In addition, studies by WHO (2010) in Tanzania and Kenya found that upon visiting antenatal clinics around half of the women did not receive appropriate education regarding antenatal health. These findings are disturbing as it may have implications on women attending ANC that are responsible for fetching water, cooking and serving what households eat and drink. Therefore, in dearth of data on water hygiene in Plateau State and to forestall the anomaly as identified by WHO and others, there is the need to determine the water hygiene knowledge, attitude, practice and enhancement strategies among women attending ANC in Plateau state. Whereas women attending ANC need special care during pregnancy, they have been implicated in water hygiene KAP. In this regard, they need some enhancement strategies. Measurement of knowledge, attitude and practice. Measurement is an important tool in any study. The importance of measurement in any study has been acknowledged by many authors. Grove (1993) viewed measurement as the process of judging or estimating extent, strength and worth of something. In addition, WHO (1996) described measurement as a perquisite for any health action. It further added that many ailments suffered by people are to a large degree self inflected practices due to ill information. Moreover Bickel, Noed, Price, Hamilton and Cook (2009) agreed that measurement of knowledge is indispensable tool for assessment and planning. In order to assert and plan well; variables have to be measured. For instance, knowledge has been measured by in various ways by authors. In order to measure knowledge, Okafor (2015) noted that Likert scale is clearly not an interval or ratio scale and so no conclusions can be drawn about the meaning of distances between scale positions but count the number in each observations in each category and calculate the proportion (percentages) of all observation that fall into each category. The knowledge measurement scale by Okafor (2015) as criteria for describing levels of knowledge was adopted and utilized for measuring water hygiene knowledge of women attending ANC in this study. In this regard, a proportion of knowledge score less than 33 per cent was regarded as less than one third, 33 per cent was considered one third, 50 per cent was considered one half while 60 per cent and above was considered majority. On the other hand, if knowledge can be measured attitude can be measured.

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In order to measure attitude, Cooper and Engeswick (2007) conducted a study on knowledge and attitude among 24 students in Minnesota State University. Five point Likert scale of strongly disagree (SD) = 1, disagree (D) = 2, neutral or unsure (U) = 3, agree (A) = 4, strongly agree (SA) = 5 for positive attitude statements was used. While negative statement are scored in the reverse order in which case strongly disagree (SD) was ranked = 5, disagree (D) = 4, neutral or unsure (U) = 3, agree (A) = 2, strongly agree (SA) = 1. An attitude that represented a lack of confidence was defined as a response of “strongly disagree” or “disagree”. A confident attitude was defined as a response of “strongly agree” or “agree”. The criterion mean was 3.0, attitude mean score below the criterion mean of 3.0 was considered negative attitude whereas attitude mean scores above the criterion mean of 3.0 was considered positive attitude. Similarly, in order to further measure attitude the Likert attitude measurement scale was used by Nworgu (2006). He stated that to measure attitude; the statement formed ought to be in such a way that half are positive while the other are negative, which ought to be placed in alternate positions. In addition, he noted that the score ought to be in such a way that a higher value should indicate a more positive responses of attitude for instance, for a positive statement with positive response of strongly agree (SA) = 5 marks, agree (A) = 4 marks, undecided (U) = 3, disagree (D) = 2, and strongly disagree (SD) = 1 mark respectively. While for negative item, the weighting is reversed in the following order: strongly agree (SA) = 1 mark, agree (A) = 2 marks, undecided (U) = 3, agree (A) = 4, and strongly disagree (SD) = 5 marks respectively. The Likert attitude measurement scale was modified by Nworgu as follows: strongly agree (SA) = 4 marks, agree (A) = 3 marks, disagree (D) = 2, and strongly disagree (SD) = 1 mark on the positive items score; whereas for negative items the score was reversed in which case strongly agree (SA) = 1 mark, agree (A) = 2 marks, agree (A) = 3, and strongly disagree (SD) = 4 marks respectively. Haeren, Cerin, Deforchce, Maes and Bourdeaudhuij (2007) conducted a study on 2,840 adolescent girls on Belgium. He employed a four point likert scale of certainly pleasant, pleasant, not pleasant and certainly not pleasant. Positive statements were scored in this order: certainly pleasant = 4, pleasant = 3, not pleasant = 2 and certainly not pleasant = 1. Negative statements were scored in this order: certainly not pleasant = 4, not pleasant = 3, pleasant = 2 and certainly pleasant = 1. Criterion mean of 2.5 was set. Nutritional mean scores below 2.5 and above were considered positive practices. In this study, the modified attitude measurement scale by Okafor (2015) as criteria for describing levels of knowledge was adopted and utilized for measuring water hygiene

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practice of women attending ANC in this study. In this regard, a proportion score either indicates one’s level of practice in which it could be “Always”, “Sometimes”, “Rarely” or “Never” practiced situation. In this regard, a four-point response options of ‘Always’, ‘Sometime”, “Rarely” and Never” was used in computation for this study. Frequencies and percentages were used to answer research questions one to nine and mean for research question ten. Therefore, to measure water hygiene attitude of women attending ANC, the frequencies and percentages were used. Based on the results above, the Chi – square statistic was used to test all the six null hypotheses at .05 level of significance. Enhancement strategies. Measures that facilitate improvements in water hygiene KAP are referred to as enhancement strategies. Bostrom and Roache (2007) defined enhancement as making efforts to improve beyond normal state. Brey (2008) conceived enhancement as modification of human minds and bodies that equips them with supernormal abilities. Enhancement in this study refers to improvement or changes of human minds aimed at promoting water hygiene KAP. It may imply improvement of rules that are aimed at refining behaviour or knowledge, dispositions or practices. In this regard, an existing state of doing things can be improved upon. Therefore, well planned practices of water hygiene can be achieved through strategies. Strategy as conceived by Mintzberg (1987) is a plan. United Nations Emergency Scientific and Cultural Organization (UNESCO, 1998) posited that strategies are actions that stimulate interests, feelings, aspirations, beliefs, convictions and goals that one holds as a basis for his practices in life. Jonas (2000) referred to strategy as that which is not the mission but the plan that allows the mission to be accomplished. Nickols (2012) refers to strategy as any complex web of thoughts, ideas, insights, experiences, goals, expertise, memories, perceptions and expectations that provides general guidance for specifications in pursuit of particular ends. Strategy in this study refers to the application of conscious and purposeful action plans or rules that allow improvement to practices of water hygiene KAP. The strategies intended for use in this study are opinions, action plans, ideas and thoughts women attending ANC should adopt that will help them improve on KAP. Therefore, enhancement strategies as used in this study mean conscious and purposeful action plans, ideas, thoughts and opinions that are aimed at refining or improving practices of water hygiene KAP among women attending ANC in Plateau State-Nigeria. Enhancement strategies which are necessary and effective in improving correct practices of water hygiene exist. These include: multi-disciplinary joint action and communication strategies (UNICEF, 2012).

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Multi-disciplinary joint action strategy is one of the ways by which water hygiene KAP status quo can be improved. Cheminais (2008) opined that multi-disciplinary joint action strategy refers to the working together towards commonly agreed aims and objectives. Multidisciplinary joint action strategy in this study would be used as the collective action where staff with different professional backgrounds and training work together with a view to improve a common or collective acceptable goal (water hygiene). Therefore, it implies that several health professionals of different areas of specialization working together with community leaders pull resources together (for example, personnel, materials, machinery, technical and money) to support activities that will enhance water hygiene KAP. Communication strategy means information plan targeted to addressing a specific event, issue or concern. As conceived by Scotland and Northern Ireland Forum for Environmental Research (SNIFFER, 2010), communication strategies are ways by which communicating information related plan are targeted to influence specific issue, event, situation or audience. In this study, communication strategies as presented by SNIFFER is adopted and used as such. Components of communication strategy as outlined by Mosquera, Obregon and Lopez (2008) involve interpersonal communication; community mobilization; advocacy; entertainment education and mass media. Mosquera et al. (2008) pointed mass media such as radio, television (TV) and print media, as well as community media, particularly radio and other forms of traditional media that may reach target audience. In this study, enhancement strategies outlined by Mosquera et al. that involve interpersonal communication, advocacy, community mobilization, entertainment-education and mass media would be adopted and used for enhancing water hygiene KAP among women attending ANC. In order to gain a better understanding of how people receive information at community level, it is necessary to explore the channels of communication currently being used and the preferences of community members in terms of what, who, how, when and where they like to receive information (UNICEF-Nigeria Trainees Participatory Hygiene and Sanitation Promotion Manual, 2014). Communication media such as television; radio; magazine; newspapers; celebrations or special events; electronic media, including email; website; face-to-face meetings with key stakeholders; focus groups; on-scene activities; public hearings; public meetings; public or private schools, social media tools as YouTube, facebook, twitter, to go; whats-up, badoo, viber, palmchat and workshops hold substantial place as tool for reaching and persuading people to adopt water hygiene and healthier lifestyles. In this regard, to understand how persuasion translates to adoption of improved practices of water hygiene; appropriate health theories explain this scenario.

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As conceived by Mosquera, Obregon and Lopez (2008) interpersonal communication make effective use of existing social networks or interpersonal relationships (family, friends, acquaintances, neighbors and colleagues) that bind people together to enhance the communication process. UNICEF Bangladesh (2008), interpersonal communication called behaviour change communication or behaviour development communication involves faceto-face dialogue with individuals or groups to inform, motivate, problem-solve or plan (for instance, water hygiene issues) with the objective to promote behaviour change. This component should be designed and monitored so that it remains adaptable to the variation in stages of behaviour change-from both the frontline worker adapting any discussions according to the participant's current knowledge and practices, to programme officers planning the next deployment of house to house visits according to water hygiene KAP coverage data. Interpersonal communication in the present study would be used as means of communicating water hygiene issues to reach women attending ANC using appropriate programme officers and/or modern technology to enhance the scope and reach of behaviour development communication through print media; celebrations or special events; electronic media; face-to-face meetings with key stakeholders; on-scene activities; public hearings; public meetings; public or private schools, social media tools as YouTube, facebook, twitter, to go; whats-up, badoo, viber, palmchat, workshops, radio and television talk shows with phone-ins allowing for dialogue on a wider scale concerning water hygiene KAP. Advocacy for health is defined as a combination of individual and social actions designed to gain political commitment, policy support, social acceptance and systems support for a particular health goal or program (WHO, 1995). Advocacy is communication targeted at leadership and the powers that be to take actions to support programme objectives (water hygiene KAP) (UNICEF Bangladesh, 2008). It noted that advocacy influences leaders to take actions such as taking legal reform or enactment of new law(s) or rules concerning water hygiene KAP; allowing policy decisions, formulation of and/or reform concerning water hygiene KAP; giving administrative directives, rules; and resource mobilization as well as financial allocation necessary for the provision of infrastructures necessary for water hygiene. In addition, the advocacy component ought to build the capacity of leaders to become advocates themselves and speak out on issues pertinent to water hygiene KAP in order to strengthen political will and remove blockages; change funding priorities; support policy change; and address social barriers. In this study, advocacy would be used to create not only mass awareness or awareness among leaders but should always go beyond awareness that lead to specified action. Therefore, the advocacy component of the strategy

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should inform and motivate appropriate leaders to create supportive environment for water hygiene KAP by taking actions such as changing policies, allocating resources, speaking out on water hygiene KAP issues, and initiating public discussion on water hygiene KAP. In addition, due to advocacy, leaders come together with the led to take decisions concerning water hygiene issues. The water hygiene KAP issues agreed should be in simple and clear language, it should be measurable, achievable, reasonable and should be timed and location specific. Community mobilization (CM) as a means of improvement of behaviour (water hygiene) is conceived by Dickin, Griffiths and Piwoz (1997) as the process through which action to change behaviour is stimulated by either a community itself or by others, which the planning, execution and evaluation can be carried out by the community’s individuals, groups and organizations. Mosquera, Obregon and Lopez (2008) posited that CM is a process by which the community defines their own problems, decides which is higher priority and organizes itself to address the priority problems. Community mobilization as used in this study would involve mobilizing women attending ANC to identify community facilitators and form a water hygiene project committee. The committee then identifies resources available to them such as resource persons, influential individuals, local community organizations, and outside organizations. The committees along with others help improve community participation through interaction concerning water hygiene between health providers, community stakeholders and women attending ANC. Entertainment-education (EE) according to Singhal and Rogers (1999) is the process of purposely designing and implementing a media message to both entertain and educate in order to increase audience members’ knowledge about an educational issue, create favorable attitude, shift social norms and change the overt behavior of individuals and communities. It involves activities the use of entertainments through radio dramas, plays, songs, games and written stories to promote public health messages (Dickin, Griffiths & Piwoz, 1997). EE have been widely used by UNICEF, Health Allieance International (HAI) and United Nations Population Fund (UNFPA) in promoting health messages (Dickin et al.,). This implies that EE contributes to the process of directed social change as it can influence audience members’ awareness, attitudes, and behaviour with regard to specific practices. In this study, women attending ANC would be presented with water hygiene KAP process through media, which media consumers develop seemingly face-to-face interpersonal relationships with media characters through radio dramas, plays, songs, games, written stories and narratives to emotionally promote public health messages that would engage women attending ANC in an

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entertaining and educative way rather than using didactic rational appeals for behavior change. As they participate in practices as well as watch others, modeling takes place it influences their water hygiene practices. Mass media is defined to include radio, television (TV) and print media, as well as community media, particularly radio and other forms of traditional media that may reach large numbers of the target audience (Mosquera et al., 2008). Mass media are expected to convey important logistical information easily for instance, about times and places for health campaigns. Mass media in this study would be used to raise awareness of water hygiene issues and behaviors and facilitate advocacy for decision and policy making for an improved environment to promote healthy water hygiene behaviors. In addition, it would be used to promote water hygiene issues through multiple activities and products such as radio and TV public service announcements, radio and TV magazines, and radio and TV shows concerning water hygiene issues. Demographic Factors Associated with Water Hygiene This section presents the factors associated with water hygiene. The factors were discussed under the following headings: knowledge associated with water hygiene, attitude associated with water hygiene and location and water hygiene. Knowledge has been found to be associated with water hygiene. Roper (1999) showed that the knowledge possessed by women influenced their willingness to reduce the use of fertilizers and pesticide contaminants compared to men in water. However, he revealed further that the water hygiene knowledge of some male respondents influenced to as they obtained their drinking water from surface water sources (lakes, rivers, reservoirs) while others from ground water wells. Correct knowledge scales up the right water hygiene. Nematian, Nematian, Gholamrezanezhad, and Asgari (2004) associated females with significantly higher positive rate on knowledge of water hygiene. They also showed that good knowledge of water hygiene was responsible for using piped water, correct method of washing vegetables and increase in the economic score of the family that resulted in decrease infection rate. However, low level of education was associated with poor socio-economic and hygienic condition of families, which is a powerful determinant of infection in people. Level of knowledge is a parameter that has been implicated in water hygiene. Chipeta (2004) showed that lack of knowledge of water hygiene, unavailability of safe water and having been used to not treating water before use and laziness were the main reason for not using good practices regarding water and sanitation or rubbish disposal. Additionally, an

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illiterate or uneducated may be less knowledgeable about teaching her children proper hygiene practices, subsequently leading to increased rates of infection and disease amongst her children (Nematian, et al., 2004). Knowledge has been associated with choice of sources of water used. Mpazi and Mnyika (2005) associated male respondents with high level of knowledge by source of water used. The distribution of respondents by type of drinking water in both high and low levels of knowledge include those who used well water not boiled, piped not boiled and boiled water. However, low knowledge of water hygiene was linked to water collection and use from various sources that may be unsafe. Economic status influences water hygiene. Phaswana-Mafuya and Shukla (2005) implicated safe hygienic practices as rich people's affair. In another research conducted in Ethiopia, discrimination experience was associated with one third of the respondents at water source and being forced to go far distance to fetch water for their family use (Tibebu & Belachew, 2007). Knowledge accounts for improvemt in the use of water. O’Reilly, Freeman, Rayani, Migele, Mwaki, Ayalo, Ombeki, Hoekstra and Quick (2008) assessed the impact of school based safe water and hygiene programme on knowledge and practices of students and their parents in Nyanza province, Western Kenya. The study associated improvement observed due to knowledge of correct water treatment procedure at final evaluation of students compared with at baseline. Location of schools is implicated in influencing learners’ water use. Adams, Bartam, Charter and Sims (2009) implicated students lacked water hygiene knowledge in schools particularly those in rural area. They also associated children ability to learn being affected with poor water quality and quantity. People drinking water from different sources accounted for diverse degree of safety. The study of European Commission for Humanitarian Aid Organization (2009) showed that respondents’ considered their current drinking water safe for drinking purpose while others were implicated ignorance about their drinking water. Additionally, some respondents associated with drinking water from tap stands of newly constructed rehabilitated gravity fed water system whereas; others were implicated with the preference to enjoy the taste of water from the stone tap. Age has been associated to with the influence on level of knowledge. However, Lian, Phing, Chat, Shin Baharruddin and Che Jalil (2010) implicated age groups with no significant difference in terms of knowledge level, but associated schools in the influence on

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knowledge. Bhattacharyal, Joon and Jaiswal (2011) implicated all households with the storage of drinking water in containers. Furthermore, they also associated mothers with the thought that unsafe water was not responsible for diarrhoea but spicy foods. Concerning the status of knowledge of water hygiene of people, Sibiya and Gumbo (2013) implicated majority of the respondents with having no knowledge when it comes to water based diseases and its prevention. Educational status is associated with the importance in utilization of water. Amenu, Menkir, and Gobena (2013) implicated educational status as the only variable which was significant after adjustment on socio-demographic, knowledge and practice variables. However, other variables that were implicated included the types of household containers used in keeping water, washing of containers before transferring water into it, method of water withdrawal from stored container, duration of stored water in the container and whether there was a good cover in the container as practiced during transportation and storage of on bivariate analysis but not in multivariate analysis. Location is a factor that has been implicated to influencing water hygiene attitude. Roper (1999) implicated Americans in the prevention of pollution of drinking water. In addition, parents with children at home were implicated than non parents in America about tap water quality and safety. Time spent in water collection depends on the sources of water available for use in an area. In Peri-Urban areas, UNICEF (2006b) implicated those in slums with irregular or interrupted supplies that cause residents to wait up to several hours before they can collect water. Moreover, deterioration in facilities in an area has been implicated in water and sanitation networks in that water was often untreated because countries lacked appropriate chemicals for purification. Also, households in given areas were associated with untreated water. Additionally, the toll of fetching water in periurban areas was implicated with being responsible for household members falling sick from water-related diseases. Occupants in households of an area have been implicated in influencing their water quality in diverse ways. Suthar (2011) implicated water sample collected from households to be contaminated. Suthar further associated potable water samples from towns and villages with showed E.coli contamination. The existence of certain facilities in some locations influences the preference of taste. UNICEF.Org (2012) implicated students in Gaza with the preferrence and drinking of water from school faucets than those in the West Bank. In addition, UNICEF.Org further associated those in both the West Bank and Gaza with the preference to drinking more from school

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faucets. Still further, it also implicated young students’ preference in the West Bank with the use of school faucets in drinking more than their older ones, while the opposite was true in Gaza. Furthermore, those in the urban, rural and camp areas were implicated in the preference to students drinking from school faucets of the West Bank. But in Gaza, camp students were implicated in the preference to drinking more from school faucets than do urban ones who brought water from home over seven times more frequently. Different areas are implicated in discriminating differently in the course of interaction with water. Yallew, Terefe, Herchlinr, Sharma, Birew, Kifle,…Adane (2012) implicated household members in Gondar city Ethiopia to discriminate during water source use. In rural Ashanti region of Ghana, Arnold, VanDerslice, Tayloe, Benson, Allen Johnson, Kiefer, Boakye, Arhinn, Crookstone, and Ansong (2013) implicated drinking water quality and source reliability among the people. Their finding implicated perception of residents with the use of water from the standpipes as being clean and not needing treatment at home (before drinking), which particularly troubling in the light of the poor bacteriological quality of water from the standpipes. The taste people have in a giving area has been implicated in influencing the quality of water they utilized. Among Syrian refugees in northern Jordan, UNICEF Inter Agency (2013) implicated the perceptions of water quality among respondents as good or very good quality compared to those that reported their water qualities as bad or very bad. Additionally, Beyene and Hailu (2013) associated positive attitude towards water hygiene among participants who believed that diarrhea infection was not preventable. Accessible potable water in some areas has been implicated in influencing safe use of water. UNICEF Inter Agency (2013) associated respondents in northern Jordan who had access to piped water in their home with not using water collection devices. Also, those who collected water from public water points were implicated with using jerry cans as their main water collection device followed by buckets or other open containers and plastic water bottles. In addition, UNICEF Inter Agency implicated respondent who collected water use the same container to collect and store water.

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Water Hygiene

Knowledge

Attitude

Practice

Women attending ANC

Enhancement Strategies Figure 1: Conceptual Framework of Enhancement Strategies of Water Hygiene The conceptual framework represents water hygiene enhancement strategies that influence water hygiene knowledge; water hygiene attitude; water hygiene practice of women attending ANC that in turn can have implications on water hygiene. Theoretical Framework Theories are necessary in any study to explain, organize and serve as a means of direction. No wonder Philips (1991) asserted that models help in interventions to promote change in behaviour for reducing the risk of the future illness and should be based upon theoretical models that identify the determination of attitude change. Moreover, Doka (1995 – 96) in the course of explaining the worth-whileness of models emphasized that models are useful guides for practice. Following from the above, it points to the fact that models exist that explain health related dispositions, even concerning knowledge, attitude and practice of water hygiene among students in Plateau state. Following from above, social cognitive theory; theory of change attitude; and transtheoretical model of change theory will be used to explain how water hygiene KAP among women attending ANC in this study. Social cognitive theory (SCT). Social cognitive theory (SCT) was conceived by Bandura in 1977. This theory emphasizes the cognitive aspect (one’s mental processes of understanding) in terms of the interrelation between behavoural, environmental and personal factors. The tenets of the theory involve behaviour, environmental factors and personal factors. Bandura’s social cognitive theory proposes that people are driven not by inner forces but external factors. This

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theory deals with cognitive, emotional aspects and aspects of behavior for understanding behavioral change. The theory is predicated on factors of environment, people personal factors (cognitive, affective and biological events) and behavior. In this theory, the tenet of environment refers to the factors (for instance: mass media, EE) that can influence (women attending ANC') behavior on water hygiene. There are social and physical environments that can influence learning. The social environment includes family members, friends and colleagues. Physical environment refers to the mass media, EE. The interaction between the environment (physical and social) and situation (water hygiene) provide the framework for understanding behavior (Parraga, 1990). Therefore, ‘situation’ as presented by Parraga implies the cognitive or mental representations of (water hygiene) and the environment that may influence (women attending ANC) behavior. It further implies that when the behaviour (water hygiene skill) is performed correctly, the person has learnt correctly or otherwise. The concept of behavior explains the need to know what behavior is observed and the skills to stimulate one to learn to perform it. The concept of behavior can be viewed among women attending ANC when in order to perform a behavior; they need to know what the behavior is and they are stimulated to learn the skills to perform it. Personal factors refer to the cognitive, affective and biological characteristics of an individual. This implies the cognitive, affective and behavioural characteristics of the women attending ANC can be influenced. The three factors environment, people and behavior are constantly influencing each other. Behavior is not simply the result of the environment and the person, just as the environment is not simply the result of the person and behavior (Glanz, Rimer & Lewis, 2002). Therefore, the water hygiene KAP of women attending ANC can be influenced through behavioural, environmental and personal factors. Theory of change attitude (TCA). The theory of change attitude was propounded by Zanna and Rempel in 1988 as a theory of changing attitude. This theory is concerned with the fact that for one to change attitudes, the presentation of information ought to consistent and congruent so that individuals can form a single attitude about an object. The tenets of the theory of changing attitude as propounded by Zanna and Rempel that influence attitude involve cognition, affect and the past. In other to explain water hygiene attitude of women attending ANC, the entire tenets of this theory will be relevant for the study. The cognition stage explains that for any attitude (water hygiene) to occur, cognition phase must be accepted by the person (woman attending ANC) who wants her attitude (to water hygiene) to change from what it was to

51

what is to be. In other to have the cognition stage of attitude (water hygiene) to occur, a source of information must exist for an individual to be able to undertake the desired change in attitude. As information is received concerning the need for a change (cognition), women attending ANC express some attitudinal response concerning water hygiene. The affect, in this theory explains the feelings and emotions that are associated with an object (water hygiene), which can influence attitudinal change. The affect as a tenet of this theory can lead to attitude (water hygiene) if the individual (woman attending ANC) is informed of how another person was affected by lack of use of safe water. The information heard or received concerning the negative influence of the use of unsafe water influences or stimulates the person (woman attending ANC) to renege her earlier use of untreated water. The past, as a component of theory of change of attitude explains that for an individual to change an attitude, the person evaluates the new information against previous or earlier information. For instance, women attending ANC may evaluate their previous attitude of the use of untreated water the information they now receive for treating and enjoying safe water to have their attitude changed. Stages of change model or transtheoretcal Model (TTM). The stage of change (transtheoretical) model (TTM) was developed by Prochaska and Diclemente in 1983 as a theoretical model of behavior change. The stages of change in this model are circular and not a linear, which has been divided into the following stages: precontempletion, contemplation, preparation, action and maintenance. Except for the precontemplation as a tenet of the model, the rest are relevant in this study. Precontemplation may not be relevant in this study if women attending ANC are not ready to make any change in their activities in the next six months unless otherwise. Contemplation is that stage which women attending ANC intend to take action to water hygiene practice in the foreseeable six months as they are motivated enough to be involved in the practices. The preparation requires women attending ANC intending to take action as effective steps are put forth. The action tenet has women attending ANC make specific covert modifications modifying their problem or practices in less than six months. Women attending ANC who have been able to sustain their practices of safe water hygiene for more than six months would have come to maintain that status quo. In summary, the transtheoretical theory has been used to describe the stages of change for water hygiene practice. The theory postulates that when women attending ANC enter into the action stage of say, boiling water before drinking; using glass with long handle to fetch drinking water for example as appropriate water hygiene measures gives some net effect of such practices on

52

health. On the basis of the net benefit experienced there would be noticeable effort, sustained efforts are put in place to maintain water hygiene practice by women attending ANC. Social Cognitive Theory (SCT

Behaviour Environmental factors Personal factors

Transtheoretical / Stages of Change Model (TTM) Precontemplation Contemplation Preparation Action Maintenance

Theory of Change Attitude (TCA)

Cognition Affect Past

Women Attending ANC

Water Hygiene KAP

Figure 2: Theoretical Framework: Schematic representation theoretical framework of Water Hygiene KAP Shows theories and model water hygiene will be anchored on: Cognitive dissonance theory (thoughts or belief; perception; behaviour/attitude and practice), transtheoretical model of change (Precontemplation, contemplation, preparation, action and maintenance), and social learning theory (observation; imitation and modelling). All these variables can and cannot impinge on water hygiene. Empirical Studies Iroegbu, Ene-Obong, Uwaegbute, Amazigo (2000) measured the bacteriological quality of weaning food and drinking water given to children of market women in Nigeria. The purpose of the study was to determine the bacteriological quality of weaning food and drinking water given to two groups of children aged two, years estimating bacteria count. A descriptive survey research design was used. A group of 184 mothers formed the sample to the study. Of the sample, 116 mothers took their children to the market and 68 other left their children at home in the care of older siblings or house-helps. The instrument for data collection was through the collection of all food samples once (except for those revisited) for bacteriological examination. Analysis of variance (ANOVA), Fisher’s Least Significant

53

Difference (F-LSD) and Student’s t-test statistics (7) were used to compute the geometric mean. The result of the study showed bacteria counts (geometric mean) ranged from 5.02 +. 82 to 8.70 + 1.0 log ^ sub 10 ^ cfu per gram (g) of milliliter (ml) of food, and from 1.15 + 1.67 to 6.53 + 0.81 log ^ sub 10 ^ cfu per g of 100ml of water. The analysis of variance showed no significant difference in counts between types of food and between meals (breakfast and lunch). This showed that bacterial contamination measured significantly with storage time, and was in all. Moreover, other factors included higher temperature, higher levels of particulates (dust, storms) in adequate hand washing and the use of stored water to prepare weaning and other foods that also become microbiologically contaminated and contributed to increased infections disease risks (Dunne, Angora-Benie, kamelan Tano, Sibailly, Monga, Kouacio, Rocds, Wiktor, Lackritz, Mintz & Luby, 2001). Therefore, availability of safe water was central to satisfactory practice of food hygiene. In this regard, in an attempt to address the purported water problem as enunciated above, the need to elicit water hygiene KAP and enhancement strategies among women attending ANC become pertinent. Dunne et al. (2001) conducted a study on drinking water in Abidjan, Cote d’Ivoire, safe for infant formula. The objective of the study was to survey knowledge, attitudes, and practices regarding water use and infant feeding in the Koumassi District of Abidjan, Côte d'Ivoire, and to evaluate the microbiologic quality of source and stored drinking water. A random cluster survey research design was used for the study. The sample involved randomly selected 20 clusters, each comprising six households with at least one child aged < or =3 years. Data was collected using the questionnaire. Stored drinking water samples were tested for chlorine levels and for total coliform and fecal bacteria count (Escherichia coli). The findings of the study show that municipal water was used for drinking in 112 (93%) of 120 households, and in 99 (83%), it was stored for later use. Since the objective of the study was to survey knowledge, attitudes, and practices regarding water use and infant feeding in the Koumassi District of Abidjan, Côte d'Ivoire, as well as to evaluate the microbiologic quality of source and stored drinking water, the current study was concerned with water hygiene KAP and enhancement strategies among various levels of education of women attending ANC in rural and urban areas, Plateau State- Nigeria. Lule, Memin, Ekwaru, Malamba, Downing, Ransom,… Bunnell (2005) studied the effect of home-based water chlorination and safe storage on diarrhea among persons with human immunodeficiency virus in Uganda. The objective of the study was to conduct a randomized controlled trial of a home-based safe water intervention on the incidence and

54

severity of diarrhea among persons with HIV living in rural Uganda. The research design for the study was the descriptive survey research design. A total of 509 persons with HIV and 1,521 HIV-negative household members were enrolled from 392 households. During weekly visits, study staff administered a questionnaire to all household members regarding diarrhea episodes to collect data. Data were analyzed using SAS version 9 software (SAS Institute, Cary, NC). Multivariable Poisson regression models using a log link function were developed for assessing associations between SWS and diarrhea episodes, days with diarrhea, and days of work or school lost due to diarrhea, adjusting for age, sex, time of year in three-month intervals, cotrimoxazole use, water quality, presence of latrine in compound, soap at home, and household wealth, including World Health Organization clinical stage and CD4 cell count for persons with HIV. The finding of the study revealed that most households used springs or boreholes as water sources. Additionally, more than 90 per cent of households’ stored water at home using wide-mouthed containers. The only effective water treatment practices reported were boiling for 21% of intervention and 24% of comparison households, and bleach for one household (0.5%) in each group. The research thus determined. The study conducted a randomized controlled trial of a home-based safe water intervention on the incidence and severity of diarrhea among persons with HIV living in rural Uganda. This study is relevant because it used level of education and locations of rural and urban areas by which water hygiene KAP of women attending ANC was determined in Plateau State. Crump, Otieno, Slutsker, Keswick, Rosen, Hoekstra,… Luby (2005) studied household based treatment of drinking water with flocculant-disinfectant for preventing diarrhoea in areas with turbid source water in rural western Kenya: cluster randomized controlled trial. The objective of the study was to compare the effect on prevalence of diarrhoea and mortality of household based treatment of drinking water with flocculantdisinfectant, sodium hypochlorite, and standard practices in areas with turbid water source in Africa. The cluster randomized controlled trial over 20 weeks was used for the study. The samples of 6650 people in 605 family compounds were used for the study. The result of the study revealed that in children < 2 years old, compared with those in the control compounds, the absolute difference in prevalence of diarrhoea was -25% in the flocculant-disinfectant arm (95% confidence interval -40 to -5) and -17% in the sodium hypochlorite arm (-34 to 4). Moreover, the mean turbidity of drinking water was 8 nephelometric turbidity units (NTU) in flocculant-disinfectant households, compared with 55 NTU in the two other compounds (P < 0.001). The study concluded that in areas of turbid water, flocculant-disinfectant was

55

associated with a significant reduction in diarrhoea among children < 2 years. This study compared the effect on prevalence of diarrhoea and mortality of household based treatment of drinking water with flocculants-disinfectant, sodium hypochlorite, and standard practices in areas with turbid water source in Africa. The current study provided water hygiene KAP enhancement strategies for use. Stockman, Fischer, Deming, Ngwira, Bowie, Cuniffe, Bresee and Quick (2007) studied the PoU water treatment and use among mothers in Malawi. The objective of the study was to determine PoU water treatment and use among mothers. The modified segment survey design described in the United Nation children’s fund’s end-decade multiple-indicator survey handbook was used for the study. The equal-probability sample of 3,000 households in 30 enumeration areas throughout the country was used for the study. All mothers of children urban = 72.8%), water collection (urban = 76.3% < rural = 75.4%) and water source protection (rural = 75.4%; urban = 74.1%). The Table also shows that over one half of the women in urban than rural areas possessed correct knowledge regarding: water storage (rural = 58.8% > urban = 57.8%) and PoU of water (urban = 50.2% > rural = 49.8%) while over 30 per cent of the women in urban and rural areas possessed correct knowledge regarding water purification (rural = 38.1% > urban = 36.3%). Responses from the FGD showed that majority of the women possessed correct knowledge regarding water transportation. The reason was that they had safely transported either farm produce or food stuffs bought from the market home and the knowledge of the transportation was transferred to the transportation of water. Furthermore, responses from the FGD showed that majority of the women possessed correct knowledge regarding water transportation. Also, responses from the FGD showed that most women did not possess correct knowledge regarding PoU of water. The reason for this was due to ignorance.

83 Research question six. What is the water hygiene attitude of women attending ANC based on level of education in Plateau State? Data answering this research question are contained in Table 6. Table 6 Percentage Responses on the Water Hygiene Attitude of Women Attending ANC based on Level of Education in Plateau State (n=642) Level of Education

S/no 1

2

3

4 5

6

7

8

9

10 11 12

13

14

15

16 17 18

Items Attitude about water storage Storing safe water by keeping it safe in any clean container with lid kept above the ground with spigot. Emptying, cleaning and drying the storage container before storing safe water. Mixing freshly fetched water with stored one in storage container. Cluster % Attitude about water transport Transporting safe water in any container. Transporting safe water in clean disinfected and dried container with lid. Transporting safe water in uncovered container. Cluster % Attitude about water collection Prefer to collect safe water in hygienic and properly covered container. Like to collect safe water without allowing part of human body contact it. Prefer to collect safe water in opened container. Cluster % Attitude about PoU of water Removing safe water of POU through spigot. Removing safe water at POU through scooping. Removing safe water at POU using ones mouth. Cluster % Attitude about water source protection Protecting safe water source by preventing animals and human waste from it. Protecting safe water source by situating refuse dump site far down the slope below water source. Protecting safe water source by preventing water runoff from mixing with safe water source. Cluster % Attitude about water purification Purifying my water using boiling. Purifying my water using aeration. Purifying my water using sedimentation. Cluster % Overall cluster %

Primary School Certificate SD + D SA + A f (%) f (%)

Secondary School Certificate SD + D SA + A f (%) f (%)

35 (38.9)

55 (61.1)

34 (30.4)

78 (69.6)

166 (56.5)

128 (43.5)

70 (47.9)

77 (53.1)

43 (47.8)

47 (52.2)

45 (40.2)

67 (69.9)

64 (21.8)

130 (78.2)

36 (24.7)

110 (75.3)

16 (17.8) 34.8

74 (65.6) 65.2

18 (76.3) 29

94 (83.9) 71.2

35 (11.9) 30.5

259 (88.1) 70

12 (8.3) 27.3

134 (91.8) 74

35 (38.9)

56 (61.1)

47 (41.9)

65 (58.1)

168 (58.0)

124 (42.2)

79 (54.1)

67 (45.9)

64 (71.1)

26 (28,9)

71 (68.8)

35 (31.2)

234 (79.0)

60 (20.4)

114 (78.1)

29 (21.9)

15 (16.7) 42.3

75 (83.3 57.7

28 (25.0) 45.2

84 (75.0) 54.7

43 (15.1) 63

151 (85.3) 49.3

23 (15.7) 49.3

123 (84.2) 50.7

67 (74.4)

23 (25.6)

75 (67.0)

37 (33.1)

239 (81.0)

55 (18.7)

119 (81.5)

27 (18.5)

49 (54.4)

41 (45.6)

58 (51.8)

54 (48.3)

220 (75.0)

74 (24.6)

101 (69.1)

45 (30.8)

60 (66.7) 65.2

30 (33.3) 34.8

68 (60.7) 59.8

44 (39.3) 40.3

186 (64.0) 73.2

108 (36.7) 26.9

96 (65.7) 72.1

50 (34.2) 27.2

30 (33.3)

60 (66.8)

38 (36.9)

74 (66.1)

126 (43.0)

168 (57.1)

66 (45.2)

80 (54.8)

44 (60.0)

36 (40.0)

60 (53.6)

52 (46.5)

115 (38.)

179 (60.9)

59 (40.1)

87 (59.6)

46 (51.1) 48.1

44 (48.9) 41.8

49 (44.8) 43.8

63 (56.3) 56.3

214 (73.0) 51.6)

80 (27.2) 48.4)

98 (67.1) 50.9

48 (32.9) 29.1

13 (14.5)

77 (85.5)

17 (15.2)

95 (84.9)

36 (12.2)

258 (87.7)

25 (17.1)

121 (82.1)

22 (35.6)

58 (64.5)

39 (34.8)

73 (65.2)

93 (30.9)

201 (68.3)

49 (33.6)

97 (66.4)

23 (25.6) 25.2

67 (74.5) 74.8

33 (29.5) 26.8

79 (70.6) 73.6

56 (19.1) 21

238 (80.9) 78.9

33 (21.9) 24.2

114 (78.1) 75.7

14 (15.6) 62 68.9)

76 (84.4) 28 (31.1)

20 (17.9) 77 (69.1)

92 (82.1) 35 (31.2)

47 (16.0) 182 (62.4)

247 (84.1) 112 (38.1)

20 (13.7) 98 (67.1)

126 (86.7) 48 (32.8)

56 (62.2) 48.9 44.1

34 (37.8) 51.1 55.9

59 (52.7) 46.5 41.8

53 (47.4) 53.6 58.3

108 (37.1) 38.5 46.2

186 (63.3) 62.8 55.8

57 (39.1) 39.9 46.6

89 (61.0) 61.1 56

SD = Strongly Disagree; D=Disagree; A=Agree; SA=Strongly Agree

NCE/ND Certificate SD + D SA + A f (%) f (%)

Bachelors degree and above SD + D SA + A f (%) f (%)

84

Data in Table 6 show that overall, over 50 per cent of women attending ANC with secondary certificate (58.3%), primary education (55.9%), NCE/ND (55.8%) and bachelor degree and above (56.0%) expressed positive attitude towards water hygiene. The Table further shows that majority of the women with NCE/ND certificate (78.9%), bachelor degree and above (75.7%), primary education (74.8%) and secondary certificate (73.6%) displayed positive attitude toward water source protection. Similarly, majority of the women with bachelor degree (74.0%), secondary education (71.2%), NCE/ND certificate (70.0%) and primary certificate (65.2%) expressed positive attitude towards water storage. In addition, majority of the women with NCE/ND certificate (62.8%) and bachelor degree and above (61.1%) expressed attitude towards water purification while slightly over one half of those with secondary certificate (53.6%) and primary education (51.1%) expressed positive attitude toward water purification. The Table further shows that over one half of the women with primary certificate (57.7%), secondary education (54.7%), bachelor degree and above (50.7%) while about one half of those with NCE/ND certificate (49.3%) displayed positive attitude towards water transportation. Furthermore, over 50 per cent of the women with secondary education (56.3%), and over 40 per cent of those with NCE/ND certificate (48.4%) and primary education (41.8%) displayed positive attitude towards PoU of water whereas less than 30 per cent of women with bachelor degree and above (29.1%) displayed positive attitude towards PoU of water. The Table also shows that over 40 per cent of women with secondary certificate (40.3%) and 34.8 per cent of primary education (34.8%) expressed positive attitude towards water collection while less than 30 per cent of women with bachelor degree and above (27.2%) and NCE/ND certificate (26.9%) expressed positive attitude towards water collection. Responses from the FGD revealed that majority of the women protected their water sources. The reason they gave was that women were responsible for cleaning, washing and tidying their home and this makes it easy for them to protect their water sources. Responses from FGD also showed that majority of the women with higher qualification displayed positive attitude towards purification of water more than those with lower educational qualification. Also, responses from the FGD show that women displayed positive attitude towards PoU of water.

85

Research question seven. What is the water hygiene attitude of women attending ANC based on location in Plateau State? Data answering this research question are contained in Table 7. Table 7 Percentage Responses on the Water Hygiene Attitude of Women Attending ANC based on Location in Plateau State (n = 642) Location Rural S/no

Urban SD + D SD + A f (%) f (%)

SD + D f (%)

SA + A f (%)

159 (50.5)

156 (49.5)

146 (44.7)

181 (55.3)

97 (30.8)

118 (69.2)

91 (27.9)

236 (72.2)

32 (10.2) 30.5

283 (89.9) 69.5

49 (15.0) 29.2

278 (85.0) 70.8

169 (53.8) 242 (76.8)

146 (31.2) 73 (23.2)

162 (49.6) 247 (75.5)

165 (50.5) 80 (24.4)

51 (16.2) 48.8

264 (83.8) 51.1

58 (17.7) 47.5

269 (82.3) 52.4

250 (79.4)

65 (20.7)

250 (76.4)

77 (23.5)

217 (68.9)

98 (31.1)

211 (64.5)

116 (35.4)

203 (64.4) 70.9

112 (35.5) 29.1

227 (63.3) 68.1

120 (36.7) 31.9

118 (37.5) 142 (45.0)

197 (62.5) 173 (54.9)

142 (43.4) 146 (44.7)

185 (56.6) 181 (55.3)

210 (66.7) 49.7

105 (33.3) 50.3

197 (60.3) 49.5

130 (39.7) 50.5

36 (11.4)

279 (88.6)

55 (16.9)

272 (83.2)

102 (32.4)

213 (67.6)

111 (33.9)

216 (66.1)

68 (21.6) 21.8

247 (78.4) 78.2

76 (23,3) 24.7

251 (76.8) 75.3

16

Items Attitude towards water storage Like to mix freshly fetched water with stored one in storage container. Prefer to keep storage container above the ground. Like to empty, clean, disinfect and dry water storage container before refilling it. Cluster % Attitude towards water transportation Like transporting safe water using clean opened container without lid. Prefer transporting safe water in any container. Like to transport safe water when lid and container are cleaned, disinfected and dried. Cluster % Attitude towards water collection Prefer to collect safe water in any container. Like touching safe water with any part of human body when collecting it. Prefer to travel long distance to collect safe water. Cluster % Attitude towards point-of-use of water Prefer to remove safe stored water by scooping. Like removing safe stored water through spigot. Prefer removing safe stored water by sending any child around. Cluster % Attitude towards water source protection Prefer to prevent water source by preventing animals and human waste from reaching it. Like to protect water source by dumping refuse far below water source on a slope. Prefer to protect fast flowing water runoff mixing with safe water source. Cluster % Attitude towards water purification Prefer to make water safe by filtration.

54 (17.2)

261 (82.9)

47 (7.4)

280 (85.6)

17

Like to make water safe by aeration.

198 (62.8)

117 (37.2)

221 (67.5)

106 (32.4)

18

Prefer to make water safe by sedimentation.

138 (43.8) 41.2 44.8

177 (56.2) 58.8 56.8

142 (43.4) 41.8 43.4

185 (56.6) 58.2 56.6

1 2 3

4 5 6

7 8 9

10 11 12

13 14 15

Cluster % Overall clusters %

Table 7 shows that an overall, more than 50 per cent of women attending ANC in rural (56.8%) and urban areas (56.6%) expressed positive attitude towards water hygiene.

86

The Table further shows that majority of the women in rural (78.2%) and urban areas (75.5%) displayed positive attitude towards water source protection. Similarly, majority of the women in the urban (70.8%) and rural areas (69.5%) expressed positive attitude towards water storage. In addition, over 50 per cent of the women in rural (58.8%) and urban areas (58.2%) displayed positive attitude towards water purification. Similarly, Table 7 also shows that over 50 per cent of the women in the urban (52.4%) and rural (51.1%) areas displayed positive attitude towards water transportation. However, over 30 per cent of the women in the urban (31.9%) and 29.1 per cent of those in the urban areas expressed positive attitude towards water collection. Responses from the FGD showed that women in both the rural and urban areas displayed positive attitude towards the protection of water. The reason given was that they more often than not use common sources of water, which when not taken care of could contaminate the water in it that when they fetched from such source and used, it led to ill health. Responses from the FGD also showed that almost half of the women displayed negative attitude towards water purification. The reason they gave was that it was difficult for them to access the water purification materials. Even when such is available, one may not know how to use it successfully.

87

Research question eight. What are the water hygiene practices of women attending ANC based on level of education in Plateau State? Data answering this research question are contained in Table 8. Table 8 Percentage Responses on the Water Hygiene Practices of Women attending ANC based on Level of Education in Plateau State (n = 642) Level of Education Never S/No 1

2

3

Items Practices of water storage Storing safe water by keeping it safe in any clean container with lid kept above the ground with spigot. Emptying, cleaning and drying the storage container before storing safe water. Mixing freshly fetched water with stored one in storage container.

5 6

Transporting safe water in uncovered container.

8

Collecting safe water without allowing part of human body contact it.

9

Collecting container.

10 11 12

13

14

15

safe

water

in

17 18

NCE/ND Sometimes

Always

Never

Bachelors degree and above Rarely Sometimes

Always

%

f

%

f

%

f

%

f

%

f

%

f

%

f

%

f

%

f

%

f

%

f

%

f

%

f

%

7

7.8

8

8.9

46

51.1

29

32.2

6

5.4

12

10.7

59

52.7

35

31.3

35

11.9

28

9.5

122

41

109

37.1

8

5.5

4

2.7

69

47.3

65

44.5

3

3.3

6

6.7

47

52.2

34

37.8

3

2.7

5

4.5

60

53.6

44

39.3

9

3.1

17

5.8

99

33.7

169

57.5

1

0.7

4

2.7

68

46.6

73

50

13

14.4

12

13.3

22

24.4

43

47.8

20

17.9

12

10.7

38

33.9

42

37.5

93

31.6

40

13.6

99

33.7

62

21.1

32

21.9

24

16.4

51

34.9

39

26.7

9.3

43

39.3

8.7

8.6

46.7

36.9

15.5

9.6

36.3

39

9.4

7.3

42.9

40.4

34

37.8

4

4.4

11

12.2

41

45.6

35

31.3

16

14.3

21

18.8

40

35.7

152

51.7

35

11.9

49

16.7

58

19.7

62

42.5

17

11.6

25

17.1

42

28.8

12

13.3

28

31.1

17

18.9

33

36.7

8

7.1

36

32.1

31

27.7

37

33

24

8.2

51

17.3

68

23.1

151

51.4

18

12.3

31

21.2

39

26.7

58

39.7

27.8

11

12.2

17

18.9

37

41.1

29

25.9

19

17

26

23.2

38

33.9

149

50.7

38

12.9

50

17

57

19.4

61

41.8

16

11

34

23.3

35

25

16

17

41.1

5

5.6

4

4.4

43

47.8

38

42.2

14

15.6

38

42.2

16

17.8

22

24.4

26

28.9

10

11.1

14

15.6

40

44.4

21

3

21

23.3

34.2

2.7

11

9.8

43

38.4

55

49.1

8

7.1

33

29.5

43

38.4

28

25

27

24.1

23

20.5

22

19.6

40

35.7

36.9

15

14

18.9

30

32.2

5.1

17

5.8

60

20.4

202

68.7

7

29

9.9

49

16.7

83

28.2

133

45.5

134

45.6

52

17.7

60

20.4

48

16.3

14.6

22.4

24 30.8

4.8

12

8.2

44

30.1

83

56.8

14

9.6

40

27.4

34

23.2

58

39.7

53

36.3

24

16.4

32

21.9

57

25.3

opened

Overall % Practices of PoU of water Removing safe water of POU through spigot. Removing safe water at POU through scooping Removing safe water at POU using one's mouth. Overall % Practices about water source protection Protecting safe water source by preventing animals and human waste from it. Protecting safe water source by situating refuse dump site far down the slope below water source. Protecting safe water source by preventing water runoff from mixing with safe water source. Practices of water purification Purifying my water using boiling. Purifying my water using aeration. Purifying my water using sedimentation. Cluster % Overall cluster %

Rarely

f

16.7

14

15.6

19

33

27

37

36.7

19

21.1

24

26.7

11

20

32.1

36.6

20.2

12

10.7

36

32.1

29

25.9

35

31.3

36

13

23

43

16.9

17.3

25.1

40.6

12.2

55

18.7

82

27.9

121

41.2

16

11

28

19.2

52

35.6

50

34.2

5

5.6

8

8.9

28

31.1

49

54.4

7

6.3

13

11.6

50

44.6

42

37.5

50

17

46

15.6

113

38.4

85

28.9

25

17.1

24

16.4

50

34.2

47

32.2

23

25.6 15.6

10

11.1 19

42

46.7 33

15

16.7 32.6

28

25 14

12

10.7 18

54

48.2 39.6

18

16.1 28.3

13

44.2 24.5

46

15.6 17

61

20.7 29

57

19.4 30

51

34.9 21

20

13.7 5

50

34.2 34.7

25

17.1 27.8

2

2.2

8

8.9

36

40

44

48.9

5

4.5

11

9.8

46

41.1

50

44.6

12

4.1

18

6.1

62

21.1

202

68.7

5

3.4

9

6.2

46

31.5

86

58.9

9

10

15

16.7

40

44.4

26

28.9

14

12.5

13

11.6

47

42

38

33.9

35

11.9

33

11.2

82

27.9

144

49

12

8.2

17

11.6

50

34.2

67

45.9

3.3

17

18.9

38

42.2

32

35.6

8

7.1

16

14.3

47

42

41

36.6

26

8.8

34

11.6

75

25.5

159

54.1

7

4.8

9

6.2

58

39.7

72

3

Overall % 16

Never

%

26.3

Practices of water collection Collecting safe water in hygienic and properly covered container.

Always

f

Overall % 7

Never

%

8.5

Practices of water transportation Transporting safe water in any container. Transporting safe water in clean disinfected and dried container with lid.

Always

Secondary School Certificate Rarely Sometimes

f

Over all % 4

Primary School Certificate Rarely Sometimes

5.2

15

42

37.8

8

12

41.7

38.4

7.9

9.6

24.8

57

5.5

7.7

35.1

49.3 51.4

9

10

31

34.4

19

21.1

31

34.4

6

5.4

41

36.6

34

30.4

31

27.7

11

3.7

48

16.3

79

26.9

156

53.1

4

2.7

35

24

51

34.9

56

38.4

10

11.1

33

36.7

19

21.1

28

31.1

7

6.3

39

34.8

35

31.3

31

27.7

19

6.5

44

15

106

36.1

125

42.5

4

2.7

36

24.7

50

34.2

56

38.4

15

16.7 12.6

13

14.4 29

37

41.1 28

25

27.8 31.1

15

13.4 8.4

22

19.6 30

44

39.3 33.7

31

27.7 27.7

40

13.6 7.9

39

13.3 15

109

37.1 33.4

106

36.1 44

14

9.6 5

17

11.6 20.1

66

45.2 38.1

49

33.6 36.8

14.2

18

32

36.5

12

18

36.2

33.5

18.8

13

27.6

41

15

12

33.1

38

88

Table 8 shows that an overall 41.0 per cent of women with NCE/ND certificate practised water hygiene always, 27.6 per cent practised sometimes and 13.0 per cent practised rarely while 38.0 per cent of those with bachelors degree and above practised always, 33.1 per cent practised sometimes, 12.0 per cent practised rarely, whereas 36.5 per cent of those with primary education practised always, 32.0 per cent practised sometimes and 18.0 per cent rarely practised, while 36.2 per cent of those with secondary education practised sometimes, 33.5 per cent practised always and 18 per cent practised rarely. The Table further shows that women with NCE/ND practised water source protection always (57.0%), sometimes (24.8%) and rarely (9.6%) while those with bachelor degree and above practised it always (51.4%), sometimes (35.1%) and rarely (7.7%) whereas those with secondary education practised it sometimes (41.7%), always (38.4%) and rarely (12.0%) while those with primary education practised sometimes (42.0%), always (37.8%) and rarely (15.0%). Table 8 also shows that women with NCE/ND practised water collection always (43.0%), sometimes (23.0%) and rarely (13.0%) while those with bachelor degree and above practised always (40.6%), sometimes (25.1%) and rarely (17.3%) whereas those with primary education practised always (37.0%), sometimes (27.0%), rarely (19.0%) while those with secondary education practised always (36.6%), sometimes (32.1%) and rarely (20.0%). Moreover, the Table further shows that women with secondary certificate practised water storage sometimes (46.7%), always (36.9%), rarely (8.6%) while those with primary certificate practised sometimes (43.0%), always (39.3%) and rarely (9.3%) whereas those with bachelor degree and above practised sometimes (42.9%), always (40.4%), rarely (7.3%) while women with NCE/ND practised always (39.3%), sometimes (36.3%) and rarely (9.6%). Also, women with NCE/ND practised water purification always (44.0%), sometimes (33.4%), and rarely (15.0%) while women with bachelor degree and above practised sometimes (38.1%), always (36.8%) and rarely (20.1%) similarly, women with secondary education practised sometimes (33.7%), rarely (30.0%) and always (27.7%), additionally, women with primary education practised always (31.1%), rarely (29.0%) and sometimes (28.0%). Table 8 also shows that women with primary education practised water transportation always (41.1%), sometimes (17.0%), rarely (16.0%) whereas women with secondary education practised always (34.2%), sometimes (23.3%), rarely (21.0%) while women with

89

bachelor degree and above practised always (30.8%), sometimes (22.4%) and rarely (14.6%) whereas those with women with NCE/ND practised always (30.0%), sometimes (18.9%) and rarely (14.0%). Only women with secondary education who practised PoU of water sometimes (39.6%), always (28.3%) and rarely (18.0%) while women with bachelor degree and above practised sometimes (34.7%), always (27.8%) and rarely (5.0%) whereas women with primary education practised sometimes (33.0%), always (32.6%) and rarely (19.0%) while women with NCE/ND practised always (30.0%), sometimes (29.0%) and rarely (17.0%).

90 Research question nine. What are the water hygiene practices of women attending ANC based on location in Plateau State? Data answering this research question are contained in Table 9. Table 9 Percentage Responses on the Water Hygiene Practices of Women attending ANC based on Location in Plateau State (n = 642) Location

S/no 1

2

3

4 5

6

7 8

9

10 11 12

13

`14

`15

16 17 18

Items Practices of water storage Storing safe water by keeping it safe in any clean container with lid kept above the ground with spigot. Emptying, cleaning and drying the storage container before storing safe water. Mixing freshly fetched water with stored one in storage container. Cluster % Practices of water transportation Transporting safe water in any container. Transporting safe water in clean disinfected and dried container with lid. Transporting safe water in uncovered container. Cluster % Practices of water collection Collecting safe water in hygienic and properly covered container. Collecting safe water without allowing part of human body contacts it. Collecting safe water in opened container. Overall % Practices of PoU of water Removing safe water of PoU through spigot. Removing safe water at PoU through scooping. Removing safe water at PoU through ones month. Cluster % Practices about water source protection Protecting safe water source by preventing animals and human waste from it. Protecting safe water source by situating refuse dump site far down the slope below water source. Protecting safe water source by preventing water runoff from mixing with safe water source. Cluster % Practices of water purification Purifying my water using boiling. Purifying my water using aeration. Purifying my water using sedimentation. Cluster % Overall Cluster %

Never f %

Rural Rarely Sometimes f % f %

Always f %

Never f %

Rarely f %

Urban Sometimes f %

Always f %

28

8.9

27

8.6

143

45.4

117

37.1

28

8.6

25

7.6

153

46.8

121

37

10

3.2

15

4.8

132

41.9

158

50.2

6

1.8

17

5.2

142

43.4

162

49.5

86

27.3 13.1

44

14 9.1

102

32.4 39.9

83

26.3 37.9

72

22 10.8

44

13.5 8.8

108

33 40.1

103

31.5 39.3

144

45.7

33

10.5

56

17.8

82

26

139

42.5

39

11.9

50

15.3

99

30.3

30

9.5

66

21

75

23.8

144

45.7

32

9.8

80

24.5

80

24.5

135

41.3

121

38.4 31.2

46

14.6 15.4

64

20.3 20.5

84

26.7 32.8

143

43.7 32

38

11.6 16

63

19.3 19.7

83

25.4 32.3

15

4.8

21

6.7

102

32.4

177

56.2

15

4.6

23

7

88

26.9

201

61.5

30

9.5

75

23.8

84

26.7

126

40

35

10.7

85

26

92

28.1

115

35.2

116

36.8 17

44

14 14.8

71

22.5 27.2

84

26.7 41

124

37.9 17.7

65

19.9 17.6

57

17.4 24.1

81

24.8 40.5

31

9.8

75

23.8

93

29.5

116

36.8

47

14.4

77

23.5

89

27.2

114

34.9

40

12.7

41

13

120

38.1

114

36.2

47

14.4

50

15.3

121

37

109

33.3

115

36.5 19.7

40

12.7 16.5

107

34 33.9

53

16.8 29.9

117

35.8 21.5

48

14.7 17.8

100

30.6 31.6

62

19 29.1

14

4.4

19

6

95

30.2

187

59.4

10

3.1

27

8.3

95

29.1

195

56.6

28

8.9

39

12.4

110

34.9

138

43.8

42

12.8

39

11.9

109

33.3

137

41.9

22

7 6.8

36

11.4 9.9

106

33.7 32.9

151

47.9 50.4

22

6.7 7.5

40

12.2 10.8

112

34.3 32.3

153

46.8 48.4

17 17

5.4 5.4

78 74

24.8 23.5

81 100

25.7 31.7

139 124

44.1 39.4

13 23

4 7

77 78

23.5 23.9

102 110

31.2 33.6

135 116

41.3 35.5

38

12.1 7.6 15.9

46

14.6 21 14.5

122

38.7 32 31.1

109

34.6 39.4 38.6

46

14.1 8.4 16.3

45

13.8 20.4 15.2

134

41 35.3 30.5

102

31.2 36 37.6

91

Results in Table 9 show the proportion of women in rural areas who practised water hygiene always (38.6%), sometimes (31.3%) and rarely (14.5%) while in the urban areas the proportion was always (37.6%), sometimes (30.5%) and rarely (15.2 %). The Table further shows the proportion of women in rural areas who practised water source protection always (50.4%), sometimes (32.9%) and rarely (9.9%) whereas in the urban areas the proportion was always (48.4%), sometimes (32.3%) and rarely (10.8%). Similarly, Table 9 also shows the proportion of women in rural areas who practised water collection always (41.0%), sometimes (27.2%) and rarely (14.8%) while in urban areas the proportion was always (40.5%), sometimes (24.1%) and rarely (17.6%). Data in Table 9 again shows the proportion of women in urban areas who practised water purification always (39.4%), sometimes (32.0%) and rarely (21.0%) whereas in the rural areas the proportion was always (36.0%), sometimes (35.3%) and rarely (20.4%). Similarly, Table 9 also shows the proportion of women in urban areas who practised water storage always (39.3%), sometimes (39.9%) and rarely (9.9%) while in the rural areas the proportion was always (37.3%), sometimes (40.1%) and rarely (8.8%). Furthermore, the Table again shows the proportion of women in rural areas who practised water transportation always (32.8%), sometimes (20.5%) and rarely (15.4%) whereas the proportion in the urban areas was always (32.3%), sometimes (19.7%) and rarely (16.0%). Also, the Table shows the proportion of women in rural areas who practised PoU of water always (29.9%), sometimes (33.9%) and rarely (16.5%) while in the urban areas the proportion was always (29.1), sometimes (31.6%) and rarely (17.8%). Responses from the FGD indicated that respondents used earthen pots, plastics and others stainless steel utensils to store drinking water. A revelation by a woman in the southern senatorial zone of the State revealed that “she did not store water in covered container because it will not cool down properly in the house, but the water becomes cool if left in earthen opened container”.

92

Research question ten. What are the enhancement strategies of water hygiene knowledge, attitude and practice of women attending ANC in Plateau State? Data answering this research question are contained in Tables 10, 11 and 12. Table 10 Responses of Experts on Water Hygiene Knowledge Enhancement Strategies (N = 27) S/no 1

2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

21 22 23

Water Hygiene Knowledge Enhancement Strategies Preparing and distributing knowledge of water hygiene manual, pamphlets and hand bill on water hygiene issues to women during water day calculation. Display of poster describing correct steps of safe water at source, during collection, transportation, storage and PoU of water. Pasting of write ups on knowledge of water hygiene on notice boards of religious organizations, schools, public places and community town halls. Distribution and pasting of pictorial pictures portraying safe water collection, transportation, storage and PoU. Using pictures on water collection, storage, transport and PoU of water to educate women regarding water hygiene. Share pamphlet regarding water source collection, transportation, storage and poll of water to teach women. Demonstrate safe ways to collect water, safe transportation water, safe storage and safe poll of water during meetings at community halls. Regular workshop and seminar on how to build fence around water source to screen animals and human wastes from getting into water source. Workshop and seminar on how to drain stagnant water around water source away from such site. Workshop on how to transport safe water. Workshop on safe ways to clean and dry water carrying containers before collecting water. Demonstrate how to store water above the ground in a covered container to women. Demonstrate how to keep drinking water away from other liquids to women. Demonstrate how to wash and disinfect water storage container to women. Demonstrate how to retrieve stored water to women. Explain water storage container characteristics to women. Demonstrate how to purify water to women. Explain how to collect water safely to women. House to house visit by influential members of the community appealing to women for the building of buffers around water source. House to house visit by influential members of the community appealing for the collection of use of safe methods to collect and transport water to women. Appeal to women of the community by influential people to avoid contacting safe waste with any part of the body. Appeal to women by influential people to retrieve stored water through the spigot (narrow opening). Appeal by influential people to women to clean, disinfect and dry water carrying container before using to collect store and transport water. Cluster Mean

ഥ) Mean (‫܆‬

SD

Decision

2.67

.480

VA

2.30

.669

A

2.41

.694

A

2.63

.492

VA

2.67

.480

VA

2.59

.572

VA

2.48

.509

A

2.74

.526

VA

2.74 2.67

.447 .480

VA VA

2.63

.565

VA

2.59 2.37 2.37 2.52 2.26 2.59 2.56

.501 .688 .565 .580 .712 .501 .577

VA A A VA A VA VA

2.52

.580

VA

2.74

.526

VA

2.57

.480

VA

2.37

.629

A

2.48 2.55

.580 .559

A VA

Key: 2.50 - 3.00 (Very Appropriate), 2.00 - 2.49 (Appropriate) and 1.00 - 1.99 (Not Appropriate)

Table 10 shows an overall mean responses value of 2.55 with standard deviation of .559. This implies that the water hygiene knowledge enhancement strategy was adjudged very appropriate. The table further shows that items (1, 4, 5, 6, 8-12, 15 and 17-21) with mean responses of water hygiene knowledge enhancement strategy values ranging from 2.52 – 2.74 (SD = 447 – 580). This implies that these water hygiene knowledge enhancement strategies

93

were adjudged very appropriate. However, the water hygiene knowledge enhancement strategies items value ranging from 2.26 – 2.48 (SD = .509 – 712). This implies that these water hygiene knowledge enhancement strategies items were adjudged appropriate. Table 11 Responses of Experts on Water Hygiene Practice Enhancement Strategies (N = 27) ഥ) S/no SD Water Hygiene Practice Enhancement Strategies Mean (‫܆‬ 24 Screening source of water from animals and human wastes as well as refuse by building a buffer zone or fence around it. 2.70 .542 25 Participating in drama display on water source protection. 2.48 .580 26 Draining spilled water around the surface away from the source of water source. 2.44 .577 27 Keeping away washing, bathing and soak away from my toilets 30 meters away from my water source. 2.59 .501 28 Protecting storm water from mixing with safe water source. 2.70 .542 29 Avoid throwing impurities into water source. 2.78 .506 30 Always washing and drying water collecting container before collecting safe water in it. 2.78 .424 31 Ensuring that safe collected water is covered at all times. 2.81 .483 32 Keep safe water collected covered and kept above the ground preferably on a height. 2.44 .577 33 Avoiding the contact of safe water with any part of human . body. 2.63 492 34 Keeping animals and children away from contacting safe collected drinking water. 2.41 .501 35 Boiling water and allowing it to cool in a hygienic container before drinking. 2.63 .565 36 Using water purifying tablets such as alum, aquatab and others to purify my water. 2.48 .643 37 Filtering water with suspended particles before using same. 2.48 .580 38 Storing safe water in covered container. 2.74 .447 39 Removing stored safe water through the spigot. 2.56 .506 40 Regularly cleaning my storage container from time to time. 2.74 .447 41 Transporting safe water in clean and covered container. 2.67 .480 42 I remove water at PoU through the spigot (narrow opening). 2.48 .509 43 Planning roster to clean and tidy water source. 2.56 .506 44 Avoiding washing and bathing around water source. 2.70 .465 45 Learning from the teaching of water source protection and teach others how to protect water source. 2.63 .492 46 Participating in water source protection programmes. 2.59 .501 47 Implementing various practices learnt from water source programmes. 2.67 .555 48 Learning from the programmes of water source protection and teach each others how to protect water source. 2.74 .447 Cluster Mean 2.62 .515

Decision VA A A VA VA VA VA VA A VA A VA A A VA VA VA VA A VA VA VA VA VA VA VA

Table 11 shows that an overall mean response of 2.62 with standard deviation of .515, which fell between 2.59 – 3.00. This implies water hygiene practice enhancement strategies were adjudged very appropriate. The Table further indicates that 18 items (24, 27 - 31, 33, 35, 38 - 41,

94

and 43 - 48) with the mean responses values ranging from 2.56 - 2.81 (SD = .447 = .565), which fell between 2.50 – 3.00. This implies that the water hygiene practice enhancement strategies for those items were adjuged very appropriate. However, the water hygiene practice enhancement strategies items 25 -26, 32, 34, 36 – 37 and 42 with their mean values ranging from 2.41 – 2.48 (SD = .501 - .643), which fell between 2.00 – 2.49. This implies that the water hygiene practice enhancement strategies for those items were adjudged appropriate. Table 12 Responses of Experts on Water Hygiene Attitude Enhancement Strategies (N = 27) ഥ) S/no Water Hygiene Attitude Enhancement Strategies SD Mean (‫܆‬ 49 Provision of information in text and pictures to influence the preference in collection of water with clean and covered container. 2.93 .267 50 Provision of information in text and pictures to influence liking to make available various water purification tablets and equipment in shops and its distribution to households for use. 2.44 .698 51 Preference to provide information displaying risks and benefits of collecting, storage, transportation and PoU. 2.70 .465 52 Liking to provide information expressing safe water sources and various qualities of safe water. 2.59 .572 53 Preference to circulate water day celebration among family members and friends and display how safe water is collected, stored, transported and purified. 2.48 .580 54 Liking to provide pictorial information on the prohibition of opened defeacation and indiscriminate surface application of fertilizers on slopes and near source water parted at homes. 2.74 .447 55 Preference to provide pictorial information to women concerning using clean and disinfected container to retrieve water at PoU, water storage, collection and transportation that are parted at water source, homes and public notice 2.59 501 board. 56 Liking the appeal by influential members of the communities to collect safe water in narrow mouth containers with a lid. 2.59 .501 57 Preference to lobby and negotiate mass media to broadcast influencing messages to women concerning safe water sources of water. 2.59 .501 58 Liking to use stories and songs to influence safe collection of water, transportation, storage and poll of water. 2.78 .424 Cluster Mean 2.65 .496

Decision

VA

A VA VA

A

VA

VA

VA

VA VA VA

Table 12 shows an overall mean response value of 2.65 with standard deviation of .496, which fell between 2.50 – 3.00. This implies that the water hygiene attitude enhancement strategy was adjudged very appropriate. The Table also indicates that all the means responses ranging from 2.59 – 2.93 (SD = .267 - .572), which falls between 2.50 –

95

3.00. This implies that water hygiene attitude enhancement strategies items were adjudged very appropriate. However, only in the provision of information in text and pictures to influence liking to make available various water purification tablets and equipment in shops and its distribution to households for use and preference to calculate water day celebration among family members and friends and display how safe water is collected, stored, transported and purified was adjudged appropriate with mean of 2.44 and SD of .698 as well as 2.48 and SD = .580, which fell between 2.00 – 2.49.

96

Hypothesis one. There is no significant difference in the water hygiene knowledge of women attending ANC based on level of education in Plateau State. Data testing this hypothesis are contained in table 13.. Table 13 Summary of Chi-square Analysis Testing the Null Hypothesis regarding Water Hygiene Knowledge of Women Attending ANC according to Level of Education in Plateau State (n = 642) Primary School Certificate

S/No

Incorrect

Correct

Incorrect

Correct

Incorrect

Correct

Incorrect

χ

O(E)

O(E)

O(E)

O(E)

O(E)

O(E)

O(E)

O(E)

value

df

P -value

57(68.0) 57(70.1) 46(57.7)

55(44.0) 55(41.9) 66(54.3)

203(178.6) 212(184.1) 168(151.6)

91(115.4) 82(109.9) 126(142.4)

91(88.7) 98(91.4) 83(75.3)

55(57.3) 48(54.6) 63(70.7)

24.655 40.806 17.082

3 3 3

.001 .001 .001

27.514

3

.001

24.019 1.970 17.145

3 3 3

.000 .597 .001

14,378

3

.199

19.919

3

.000

1 2 3

39(54.7) 35(56.4) 34(46.4)

4 5 6

Knowledge of water transportation Transporting safe water in a clean container with lid. Transporting safe water using hygienically clean container. Transporting safe water using clean, disinfected and dried container. Cluster χ 2 value, df & P-value

27(45.8) 78(79.3) 71(75.3)

7 8

9 10 11

12 13 14

15 16 17

Knowledge of PoU of water Removing safe water at point-of-use through narrow opening. Removing safe water at point-of-use through scooping Removing safe water at point-of-use through any means Cluster χ 2 value, df & P-value Knowledge of water source protection Keeping water source surroundings safe and clean. Screening animals and human water from mixing with safe water at source as water protection measure. Protecting water runoff from mixing with safe water during rainfall. Cluster χ 2 value, df & P-value Knowledge of water purification Having best water treatment method as filtration. Aeration is not a water treatment method. Having sedimentation as best water treatment method. Cluster χ 2 value, df & P-value Overall cluster

χ

2

value, df & P-value

Bachelor Degree and above

Correct Items Knowledge of water storage Removal of safe stored drinking water through spigot Keeping water storage container above the ground Keeping safe freshly fetched water away from stored one at home Cluster χ 2 value, df & P-value

Knowledge of water collection Safely collecting safe water in hygienically and properly covered container. Using no part of the human today to contact safe water in hygienically and properly covered container. Cluster χ 2 value, df & P-value

Level of Education Secondary school certificate NCE/ND

51(35.3) 55(33.6) 56(43.6)

63(44.2) 12(10.7) 19(14.7)

51(57.0) 95(98.7) 81(93.7

61(55.0) 17(13.3) 31(18.3)

172(149.7) 263(259.9) 255(245.9)

122(144.3) 31(34.8) 39(48.1)

77(74.4) 130(128.7) 130(122.1)

69(71.6) 16(17.3) 16(23.9)

72(80.9)

18(9.1)

95(100.7)

17(11.3)

278(264.2)

16(29.8)

132(131.2)

14(14.4)

42(55.7)

48(34.3)

60(69.3)

52(42.7)

196(181.8)

98(112.2)

99(90.3)

47(55.7)

39(51.6) 30(34.6) 25(46.5)

51(38.4) 60(55.4) 65(43.5)

52(64.2) 40(43.1) 40(57.9)

60(47.8) 72(68.9) 72(54.1)

191(168.5) 124(131.1) 181(152.0)

103(125.5) 170(180.9) 113(142.0)

86(83.7) 53(56.2) 86(75.5)

60(62.3) 93(89.8) 60(70.5)

2

17.131

3

.001

18.525

3

.001

19.803 3.359 46.576

3 3 3

.000 .339 .000

23.246

3

.113

79(80.5)

11(9.5)

93(100.1)

19(11.9)

271(262.9)

23(31.1)

131(130.5)

15(15.5)

7.451

3

.059

41(58.3) 48(63.1)

49(31.7) 42(26.9)

63(72.6) 63(78.5)

49(39.4) 49(33.5)

214(190.5) 234(206.1)

80(103.5) 60(87.9)

98(94.6) 105(102.5)

48(51.4) 41(43.7)

26.774 35.184

3 3

.000 .000

23.136

3

.020

2.990 1.210 11.79

3 3 3

.393 .751 .008

5.330

3

.384

18.698

3

.126

18(23.0) 25(24.7) 45(52.7)

72(67.0) 65(65.3) 45(37.3)

25(28.6) 31(30.7) 56(65.6)

87(83.4) 81(81.3) 56(46.4)

80(75.1) 85(80.6) 192(172.2)

214(218.9) 209(213.4) 102(121.8)

41(37.3) 35(40.0) 83(85.5)

105(108.7) 111(106.0) 63(60.5)

97

Data in Table 13 show that the overall Chi-square value of 18.698 with P-value of .126 which is greater than .05 level of significance at three degrees of freedom. The null hypothesis of no significant difference with regard to the water hygiene knowledge of women attending ANC based of level of education was therefore accepted. This implies that there was no significant difference in the water hygiene knowledge of women attending ANC according to level of education. The Table further shows the Chi-square values with their corresponding P-values for: knowledge of water storage ( χ 2 = 27.514 > P = .001, df = 3), knowledge of water collection (

χ 2 = 18.522 > P = .001, df = 3) and knowledge of water source protection ( χ 2 = 23.136 > P = .020, df = 3). The null hypothesis of no significant difference in these components of water hygiene regarding knowledge of water storage, collection and water source protection according to level of education was rejected since the P-values were less than .05 level of significance. This implies that knowledge of water storage, collection and water source protection of women attending ANC in Plateau State significantly differed according to level of education. The Table further shows the Chi-square values with their corresponding P-values for: knowledge of water transporting ( χ

2

= 14.378 > P = .199, df = 3), knowledge of PoU of

water ( χ 2 = 23.246 > P = .113, df = 3) and knowledge of water purification ( χ 2 = 5.330 > P = .384, df = 3). The null hypothesis of no significant difference in these components of water hygiene regarding knowledge of women according to level of education was accepted since the P-values were greater than .05 level of significance. This implies that knowledge of water transportation, PoU of water and water purification of women in these dimensions did not differ based on levels of education.

98

Hypothesis two There is no significant difference in the water hygiene knowledge of women attending ANC based on location in Plateau State. Data testing this hypothesis are contained in table 14.. Table 14 Summary of Chi-square Analysis Testing the Null Hypothesis regarding Water Hygiene Knowledge of Women Attending ANC according to Location (n = 642) Location Rural S/No 1 2 3

4 5 6

7 8

Knowledge items Knowledge of water storage Removal of safe stored drinking water through spigot Keeping water storage container above the ground Keeping safe freshly fetched water away from stored one at home Cluster χ 2 value, df & P-value Knowledge of water transportation Transporting safe water in a clean container with lid. Transporting safe water using hygienically clean container. Transporting safe water using clean, disinfected and dried container. Cluster χ 2 value, df & P-value Knowledge of water collection Safely collecting safe water in hygienically and properly covered container. Using no part of the human today to contact safe water in hygienically and properly covered container. Cluster

9 10 11

12 13

14

15 16 17

χ

2

Urban

Knowledge of water source protection Keeping water source surroundings safe and clean. Screening animals and human water from mixing with safe water at source as water protection measure. Protecting water runoff from mixing with safe water during rainfall. Cluster χ 2 value, df & P-value Knowledge of water purification Having best water treatment method as filtration. Aeration is not a water treatment method. Having sedimentation as best water treatment method. Cluster χ 2 value, df & P-value Overall cluster

χ

2

value, df & P-value

2

Incorrect O(E)

Correct O(E)

Incorrect O(E)

value

df

Pvalue

195(191.4)

120(123.6)

195(198.6)

132(128.4)

.347

1

.556

194(197.2)

121(117.8)

208(204.8)

119(122.2)

.280

1

.597

167(162.4)

148(152.6)

164(168.6)

153(158.4)

.527

1

.468

.385

1

.540

167(160.4)

148(154.6)

160(166.6)

167(160.4)

1.072

1

.301

279(277.7)

36(37.3)

287(288.3)

40(32.7)

.099

1

.753

270(263)

45(51.5)

267(273.5)

60(53.5)

1.936

1

.164

1.036

1

.406

281(283.1)

34(31.9)

296(293.9)

31(33.1)

.304

1

.581

194(194.8)

121(120.2)

203(202.2)

124(124.8)

.016

1

.898

.160

1

.740

value, df & P-value

Knowledge of PoU of water Removing safe water at point-of-use through narrow opening. Removing safe water at point-of-use through scooping Removing safe water at point-of-use through any means Cluster χ 2 value, df & P-value

χ

Correct O(E)

190(180.6)

125(134.4)

178(187.4)

149(139.6)

2.27

1

.132

118(12.2)

197(193.8)

129(125.8)

198(201.2)

.268

1

.605

163(162.9)

152(152.1)

169(169.1)

158(157.9)

.000

1

.987

.846

1

.575

289(281.6)

26(33.4)

285(292.4)

42(34.6)

3.57

1

.059

203(204.1)

112(110.9)

213(211.9)

114(115.1)

.034

1

.854

221(220.8)

94(94.2)

229(229.2)

98(97.8)

.001

1

.972

1.202

1

.628

75(80.5) 88(86.4)

240(234.5) 227(228.6)

89(83.5) 88(89.6)

238(243.5) 239(237.4)

.980 .085

1 1

.322 .771

197(184.5)

118(130.5)

179(191.5)

148(135.5)

4.022

1

.045

1.696

1

.379

.930

1

.533

Results in Table 14 show the overall Chi-square value of .930 with P-value of .533 which is greater than .05 level of significance at one degree of freedom. The null hypothesis of no significant difference with regard to the knowledge of water hygiene of women attending ANC based on location was therefore accepted since the P-values were more than

99

.05 level of significance. This implies that knowledge of water hygiene of women was the same for urban and rural locations. The Table also shows the Chi-square values with their corresponding P-values for knowledge of: water storage ( χ 2 = .385 < P = .540, df = 1), water transportation ( χ 2 = 1.036 > P = .406, df = 1), water collection ( χ 2 = .160 < P = .740, df = 1), PoU of water ( χ 2 = .846 > P = .575, df = 1), water source protection ( χ

2

= 1.202 > P = .628, df = 1) and water

purification ( χ 2 = 1.696 > P = .379, df = 1). The null hypothesis of no significant difference in these components of water hygiene knowledge according to location was accepted since the P-values were greater than .05 level of significance. This implies that there was no disparity among women attending ANC in rural and urban areas regarding knowledge of water storage, transportation, collection, PoU, source protection and purification.

100 Hypothesis three. There is no significant difference in the water hygiene attitude of women attending ANC based on level of education in Plateau State. Data testing this hypothesis are indicated in table 15. Table 15 Summary of Chi-square Analysis Testing Water Hygiene Attitude of Women Attending ANC according to Level of Education in Plateau State (n = 642) Primary School Certificate

S/No 1 2 3

Items Attitude about water storage Liking to mix freshly fetched water with stored one in storage container Prefer to keep storage container above the ground. Like to empty clean, disinfect and dry water storage container before refilling it. Cluster

4 5 6

8 9

11 12

14 15

χ

2

χ

2

χ

2

χ

2

SA

SD

D

A

SA

SD

D

A

SA

SD

D

A

SA

χ

O(E)

O(E)

O(E)

O(E)

O(E)

O(E)

O(E)

O(E)

O(E)

O(E)

O(E)

O(E)

O(E)

O(E)

O(E)

O(E)

value

df

Pvalue

15(14.9)

20(27.9)

17(19.5)

38(27.8)

13(18.5)

21(34.7)

28(24.2)

50(34.5)

52(48.5)

114(91.1)

61(63.7)

67(90.7)

26(24.1)

44(45.3)

33(31.6)

43(45.0)

33.495

9

.000

10(8.4)

28(31.0)

19(32.7)

31(22.3)

14(10.5)

35(38.6)

32(40.6)

42(58.6)

22(27.5)

108(101.2)

122(106.7)

22(29.1)

14(13.6)

50(50.3)

60(53.0)

36.788

9

.000

6(3.4)

10(8.0)

15(21.0)

59(57.6)

6(4.2)

12(9.9)

39(26.2)

55(71.7)

9(11.0)

26(26.1)

63(68.7)

196(188.2)

3(5.5)

9(13.0)

33(34.1)

101(93.5)

19.84

9

.019

30.041

9

.006

17(22.9)

18(23.6)

19(17.2)

36(26.4)

24(28.4)

23(29.3)

21(21.5)

44(32.8)

87(74.6)

83(76.9)

62(56.3)

62(86.1)

35(37.1)

44(38.2)

21(28.0)

46(42.8)

25.217

9

.003

46(41.5)

18(27.1)

10(11.6)

16(9.8)

49(51.6)

28(33.7)

25(14.5)

10(12.2)

127(135.6)

107(88.4)

29(38.0)

31(32.1)

74(67.3)

40(43.9)

19(18.9)

13(15.9)

24.961

9

.003

6(4.6)

9(10.7)

19(22.7)

56(52.0)

10(5.8)

18(13.3)

27(28.3)

57(64.7)

12(15.1)

31(34.8)

78(74.2)

173(169.9)

5(7.5)

18(17.3)

38(36.8)

85(84.4)

9.594

9

.384

19.924

9

.130

49(39.8)

18(30.3)

6(10.2)

17(9.7)

41(49.5)

34(37.7)

20(12.7)

17(12.0)

121(130.1)

118(98.9)

29(33.4)

26(31.6)

73(64.6)

46(49.1)

18(16.6)

9(15.7)

32.583

9

.000

27(30.3)

22(29.7)

8(9.8)

33(20.2)

21(37.7)

37(37.0)

20(12.2)

34(25.1)

117(98.9)

103(97.1)

29(32.1)

45(65.9)

51(49.1)

50(48.2)

13(15.9)

32(32.7)

37.619

9

.000

42(32.0)

18(25.5)

22(20.2)

8(12.3)

53(39.8)

15(31.8)

31(25.1)

13(15.4)

87(104.4)

99(83.3)

61(65.9)

47(40.3)

46(51.9)

50(41.4)

30(32.7)

20(20.0)

32.033

9

.000

34.078

9

.000

10(10.9)

20(25.5)

14(24.8)

46(28.7)

14(13.6)

24(31.8)

29(30.9)

43(35.8)

39(22.4)

15(17.9)

20(31.8)

16(17.8)

31(27.9)

29(22.3)

32(39.6)

20(22.2)

21(22.9)

25(34.2)

6(9.4)

38(23.6)

15(28.4)

34(42.6)

14(11.7)

49(29.3)

34(35.7)

46(46.6)

35.079

9

.000 .001

92(83.3)

100(81.1)

68(93.9)

20(17.7)

46(41.4)

34(40.3)

57(73.3

58(58.6)

121(104.0)

58(58.2)

33(36.4)

26(29.1)

54(51.6)

33(28.9)

29.061

9

88(74.6)

126(111.7)

33(30.7)

47(76.9)

39(37.1)

59(55.5)

14(15.2)

34(38.2)

51.395

9

.000

38.512

9

.000

95(91.6)

12.892

9

.168 .023

value, df, P-value

8(6.2)

5(6.6)

22(20.7)

55(56.5)

10(7.7)

7(82)

34(25.8)

61(70.3)

18(20.1)

18.21.5)

66(67.8)

192(184.6)

8(10.0)

17(10.7)

26(33.7)

16(15.8)

16(14.0)

14(24.7)

44(35.5)

13(19.7)

26(17.4)

29(30.7)

44(44.1)

58(51.7)

35(45.8)

93(80.6)

108(115.9)

26(25.7)

23(22.7)

40(40.0)

57(57.5)

19.28

9

9(7.1)

14(13.0)

24(28.7)

43(41.1)

12(8.9)

21(16.2)

32(35.8)

47(51.1)

19(23.4)

37(42.6)

108(93.9)

130(134.2)

11(11.6)

21(21.1)

41(46.6)

73(66.6)

9.754

9

.371

13.975

9

.187

16.406 24.844 35.09

9 9 9

.059 .003 .000

25.447

9

.021

28.584

9

.061

value, df, P-value

value, df, P-value

Overall cluster

χ

2

value, df, P-value

2

33(17.9)

value, df, P-value

Attitude about water purification Prefer to make water safe by filtration. Like to make water safe by aeration. Prefer to make water safe by sedimentation. Cluster

Bachelor degree and above

A

value, df, P-value

Attitude about water source protection Preferring to prevent water source by preventing animals and human wastes from reaching it. Like to protect water source by dumping refuse far below water source on a slope. Prefer to protect fast flowing water from mixing with safe water source. Cluster

16 17 18

2

Attitude about PoU of water Prefer to remove safe stored water by scooping. Like removing safe stored water through spigot. Prefer removing safe stored water by sending any child around. Cluster

13

χ

NCE/ND

D

value, df, P-value

Attitude about water collection Prefer to collect safe water in any container. Like touching safe water with human body when collecting it. Prefer traveling long distance to collect safe water. Cluster

10

2

Attitude about water transport Like transporting safe water using clean opened container without lid. Like transporting safe water in any container. Prefer to transport safe water when lid and container are cleaned, disinfected and dried. Cluster

7

χ

Secondary School Certificate

SD

6(3.8) 43(28.6) 13(10.9)

8(10.4) 19(30.1) 43(28.3)

18(29.2) 21(20.9) 14(30.0)

58(46.7) 7(10.4) 20(20.7)

5(4.7) 45(35.6) 11(13.6)

15(12.9) 32(37.5) 48(35.2)

36(36.3) 22(26.0) 33(37.3)

56(58.1) 13(12.9) 20(25.8)

13(12.4) 72(93.4) 40(35.7)

34(33.9) 110(98.5) 68(92.5)

111(95.3) 76(68.2) 111(98.0)

136(152.5) 36(33.9) 75(67.8)

3(6.1) 44(46.4) 14(17.7)

17(16.8) 54(48.9) 43(45.9)

43(47.3) 30(33.9) 56(48.7)

83(75.7) 18(16.8) 33(33.7)

101

Table 15 shows that the overall Chi-square value of 28.584 with P-value of .061 which is greater than .05 level of significance at nine degrees of freedom. The null hypothesis on no significant difference with regard to attitude towards water hygiene of women attending ANC according to level of education was therefore accepted since the P-values were more than .05 level of significance. This implies that women did not differ in attitude toward water hygiene according to level of education. The Table also shows the Chi-square values with their corresponding P-values for water hygiene attitude such as: attitude about water storage ( χ 2 = 30.041 > P = .006, df = 9), water collection ( χ 2 = 34.078 > P = .000, df = 9), PoU of water ( χ 2 = 38.512 > P =.000, df = 9) and water purification ( χ

2

= 25.447 > P = .021, df = 9). The null hypotheses of no

significant difference in the attitude of women to water hygiene components according to level of education was rejected since the P-values were less than .05 level of significance. This implies that women attending ANC significantly differed in their attitude towards water storage, collection, PoU of water and purification according to level of education. The Table further shows the Chi-square values with their corresponding P-values for: attitude about water transportation ( χ 2 = 19.924 > P = .130, df = 9) and attitude about water source protection ( χ

2

= 13.975 > P = .187, df = 9). The null hypotheses of no significant

difference in the attitude of women in these components of water hygiene was same according to the different level of education was therefore accepted since the P-values were greater than .05 level of significance. This implies that the attitude of women towards the items of these components was the same for the various level of education.

102

Hypothesis four. There is no significant difference in the water hygiene attitude of women attending ANC based on location in Plateau State. Data testing this hypothesis are indicated in able 16. Table 16 Summary of Chi-square Analysis Testing Water Hygiene Attitude of Women Attending ANC according to Location in Plateau State (n = 642) Location Rural

S/no 1 2 3

4 5 6

Items Attitude about water storage Like to mix freshly fetched water with stored one in storage container Prefer to keep storage container above the ground. Like to empty clean, disinfect and dry water storage container before refilling it. Cluster χ 2 value, df & P-value Attitude about water transport Like transporting safe water using clean opened container without lid. Like transporting safe water in any container. Prefer to transport safe water when lid and container are cleaned, disinfected and dried. Cluster χ 2 value, df & P-value

Strongly Disagree

Disagree

O(E)

O(E)

57(52.0) 65(62.8) 10(11.8)

Overall cluster

χ

2

value, df & P-value

O(E)

O(E)

O(E)

O(E)

O(E)

value

df

Pvalue

102(97.6) 32(29.4)

68(68.2) 109(108.4)

88(97.1) 109(114.3)

49(54.0) 63(65.2)

97(101.4) 28(30.6)

71(70.8) 112(112.6)

110(100.9) 124(118.7)

3.015 1.08

3 3

.389 .782

22(28.0)

79(73.6)

204(201.7)

14(12.2

35(29.0)

71(76.4)

207(209.3)

84(85.6) 106(98.3)

65(62.6) 42(42.3)

100(95.8) 38(35.7)

16(16.2)

35(37.3)

82(79.5)

182(182.0)

17(16.8)

41(38.7)

80(82.5)

189(189.0)

39(38.3) 82(78.5) 78(80.0)

16 17 18

Strongly Agree

78(83.0) 141(150.8)

10 11 12

Attitude about water purification Prefer to make water safe by filtration. Like to make water safe by aeration. Prefer to make water safe by sedimentation. Cluster χ 2 value, df & P-value

O(E)

Agree

88(92.2) 32(34.3)

Attitude about PoU of water Prefer to remove safe stored water by scooping. Like removing safe stored water through spigot. Prefer removing safe stored water by sending any child around. Cluster χ 2 value, df & P-value

15

Disagree

58(60.4) 41(40.7)

143(139.3) 111(106.0) 115(111.9)

14

Strongly Disagree

84(82.4) 87(94.7)

Attitude about water collection Prefect to collect safe water in any container. Like touching safe water with human body when collecting it. Prefect traveling long distance to collect safe water. Cluster χ 2 value, df & P-value

13

Strongly Agree

Agree

85(80.0) 155(145.2)

7 8 9

Attitude about water source protection Preferring to prevent water source by preventing animals and human waste from reaching it. Like to protect water source by dumping refuse far below water source on a slope. Prefer to protect fast flowing water runoff mixing with safe water source. Cluster χ 2 value, df & P-value

Urban

107(106.0) 106(104.0) 88(89.3)

79(89.3) 60(62.8) 132(119.7)

32(35.8) 30(34.3) 77(70.7)

97(86.8) 116(111.4) 28(32.9)

33(33.9) 68(70.7) 35(43.2)

100(100.6) 57(62.3) 77(82.4)

141(144.7) 105(110.0) 113(116.1)

39(39.7) 78(81.5) 85(83.0)

109(110.0) 106(108.0) 94(92.7)

103(92.7) 68(65.2) 112(124.3)

41(37.2) 40(35.7) 67(73.3)

80(90.2) 111(115.6) 39(34.1)

36(35.1) 76(73.3) 53(44.8)

105(104.4) 70(64.7) 91(85.6)

χ

2

3.857

3

.277

2.652

3

.483

1.241 2.836

3 3

.743 .418

.437

3

.933

1.505

3

.698

1.049 1.816 4.369

3 3 3

.789 .611 .224

2.411

3

.541

4.697 1.817 4.69

3 3 3

.195 .611 .196

3.735

3

.334

18(21.6)

18(23.1)

68(72.6)

211(197.7)

26(22.4)

29(23.9)

80(75.4)

192(205.3)

5.675

3

.129

53(55.4) 22(25.0)

49(49.1) 46(45.6)

91(86.4) 105(100.6)

122(124.1) 142(143.8)

60(57.6) 29(26.0)

51(50.9) 47(47.4)

85(89.6) 100(104.4)

131(128.9) 151(149.2)

.774 1.146

3 3

.856 .766

2.532

3

.584

1.078 2.026 1.457

3 3 3

.782 .576 .692

1.520

3

.683

2.392

3

.586

15(13.2) 93(100.1) 35(38.3)

39(36.3) 105(105.5) 103(99.1)

102(102.1) 78(73.1) 101(105.0)

159(163.4) 39(36.3) 76(72.6)

12(13.8) 111(103.9) 43(39.7)

35(37.7) 110(109.5) 99(102.9)

106(105.9) 71(75.9) 113(109.0)

174(169.6) 35(37.7) 72(75.4)

103

Data in Table 16 show that the overall Chi-square value of 2.392 with corresponding P-value of .586 which is greater than .05 level of significance at three degrees of freedom. The null hypothesis of no significant difference with regard to attitude towards water hygiene of women attending ANC according to location was therefore accepted since the P-values were greater than .05 level of significance. This implies that there was no significant difference in the attitude towards water hygiene to women attending ANC in Plateau State according to location (rural and urban areas). The Table further shows the Chi-square values with their corresponding P-values for attitude to: storage of water ( χ 2 = 2.652 > P = .483, df = 3), water transportation ( χ 2 = 1.505 > P = .698, df = 3), water collection ( χ

2

= 2.411 > P = .541, df = 3), PoU of water ( χ

2

=

3.735 > P = .334, df = 3), water source protection ( χ 2 = 2.532 > P = .584, df =3) and water purification ( χ 2 = 1.520 > P = .683, df = 3). The null hypotheses of no significant difference in the attitude of women to water hygiene components items according to location was accepted since the P-values were greater than .05 level of significance. This implies that attitude of women was the same according to urban rural dichotomy.

104

Hypothesis five. There is no significant difference in water hygiene practice of women attending ANC based on location in Plateau State. Data testing this hypothesis are contained in Table 17. Table 17 Summary of Chi-square Analysis Testing the Null Hypothesis regarding Water Hygiene Practices of Women Attending ANC according to Level of Education (n = 642) Level of Education Primary School Certificate

S/No 1 2 3

Items Practices of safe storage of water Storing safe water by keeping it safe in any clean container with lid kept above the ground with spigot. Emptying, cleaning and drying the storage container before storing safe water. Mixing freshly fetched water with stored one in storage container. 2 Cluster , df, P-value

χ

4 5 6

7 8 9

10 11 12

13 14 15

Practices of safe transportation of water Transporting safe water in any container. Transporting safe water in clean disinfected and dried container with lid. Transporting safe water in uncovered container. 2 Cluster , df, P-value

χ

Practices at safe collection of water Collecting safe water in hygienic and properly covered container. Collecting safe water without allowing any part of human body contact it. Collecting safe water in opened container. 2 Cluster , df, P-value

χ

Practices at PoU of water Removing safe water at PoU through spigot. Removing safe water at PoU through scooping. Removing safe water at PoU using one’s mouth. 2 Cluster , df, P-value

χ

Practices of water source protection Protecting safe water source by preventing animals and human waste from it. Protecting safe water source by situating refuse dump site far down the slope below water source. Protecting safe water source by preventing water runoff from mixing with safe water source. 2 Cluster , df, P-value

χ

16 17 18

Practices of safe purification of water Purifying my water using boiling. Purifying my water using aeration. Purifying my water using sedimentation. Cluster

χ

2 , df, P-value

Overall cluster

χ

2 , df, P-value

Secondary School Certificate

NCE/ND

Bachelors degree and above

χ

2

Never

Rarely

Sometimes

Always

Never

Rarely

Sometimes

Always

Never

Rarely

Sometimes

Always

Never

Rarely

Sometimes

Always

O(E)

O(E)

O(E)

O(E)

O(E)

O(E)

O(E)

O(E)

O(E)

O(E)

O(E)

O(E)

O(E)

O(E)

O(E)

O(E)

7(7.9)

8(7.3)

46(41.5)

29(33.4)

6(9.8)

12(9.1)

59(51.6)

35(41.5)

35(26.5)

28(23.8)

122(135.6)

109(109.0)

8(12.7)

4(11.8)

69(67.3)

65(54.1)

20.37

9

.020

3(2.2)

6(4.5)

47(38.4)

34(44.9)

3(2.8)

5(5.6)

60(47.8)

44(55.8)

9(7.3)

17(14.4)

99(125.5)

169(146.5)

1(3.6)

4(7.3)

68(62.3)

73(72.8)

24.71

9

.000

13(22.1)

12(12.3)

22(28.4)

43(26.1)

20(27.6)

12(15.4)

38(36.6)

42(32.4)

93(72.4)

40(40.3)

99(96.2)

62(85.2)

32(35.9)

24(20.0)

51(47.8)

39(42.3)

36.31

9

.000

27.1

9

.007

value

df

Pvalue

34(39.7)

4(10.1)

11(14.9)

41(25.4)

35(49.4)

16(12.6)

21(18.5)

40(31.6)

152(129.6)

35(33.0)

49(48.5)

58(82.9)

62(64.4)

17(16.4)

25(24.1)

42(41.2)

34.46

9

.000

12(8.7) 25(37.0)

28(20.5) 11(11.8)

17(21.7) 17(17.8)

33(39.1) 37(23.4)

8(10.8) 29(46.1)

36(25.5) 19(14.7)

31(27.0) 26(22.2)

37(48.7) 38(29.1)

24(28.4) 149(120.9)

51(66.9) 38(38.5)

68(71.0) 50(58.2)

151(127.8) 57(76.5)

18(14.1) 61(60.0)

31(33.2) 16(19.1)

39(35.2) 34(28.9)

58(63.4) 35(38.0)

25.37 37.15

9 9

.000 .000

32.32

9

.000

5(4.2)

4(6.2)

43(26.6)

38(53.0)

3(5.2)

11(7.7)

43(33.1)

55(65.9)

15(13.7)

17(20.1)

60(87.0)

202(173.1)

7(6.8)

12(10.0)

44(43.2)

83(86.0)

36.68

9

.000

14(9.1) 26(33.6)

38(22.4) 10(15.3)

16(24.7) 14(17.9)

22(33.8) 40(23.1)

8(11.3) 27(41.9)

33(27.9) 23(19.0)

43(30.7) 22(22.3)

28(42.0) 40(28.8)

29(29.8) 134(109.9)

49(73.3) 52(49.9)

83(80.6) 60(58.6)

133(110.4) 48(75.6)

14(14.8) 53(54.6)

40(36.4) 24(24.8)

34(40.0) 32(29.1)

58(54.8) 37(37.5)

46.38 43.04

9 9

.000 .000

42.03

9

.000

14(10.9) 5(12.2) 23(32.5)

33(21.3) 8(12.8) 10(12.3)

19(25.5) 28(33.8) 42(29.0)

24(32.2) 49(31.3) 15(16.1)

12(13.6) 7(15.2) 28(40.5)

36(26.5) 13(15.9) 12(15.4)

29(31.8) 50(42.0) 54(36.1)

35(40.1) 42(38.9) 18(20.1)

36(35.7) 50(39.8) 130(106.2)

55(69.6) 46(41.7) 46(40.3)

82(83.3) 113(110.4) 61(94.8)

121(105.3) 85(102.1) 57(52.7)

16(17.7) 25(19.8) 51(52.8)

28(34.6) 24(20.7) 20(20.0)

52(41.4) 50(54.8) 50(47.1)

50(52.3) 47(50.7) 25(26.2)

25.18 32.32 41.58

9 9 9

.000 .000 .000

33.02

9

.000

2(3.4)

8(6.4)

36(26.6)

44(53.6)

5(4.2)

11(8.0)

46(33.1)

50(66.6)

12(11.0)

18(21.1)

62(87.0)

202(174.9)

5(5.5)

9(10.5)

46(43.2)

86(86.9)

28.67

9

.000

9(9.8)

15(10.9)

40(30.7)

26(38.6)

14(12.2)

13(13.6)

47(38.2)

38(48.0)

35(32.1)

33(35.7)

82(100.3)

144(125.9)

12(15.9)

17(17.7)

50(49.8)

67(62.5)

20.59

9

.020

3(6.2)

17(10.7)

38(30.6)

32(42.6)

8(7.7)

16(13.3)

47(38.0)

41(53.0)

26(20.1)

34(34.8)

75(99.8)

159(139.2)

7(10.0)

9(17.3)

58(49.6)

72(69.1)

9(4.2) 10(5.6)

31(21.7) 33(21.3)

19(25.7) 19(29.4)

31(38.4) 28(33.6)

6(5.2) 7(7.0)

41(27.0) 39(26.5)

34(31.9) 35(36.6)

31(47.8) 31(41.9)

11(13.7) 19(18.3)

48(71.0) 44(69.6)

79(83.8) 106(96.2)

156(125.5) 125(109.9)

4(6.8) 4(9.1)

35(35.2) 36(34.6)

51(41.6) 50(47.8)

56(62.3) 56(54.6)

15(11.8)

13(12.8)

37(35.9)

25(29.6)

15(14.7)

22(15.9)

44(44.7)

31(36.8)

40(38.5)

39(41.7)

109(117.2)

106(96.6)

14(19.1)

17(20.7)

66(58.2)

49(48.0)

32.42

9

.000

27.25

9

.007

45.55 38.86

9 9

.000 .000

9.733

9

.370

31.37

9

.123

31.05

9

.137

105

Results in Table 17 show overall Chi-square value of 32.187 with P-value of .023 which is less than .05 level of significance at nine degrees of freedom. The null hypothesis of no significant difference with regard to practices of water hygiene according to level of education was therefore rejected since the P-value was less than .05 level of significance. This implies that practises of water hygiene by women attending ANC in Plateau State significantly differed according to level of education. Table 17 further shows the Chi-square values with their corresponding P-values for practices such as: storage of water ( χ 2 = .27 > P = .007, df = 9), transportation of water ( χ

2

= 32.32 > P = .000, df = 9), collection of water ( χ 2 = 42.03 > P = .000, df = 9), PoU of water ( χ 2 = 33.02 > P = .000, df = 9) and water source protection ( χ 2 = 27.25 > P = .007, df = 9). The null hypotheses of no significant difference in these practices of components of water hygiene such as storage of water, transportation of water, collection of water and water source protection according to the various levels of education was therefore rejected since the Pvalues were less than .05 level of significance. This implies that the practices of water hygiene of women significantly differed according to level of education. The Table further shows the Chi-square value with their corresponding P-value for purification of water ( χ 2 = 31.37 > P = .023, df = 9). The null hypothesis of no significant difference in the practice of water purification by women attending ANC according to level of education was therefore accepted since the P-value was greater than .05 level of significance. This implies that the practice of water purification by women attending ANC in Plateau State was the same for the various levels of education.

106 Hypothesis six. There is no significant difference in water hygiene practice of women attending ANC based on location in Plateau State. Data testing this hypothesis are contained in Table 18. Table 18 Summary of Chi-square Analysis Testing the Null Hypothesis regarding Water Hygiene Practices of Women Attending ANC according to Location (n = 642) Location Rural

S/No 1 2 3

Items Practices of water storage Storing safe water by keeping it safe in any clean container with lid kept above the ground with spigot. Emptying, cleaning and drying the storage container before storing safe water. Mixing freshly fetched water with stored one in storage container. Cluster

4 5 6

14 15

2

χ

2

χ

2

Practices of water purification Purifying my water using boiling. Purifying my water using aeration. Purifying my water using sedimentation.

χ

2

Always

Never

Rarely

Sometimes

Always

χ

O(E)

O(E)

O(E)

O(E)

O(E)

O(E)

O(E)

O(E)

value

df

P -value

28(27.5)

27(25.5)

143(145.2)

117(116.8)

28(28.5)

25(26.5)

153(150.8)

121(121.2)

.258

3

.968

10(7.9) 86(77.5)

15(15.7) 44(43.2)

132(134.4) 102(103.0)

158(157.0) 83(91.3)

6(8.1) 72(80.5)

17(16.3) 44(44.8)

142(139.6) 108(107.0)

162(163.0) 103(94.7)

1.316 3.339

3 3

.725 .324

1.638

3

.672

2.301 1.635 2.386

3 3 3

.512 .652 .496

2.107

3

.551

2.423 1.652 5.676

3 3 3

.489 .648 .128

3.25

3

.422

3.19 1.346 1.462

3 3 3

.363 .718 .691

1.999

3

.591

144(138.9) 30(30.4) 121(129.5)

33(35.3) 66(71.6) 46(41.2)

56(52.0) 75(76.1) 64(62.3)

82(88.8) 144(136.9) 84(81.9)

139(144.1) 32(31.6) 143(134.5)

39(36.7) 80(74.4) 38(42.8)

50(54.0) 80(78.9) 63(64.7)

99(92.2) 135(142.1) 83(85.1)

15(14.7) 30(31.9) 116(117.8)

21(21.6) 75(78.5) 44(53.5)

102(93.2) 84(86.4) 71(62.8)

177(185.5) 126(118.2) 84(81.0)

15(15.3) 35(33.1) 124(122.2)

23(22.4) 85(81.5) 65(55.5)

88(96.8) 92(89.6) 57(65.2)

201(192.5) 115(122.8) 81(84.0)

31(38.3) 40(42.7) 115(113.8)

75(74.6) 41(44.6) 40(43.2)

93(89.3) 120(118.2) 107(101.6)

116(112.9) 114(109.4) 53(56.4)

47(39.7) 47(44.3) 117(118.2)

77(77.4) 50(46.4) 48(44.8)

89(92.7) 121(122.8) 100(105.4)

114(117.1) 109(113.6) 62(58.6)

value, df & P-value

Practices about water source protection Protecting safe water source by preventing animals and human waste from it. Protecting safe water source by situating refuse dump site far down the slope below water source. Protecting safe water source by preventing water runoff from mixing with safe water source. 2 Cluster value, df & P-value

Cluster

Sometimes

value, df & P-value

χ

16 17 18

Rarely

value, df & P-value

Practices of PoU of water Removing safe water at PoU through spigot. Removing safe water at PoU through scooping. Removing safe water at PoU using one’s mouth. Cluster

13

χ

Never

value, df & P-value

Practices of water collection Collecting safe water in hygienic and properly covered container. Collecting safe water without allowing any part of human body contact it. Collecting safe water in opened container. Cluster

10 11 12

2

Practices of water transportation Transporting safe water in any container. Transporting safe water in clean disinfected and dried container with lid. Transporting safe water in uncovered container. Cluster

7 8 9

χ

Urban

value, df & P-value

Overall cluster

χ

2

value, df & P-value

2

14(11.8)

19(22.6)

95(91.2)

187(187.4)

10(12.2)

27(23.4)

95(96.8)

195(194.6)

2.002

3

.572

28(34.3)

39(38.3)

110(107.5)

138(134.9)

42(35.7)

39(39.7)

109(111.5)

137(140.1)

2.585

3

.460

22(21.6)

36(37.3)

106(107.0)

151(149.2)

22(22.4)

40(38.7)

112(111.0)

153(154.8)

17(14.7) 17(19.6) 38(41.2)

78(76.1) 74(74.6) 46(44.6)

81(89.8) 100(103.0) 122(125.6)

139(134.4) 124(117.8) 109(103.5)

13(15.3) 23(20.4) 46(42.8)

77(78.9) 7877.4) 45(46.4)

102(93.2) 110(107.0) 134(130.4)

135(139.6) 116(122.2) 102(107.5)

.165

3

.983

1.584

3

.672

2.785 1.524 1.344

3 3 3

.426 .677 .719

1.884

3

.607

2.077

3

.586

107

Table 18 shows the overall Chi-square value of 2.077 with P-value of .586 which is greater than .05 level of significance at three degrees of freedom. The null hypothesis of no significant difference with regard to practises of water hygiene of women attending ANC based on location was therefore accepted since the P-value is greater than .05 level of significance. This implies that practices of water hygiene by women attending ANC in Plateau State did not significantly differ according to urban rural dichotomy. The Table further shows the Chi-square values with their corresponding P-values for practices such as: storage of water ( χ 2 = 1.638 > P = .672, df = 3), transportation of water ( χ 2 = 2.107 > P = .551, df = 3), water collection ( χ 2 = 3.25 > P = .422, df = 3), PoU of water ( χ 2 = 1.999 > P = .591, df = 3), water source protection ( χ 2 = 1.584 > P = .673, df = 3) and purification of water ( χ

2

= 1.884 > P = .607, df = 3). The null

hypotheses of no significant difference in these practices of the components of water hygiene by women attending ANC based on location was therefore accepted since the Pvalues were greater than .05 level of significance. This implies that the practice of water hygiene for those components by women was the same for rural urban woman. Summary of Major Findings The major findings of the study are summarized in line with the specific objectives and hypotheses as follows: 1. Majority (61.6%) of women attending ANC possessed correct knowledge regarding: water hygiene, water collection (75%), water source protection (74.8%), water transportation (74.2%). More than 50 per cent of women possessed correct knowledge regarding: water storage (58.3%), about one half of women possessed correct knowledge regarding PoU of water (49.2%) and over one third of women possessed correct knowledge regarding water purification (37.1%) (Table 1). 2. Over 50 per cent of women (56.4%) expressed positive attitude regarding water hygiene. Majority of the women expressed positive attitude regarding: water source protection (76.7%) and water storage (70.2%. over 50 per cent of the women displayed positive attitude towards: water purification (58.5%), water transportation (51.8%) and PoU of water (50.5%). Thirty per cent of women expressed positive attitude regarding water collection (30.6%) (Table 2). 3. Women attending ANC practised water hygiene (overall always = 32.7%, sometimes = 23.7%, rarely = 22.9%); water source protection (always = 49.9%, sometimes = 32.6%, rarely = 10.4%); water collection (always = 40.7%,

108

sometimes = 25.6%, rarely = 16.3%), water storage (sometimes = 40.5%, always = 38.6%, rarely = 8.9%); water purification (always = 37.7%, sometimes = 33.7%, rarely = 20.3%), transportation of water (always = 34.2%, sometimes = 20.1%, rarely = 15.7%); water PoU (sometimes = 32.7%, always = 29.5%, rarely = 17.2%) (Table 3). 4. Majority of the women attending ANC possessed correct knowledge regarding water hygiene with: Nigeria Certificate in Education/National Diploma (NCE/ND) certificate (67.2%) and bachelors’ degree and above (63.6%). Women possessed

correct

knowledge

of

water

hygiene

with:

secondary

certificate/education (53.5%) and primary certificate/education (49.8%). Majority of the women possessed correct knowledge regarding: water source protection with NCE/ND (81.5%), bachelors’ degree and above (76.2%), secondary education (64.2%) and primary certificate (62.2%); water collection with NCE/ND (80.7%), bachelor degree and above (79.1%), secondary education (69.2%) and primary certificate (63.4%); water transportation with NCE/ND (78.2%), bachelor degree and above (76.9%), secondary certificate (67.5%) and primary education (65.4%); majority of the women possessed correct knowledge regarding water storage with NCE/ND (66.0%) and bachelor degree and above (62.0%), over one third of those with primary (40.0%) and secondary certificate (47.6%) possessed correct knowledge regarding water storage. More than 50 per cent of women possessed correct knowledge regarding PoU of water with NCE/ND (56.3%) and bachelor degree and above (51.4%), whereas less than 40 per cent with secondary (39.3%) and primary certificate (34.8%) possessed correct knowledge regarding PoU of water. Women with NCE/ND (40.5%) and bachelor degree and above (36.2%) possessed correct knowledge regarding water purification while those with secondary (33.0%) and primary certificate (32.6%) possessed correct knowledge regarding water purification (Table 4). 5. Majority of the women possessed correct knowledge regarding water hygiene in rural areas (62.2%) and urban areas (61.0%); water transportation (rural = 75.8% > urban = 72.8%); water collection (urban = 76.3% < rural = 75.4%) and water source protection (rural = 75.4%; urban = 74.1%). Over 50 per cent of women possessed correct knowledge regarding: water storage (rural = 58.8% > urban = 57.8%) and PoU of water (urban = 50.2% > rural = 49.8%); more than 30 per cent

109

of women possessed correct knowledge of water purification (rural = 38.1% > urban = 36.3%) (Table 5). 6. Over 50 per cent of women attending ANC expressed positive attitude towards water hygiene with secondary certificate (58.3%), primary education (55.9%), NCE/ND (55.8%) and bachelor degree and above (56.0%). Majority of the women displayed positive attitude toward: water source protection with NCE/ND certificate (78.9%), bachelor degree and above (75.7%), primary education (74.8%) and secondary certificate (73.6%); also majority of the women attending ANC expressed positive attitude towards water storage with bachelor degree (74.0%), secondary education (71.2%), NCE/ND certificate (70.0%) and primary certificate (65.2%); water purification NCE/ND certificate (62.8%) and bachelor degree and above (61.1%) and more than 50 per cent of the women expressed positive attitude toward: purification of water with secondary certificate (53.6%) and primary education (51.1%); transportation of water with primary certificate (57.7%), secondary education (54.7%), bachelor degree and above (50.7%) and about 50 per cent of those with NCE/ND certificate (49.3%); women who attended ANC displayed positive attitude towards PoU of water with secondary education (56.3%), NCE/ND certificate (48.4%) and primary education (41.8%) PoU of water with bachelor degree and above (29.1%). Forty point three per cent of women who attended ANC displayed positive attitude towards water collection with secondary certificate and primary education (34.8%), bachelor degree and above (27.2%) and NCE/ND certificate (26.9%) (Table 6). 7. More than 50 per cent of women attending ANC expressed positive attitude towards water hygiene in rural areas (56.8%) and urban areas (56.6%). Majority of the women displayed positive attitude towards water source protection with those in rural areas (78.2%) and urban areas (75.5%); water storage with those in the urban areas (70.8%) and rural areas (69.5%). More than half of the women who attended ANC displayed correct attitude towards: water purification in rural areas (58.8%) and urban areas (58.2%); while water transportation in urban areas (52.4%) and rural areas (51.1%) and PoU of water in urban areas (50.5%) and rural areas (50.3%). Less than 33 per cent of the women who attended ANC expressed positive attitude towards water collection in the urban areas (31.9%) and urban areas (29.1%) (Table 7).

110

8. Women attending ANC practised water hygiene with: NCE/ND certificate (overall always = 41.0 %, sometimes = 27.6%, rarely = 13.0%), bachelor degree and above (always = 38.0%, sometimes 33.1%, rarely = 12.0%), primary education (always = 36.5%, sometimes = 32.0%, rarely = 18.0%), secondary education (sometimes = 36.2%, always = 33.5%., rarely = 18%); women attending ANC with NCE/ND practised water source protection thus: (always = 57.0%, sometimes = 24.8%, rarely = 9.6%), bachelor degree and above (always = 51.4%, sometimes = 35.1%, rarely = 7.7%), secondary education (sometimes = 41.7%, always = 38.4%, rarely = 12.0%), primary education (sometimes = 42.0%, always = 37.8%, rarely = 15.0%); women with secondary certificate practised water storage sometimes (46.7%), always (36.9%), rarely (8.6%) while those with primary certificate practised sometimes (43.0%), always (39.3%) and rarely (9.3%) whereas those with bachelor degree and above practised sometimes (42.9%), always (40.4%), rarely (7.3%) while women with NCE/ND practised always (39.3%), sometimes (36.3%) and rarely (9.6%); women with NCE/ND practised water purification always (44.0%), sometimes (33.4%), and rarely (15.0%) while women with bachelor degree and above practised sometimes (38.1%), always (36.8%) and rarely (20.1%), women with secondary education practised sometimes (33.7%), rarely (30.0%) and always (27.7%) moreover, women with primary education practised always (31.1%), rarely (29.0%) and sometimes (28.0%); women with primary education practised transportation of water always (41.1%), sometimes (17.0%), rarely (16.0%) whereas women with secondary education practised always (34.2%), sometimes (23.3%), rarely (21.0%) while women with bachelor degree and above practised always (30.8%), sometimes (22.4%) and rarely (14.6%) whereas those with women with NCE/ND practised always (30.0%), sometimes (18.9%) and rarely (14.0%) and women with secondary education practised PoU of water sometimes (39.6%), always (28.3%) and rarely (18.0%); women with bachelor degree and above practised sometimes (34.7%), always (27.8%) and rarely (5.0%) whereas women with primary education practised sometimes (33.0%), always (32.6%) and rarely (19.0%) while women with NCE/ND practised always (30.0%), sometimes (29.0%) and rarely (17.0%) (Table 8). 9.

The proportion of women in the rural areas practised water hygiene (overall always = 38.6%, sometimes = 31.3%, rarely = 14.5% while in the urban areas the

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proportion was always = 37.6%, sometimes = 30.5%, rarely = 15.2 %); the proportion of women in the rural areas practised water source protection (always = 50.4%, sometimes = 32.9%, rarely = 9.9%, whereas in the urban areas the proportion was always = 48.4%, sometimes = 32.3%), rarely = 10.8%); proportion of women in the rural areas practised collection of water (always = 41.0%, sometimes = 27.2%, rarely = 14.8% while in the urban areas the proportion was always = 40.5%, sometimes = 24.1%, rarely = 17.6%); proportion of women in urban areas who practised water purification always (39.4%), sometimes (32.0%) and rarely (21.0%) whereas in the rural areas the proportion was always (36.0%), sometimes (35.3%) and rarely (20.4%); proportion of women in urban areas who practised water storage sometimes (39.9%), always (39.3%) and rarely (9.9%) while in the rural areas the proportion was sometimes (40.1%), always (37.3%) and rarely (8.8%); proportion of women in rural areas who practised water transportation always (32.8%), sometimes (20.5%) and rarely (15.4%) whereas the proportion in the urban areas was always (32.3%), sometimes (19.7%) and rarely (16.0%); proportion of women in rural areas who practised PoU of water always (29.9%), sometimes (33.9%) and rarely (16.5%) while in the urban areas the proportion was always (29.1), sometimes (31.6%) and rarely (17.8%) (Table 9). 10. Enhancement strategies of water hygiene knowledge, attitude and practice were adgjudged very appropriate with mean of 2.55 with SD of, 559, which fall between 2.49 – 3.00; 2.62 with SD = .515, which fall between 2.49 – 3.00 and 2.65 with SD = .496, which fall between 2.49 - 3.00. These are contained in table 10, 11 and 12 respectively. 11. There was no significant difference in the water hygiene knowledge of women attending ANC according to level of education (overall χ .126 > p .05), knowledge of water storage ( χ knowledge of collection of water ( χ

2

2

2

= 18.698, P-value

= 27.514 > P = .001, df = 3),

= 18.522 > P = .001, df = 3) and

knowledge of water source protection ( χ 2 = 23.136 > P = .020, df = 3); there was significant difference in the components of water hygiene regarding knowledge of transporting of water ( χ

2

= 14.378 > P = .199, df = 3), knowledge of PoU of

water ( χ 2 = 23.246 > P = .113, df = 3) and knowledge of purification of water (

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χ

2

= 5.330 > P = .384, df = 3 according to level of education These are

contained in Table 13. 12. The null hypothesis of no significant difference with regard to the knowledge of water hygiene of women attending ANC based on location was therefore accepted (overall χ 2 = .930, P-value .533 > .05); there was no significant difference in the components of water hygiene knowledge of: storage of water ( χ

2

= .385 < P =

.540, df = 1), transportation of water ( χ 2 = 1.036 > P = .406, df = 1), collection of water ( χ 2 = .160 < P = .740, df = 1), PoU of water ( χ 2 = .846 > P = .575, df = 1), water source protection ( χ

2

= 1.202 > P = .628, df = 1) and purification of

water ( χ 2 = 1.696 > P = .379, df = 1) according to location. These are contained in Table 14. 13. There was no significant difference with regard to attitude towards water hygiene of women attending ANC according to level of education (overall χ 2 = 28.584, P-value .061 > .05), attitude about transportation of water ( χ

2

= 19.924 > P =

.130, df = 9) and attitude about water source protection ( χ 2 = 13.975 > P = .187, df = 9); there was significant difference in attitude about storage of water ( χ 2 = 30.041 > P = .006, df = 9), collection of water ( χ 2 = 34.078 > P = .000, df = 9), PoU of water ( χ

2

= 38.512 > P =.000, df = 9) and purification of water ( χ

2

=

25.447 > P = .021, df = 9) . These are contained in Table 15. 14. There was no significant difference with regard to attitude towards water hygiene of women attending ANC according to location (overall χ 2 = 2.392, P-value .586 > .05), storage of water ( χ 2 = 2.652 > P = .483, df = 3), transportation of water (

χ 2 = 1.505 > P = .698, df = 3), collection of water ( χ 2 = 2.411 > P = .541, df = 3), PoU of water ( χ 2 = 3.735 > P = .334, df = 3), water source protection ( χ 2 = 2.532 > P = .584, df =3) and purification of water ( χ 2 = 1.520 > P = .683, df = 3). These are contained in Table 16. 15. There was significant difference with regard to practices of water hygiene according to level of education (overall χ 2 = 32.187, P-value .023 > .05), storage of water ( χ 2 = .27 > P = .007, df = 9), transportation of water ( χ 2 = 32.32 > P = .000, df = 9), collection of water ( χ 2 = 42.03 > P = .000, df = 9), PoU of water (

χ 2 = 33.02 > P = .000, df = 9) and water source protection ( χ 2 = 27.25 > P =

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.007, df = 9). There was no significant difference in purification of water ( χ 2 = 31.37 > P = .023, df = 9). These are contained in Table 17. 16. There was no significant difference with regard to practices of water hygiene of women attending ANC based on location (overall χ

2

= 2.077, P-value .586 >

.05), storage of water ( χ 2 = 1.638 > P = .672, df = 3), transportation of water ( χ 2

= 2.107 > P = .551, df = 3), water collection ( χ 2 = 3.25 > P = .422, df = 3), PoU

of water ( χ 2 = 1.999 > P = .591, df = 3), water source protection ( χ 2 = 1.584 > P = .673, df = 3) and purification of water ( χ 2 = 1.884 > P = .607, df = 3). This is contained in Table 18. Discussion The discussion is presented under the following headings: 1. Water hygiene knowledge of women attending ANC. 2. Water hygiene attitude of women attending ANC. 3. Water hygiene practice of women attending ANC. 4. Water hygiene enhancement strategies. Water hygiene knowledge of women attending ANC. Data in Table 1 revealed that majority of women attending ANC possessed correct knowledge regarding water hygiene. This finding was expected because it is in line with the finding of Nematin et al. (2010) who showed that females’ possessed correct knowledge of water hygiene. The finding also agrees with the finding of Kioko and Obiri (2012) who found that women were knowledgeable about ideal methods of water hygiene. However, the finding of this study is not in agreement with the finding of Chipeta (2004) who pointed that women lacked water hygiene knowledge in Solola Mzimba. The result also indicated that majority of women possessed correct knowledge of water collection. The study finding was expected and not surprising because Crampton (2005) submitted that water drawers using the NGO water points more likely to have been educated about the importance of not touching water during water collection. This is because the finding agrees with the finding of Kioko and Obiri (2012) who pointed that respondents were knowledgeable about ideal methods of water collection. Table 1 further showed that majority of the women possessed correct knowledge of water source protection. This finding is expected and therefore not surprising. This finding is not surprising because Crampton (2005) pointed that the protection and

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maintenance of water source from risk of contamination can be curtailed by better knowledge of water hygiene. The Table further revealed that majority of the women possessed correct

knowledge of water transportation. This finding is expected and therefore not surprising. The finding is expected because Mallick and Roldan-Rojas (2015) pointed that water quality during transport rests on the conveyer’s level of knowledge. The finding is in line with the submission of Government of Albertat (2011) that water issues were complex and only correct knowledge is necessary for making informed decisions during transportation. Table 1 also revealed that over one half of women possessed correct knowledge regarding water storage. This finding is expected. The finding is expected because CAWST (2009) posited that water is safe to drink only when handled and stored properly else could cause ill health when ingested. This finding disagrees with that of Dusabe, Raobelison, Nzabnimpa and Wilson (2010) who found that over half 54 per cent of caregivers properly stored their water in a separate container with a cover. The finding is at par with that of WHO (2013) that the present state of knowledge of water storage was poor. Data in Table 1 further showed that half of women attending ANC possessed correct knowledge regarding PoU. This finding was expected because it is in line with the submission of Holme (2006) that the use of appropriate knowledge at PoU of water provides protection from ingesting disease causing organisms from infecting man. The finding agrees with the view of USEPA (2006) who pointed that education was required to remove nitrate at POU of water in order to avoid associated health risks on ingestion. The Table further revealed that more than 30 per cent of the women who attended

ANC possessed correct knowledge regarding water purification. This finding was anticipated and is consistent with the finding of Dusabe et al. (2010) which revealed that over 30 per cent of the women possessed the right knowledge to purify their water by boiling. The result also agrees with that of Godfrey (2009) who found that knowledge of water purification was only practiced in minority of households, by women. The implication of the finding is that knowledge of water hygiene pertaining to water collection, source protection, transportation, storage and PoU of water need to be enhanced by the use of knowledge enhancement strategies. Findings in Table 11 indicated no significant difference in the knowledge of water hygiene regarding water storage, collection and source protection of women attending

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ANC according to level of education. This finding is expected because it is corroborated by the finding of Borrazzo and Rainey (2010) that no difference existed in knowledge of water storage, collection and source protection. The finding is also in line with the finding of Kioko and Obiri (2012) that most respondents were knowledgeable about ideal methods of water collection and storage. The Table also indicated that a significant difference was found in knowledge of water transportation, PoU of water, and water purification according to level of education. This finding is expected and therefore not surprising. The finding is corroborated by the finding of Responsive Management (2005) that there was difference in knowledge levels regarding water hygiene of women. Also, the finding concurs with that of O’Reilly et al. (2006) who found that there was significant difference in the knowledge of water hygiene (p < .01). The current finding disagrees with the finding of Borrazzo and Rainey (2010) that no difference existed in knowledge of water storage, collection and source protection. The difference in the finding of present study and the previous ones may be due to difference in location and culture of the respondents. The implication of the findings is that knowledge of water hygiene pertaining to water collection, source protection, transportation, storage and PoU of water needs to be enhanced by the use of PoU knowledge enhancement strategies. Findings in Table 12 indicated no significant difference in the knowledge of water hygiene storage, transportation, collection, PoU of water, water source protection and purification according to location. This finding was expected and not surprising. The finding was not surprising because Borrazzo and Rainey (2010) showed no difference existed in knowledge of water storage, collection and source protection in Uttar Pradesh. This finding disagreed with the finding of Amenu et al. (2013) who found significant difference on knowledge variables regarding water hygiene components in rural community of Dire Dawa, Ethiopia. The findings imply that knowledge of water storage, transportation and collection, PoU of water, source protection and purification among women in different locations need to be enhanced by the use of enhancement strategies of knowledge of water hygiene storage, transportation, collection, PoU of water, water source protection and purification. The finding in Table 4 showed that majority of women with NCE/ND and bachelors’ degree and above possessed correct knowledge regarding water hygiene. This finding was expected. This finding was expected because it is in line with the finding of Nematian et al. (2004) who found that females various academic status showed higher

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positive rate on knowledge of water hygiene. The finding disagrees with the finding of Sibiya and Gumbo (2013) that majority of the respondents in grade 8-12 had no knowledge when it came to water related issues (78.4 ± 1.71%). By implication, it implies that enhancement strategies may be required to improve on the level of knowledge of the women across all levels of education. The responses from the FGD revealed that respondents indicated that most women possessed correct knowledge of water hygiene in knowing that the surroundings of water source need to be kept clean. The responses from the FGD also revealed that there were few women who possessed incorrect knowledge of water hygiene regarding having safe freshly fetched water better mixed with the stored safe one at home. In addition, that water is best transported using hygienically uncovered container. The finding in Table 4 revealed that majority of women with NCE/ND, bachelors’ degree and above, secondary education and primary certificate possessed correct knowledge regarding water source protection. This finding was anticipated. The finding is in line with the finding of Sibiya and Gumbo (2013) that majority of the respondents in grade 8-12 had no knowledge when it comes to water related issues (78.4 ± 1.71%). This implies that the knowledge of water hygiene regarding water source protection should be enhanced using appropriate enhancement strategies. Responses in the FGD showed that some women do not protect water source. The reason given was that the women who do not protect the water source from contamination were those who were not many. They also mentioned that women who attended school learnt from the experience they acquired from the school that involved the use of urinary, school toilets, sweeping of class and school environment and refuse disposal in a particular area among many others that had helped them to key with ease into the protection of their water source environment. The finding in Table 4 showed that majority of women with NCE/ND, bachelor degree and above, secondary education and primary certificate possessed correct knowledge regarding water collection. This result was anticipated and it is in line with the submission of Gbadegesin and Olorunfemi (2007) who found that more than half of the total respondents between secondary and tertiary level of education collected water at source daily in Eruwa. The result is in line with Kioko and Obiri (2012) that most respondents were knowledgeable about ideal methods of water collection across diverse level of education. The finding disagrees with that of Jossoe (2010) who found that water source protection reduced the probability of in-home treatment across different levels of

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education to between 27 and 39 per cent The implication of the finding is that health educators need to stress the teaching of water related issues including water source protection as this can be enhanced using enhancement strategies regarding knowledge of water source protection. The finding in Table 4 which revealed that majority of women with NCE/ND, bachelor degree and above, secondary certificate and primary education possessed correct knowledge regarding water transportation. This finding was not anticipated and therefore surprising. The finding was not anticipated because Mallick and Roldan-Rojasl (2015) submitted that even among respondents of different levels of education, water quality cannot be assured due to the use of vessels for the water transport that can be contaminated or do not protect the water during the transport. The difference in the present study and the previous one may be ascribed to difference in location, culture and tradition of the respondents. Data in the Table also revealed that majority of the women possessed correct knowledge regarding water storage with NCE/ND and bachelor degree and above while over one third of those with primary and secondary certificate possessed correct knowledge regarding water storage. This result is expected and therefore not surprising. The result is not surprising because Chege and Agha (1999) found that majority of the respondents with no education use 20 liter containers to store water compared to over one half of those with secondary or higher education. This finding agrees with the finding of Wasonga, Olang’o, Kioli (2014) who revealed that among those with none, primary, middle, secondary or higher education; majority, 92.7 per cent of the respondents in household had the right knowledge about safe water storage containers The finding in Table 4 also revealed that over one half of women with NCE/ND and bachelor degree and above possessed correct knowledge regarding PoU of water. This finding was expected and therefore not surprising. The finding is in line with the finding of Jalan and Somanathan (2008) which showed that 53 per cent of the respondents in their study had correct knowledge of PoU of water as they filtered, boiled or chemically treated their water before use. This implies that about one half of the respondents possessed incorrect knowledge regarding PoU of water. In this regard, there was the need to enhance the knowledge of PoU of the women with enhancement strategies of knowledge of knowledge of PoU of water. Responses from FGD showed that PoU of water was not handled the same way by women. The reason they gave was that they collected water from different sources. The

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women who collected water from the different sources can be made to possess correct knowledge regarding PoU of water by the use of enhancement strategies of PoU of water. Furthermore, the finding showed that more than 30 per cent of the women who attended ANC with NCE/ND and bachelor degree and above possessed correct knowledge regarding water purification. This finding was not anticipated because respondents with higher level of education are expected to possess correct knowledge of water purification more than those with incorrect level of education due to their length of training in school. This finding disagrees with the finding of Lule et al. (2005) which submitted that less than one third of the respondents possessed correct knowledge regarding water hygiene. Data in Table 5 showed that majority of women in both the rural and urban areas possessed correct knowledge regarding water hygiene. This finding is expected. The finding agrees with the finding of Nematian et al. (2004) which showed that in Tehran, respondents significantly had knowledge of water hygiene. The finding disagrees with the finding of Adams (2009) which revealed that respondents lacked knowledge of water hygiene particularly those in rural areas. Responses from the FGD revealed that most women possess the right knowledge of water hygiene such as protecting water runoff from mixing with safe water during rainfall, transporting safe water using hygienically clean container and others. However, there were some women who did not possess correct knowledge regarding water hygiene. The reason for the lack of the correct knowledge regarding knowledge of water hygiene was ignorance, which can be addressed by the adoption of knowledge enhancement strategies of water hygiene on water collection, transportation, PoU, purification, storage and source protection. The finding in Table 5 also showed that majority of women in both the rural and urban areas possessed correct knowledge regarding water transportation. This finding was expected and not surprising because Yallew et al. (2012) showed that in Gonder city Ethiopia, majority of the clients possessed correct knowledge of transportation of water. This finding agrees with the finding of Lockwood, Msapato, Senefeld, Nogi, Perrin, and Mitika (2006) which showed that majority of the respondents in Malawi transported drinking water safely. This implies that although majority of the women possessed correct knowledge regarding safe transportation of water; all the women ought to possess the correct knowledge regarding safe transportation of water. In other to correct this anomaly, enhancement strategies of knowledge of transportation need to be adopted by the women.

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Responses from the FGD showed that majority of the women possessed correct knowledge regarding water transportation. The reason was that they had safely transported either farm produce or food stuffs bought from the market home, and the knowledge of the transportation was transferred to the transportation of water. However, some women possessed incorrect knowledge regarding water transportation. Data in Table 5 further showed that majority of the women in both the rural and urban areas possessed correct knowledge regarding safe collection of water. This finding is expected and not surprising because International Conference on Water and the Environment (1992) submitted that in Wanaraniya, Sri Lanka women were acutely aware of the power of having reliable access to clean water for drinking, cooking, cleaning and running their households. This finding concurs with the finding of McCauley (2015) which pointed that across the world, educational empowerment of women can have both direct and indirect impacts on access to clean water in developing nations. This may imply that educational empowerment in relation to water collection can be achieved when enhancement strategy of water collection is adopted by women. The finding in the Table also showed that majority of the women in both the rural and urban areas possessed correct knowledge regarding the protection of water source. This finding was not anticipated because people do such things that contaminate water sources like open defecation, littering of the environment with domestic and household wastes, broadcast of fertilizers on farms and so on. This finding disagrees with the finding of Mpazi and Mnyika (2005) which revealed that male respondents in Hala municipality of Dar Es Salaam region, Tanzania have high level of knowledge of protection of water source. The finding however disagrees with the finding of Sibiya and Gumbo (2013) which showed that 46.6 ± 2.07 per cent respondents knew at least one source of clean water compared to 54.4 ± 2.07 per cent who did not know any source of clean water. The finding implies that the contradiction by respondents concerning knowledge of water source protection can be corrected through the adoption of enhancement strategy of protection of water source. Data in the Table also showed that over one half of women possessed correct knowledge regarding: water storage in the rural and urban areas. This finding was unexpected and surprising. The finding was surprising because women were expected to possess correct knowledge of water storage because in both urban and rural areas; water storage was a regular feature since potable water was not connected to all homes. Even when it was connected to homes, it did not run all day and the frequency of storage may

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account for their level of knowledge regarding storage of water. The finding disagrees with the finding of Iroegbu et al. (2000) who showed that all water stored by market women in south eastern Nigeria had bacterial contamination measuring significantly with storage time. The finding also disagrees with the finding of Lule et al. (2005) which found that more than 90 per cent of households’ in rural areas of Uganda stored water at home using wide-mouthed containers. The finding also disagrees with that finding of Bhattacharyal et al. (2011) which showed that in rural Madya Pradesh India, women in all households stored drinking water in any container. The implication is that although all women stored their drinking water in containers, the storage may be in narrow mouth or opened containers. In other to improve on the knowledge of water storage of women, an enhancement strategy of knowledge of storage of water is needed. The finding in Table 5 also showed that over one half of the women who attended ANC possessed correct knowledge regarding PoU of water in urban and rural areas. This finding was expected. The finding agrees with the finding of United Stated Agency for International Development - USAID (2014) which found that 32 and 42 per cent of urban and rural Rwandans possessed correct knowledge regarding PoU of water with a chemical product. The finding further agrees with the finding of Shalett (2011) which showed that in the Houndo village in the Zou region of Benin, almost one half of caregivers used zinc coupled with ORS to treat their children. The finding implies that in other to have all women possess correct knowledge regarding PoU of water, enhancement strategy of PoU of water would be required. Responses from the FGD showed that most women did not possess correct knowledge regarding PoU of water. The reason for this was due to ignorance. Furthermore, the Table showed that more than 30 per cent of the women who attended ANC possessed correct knowledge regarding water purification in rural and urban areas. This finding was expected. The finding concurs with the finding of O’Reilly et al. (2006) which revealed that in Nyanza province of western Kenya; improvement was seen in respondents' knowledge of correct water purification procedure from 21 to 65 per cent (P < 0.01). The finding disagrees with the finding of Joshi and Amadi (2013) which showed that between 49 to 91 per cent of school children in Kenya possessed correct knowledge of water purification. This finding implies that in other to have all women possess correct knowledge regarding water purification, the water purification enhancement strategy is needed to be adopted by all.

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Water hygiene attitude of women attending ANC. The finding in Table 6 that more than one half of the women who attended ANC with secondary certificate, primary education, NCE/ND and bachelor degree and above expressed positive attitude towards water hygiene was not anticipated but surprising. This finding was surprising because women with higher qualification ordinarily were expected to express more positive attitude towards water hygiene than those with lower qualification due to their duration of training in school, which would have been responsible for the marked difference in the expression of the positive attitude towards water hygiene. This finding is in consonance with the finding of National Population Commission - NPC and ICF Macro (2009) which found that among literate and non literate respondents in Nigeria, 75.4 and 43.6 per cent of the rural population respectively displayed positive attitude to water hygiene. The finding disagrees with the finding of Nauges and vandenBerg (2009) who submitted that better educated households have more positive attitude to water quality and related health risk. This also disagrees with the finding of Abebaw, Tadesse and Mogues (2010) who showed that keeping other factors constant, households with a literate head are significantly less satisfied with the quality of water hygiene they use than are households with a nonliterate head. This implies that the expression of positive attitude towards water hygiene is predicated on adoption of enhancement strategy of water hygiene. Data in the Table also showed that majority of the women with NCE/ND certificate, bachelor degree and above, primary education and secondary certificate displayed positive attitude toward the protection of water source. This finding is surprising because women with high educational attainment ought to think and behave superiorly to those with lower educational attainment. This finding was expected and not surprising. However, this finding disagrees with the finding of Arcury (1990) and Inglehart (1995) who found that highly educated respondents always have more values than lower educated respondents. This implies that negative attitude can be corrected by the adoption of enhancement strategy of protection water source. Responses from the FGD revealed that majority of the women protected their water sources. The reason they gave was that women were responsible for cleaning, washing and tidying their home and this makes it easy for them to protect their water sources. Furthermore, the Table showed that majority of the women with bachelor degree, secondary education, NCE/ND certificate and primary certificates displayed positive

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attitude toward water storage. This finding was not anticipated as all women and not majority were expected to display positive attitude towards water storage. The expression of negative attitude towards water storage can result to having or increasing micro organisms that contaminate water in storage containers at home, which on ingestion, could result to ill health that may become an epidemic. However, this finding disagrees with the finding of Chege and Agha (1999) which revealed that about 21 per cent of respondents with secondary or higher education compared to less than 11 per cent of other respondents expressed some disposition concerning the use of any five liter containers to store water. This implies that respondents with different levels of education present different attitude towards water storage, which can be corrected by the adoption of enhancement strategies of storage of water. The finding in Table 6 that majority of the women with NCE/ND certificate, bachelor degree and above and over half of women with secondary certificate and primary education displayed positive attitude toward water purification was not anticipated but surprising. The finding was surprising because Chege and Agha (1999) showed that about 21 per cent of respondents with secondary or higher education compared to less than 11 per cent of other respondents expressed some disposition concerning the use of any five liter containers to store water. However, this finding disagrees with the finding of Boateng, Tia-Adjei and Adams (2013) who found that attitude toward purification of water was higher among non-literate respondents than their literate counterparts (61.5% versus 38.5%). Also, this finding disagrees with the finding of Miner, Dakhim, Zoakah, Afolaranmi and Envuladu (2015) which found that both literate and nonliterate respondents 199 (54.1%) stated that the household drinking water had undergone at least a method of purification. This implies that about one half of the respondents did no form of water purification. In other to curb this anomaly, water purification enhancement strategy is required to be adopted by the women. Responses in FGD showed that majority of the women with higher qualification displayed positive attitude towards purification of water more than those with lower educational qualification. Therefore, in other to ensure that women display positive attitude towards the purification of water, the adoption of water purification enhancement strategy is important. The Table also showed that majority of the women with primary certificate, secondary education, bachelor degree and above and NCE/ND certificate displayed positive attitude toward transportation of water. This finding was expected. However, the

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finding disagrees with the finding of Green (1987) who showed that respondents with over one third (45.8%) who used unbreakable plastic container of any sort; 35.6 per cent who used uncovered bucket; 2.2 per cent who used another type of closed container; two respondents (0.4 %) who used the traditional clay pot; and 3.1 per cent displayed negative attitude towards transportation of water. This implies that while some women displayed negative attitude to transportation of water, there is the need to ensure that the negative attitude to transportation of water is transformed to positive attitude, which can only be achieved through the adoption of enhancement strategies of transportation of water. Furthermore, the Table showed that more than half of the women with secondary education, NCE/ND certificate, primary education and less than one third of women with bachelor degree and above displayed positive attitude toward PoU of water. This finding was expected. This finding was surprising because women with lower certificate displayed more positive attitude over those with higher certificates perhaps due to status. However, the finding disagrees with the finding of Abt Associates Inc/ Population Services International (2010) which showed that during PoU of zinc (POUZN) project, a positive impact on awareness of Sûr’Eau, as well as brand appeal and self-efficacy resulted to 37 per cent of those surveyed to having ever used Sûr’Eau (zinc tablet) at PoU of water. Also, the finding disagrees with the finding of Singh, Lutchmanariyan, Wright, Knight, Jackson, Langmark,…Rodda (2013) which showed that at PoU of water, respondents with poorer socio-economic standing and lower educational standard were associated with poorer water quality, poorer hygiene practices and higher rates of diarrhoea and vomiting. This implies that level of education can be associated with or may influence PoU of water, however, strategies of PoU of water enhancement can influence one to display positive attitude towards PoU of water. Responses from the FGD show that women displayed positive attitude towards PoU of water. However, not all women expressed negative attitude towards PoU of water, but in other to ensure that women display positive attitude towards PoU of water, enhancement strategies on PoU of water is needed to be adopted by the women. Data in the Table also showed that over 30 per cent third of women with secondary

certificate, primary education, and less than one third of women expressed positive attitude towards water collection with bachelor degree and above and NCE/ND certificate displayed positive attitude towards water collection. This finding was not anticipated but surprising. The finding was surprising because attitude towards water collection seems not to be predicated on educational level. The finding agrees with the finding of Kioko

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and Obiri (2012) which showed that some attitudes among the respondents worked against the ideals of achieving safe water collection. This implies that not all women expressed positive attitude towards the collection of water, however, this can be corrected by the use of enhancement strategies of the collection of water. The finding in Table 7 that over 50 per cent of the women attending ANC expressed positive attitude towards water hygiene in rural and urban areas was expected. The finding was expected because water hygiene of respondents as submitted by Cairncross and Valdmanis (2006) depends on the perception of water quality that people have before drinking which later on may have strong health impacts. The finding disagrees with the finding of Anderson, Romani, Philips, Wentzal and Tlabela (2007) which showed that in Gangapur Pakistan, lack of awareness about the right knowledge towards water hygiene barred majority of women from expressing positive attitude towards water hygiene. This implies that the right knowledge of water hygiene can influence positive attitude towards water hygiene, which can be achieved through the adoption of enhancement strategies of water hygiene. Furthermore, the Table showed that majority of the women in rural and urban areas displayed positive attitude towards protection of water source. This finding was not surprising but expected because well protected water source that taste good and is free from contaminants can be a driving factor behind having positive attitude to its consumption and perception. The finding is in consonance with the finding of Levallois, Grondin and Gingras (1999) which showed that in Quebec, majority of the attitude of many consumers was determined by his dissatisfaction with the source and taste of any drinking water. Also, the finding agrees with the finding of Wright, Gundry and Conroy (2004) which showed that the attitude towards microbiological contamination of water source was widespread. Responses from the FGD showed that women who attended ANC in both the rural and urban areas displayed positive attitude towards the protection of water. The reason given was that they more often than not use common sources of water, which when not taken care of could contaminate the water in it that when they fetched from such source and used, it led to ill health. However, in other to curb this anomaly, the adoption of water source protection enhancement strategies is important. Data in the Table also showed that majority of the women in rural and urban areas displayed positive attitude towards water storage. This finding was not anticipated. The reason was because Kioko and Obiri (2012) found that some attitudes among the

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respondents in peri-urban communities in Western Kenya worked against the ideals of achieving safe storage of water. This finding disagrees with the finding of Lule et al. (2005) which showed that in Uganda, 90 per cent of households’ stored water at home using wide-mouthed containers. This implied that there was the existence of lack of expression of positive attitude of storage of water among the respondents. However, this anomaly can only be corrected with the adoption of water storage attitude enhancement strategy. The Table also showed that over 50 per cent of the women who attended ANC in the rural and urban areas displayed positive attitude towards water purification. This finding was expected. The finding is expected because Kaiko (2012) showed that a large number of respondents had positive attitudes towards water purification. The finding agrees with the submission of Population Services International / Kenya (2005) which showed that over half of users that displayed positive attitude towards water purification resided in urban areas as compared to rural areas. The finding implies that almost one half of the women do not display positive attitude to water purification. To curb this trend, the use of water purification attitude enhancement strategies is important. Responses from the FGD showed that almost half of the women displayed negative attitude towards water purification. The reason they gave was that it was difficult for them to access the water purification materials. Even when such is available, one may not know how to use it successfully. Furthermore, the Table showed that one 50 per cent of the women in the urban and rural areas displayed positive attitude towards water transportation. This finding was expected. This finding was expected because women in urban areas were highly motivated to be aware that contamination of water arises from transport of water and this may influence their disposition towards the positive attitude to transportation of water. However, the finding disagrees with the finding of Green (1987) who showed that respondents in rural Swaziland displayed negative attitude towards transportation of water with over 40 per cent (45.8%) who used unbreakable plastic container of any sort; 35.6 per cent used uncovered bucket; 12.9 per cent used a covered bucket, 2.2 per cent used another type of closed container; only 2 respondents (0.4 %) used the traditional clay pot; and 3.1 per cent gave miscellaneous answers such as jugs and metal drums. This implies that over 40 per cent of the women expressed negative attitude towards water transportation. To reverse this trend, the use of enhancement strategy of transportation of water by the women becomes necessary.

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Responses from the Table also showed that less than 30 per cent of the women in the urban and rural areas displayed positive attitude towards water collection. This finding was not anticipated because women regularly collected water from diverse sources since most of their homes were not connected with potable water. This finding disagrees with the finding of Wright et al. (2004) which showed that among women in developing world, the extent of contamination of water after water collection varies considerably between settings, but is proportionately greater where faecal and total coliform counts in source water are low. This implies that water collection of women is not certain. In other to have all women display positive attitude towards water collection, enhancement strategy on water collection ought to be adopted by women. Findings in Table 13 indicated no significant difference in the attitude of women towards water hygiene, attitude about transportation of water and protection of water source, according to level of education. This finding was expected and not surprising. The finding was not surprising because women in the rural and urban areas were expected to display positive attitude towards water hygiene since in both areas, portable water was not a regular feature. Even where potable water facility were in place, it might have been over stretched, obsolete or in a state of disrepair, thus influencing women to express all sorts of attitude. This finding disagrees with the finding of Miller (2003) which found significant differences in attitude toward water protection and enforcement in 11 (71%) of the 15 statements measuring attitudes. The difference in the finding of the present study and the previous one may be due to culture and location of the respondents. The implication of the finding is that not all the women displayed positive attitude towards water hygiene. Therefore, there is the need to adopt the enhancement strategy of water hygiene by the women. Tthe finding also revealed significant difference in the attitude of women towards storage, collection and purification of water according to level of education. This finding was expected because women often play important roles in influencing collection, treatment and storage of water. The finding agrees with the finding of Miner et al. (2015) which found statistically significant relationship between purification of drinking water in the household and the occurrence of diarrhoea amongst children (p urban = 57.8%) and PoU of water (urban = 50.2% > rural = 49.8%); more than 30 per cent of women possessed correct knowledge of water purification (rural = 38.1% > urban = 36.3%) (Table 5). 6. Over 50 per cent of women attending ANC expressed positive attitude towards water hygiene with secondary certificate (58.3%), primary education (55.9%), NCE/ND (55.8%) and bachelor degree and above (56.0%). Majority of the women displayed positive attitude toward: water source protection with NCE/ND certificate (78.9%), bachelor degree and above (75.7%), primary education (74.8%) and secondary certificate (73.6%); also majority of the women attending ANC expressed positive attitude towards water storage with bachelor degree (74.0%), secondary education (71.2%), NCE/ND certificate (70.0%) and primary certificate (65.2%); water purification NCE/ND certificate (62.8%) and bachelor degree and above (61.1%) and more than 50 per cent of the women expressed positive attitude toward: purification of water with secondary certificate (53.6%) and primary education (51.1%); transportation of water with primary certificate (57.7%), secondary education (54.7%), bachelor degree and above (50.7%) and about 50 per cent of those with NCE/ND certificate (49.3%); women who attended ANC displayed positive attitude towards PoU of water with secondary education (56.3%), NCE/ND certificate (48.4%) and primary education (41.8%) PoU of water with bachelor degree and above (29.1%). Forty point three per cent

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of women who attended ANC displayed positive attitude towards water collection with secondary certificate and primary education (34.8%), bachelor degree and above (27.2%) and NCE/ND certificate (26.9%) (Table 6). 7. More than 50 per cent of women attending ANC expressed positive attitude towards water hygiene in rural areas (56.8%) and urban areas (56.6%). Majority of the women displayed positive attitude towards water source protection with those in rural areas (78.2%) and urban areas (75.5%); water storage with those in the urban areas (70.8%) and rural areas (69.5%). More than half of the women who attended ANC displayed correct attitude towards: water purification in rural areas (58.8%) and urban areas (58.2%); while water transportation in urban areas (52.4%) and rural areas (51.1%) and PoU of water in urban areas (50.5%) and rural areas (50.3%). Less than 33 per cent of the women who attended ANC expressed positive attitude towards water collection in the urban areas (31.9%) and urban areas (29.1%) (Table 7). 8. Women attending ANC practised water hygiene with: NCE/ND certificate (overall always = 41.0 %, sometimes = 27.6%, rarely = 13.0%), bachelor degree and above (always = 38.0%, sometimes 33.1%, rarely = 12.0%), primary education (always = 36.5%, sometimes = 32.0%, rarely = 18.0%), secondary education (sometimes = 36.2%, always = 33.5%., rarely = 18%); women attending ANC with NCE/ND practised water source protection thus: (always = 57.0%, sometimes = 24.8%, rarely = 9.6%), bachelor degree and above (always = 51.4%, sometimes = 35.1%, rarely = 7.7%), secondary education (sometimes = 41.7%, always = 38.4%, rarely = 12.0%), primary education (sometimes = 42.0%, always = 37.8%, rarely = 15.0%); women with secondary certificate practised water storage sometimes (46.7%), always (36.9%), rarely (8.6%) while those with primary certificate practised sometimes (43.0%), always (39.3%) and rarely (9.3%) whereas those with bachelor degree and above practised sometimes (42.9%), always (40.4%), rarely (7.3%) while women with NCE/ND practised always (39.3%), sometimes (36.3%) and rarely (9.6%); women with NCE/ND practised water purification always (44.0%), sometimes (33.4%), and rarely (15.0%) while women with bachelor degree and above practised sometimes (38.1%), always (36.8%) and rarely (20.1%), women with secondary education practised sometimes (33.7%), rarely (30.0%) and always (27.7%) moreover, women with primary education practised always (31.1%), rarely (29.0%) and

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sometimes (28.0%); women with primary education practised transportation of water always (41.1%), sometimes (17.0%), rarely (16.0%) whereas women with secondary education practised always (34.2%), sometimes (23.3%), rarely (21.0%) while women with bachelor degree and above practised always (30.8%), sometimes (22.4%) and rarely (14.6%) whereas those with women with NCE/ND practised always (30.0%), sometimes (18.9%) and rarely (14.0%) and women with secondary education practised PoU of water sometimes (39.6%), always (28.3%) and rarely (18.0%); women with bachelor degree and above practised sometimes (34.7%), always (27.8%) and rarely (5.0%) whereas women with primary education practised sometimes (33.0%), always (32.6%) and rarely (19.0%) while women with NCE/ND practised always (30.0%), sometimes (29.0%) and rarely (17.0%) (Table 8). 9.

The proportion of women in the rural areas practised water hygiene (overall always = 38.6%, sometimes = 31.3%, rarely = 14.5% while in the urban areas the proportion was always = 37.6%, sometimes = 30.5%, rarely = 15.2 %); the proportion of women in the rural areas practised water source protection (always = 50.4%, sometimes = 32.9%, rarely = 9.9%, whereas in the urban areas the proportion was always = 48.4%, sometimes = 32.3%), rarely = 10.8%); proportion of women in the rural areas practised collection of water (always = 41.0%, sometimes = 27.2%, rarely = 14.8% while in the urban areas the proportion was always = 40.5%, sometimes = 24.1%, rarely = 17.6%); proportion of women in urban areas who practised water purification always (39.4%), sometimes (32.0%) and rarely (21.0%) whereas in the rural areas the proportion was always (36.0%), sometimes (35.3%) and rarely (20.4%); proportion of women in urban areas who practised water storage sometimes (39.9%), always (39.3%) and rarely (9.9%) while in the rural areas the proportion was sometimes (40.1%), always (37.3%) and rarely (8.8%); proportion of women in rural areas who practised water transportation always (32.8%), sometimes (20.5%) and rarely (15.4%) whereas the proportion in the urban areas was always (32.3%), sometimes (19.7%) and rarely (16.0%); proportion of women in rural areas who practised PoU of water always (29.9%), sometimes (33.9%) and rarely (16.5%) while in the urban areas the proportion was always (29.1), sometimes (31.6%) and rarely (17.8%) (Table 9).

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10. Enhancement strategies of water hygiene knowledge, attitude and practice were adgjudged very appropriate with mean of 2.55 with SD of, 559, which fall between 2.49 – 3.00; 2.62 with SD = .515, which fall between 2.49 – 3.00 and 2.65 with SD = .496, which fall between 2.49 - 3.00. These are contained in table 10, 11 and 12 respectively. 11. There was no significant difference in the water hygiene knowledge of women attending ANC according to level of education (overall χ .126 > p .05), knowledge of water storage ( χ knowledge of collection of water ( χ

2

2

2

= 18.698, P-value

= 27.514 > P = .001, df = 3),

= 18.522 > P = .001, df = 3) and

knowledge of water source protection ( χ 2 = 23.136 > P = .020, df = 3); there was significant difference in the components of water hygiene regarding knowledge of transporting of water ( χ

2

= 14.378 > P = .199, df = 3), knowledge of PoU of

water ( χ 2 = 23.246 > P = .113, df = 3) and knowledge of purification of water (

χ

2

= 5.330 > P = .384, df = 3 according to level of education These are

contained in Table 13. 12. The null hypothesis of no significant difference with regard to the knowledge of water hygiene of women attending ANC based on location was therefore accepted (overall χ 2 = .930, P-value .533 > .05); there was no significant difference in the components of water hygiene knowledge of: storage of water ( χ

2

= .385 < P =

.540, df = 1), transportation of water ( χ 2 = 1.036 > P = .406, df = 1), collection of water ( χ 2 = .160 < P = .740, df = 1), PoU of water ( χ 2 = .846 > P = .575, df = 1), water source protection ( χ

2

= 1.202 > P = .628, df = 1) and purification of

water ( χ 2 = 1.696 > P = .379, df = 1) according to location. These are contained in Table 14. 13. There was no significant difference with regard to attitude towards water hygiene of women attending ANC according to level of education (overall χ 2 = 28.584, P-value .061 > .05), attitude about transportation of water ( χ

2

= 19.924 > P =

.130, df = 9) and attitude about water source protection ( χ 2 = 13.975 > P = .187, df = 9); there was significant difference in attitude about storage of water ( χ 2 = 30.041 > P = .006, df = 9), collection of water ( χ 2 = 34.078 > P = .000, df = 9), PoU of water ( χ

2

= 38.512 > P =.000, df = 9) and purification of water ( χ

25.447 > P = .021, df = 9) . These are contained in Table 15.

2

=

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14. There was no significant difference with regard to attitude towards water hygiene of women attending ANC according to location (overall χ 2 = 2.392, P-value .586 > .05), storage of water ( χ 2 = 2.652 > P = .483, df = 3), transportation of water (

χ 2 = 1.505 > P = .698, df = 3), collection of water ( χ 2 = 2.411 > P = .541, df = 3), PoU of water ( χ 2 = 3.735 > P = .334, df = 3), water source protection ( χ 2 = 2.532 > P = .584, df =3) and purification of water ( χ 2 = 1.520 > P = .683, df = 3). These are contained in Table 16. 15. There was significant difference with regard to practices of water hygiene according to level of education (overall χ 2 = 32.187, P-value .023 > .05), storage of water ( χ 2 = .27 > P = .007, df = 9), transportation of water ( χ 2 = 32.32 > P = .000, df = 9), collection of water ( χ 2 = 42.03 > P = .000, df = 9), PoU of water (

χ 2 = 33.02 > P = .000, df = 9) and water source protection ( χ 2 = 27.25 > P = .007, df = 9). There was no significant difference in purification of water ( χ 2 = 31.37 > P = .023, df = 9). These are contained in Table 17. 16. There was no significant difference with regard to practices of water hygiene of women attending ANC based on location (overall χ

2

= 2.077, P-value .586 >

.05), storage of water ( χ 2 = 1.638 > P = .672, df = 3), transportation of water ( χ 2

= 2.107 > P = .551, df = 3), water collection ( χ 2 = 3.25 > P = .422, df = 3), PoU

of water ( χ 2 = 1.999 > P = .591, df = 3), water source protection ( χ 2 = 1.584 > P = .673, df = 3) and purification of water ( χ 2 = 1.884 > P = .607, df = 3). This is contained in Table 18. Conclusions Based on the findings and the discussion of the study, the following conclusions were made: Correct knowledge of water hygiene was possessed by majority of women in water collection, source protection and transportation with one half and one third possessing correct knowledge regarding PoU of water and purification. Therefore, there is need to adopt the items of awareness, education and advocacy of knowledge of water hygiene enhancement strategy in other to ensure that all women attending ANC possess correct knowledge of water hygiene. This emanated from research question one. Positive attitude was expressed by one half of women regarding water hygiene with majority expressing positive attitude regarding water source protection, storage

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while one half displayed positive attitude towards water purification, transportation and PoU whereas less than one third displayed positive attitude towards water collection. Therefore, in other to have all women display positive attitude regarding water hygiene, the adoption of various items of information, adovocacy and entertainment education (EE) of attitude toward water hygiene enhancement strategy was needed. This emanated from research question two. Women attending ANC always practised water hygiene, water source protection, storage, collection, purification and transportation of water while PoU of water was sometimes practised. Therefore, to always practise water source protection, storage, collection, purification, transportation and PoU by all women; constant use of various items as contained in EE, community mobilization and education practice water hygiene enhancement strategies need to be used. This emanated from research question three. Correct knowledge regarding water hygiene was possessed by majority of women attending ANC with NCE/ND in water source protection, water collection, water transportation, water storage and one half of women possessed correct knowledge rdgarding regarding water hygiene at PoU while one third and less than one third with secondary school certificate possessed correct knowledge regarding water purification. Therefore, to ensure that all women possessed correct knowledge regarding water source protection, collection, transportation, storage, PoU and purification of water; items of of water hygiene knowledge enhancement strategies of awareness, education and advocacy need to be adopted by women. This emanated from table four. Correct knowledge regarding water hygiene was possessed by women in rural than urban areas in water transportation, source protection, storage, and purification while those in urban than rural areas possessed correct knowledge in PoU of water and water collection. Therefore, the adoption of items of knowledge of water hygiene enhancement strategies of awareness, education and advocacy need to be adopted by women. This emanated from table five. Positive attitude towards water hygiene was expressed by those with secondary education than those with primary education and NCE/ND than bachelor degree and above. Therefore, there is the need to adopt the attitude to water enhancement strategies of information, advocacy and EE in other to possess positive attitude towards water hygiene. This emanated from table six. Positive attitude towards water hygiene was expressed in the rural than urban areas. Therefore, there is the need to adopt the items of attitude water hygiene

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enhancement strategy in other to influence all women in both rural and urban areas express positive attitude towards water hygiene. This emanated from table seven.

Women practised water hygiene always with NCE/ND more than bachelor degree and above than primary education and secondary education. Therefore, to curb the anomaly of inequality in always practicing water hygiene by women, the use of water hygiene knowledge, attitude and practice enhancement strategy is important. This emanated form table eight. Women in the rural than urban areas always practised water hygiene. Since in the rural than urban areas women always practised water hygiene, there is therefore need to for all women to always practise water hygiene. Therefore, the need for the adoption of the practice of water hygiene enhancenment strategies by women attending ANC is urgently needed. This emanated form table nine. Enhancement strategies of water hygiene knowledge, attitude and practice were considered very appropriate. Therefore there is the need for its adoption and use by women attending ANC. This emanated form table ten, eleven and twelve. Level of education of women did not account for difference in attitude towards water hygiene. Therefore, in other to improve the status quo, enhancement strategies of water hygiene knowledge, attitude and practice is needed to be adopted by women. This emanated form table thirteen. Location of women did not account for difference in attitude towards attitude water hygiene. Therefore, there is need for women to adopt the enhancement strategies of attitude towards water hygiene so as to enhance the attitude towards water hygiene of women based on location. This emanated form table fourteen. Level of education had significant difference in regards to practises towards water hygiene. Therefore, women should embark on the adoption of practice enhancement strategies of water hygiene so as to enhance their practices of water hygiene. This emanated form table fifteen. Location of women had no difference in the practices of water hygiene. Therefore, there is the need to scale up the practice of water hygiene based on location through the adoption of water hygiene practice enhancement strategy. This emanated form table sixteen.

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Recommendations Based on the finding of the present study, the discussion, and conclusions thereof, the following recommendations were made: 1. Women attending ANC should adopt the awareness, education and advocacy

items contained in the knowledge of water hygiene enhancement strategy as designed. This is to ensure that all those who adopted such enhancement strategies possessed correct knowledge regarding water hygiene. 2. Women attending ANC should adopt the items contained in the water hygiene enhancement strategy aspects of the strategies on attitude towards water hygiene. This becomes necessary so as to influence all women attending ANC in both rural and urban areas express positive attitude towards water hygiene. 3. The use of entertainment education (EE), community mobilization and education items in the practises of water hygiene enhancement strategies need to be practised by all women in the area of water source protection, storage, collection, purification, transportation and PoU. The practise of the above would ensure that all women attending ANC always practise the various aspects of water hygiene components. Limitation of the Study The constraint during the study was that: 1. There was civil unrest in some parts of the State which to a large extent made the environment tensed while the period of the collection of data lasted. The insurgency activities such as abduction killings, burning of houses and belongings of people were regular features then. It was under this tensed environment that women attending ANC responded to the instruments. This problem was surmounted and did not negatively influence respondents from responding to the instrument. Suggestions for Further Study On the basis of the findings, the following were suggested: 1. Studies similar to the present one should be carried out in all the States of the middle belt region since they serve as sources of surface water to other places in Nigeria and beyond. 2. Studies on quality of water supply through tankers and other water suppliers should be routinely done in other to monitor closely our domestic water so as to avoid contaminants from our purported safe water sources.

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3. A similar study should be carried out in other Statees of the country where such a study has not been conducted.

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Appendices Appendix A

Introductory Letter

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Appendix B Letter to the Respondents Department of Human Kinetics and Health Education, University of Nigeria, Nsukka Dear Respondent, Water Hygiene Knowledge, Attitude and Practice Questionnaire (WaHKAPQ) This study is to determine the water hygiene knowledge, attitude and practice by women attending ANC in Plateau State. The findings of the study will enable the researcher to design enhancement strategies that will help in improving the knowledge, attitude and practices of women attending ANC in the use of water. You are therefore, kindly requested to give honest and frank responses to the under listed statements as they apply to you. There are no right or wrong answers but attempt to react to all the items honestly and frankly as they apply to you. The responses you indicate will be treated confidentially and will be used for the purposes of this research only. Therefore, do not write your name on any part of this questionnaire. The answers you give will be kept private. Make sure you read and understand every statement very well. Please return the completed copy of the questionnaire. Thank you. Yours sincerely,

Dangbin, J. P. (Investigator)

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Appendix C Water Hygiene Knowledge, Attitude, Practice Questionnaire (WaHKAPQ) for Women Attending ANC Instructions: 1. You are please requested to kindly and honestly respond to each of the questions or statements by ticking [√] against the response that best applies to you. 2. You can use HB pencil or pen only. 3. If you change your answer, delete the old answer completely by making a delete (X) mark across it. 4. Kindly indicate your response to each statement by ticking appropriately the column as it applies to you. Section A: Demographic Information Kindly complete the information below by placing a tick [√] in the box (bracket) as it applies to you. Indicate your place of residence. 1. A. Rural ( ) B. Urban ( ) 2. Level of education: A. Primary education ( ) B. Secondary certificate ( ) C. NCE/ND ( )

D. Bachelors degree and above.( )

Section B: Knowledge of Water Storage. Instructions: Indicate by tick ( √ ) the right option answers to the statements below. 3. Safe stored drinking water is best taken out of the storage container through a spigot (narrow opening on the stored container). True ( ) False ( ) 4. For safe storage of clean water, water storage container ought to be kept above the ground. True ( ) False ( ) 5. Safe freshly fetched water is better mixed with the stored safe one at home. True ( ) False ( ) Section C: Knowledge of Water Transportation. 6. Safe water ought to be transported in a clean opened container without lid. True ( ) False ( ) 7. Water is best transported using hygienically covered container. True ( ) False ( ) 8. Before transporting safe water, both lid and container used in transporting safe water need to have been cleaned, disinfected and dried. True ( ) False ( ) Section D: Knowledge of Water Collection. 9. Safe water collected can be safe in clean hygienic and properly covered container. True ( ) False ( ) 10. Safe water is best collected in a hygienic container when no parts of the human body contact it. True ( ) False ( ) 11. Safe water is best collected in opened container. True ( ) False ( )

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Section E: Knowledge of Point-of-Use of Water. 12. Safe water is best removed at point-of-use through the use of narrow opening. True ( ) False ( ) 13. Collecting safe water at point-of-use is best done through scooping or dipping with a smaller container. True ( ) False ( ) 14. It is good to use any means to remove safe water at the point-of-use. True ( ) False ( ) Section F: knowledge of Water Source Protection. 15. The surroundings of water source need to be kept clean always. True ( ) False ( ) 16. Safe water source is protected by screening animals and human waste from it. True ( ) False ( ) 17. Water runoff need to be protected from entering the pool of safe water during rainfall. True ( ) False ( ) Section G: Knowledge of Water Purification. 18. Filtration is the best water treatment method that is used to get the safe water. True ( ) False ( ) 19. Aeration (exposing raw water to air) is not a water treatment method. True ( ) False ( ) 20. Sedimentation (allowing particles in water settle down) is a water treatment method. True ( ) False ( )

S/no 21. 22. 23.

S/no 24. 25. 26.

Section H: Water Storage Attitude Statements

Strongly Agree

Agree Disagree

Strongly Disagree

Strongly Agree

Agree Disagree

Strongly Disagree

I like to mix freshly fetched safe water with the stored one in a storage container. I prefer to keep safe water storage container above the ground. The procedures I like to adopt before refilling my water storage container with safe water involve emptying, cleaning, disinfecting and drying the water storage container before storage. Section I: Water Transport Attitude Statements For safe water transportation, I like using clean opened container without lid I like transporting safe water in any container. I prefer to transport safe water when both the lid and container used in transporting the water is clean, disinfected and dried.

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S/no 27. 28.

Section J: Water Collection Attitude Statements

S/no

I prefer collecting safe water in any container. In the process of collecting safe water, I like my hands touching the water. I prefer travelling long distance to collect safe water. Section K: Water Point-of-Use Attitude Statements

30. 31. 32.

I prefer removing safe stored water through (for items 30-32) Scooping or dipping container to retrieve water. Spigot or narrow opening. Sending any child around.

29.

S/no 33. 34. 35.

S/no

36. 37. 38.

Section L: Water Source Protection Attitude Statements

Strongly Agree

Agree Disagree

Strongly Disagree

Strongly Agree

Agree Disagree

Strongly Disagree

Strongly Agree

Agree Disagree

Strongly Disagree

Strongly Agree

Agree Disagree

Strongly Disagree

In order to protect water source, I prefer to prevent animals and human waste from reaching the water. For water source protection, I like to dump refuse far below water source on a slope. I prefer to protect fast flowing water runoff during rainfall from entering safe water source as a measure of source water protection. Section M: Water Purification Attitude Statements I prefer making water safe using (for items 36-38) Filtration Aeration (exposing raw water to surface air) Sedimentation (allowing particles settle down)

Section N: Water Storage Practices Instructions: Please tick ( √ ) truthfully against the best option that agrees with your practices in the following statements as it applies to you. S/no Statements Always Sometimes Rarely 39. I normally store safe water by keeping it in any clean container with lid kept above bare ground with a spigot (narrow opening). 40. In order to store safe water, I empty, clean and dry the storage container before refilling. 41. I mix freshly fetched safe water with previously stored one in storage container.

Never

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Section O: Water Transportation Practices Statements S/no I transport safe water in (for items 42-44) 42. Any container. 43. A clean, disinfected and dried container and lid. 44. In uncovered container. Section P: Water Collection Practices S/no Statements I collect safe water (for items 45-47) 45. In a hygienic and properly covered container. 46. Without allowing any parts of my body contact it. 47. In opened container.

Always

Sometimes

Rarely

Never

Always

Sometimes

Rarely

Never

Sometimes

Rarely

Never

Always

Sometimes

Rarely

Never

Always

Sometimes

Rarely

Never

Section Q: Water Point-of-Use Practices Statements Always S/no I remove safe water at point-of-use through (for items 48-50) 48. The use of narrow opening. 49. Scooping (dipping container) to remove it. 50. Using the mouth. Section R: Water Source Protection Practices. S/no Statements I protect water source by (for items 51-53) 51. Preventing animals and human waste from it. 52. Situating refuse dump site far down the slope below water source. 53. Protecting water runoff from mixing with safe water source. Section S: Water Purification Practices. S/no Statements I purify my water using (for items 54-56) 54. Boiling. 55. Filtration. 56. Sedimentation (allowing particles to settle below the container).

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Appendix D Women Hygiene Focus Group Discussion Guide (WaHFoG) Preamble Verbal consent sought. Thank you for joining this discussion. We want to find out your opinions, what you do concerning water hygiene issues. 1. Where do you get your drinking water from? 2. Where do you collect water for domestic use? 4. What container do you use in collecting your water? 5. Does the container you use in collectiong water have cover? 6. Where do you store your water? 7. Does your stored domestic water have cover? 8. How do you transport the fetched water home from source? 9. Where do you collect your domestic water from? 10. How often do you wash your water collection container? 11. How often do you wash your water carrying container? 12. Where do you use for convenience at home? 13. Through what means do you retrieve stored water at home for use? 14 Do you place your stored water on platform? 15. How do you purify domestic drinking water? 16. Do you disinfect domestic water? 17. What do you purify domestic water with? 18. What is your feeking about water purification tablets? 19. Does your water source have barrier to screen animals from unnecessary contact? 20. Do you prefer making water safe by screening the source? 21. How do you store domestic water? 22. How do you transport domestic water? 23. Do you use scooping to retrieve stored water for domestic use? 24. By what means do you purufy domestic water? 25. How do you retrieve stored domestic water?

Thank you for your attention and participation.

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Appendix E WATER ENHANCEMENT STRATEGIES QUESTIONNAIRE (WaHESQ) Department of Human Kinetics and Health Education, University of Nigeria, Nsukka. 25th November, 2015. Dear Sir/Madam, I am a Post graduate student of the Department of Human Kinetics and Health Education, University of Nigeria, Nsukka, currently undertaking a research project on “Water Hygiene Knowledge, Attitude and Practice among Women attending Antenatal Care in Plateau State”. Below are the major findings obtained from the study of water hygiene knowledge, attitude and practice among women attending Antenatal case in Plateau State. Based on the major findings, objectives and strategies (methods, activities and plans) were designed for adoption by Women, Government, Non-Governmental Organizations, National Orientation Agency, Health Professionals, School Authorities, Public Health Educators, Churches, Communities, Female Organizations and all who use water for the enhancement of Water hygiene knowledge, attitude and practice. As an Expert, you are kindly requested to go through the strategies (activities, methods and plans), and indicate by ticking (√ ) the degree of appropriateness or otherwise. Your comments will help to improve the final instrument. I await your kind cooperation. Yours faithfully,

Dangbin, Joseph P.

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Summary of Major Findings The major findings are summarized in line with the specific objectives and hypotheses as follows: 1. Majority (61.6%) of women attending ANC possessed correct knowledge regarding: water hygiene, water collection (75%), water source protection (74.8%), water transportation (74.2%). More than 50 per cent of women possessed correct knowledge regarding: water storage (58.3%), about one half of women possessed correct knowledge regarding PoU of water (49.2%) and over one third of women possessed correct knowledge regarding water purification (37.1%) (Table 1). 2. Over 50 per cent of women (56.4%) expressed positive attitude regarding water hygiene. Majority of the women expressed positive attitude regarding: water source protection (76.7%) and water storage (70.2%. over 50 per cent of the women displayed positive attitude towards: water purification (58.5%), water transportation (51.8%) and PoU of water (50.5%). Thirty per cent of women expressed positive attitude regarding water collection (30.6%) (Table 2). 3. Women attending ANC practised water hygiene (overall always = 32.7%, sometimes = 23.7%, rarely = 22.9%); water source protection (always = 49.9%, sometimes = 32.6%, rarely = 10.4%); water collection (always = 40.7%, sometimes = 25.6%, rarely = 16.3%), water storage (sometimes = 40.5%, always = 38.6%, rarely = 8.9%); water purification (always = 37.7%, sometimes = 33.7%, rarely = 20.3%), transportation of water (always = 34.2%, sometimes = 20.1%, rarely = 15.7%); water PoU (sometimes = 32.7%, always = 29.5%, rarely = 17.2%) (Table 3). 4. Majority of the women attending ANC possessed correct knowledge regarding water hygiene with: Nigeria Certificate in Education/National Diploma (NCE/ND) certificate (67.2%) and bachelors’ degree and above (63.6%). Women possessed correct knowledge of water hygiene with: secondary certificate/education (53.5%) and primary certificate/education (49.8%). Majority of the women possessed correct knowledge regarding: water source protection with NCE/ND (81.5%), bachelors’ degree and above (76.2%), secondary education (64.2%) and primary certificate (62.2%); water collection with NCE/ND (80.7%), bachelor degree and above (79.1%), secondary education (69.2%) and primary certificate (63.4%); water transportation with NCE/ND (78.2%), bachelor degree and above (76.9%), secondary certificate (67.5%) and primary education (65.4%); majority of the women possessed correct knowledge regarding water storage with NCE/ND (66.0%) and bachelor degree and above (62.0%), over one third of those with primary (40.0%) and secondary certificate (47.6%) possessed correct knowledge regarding water storage. More than 50 per cent of women possessed correct knowledge

176

regarding PoU of water with NCE/ND (56.3%) and bachelor degree and above (51.4%), whereas less than 40 per cent with secondary (39.3%) and primary certificate (34.8%) possessed correct knowledge regarding PoU of water. Women with NCE/ND (40.5%) and bachelor degree and above (36.2%) possessed correct knowledge regarding water purification while those with secondary (33.0%) and primary certificate (32.6%) possessed correct knowledge regarding water purification (Table 4). 5. Majority of the women possessed correct knowledge regarding water hygiene in rural areas (62.2%) and urban areas (61.0%); water transportation (rural = 75.8% > urban = 72.8%); water collection (urban = 76.3% < rural = 75.4%) and water source protection (rural = 75.4%; urban = 74.1%). Over 50 per cent of women possessed correct knowledge regarding: water storage (rural = 58.8% > urban = 57.8%) and PoU of water (urban = 50.2% > rural = 49.8%); more than 30 per cent of women possessed correct knowledge of water purification (rural = 38.1% > urban = 36.3%) (Table 5). 6. Over 50 per cent of women attending ANC expressed positive attitude towards water hygiene with secondary certificate (58.3%), primary education (55.9%), NCE/ND (55.8%) and bachelor degree and above (56.0%). Majority of the women displayed positive attitude toward: water source protection with NCE/ND certificate (78.9%), bachelor degree and above (75.7%), primary education (74.8%) and secondary certificate (73.6%); also majority of the women attending ANC expressed positive attitude towards water storage with bachelor degree (74.0%), secondary education (71.2%), NCE/ND certificate (70.0%) and primary certificate (65.2%); water purification NCE/ND certificate (62.8%) and bachelor degree and above (61.1%) and more than 50 per cent of the women expressed positive attitude toward: purification of water with secondary certificate (53.6%) and primary education (51.1%); transportation of water with primary certificate (57.7%), secondary education (54.7%), bachelor degree and above (50.7%) and about 50 per cent of those with NCE/ND certificate (49.3%); women who attended ANC displayed positive attitude towards PoU of water with secondary education (56.3%), NCE/ND certificate (48.4%) and primary education (41.8%) PoU of water with bachelor degree and above (29.1%). Forty point three per cent of women who attended ANC displayed positive attitude towards water collection with secondary certificate and primary education (34.8%), bachelor degree and above (27.2%) and NCE/ND certificate (26.9%) (Table 6). 7. More than 50 per cent of women attending ANC expressed positive attitude towards water hygiene in rural areas (56.8%) and urban areas (56.6%). Majority of the women displayed positive attitude towards water source protection with those in rural areas

177

(78.2%) and urban areas (75.5%); water storage with those in the urban areas (70.8%) and rural areas (69.5%). More than half of the women who attended ANC displayed correct attitude towards: water purification in rural areas (58.8%) and urban areas (58.2%); while water transportation in urban areas (52.4%) and rural areas (51.1%) and PoU of water in urban areas (50.5%) and rural areas (50.3%). Less than 33 per cent of the women who attended ANC expressed positive attitude towards water collection in the urban areas (31.9%) and urban areas (29.1%) (Table 7). 8. Women attending ANC practised water hygiene with: NCE/ND certificate (overall always = 41.0 %, sometimes = 27.6%, rarely = 13.0%), bachelor degree and above (always = 38.0%, sometimes 33.1%, rarely = 12.0%), primary education (always = 36.5%, sometimes = 32.0%, rarely = 18.0%), secondary education (sometimes = 36.2%, always = 33.5%., rarely = 18%); women attending ANC with NCE/ND practised water source protection thus: (always = 57.0%, sometimes = 24.8%, rarely = 9.6%), bachelor degree and above (always = 51.4%, sometimes = 35.1%, rarely = 7.7%), secondary education (sometimes = 41.7%, always = 38.4%, rarely = 12.0%), primary education (sometimes = 42.0%, always = 37.8%,

rarely = 15.0%); women with secondary

certificate practised water storage sometimes (46.7%), always (36.9%), rarely (8.6%) while those with primary certificate practised sometimes (43.0%), always (39.3%) and rarely (9.3%) whereas those with bachelor degree and above practised sometimes (42.9%), always (40.4%), rarely (7.3%) while women with NCE/ND practised always (39.3%), sometimes (36.3%) and rarely (9.6%); women with NCE/ND practised water purification always (44.0%), sometimes (33.4%), and rarely (15.0%) while women with bachelor degree and above practised sometimes (38.1%), always (36.8%) and rarely (20.1%), women with secondary education practised sometimes (33.7%), rarely (30.0%) and always (27.7%) moreover, women with primary education practised always (31.1%), rarely (29.0%) and sometimes (28.0%); women with primary education practised transportation of water always (41.1%), sometimes (17.0%), rarely (16.0%) whereas women with secondary education practised always (34.2%), sometimes (23.3%), rarely (21.0%) while women with bachelor degree and above practised always (30.8%), sometimes (22.4%) and rarely (14.6%) whereas those with women with NCE/ND practised always (30.0%), sometimes (18.9%) and rarely (14.0%) and women with secondary education practised PoU of water sometimes (39.6%), always (28.3%) and rarely (18.0%); women with bachelor degree and above practised sometimes (34.7%), always (27.8%) and rarely (5.0%) whereas women with primary education practised

178

sometimes (33.0%), always (32.6%) and rarely (19.0%) while women with NCE/ND practised always (30.0%), sometimes (29.0%) and rarely (17.0%) (Table 8). 9. The proportion of women in the rural areas practised water hygiene (overall always = 38.6%, sometimes = 31.3%, rarely = 14.5% while in the urban areas the proportion was always = 37.6%, sometimes = 30.5%, rarely = 15.2 %); the proportion of women in the rural areas practised water source protection (always = 50.4%, sometimes = 32.9%, rarely = 9.9%, whereas in the urban areas the proportion was always = 48.4%, sometimes = 32.3%), rarely = 10.8%); proportion of women in the rural areas practised collection of water (always = 41.0%, sometimes = 27.2%, rarely = 14.8% while in the urban areas the proportion was always = 40.5%, sometimes = 24.1%, rarely = 17.6%); proportion of women in urban areas who practised water purification always (39.4%), sometimes (32.0%) and rarely (21.0%) whereas in the rural areas the proportion was always (36.0%), sometimes (35.3%) and rarely (20.4%); proportion of women in urban areas who practised water storage sometimes (39.9%), always (39.3%) and rarely (9.9%) while in the rural areas the proportion was sometimes (40.1%), always (37.3%) and rarely (8.8%); proportion of women in rural areas who practised water transportation always (32.8%), sometimes (20.5%) and rarely (15.4%) whereas the proportion in the urban areas was always (32.3%), sometimes (19.7%) and rarely (16.0%); proportion of women in rural areas who practised PoU of water always (29.9%), sometimes (33.9%) and rarely (16.5%) while in the urban areas the proportion was always (29.1), sometimes (31.6%) and rarely (17.8%) (Table 9). 10. Enhancement strategies of water hygiene knowledge, attitude and practice were adgjudged very appropriate with mean of 2.55 with SD of, 559, which fall between 2.49 – 3.00; 2.62 with SD = .515, which fall between 2.49 – 3.00 and 2.65 with SD = .496, which fall between 2.49 - 3.00. These are contained in table 10, 11 and 12 respectively. 11. There was no significant difference in the water hygiene knowledge of women attending ANC according to level of education (overall χ

2

= 18.698, P-value .126 > p .05),

knowledge of water storage ( χ 2 = 27.514 > P = .001, df = 3), knowledge of collection of water ( χ 2 = 18.522 > P = .001, df = 3) and knowledge of water source protection ( χ 2 = 23.136 > P = .020, df = 3); there was significant difference in the components of water hygiene regarding knowledge of transporting of water ( χ 2 = 14.378 > P = .199, df = 3), knowledge of PoU of water ( χ purification of water ( χ

2

2

= 23.246 > P = .113, df = 3) and knowledge of

= 5.330 > P = .384, df = 3 according to level of education

These are contained in Table 13.

179

12. The null hypothesis of no significant difference with regard to the knowledge of water hygiene of women attending ANC based on location was therefore accepted (overall χ

2

= .930, P-value .533 > .05); there was no significant difference in the components of water hygiene knowledge of: storage of water ( χ

2

= .385 < P = .540, df = 1),

transportation of water ( χ 2 = 1.036 > P = .406, df = 1), collection of water ( χ 2 = .160 < P = .740, df = 1), PoU of water ( χ 2 = .846 > P = .575, df = 1), water source protection (

χ 2 = 1.202 > P = .628, df = 1) and purification of water ( χ 2 = 1.696 > P = .379, df = 1) according to location. These are contained in Table 14. 13. There was no significant difference with regard to attitude towards water hygiene of women attending ANC according to level of education (overall χ 2 = 28.584, P-value .061 > .05), attitude about transportation of water ( χ 2 = 19.924 > P = .130, df = 9) and attitude about water source protection ( χ

2

= 13.975 > P = .187, df = 9); there was

significant difference in attitude about storage of water ( χ 2 = 30.041 > P = .006, df = 9), collection of water ( χ

2

= 34.078 > P = .000, df = 9), PoU of water ( χ

=.000, df = 9) and purification of water ( χ

2

2

= 38.512 > P

= 25.447 > P = .021, df = 9) . These are

contained in Table 15. 14. There was no significant difference with regard to attitude towards water hygiene of women attending ANC according to location (overall χ 2 = 2.392, P-value .586 > .05), storage of water ( χ 2 = 2.652 > P = .483, df = 3), transportation of water ( χ 2 = 1.505 > P = .698, df = 3), collection of water ( χ 2 = 2.411 > P = .541, df = 3), PoU of water ( χ 2 = 3.735 > P = .334, df = 3), water source protection ( χ

2

= 2.532 > P = .584, df =3) and

purification of water ( χ 2 = 1.520 > P = .683, df = 3). These are contained in Table 16. 15. There was significant difference with regard to practices of water hygiene according to level of education (overall χ 2 = 32.187, P-value .023 > .05), storage of water ( χ 2 = .27 > P = .007, df = 9), transportation of water ( χ 2 = 32.32 > P = .000, df = 9), collection of water ( χ 2 = 42.03 > P = .000, df = 9), PoU of water ( χ 2 = 33.02 > P = .000, df = 9) and water source protection ( χ

2

= 27.25 > P = .007, df = 9). There was no significant

difference in purification of water ( χ 2 = 31.37 > P = .023, df = 9). These are contained in Table 17. 16. There was no significant difference with regard to practices of water hygiene of women attending ANC based on location (overall χ

2

= 2.077, P-value .586 > .05), storage of

water ( χ 2 = 1.638 > P = .672, df = 3), transportation of water ( χ 2 = 2.107 > P = .551, df

180

= 3), water collection ( χ 2 = 3.25 > P = .422, df = 3), PoU of water ( χ 2 = 1.999 > P = .591, df = 3), water source protection ( χ 2 = 1.584 > P = .673, df = 3) and purification of water ( χ 2 = 1.884 > P = .607, df = 3). This is contained in Table 18. Water Hygiene Enhancement Strategies Questionnaire (WaHESQ) Key: VA= Very Appropriate; A = Appropriate; NA = Not Appropriate PART ONE Overall Summary of Major Findings on Knowledge of Water Hygiene About 62 per cent of women attending ANC possessed correct knowledge regarding water hygiene

Strategy (Methods Plan/Activity)

Awareness a.

Preparing and distributing knowledge of water hygiene manual, pamphlets and hand bills on water hygiene issues to women during water day celebration. b. Periodic display of posters describing correct steps of safe water at source, during collection, transportation storage and point of use of water. c. Pasting of write ups on knowledge of water hygiene at religious organizations, schools, public places and community town hall notice boards. d. Distribution and pasting of pictorial pictures portraying safe water collection, transportation, storage and point-of-use (PoU) of water. Education e.

Using pictures on water collection, storage, transport and PoU of water to educate stakeholders regarding water hygiene. f. Share pamphlets regarding water source collection, transportation, storage and PoU of water to teach stakeholders. g. Demonstrate safe ways to collect water, safe transportation of water, safe storage and safe PoU of water during meetings at community halls. h. Workshop on how to store water above the ground in a covered container; i. Demonstrate how to keep drinking water away from other liquids to women; i. Demonstrate how to purify water to women; j. Avoid contacting water with any part of the human body Advocacy

k. .Seventy five per cent of women possessed correct knowledge regarding water collection

House to house visit by influential members of the communities appealing to women for the: Appeal to avoid contacting safe water with any part of the human body.

l.

Workshop on safe ways to clean and dry water carrying containers before collecting water; m. Explain how to collect water safely to women. n. Displaying correct steps regarding correct and safe ways of collecting water from source and stored sources o. Pasting of phamphlets containing correct and safe ways to collect water at source and from stored sources on notice boards at sources of water and meetings Advocacy p.

Appeal by influential people to clean, disinfect and dry water carrying container before collecting water in it.

VA

A

NA

181 Seventy four per cent of women possessed correct knowledge regarding water transportation

Education q. Regular workshops and seminars on how to transport safe water; r. Use of safe methods to transport and collect safe water by women; s. Workshop on how to transport safe water; t. Workshop on safe ways to clean and dry water carrying containers before collecting water u. Using covered container to convey safe water v. Using clean, dried and clean containers to collect water

Over one half of women possessed correct knowledge regarding water storage.

Education w. Explain the characteristics of safe water storage container to women; x. Demonstrate how to wash and disinfect water storage container to women y. Demonstrate how to retrieve stored water to women; Advocacy

About seventy five per cent of women possessed correct knowledge regarding water source protection.

Education

z.

Appeal to retrieve stored water through the spigot;

aa. Demonstrate safe ways to collect water, safe transportation of water, safe storage and safe PoU of water during meetings at community halls. bb. Regular workshops and seminars on how to: cc. Build fence around water source to screen animals and human wastes from getting into to water source; dd. Displaying posters appearing clean water carrying container as against dirty one used for both collection and retrieval of water from storage media ee. Displaying posters containing the correct and safe water source protecting pictures at town hall notice boards, notice boards and public places Advocacy House to house visit by influential members of the communities appealing to women for the: ff. Building of buffers around water source; gg. Regular workshops and seminars on how to drain stagnant water around water source away from such site;

About one half of women possessed correct knowledge of regarding PoU of water

.

Education hh. Distribution and pasting of pictorial pictures portraying safe water collection, transportation, storage and point-of-use (PoU) of water. ii. Using pictures on water collection, storage, transport and PoU of water to educate stakeholders regarding water hygiene. jj. Share pamphlets regarding water source collection, transportation, storage and PoU of water to teach stakeholders. kk. Demonstrate safe ways to collect water, safe transportation of water, safe storage and safe PoU of water during meetings at community halls. Entertainment Education dd. Removing water at PoU through the spigot (narrow opening)

182

PART TWO Overall Summary of Major Findings on Practises of Water Hygiene More than half of the women in the urban and rural areas practised water source protection Over one half of the women with NCE/ND more than bachelor degree and above more than primary and secondary certificate holders always practised water source protection Over one half of the women with NCE/ND more than bachelor degree and above more than primary and secondary certificate holders always practised water source protection Over half of women with NCE/ND certificate always more than bachelor degree holders and above always practiced water source protection than secondary school and primary school holders sometimes practised water source protection.

About one half 48.4 per cent of women in the rural than urban areas practised water collection always.

VA

Entertainment Education a. Screening my source of water from animals and human wastes as well as refuse by building a buffer zone or fence around it. b. Participating in drama display on water source protection c. Draining spilled water around the surface at the source away from my water source. d. Keeping away washing, soak away and bathing at least 30 meters away from source of water e. Protecting storm water from mixing with safe water source f. Avoiding throwing impurities into water source Community Mobilization a. b. c. d. e.

Education a. Participating in water source protection programmes b. Learning from the programmes of water source protection and teach others how to protect water source. c.

f. g. h. i. j. k.

Over 30 per cent of women in the urban and rural areas practised water purification

Planning roster to clean and tidy water source Avoiding washing and bathing around water source. Learning from the programmes of water source protection and teach others how to protect water source Planning roster to clean and tidy water source Implementing various practices learnt from water source protection programmes.

Aways washing and drying water collecting container before collecting safe water in it. Ensuring that safe collected water is covered at all times. Keeping safe water collected covered and should be kept above the ground, preferably on a height. Keeping animals and children away from contacting safe collected drinking water. Removing stored safe water through a spigot Transporting anc collecting safe water in clean and covered container

l. Regularly cleaning storage container from time to time m. Boiling my water and allow it to cool in hygiene container before drinking. n. Using water purifying tablets such as alum, aquatab and others to purify water. o. Filtering water with suspended particles before using same. p. Storing safe water in covered container

A

NA

183

PART THREE Overall summary of Major Findings on Attitude of Water Hygiene One half of women expressed positive attitude towards water hygiene Fifty eight per cent of women expressed positive attitude towards water hygiene with secondary certificate more than primary Education than NCE/ND and bachelor degree and above About 7 per cent of women displayed positive attitude regarding water source protection Seventy per cent of women expressed positive attitude towards water storage Over one half of women displayed positive attitude towards water purification About 52 oer cent of women displayed positive attitude regarding transportation of water One half of women displayed positive attitude towards PoU of water Less than one third of women displayed positive attitude towards water collection Fifty eight per cent of women expressed positive attitude towards water hygiene with secondary certificate more than primary education than NCE/ND and bachelor degree and above

Strategy (methods plan/activity)

VA

Information a. Liking to make available various water purification tablets and equipments in shops and it distribution to households for use. b. Prefering to provide pictorial information to community members concerning using clean and disinfected container to retrieve water at PoU, water storage collection and transportation that are pasted at water sources, homes and public notice boards. c. d.

e.

Liking to provide information expressing safe water sources and various qualities of safe water. Liking to provide pictorial information on the prohibition of opened defecation and indiscriminate surface application of fertilizers on slopes and near source water pasted at homes, public places, and notice boards. Prefer to lobby and negotiate with mass media to broadcast influencing messages to the community members concerning safe sources of water.

Entertainment Education a. Like using stories and songs to influence safe collection of water, transportation, storage and PoU of water. Advocacy f. Like the appeal by influential members of the communities to collect safe water in narrow mouth containers with a lid. Information Provision of information in text and pictures to influence: b. The preference to collecting water with clean and covered container; g. Preference to provide information displaying risks and benefits of collecting, storage, transportation and PoU of water to women. h. Prefering to celebrate water day among family members and friends and friends display how water is collected, stored, transported and purified. i. Prefering to provide pictorial information to community members concerning using clean and disinfected container to retrieve water at PoU, water storage collection and transportation that are pasted at water sources, homes and public notice boards.

Remark/Note Please indicate in the space below any modifications you would wish me to make. Thank you for your anticipated cooperation. Name:……………………………………… Signature:………………………………… Date:………………………………………..

A

NA

184

Appendix F LIST OF LOCAL GOVERNMENT AREAS IN THE SENATORIAL ZONES OF PLATEAU STATE WITH ANTENATAL CARE FACILITIES (ANCF) a. Northern Senatorial Zone LGAs i. Bassa ii. Barkin-Ladi iii. Jos North iv. Jos East v. Jos South vi. Riyom b. Central Senatorial Zone LGAs i. Bokkos ii. Kanke iii. Kanam iv. Mangu v. Pankshin c. Southern Senatorial Zone LGAs i. Langtang North ii. Langtang South iii. Mikang iv. Qua’an Pan v. Shendam vi. Wase

185 Appendix G LIST OF PLATEAU STATE SENATORIAL ZONE ANTENATAL CARE FACILITIES (ANCF) NORTHERN SENATORIAL ZONE ANCF BY LOCAL GOVERNMENT AREAS (LGA): BARKIN LADI S/NO

Name of state

Name of LGA

Political wards

Name of Health Facility

1 2 3 4 5 6 7 8 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 35 36 37 38

Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau

Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi

Gafat

Gen. Hospital PHC Gafat PHC of Gana Ropp PHC Secretariat B/Ladi PHC Rakwok PHC Barkin Ladi (Gwol) PHC Staff Clinic B/Ladi PHC Dental Clinic B/Ladi Sunah Clinic/Maternity Sauki Clinic Na’Allah Na Kowa Clinic. PHC Ta-Kwok PHC Mazat PHC Tudun Mazat PHC Rahol Mazat PHC Dorowa Babuje PHC Maraba Kantoma PHC Lobiring PHC Marit PHC Gassa PHC Sho PHC Kura falls PHC Zakarek PHC Makoli PHC Kai PHC Uyurai PHC dispensasry K/Falls PHC Kakuruk PHC Hai PHC Kuzen PHC Ruku PHC Rite PHC Barkin Joji PHC Rahai PHC Fa Lo

39 40 41 42 43 44 45

Plateau Plateau Plateau Plateau Plateau Plateau Plateau

Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi

46 47 48 49 50 51 52 53

Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau

Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi

54 55 56 57 58

Plateau Plateau Plateau Plateau Plateau

Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi

59 60 61 62

Plateau Plateau Plateau Plateau

Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi

63 64

Plateau Plateau

Barkin Ladi Barkin Ladi

Rakwok

Ta-kwok Mazat

Lobiring

Marit Gassa Sho Kurra falls

Kakuruk

Tafan/Nwo k “A”

Tafan/Nwo k “B”

Heipang

Pwomol Chit Kapwis

KapwenKet

KamangNafor Zabot

PHC Tussung PHC Nziring PHC Nding PHC Kanakong PHC Razek (WIH) PHC Dorowan Tsoho PHC Bawan Dodo PHC Rahai PHC Kugot PHC Rabwak PHC Tatu PHC Larwin PHC Heipang PHCPCH Kpang PHC Chit

Antenatal care (ANC) facility present

























Category

Ownership




Secondary PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC

Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt.









PHC PHC PHC PHC PHC PHC PHC

Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt.

PHC PHC PHC PHC PHC PHC PHC PHC

Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt.

PHC PHC PHC PHC PHC

Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt.











PHC Kapwis PHC Zakupang PHC Pandadi PHC Dorong PHC Bakin Kogi





PHC Kuzek PHC Zaron PHC Vat Njong PHC Mai Idin Toro







PHC PHC PHC PHC

PHC Bisichi PHC Rasat





PHC PHC




186 65 66 67 68 69

Plateau Plateau Plateau Plateau Plateau

Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi Barkin Ladi








PHC Foron PHC Ratt PHC D-Nahawa

PHC PHC PHC PHC PHC

Local Govt. Local Govt. Local Govt. Local Govt. Local Govt.

Category

Ownership

Secondary PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC

Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt.

NAME OF LGA: BASSA S/N

Name state

70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 104 105 106 107 108 109 110 111 112 113 114

Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau

of

Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau

Name LGA

of

Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa Bassa

Political wards

Name of Health Facility

Buhit

Cottage Hospital Bassa PHC Jebbu Bassa PHC PSSD Sch. PHC Assak PHC Bakin Kogi PHC Bugu PHC Fuskan Mata PHC Rumfa Gwamna PHC Kpasho PHC Mista-Ali PHC Gurum PHCTarya PHC Jengre PHC Pandauda PHC Pandauda Shanu PHC Sarkin Shau PHC Government College SDA Hopital Jengre PHC Amo Katako PHC Zagun PHC Igbak PHC Kihanag Military Hopsital Bassa PHC Kawam PHC Maiyanga PHC Dundu PHC Buyo PHC Kishi I PHC Kishi II PHC Binchi PHC Kishika PHC Kasakuk PHC Mafara PHC Rimi PHC Ta’agbe PHC Hukke PHC Kpara PHC Zabolo PHC Zauaki PHC Tumu Sarari PHC Miango PHC Miango Town PHC Kwall PHC Dreedam

Assak Bakin Kogi Buji Gabia Gurum “A” Gurum “B” Jengre

Kadamo Kakkek

Kasuru Kimakpa Kishika

Mafara Rimi Ta’agbe Tahu Zabolo

Zabwu Zodu

Antenatal care (ANC) facility present










































NAME OF LGA: JOS EAST S/N

Name of state

Name of LGA

Political wards

Name of Facility

200 201 202 203 204 205 206 207 208

Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau

Jos East Jos East Jos East Jos East Jos East Jos East Jos East Jos East Jos East

Jarawan Kogi “A”

Gen. Hospital PHC Nashanang PHC Angware PHCNew land PHC Kauna PHC Gada PHC Dadin Kaura PHC Fadan Fobur PHC Sabon Kura

Jarawan Kogi “B” Fobur central

Health

Antenatal care (ANC) facility present

Category

Ownership

Secondary PHC PHC PHC PHC PHC PHC PHC PHC

State Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt.

187 209 210 211

Plateau Plateau Plateau

Jos East Jos East Jos East

Fobur East Fobur “A”

212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 324 235 236 237 238 239 240 241 242 243 244

Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau

Jos East Jos East Jos East Jos East Jos East Jos East Jos East Jos East Jos East Jos East Jos East Jos East Jos East Jos East Jos East Jos East Jos East Jos East Jos East Jos East Jos East Jos East Jos East Jos East Jos East Jos East Jos East Jos East Jos East Jos East Jos East

Fobur “B”

S/N

Name state

of

Name LGA

245

Plateau

Jos North

246 247 248 249

Plateau Plateau Plateau Plateau

Jos North Jos North Jos North Jos North

250 251 252 253 254 255 256

Plateau Plateau Plateau Plateau Plateau Plateau

Jos North Jos North Jos North Jos North Jos North Jos North Jos North

257 258

Plateau Plateau

Jos North Jos North

259 260 261 262 263 264 265 266 267 268 269 270 271 272 273

Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau

Jos North Jos North Jos North Jos North Jos North Jos North Jos North Jos North Jos North Jos North Jos North Jos North Jos North Jos North Jos North

Fobur “B” west

Shere west Sbere central Shere East Naton Fusa Fadan Fursum

PHC Boda PHC Sabon Fobur PHC COCIN Fobur Ekan PHC Rizek PHC Kerker PHC Nuratong PHC Sabon Gari PHC Laminga PHC Zarazong PHC Durbi PHC Shere Ekan PHC Dinya PHC Shere Jankasa PHC Kashidung PHC Naton Fusa PHC Bayan Dutse PHC Fusa PHC Fewit PHC Ribung PHC COCIN Gora PHC N-Jajel

Fursum

PHC Niji PHC Nabar Zabir PHC Keben Koromin PHC febas Nakwang PHC Nakwang PHC Dorong Zandi PHC Zandi PHC Zigam PHC Riseh Maigemu PHC Maigemu PHC Godong PHC Danche NAME OF LGA: JOS NORTH of

Political wards

Name of Facility

Tudun

Plateau Specialist hospital PHC Tudun Wada Jos PHC Dong Jos Wholistic Health centre Foundation Medical centre Godiya Clinic Focus medical centre Nareeedeen clinic PHC Township PHC Abbana Shehu PHC Gangare Jos Jos University Teaching Hosp. FOMWAN clinic Kowa special research hosp. School clinic PHC Dogon Agogo Comfort Maternity Marnathaer hospital ECWA Evangel Hosp. OLA Hosp. Amaco research centre Faith alive hospital GMZA Eye Clinic Mikan clinic PACO Hospital PHC Ali Kazaure PHC Naraguta Jos PHC Bable PHC Angwan Rogo

Ibrabim Kasina Gangare

Garba Daho Abba Na-shehu Vandapuye

Tafawa Balewa

Ali Kazaure Tragunrig Izan Angwa Rogo/Rimi

Health

Antenatal care (ANC) facility present

PHC PHC PHC

Private Private Local Govt.

PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC

Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Private Community Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Mission Community Private. Private Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt.

Category

Ownership

Secondary

State Govt.

PHC PHC PHC Secondary

Local Govt. Local Govt. Mission Private

PHC Secondary PHC PHC PHC PHC Tertiary

Private Private Mission Local Govt. Local Govt. Local Govt. Fed. Govt.

Secondary Secondary

Private Private

PHC PHC Secondary Secondary Secondary Secondary Secondary Secondary Secondary Secondary Secondary Secondary PHC PHC PHC

Local Govt. Local Govt. Private Private Mission Mission Private Mission . Private Private Private Local Govt. Local Govt. Local Govt. Local Govt.

188 274 275 279 280 281 282 283 284 285 286 287 288 289 290 291 292

Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau

Jos North Jos North Jos North Jos North Jos North Jos North Jos North Jos North Jos North Jos North Jos North Jos North Jos North Jos North Jos North Jos North

293

Plateau

Jos North

294 295

Plateau Plateau

Jos North Jos North

Naraguta “A” Lamingo Mazah Kabong Jenta Adamu Jenta Apata

Ahol

PHC Rimi Suna Hospital PHC Nassarawa Edurance Clinic Salaco Hospital PHC Dogon Dutse PHC Lamingo PHC Kuwanga PHC Mazah PHC Kabong GOZ clinic PHC Jenta Adamu Ande Hospital PHC Jenta Apata PHC Utan New Christian Hospital3 Brendan Memorial hospital PHC Yellwan Zangam PHC Motor Park

PHC PHC PHC PHC Secondary PHC PHC PHC PHC PHC PHC PHC Secondary Secondary PHC PHC

Local Govt. Private Local Govt. Private Private Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Private Local Govt. Local Govt. Private Private Local Govt. Local Govt.

NAME OF LGA JOS SOUTH S/N

Name of state

Name of LGA

Political wards

Name of Facility

296 297 298

Plateau Plateau Plateau

Jos South Jos South Jos South

Zawan “A”

299 300 301

Plateau Plateau Plateau

Jos South Jos South Jos South

302 303 304 305 306 307 308 309 310 311 312 313 314 315 316 317 318 319 320 321 322 323 324 325 326 327 330 331 332 333 334 335 336

Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau

Jos South Jos South Jos South Jos South Jos South Jos South Jos South Jos South Jos South Jos South Jos South Jos South Jos South Jos South Jos South Jos South Jos South Jos South Jos South Jos South Jos South Jos South Jos South Jos South Jos South

Plateau Plateau Plateau Plateau Plateau Plateau Plateau

Jos South Jos South Jos South Jos South Jos South Jos South Jos South

337 338 339 340

Plateau Plateau Plateau Plateau

Jos South Jos South Jos South Jos South

PHC Kwata Salama Clinic Women in Health Zawan Police Staff college OLA Hospital Comprehensive Hospital PHC Du TCNN Clinic PHC Rayfield PHC Gura Topp PHC Kwang Siban Cho Hospital PHC Shen PHC Doi PHC Waduruk PHC Kazong Tim-Tim Clinic PHC Abattoir NAF Hospital PHC Hwolshe Tadam Medical Centre New Health Clinic PHC Bukuru Central Tausayi clinic Farida clinic ECWA Clinic Sita Clinic Sunnah Clinic Aminchi Clinic PHC Gyel COCIN Clinic Specialist Hospital PHC Kangang PHC State Lowcost PHC Sot Gyel PHC Gurariyom PHC Vom Vwang PHC Chakarum Women in Health Chaha Vom Christian Hospital PHC Kogom PHC Chugwi PHC Chol-Chugwi

Zawan “B” Du “A” Du “B”

Shen

Giring Hwolshe bukuru

Gyel “A”

Sot Vwang

Chugwi

Health

Antenatal care (ANC) facility present

Category

Ownership

PHC PHC PHC

Local Govt. Private Community

Secondary Secondary Secondary

Fed. Govt. Mission State Govt.

PHC PHC PHC PHC PHC Secondary PHC PHC PHC PHC PHC PHC Secondary PHC Secondary Secondary PHC PHC Secondary PHC PHC PHC PHC PHC PHC Secondary PHC PHC PHC PHC PHC PHC PHC

Local Govt. Mission Local Govt. Local Govt. Local Govt. Private Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Fed. Govt. Local Govt. Private Private Local Govt. Private Private Mission Private Private Private Local Govt. Local Govt. Private Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Community

Secondary PHC PHC PHC

Mission Local Govt. Local Govt. Local Govt.

189 341 342 343

Plateau Plateau Plateau

Jos South Jos South Jos South

344 345 346

Plateau Plateau Plateau

Jos South Jos South Jos South

347 348 349 350 351 352

Plateau Plateau Plateau Plateau Plateau Plateau

Jos South Jos South Jos South Jos South Jos South Jos South

Turu “A” Turu “B”

Kuru “A”

Kuru “B” Kushe Dahonong

PHC Heitafwil PHC Farin Lamba Mandela Clinic Kaduna Vom PHC Dahwol-lal PHC Kuru III Science School Clinic Kuru Practice Area Kuru GSTC Clinic PHC Kuru II Lowrack Hospital Apolo Clinic PHC Heitafwil

PHC PHC PHC

Local Govt. Local Govt. Local Govt.

PHC PHC PHC

Private Local Govt. Local Govt.

PHC PHC PHC Secondary PHC

Local Govt. State Govt. Local Govt. Local Govt. Private Private

NAME OF LGA: PANKSHIN S/N

Name state

of

Name LGA

655 656

Plateau Plateau

Pankshin Pankshin

657 658 659 660

Plateau Plateau Plateau Plateau

Pankshin Pankshin Pankshin Pankshin

661 662 663

Plateau Plateau Plateau

Pankshin Pankshin Pankshin

664 665

Plateau Plateau

Pankshin Pankshin

666 667 668 669 670 671 672 673 674 675 676 677

Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau

Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin

678 679 680 681 682 683 684 689 690 691 692 693 694 695 696 697 698 699 700 701 702 703 704 705 706

Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau

Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin

of

Political wards

Name Facility

Pankshin

Gen. Hospital PHC Town Clinic Pankshin PHC Vel PHC Dilla PHC Wulmu Govt. College Clinic Pankshin GSS Clinic Pankshin St. Benedick Pankshin Medical Centre Pankshin Frank Clinic Pankshin Standard Medical Laboratory All Comfort Clinic Salam Dispensary Buns Clinic PHC Fwor PHC Chigwong PHC Shippang PHC Kalep PHC Wentul PHC Mudel PHC Dung-Wuseli PHC Wuseli central PHC Nyelleng

Wuchenbe

Wuseli Mukang Nyelleng

Kasgong

Wokkos

Lankan

Kadung

of

Health

PHC Mier PHC Gwabi Bok PHC Gasharak PHC Kadyis PHC Fumbis PHC Tambes PHC Duk PHC Dungye PHC Kulingwong PHC Korlok COCIN Maternity PHC Tazuk PHC Kwalla Wokkos PHC Wokkos Central PHC Gile PHC Dang PHC Jimin PHC Lankan PHC Ninukut GSS Clinic Jak PHC Jivir Mwel PHC Gurup PHC Kumbul PHC Gilling

Antenatal care (ANC) facility present

Category

Ownership

Secondary PHC

State Govt. Local Govt.

PHC PHC PHC PHC

Local Govt. Local Govt. Local Govt. State Govt.

PHC PHC PHC

Min. of Education Mission Private

PHC PHC

Private Private

PHC PHC PHC PHC PHC PHC

Private Private Private Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt.

PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC

Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt.

190 707 708 709 710 711 712 713 714 715 716 717 718 719 720 724 725 726 727 728 729 730 731 732 733 734 735 736 737 738 739 740 741 742 743 744 745 746 747 748 749 750 751

Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau

Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin

Longbam Dok-Pai

Chip central

Tal “A” Tal “B” Kangmun Jiblik

Fier

Jing Kagu

Kangshu

COCIN Clinic Kumbul PHC Jibam Women in Health Kapil PHC Dok-Pai PHC Bwer PHC Nkup PHC Chip PHC Nadu PHC Shoro PHC Jepmidel PHC Hikmuram PHC Tal PHC Mungne PHC Mungkohort PHC Jiblik PHC Dyis PHC Guzah Retyil- Dyis PHC Fier PHC Kromlu PHC Mile 8 PHC Takkas PHC Posat PHC Fifen PHC Dungkwak PHC Bumnan PHC Jakwal Bony Dispensary COCIN Dispensary PHC Sihin PHC Jing PHC Kagu PHC Laplek PHC Dagmet PHC Guntong Baptish High Clinic COCIN Clinic Kagu PHC Kwanka PHC Jinjim PHC Janaret Goung Memorial clinic COCIN Maternity Janaret

PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC

Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Private Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Private

NAME OF LGA: RIYOM S/N

Name state

811 812 813 814 815 816 817 818 819 820 821 822 823 824 825 826 827 828 829 830 831 832 833 834

Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau

of

Name of LGA

Political wards

Name of Health Facility

Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom

Riyom

Gen. Hospital PHC Riyom Ganweng Clinic Ade J/ Memorial Clinic Da-Pam Fom Clinic PHC Kwi PHC Kwi-Riyom PHC Wereng PHC Wereng Camp PHC Wereng Kerana PHC Janyaro PHC Dabwan PHC Baten GSS Clinic PHC Ra-Hoss PHC Mere PHC Got-Hoss PHC Bindi PHC Ta-Hoss PHC Gonkot PHC Jol PHC Daku PHC Janda PHC Korofang

Kwi Wereng Kwok

Ra-Hoss

Ta-Hoss Fanroi Jol

Dantoe

Antenatal care (ANC) facility present

Category

Ownership

PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC

State Govt. Local Govt. Private Private Private Private Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt.

191 835 836 837 838 839 840 841 842 845 846 847 848 849 850 851 852 853 854 855 856 857 858 859 860 861 862 863 864 865 866 867 868 869

Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau

Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom Riyom

PHC Koronihio PHC Gotron PHC Bum PHCDanwal PHC Tamboron PHC Sopp PHC Tom Gangare PHC Dajak PHC Kwakwi Private Clinic Kwakwi PHC Kwakwi Station PHC Sharubutu PHC Bangai Women in Health Bangai PHC Ganawuri PPFN Ganawuri PHC Danuwal PHC Shonong PHC Nichi PHC Zere PHC Law PHC Fang PHC Korrong Fang PHC Sehshong PHC Rim PHC Dyan PHC Kwogo PHC Nichi PHC Rafin Acha PHC Bindi PHC Bachit PHC Rakwang Bachit PHC Kwa-Bachi

Bum

Sopp

Sharubutu

Dantse

Shonong

Rim Kwogo

Bachit

PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC

Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Private Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt.

CENTRAL SENATORIAL ZONE NAME OF LGA: BOKKOS S/N

Name state

115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143

of

Name of LGA

Political wards

Name of Facility

Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau

Bokkos Bokkos Bokkos Bokkos Bokkos Bokkos Bokkos Bokkos Bokkos Bokkos Bokkos Bokkos Bokkos Bokkos Bokkos Bokkos Bokkos Bokkos Bokkos

Bokkos central

Gen. Hospital PHC Makada PHC Bot PHC Dakanung PHC Ruwi PHC Ngochom Luna Hospital PHC Kopmadarken PHC Matol PHC Bokkos Jibwis Clinic Kauna Hospital PHC Pykmalu PHC Mandung PHC Tangur Gida PHC Ndun PHC Kawel

Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau

Bokkos Bokkos Bokkos Bokkos Bokkos Bokkos Bokkos Bokkos Bokkos Bokkos

Bokkos west

Tangur

Mushere North PHC Garah COCIN Kawel Langle Memorial Clinic Kawel Women in Health Mbar PHC Mbar PHC Magor PHC Mangar PHC Horom PHC Daffo PHC Josho PHC Hottom PHC Maiduna COCIN Daffo

Health

Antenatal care (ANC) facility present
























Category

Ownership

Secondary PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC

State Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Private Private Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt.

PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC

Private Community Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Mission

192 144 145 146 149 150

Plateau Plateau Plateau Plateau Plateau

Bokkos Bokkos Bokkos Bokkos Bokkos

Community Clinic Daffo Musa Memorial Clinic Daffo Alan Memorial Clinic Josho Bargesh/Ambul

151 152 153 154 155

Plateau Plateau Plateau Plateau Plateau

Bokkos Bokkos Bokkos Bokkos Bokkos

Gwande

156 157 158 159

Plateau Plateau Plateau Plateau

Bokkos Bokkos Bokkos Bokkos

160 161 162 163

Plateau Plateau Plateau Plateau

Bokkos Bokkos Bokkos Bokkos

Kamwai

164 165 166

Plateau Plateau Plateau

Bokkos Bokkos Bokkos

Kwatas

167 168 169

Plateau Plateau Plateau

Bokkos Bokkos Bokkos

170 171

Plateau Plateau

Bokkos Bokkos

172 173 174 175

Plateau Plateau Plateau Plateau

Bokkos Bokkos Bokkos Bokkos

176

Plateau

Bokkos

177

Plateau

Bokkos

178 179

Plateau Plateau

Bokkos Bokkos

Mandar

184 185 186

Plateau Plateau Plateau

Bokkos Bokkos Bokkos

Mushere central

187 188 189

Plateau Plateau Plateau

Bokkos Bokkos Bokkos

Mushere west

190 191 192 193 194 195 196 197 198 199

Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau

Bokkos Bokkos Bokkos Bokkos Bokkos Bokkos Bokkos Bokkos Bokkos Bokkos

Richa

Butura

Manguna

Sha Toff




PHC Dashid COCIN Dispensary Ambul PHC Gwande PHC Karfa COCIN Kunet PHC Maikatako Govt. College Clinic Butura PHC Butura PHC Kuba Zion Clinic Kuba Salvation Dispensary Maikatako PHC Kamwai PHC Amban PHC Wanze Malenshak Dispensary Amban PHC Kwatas PHC Mazere Women in Health Marish PHC Wumat PHC Changet Alheri Dispensary Sabon Barki Esvi Clinic Marish Unity Dispensary Dimish PHC Manguna PHC Mahurum PHC Hurti Women in Health Danbwash Masau Dispensary Manguna Alans Dispensary Manguna PHC Tenti PHC Nghassi




PHC PHC PHC PHC PHC

Community Private. Private Local Govt. Local Govt.








PHC PHC PHC PHC PHC

Local Govt. Local Govt. Local Govt. Local Govt. Local Govt.





PHC PHC PHC PHC

Local Govt. Local Govt. Private Private





PHC

Local Govt.

Private



Private Private




Community Private Private




PHC Mushere PHC Kangyer COCIN Clinic Musher PHC Kaban PHC Hokk Tanak Dispensary Horop PHC Richa PHC Digot PHC Siken PHC Horom Mangam Clinic Richa Taimako Clini Richa PHC Sha Ajan Dispensary Sha COWAN Clinic Toff COWAN Clinic Karkwa

Local Govt. Local Govt. Mission Local Govt. Local Govt. Private Local Govt. Local Govt. Local Govt. Local Govt. Private Private Local Govt. Local Govt. Local Govt. Local Govt.

NAME OF LGA: KANAM S/N

Name of state

Name of LGA

353 354 355

Plateau Plateau Plateau

Kanam Kanam Kanam

Political wards

Name of Facility

Health

Gen. Hospital PHC secretariat Dengi PHC GSS Dengi

Antenatal care (ANC) facility present

Category

Ownership

PHC PHC PHC

Local Govt. Private Community

193 356 357 358 359 360 361 362 363 364 365 366 367 368 369 370 371 372 373 374 375 376 377 378 379 380 381 382 383 384 387 388 389 390 391 392

Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau

Kanam Kanam Kanam Kanam Kanam Kanam Kanam Kanam Kanam Kanam Kanam Kanam Kanam Kanam Kanam Kanam Kanam Kanam Kanam Kanam Kanam Kanam Kanam Kanam Kanam Kanam Kanam Kanam Kanam Kanam Kanam Kanam Kanam Kanam Kanam

Kunkyam Gar/Bagyar Namanar

Gumshar Gargar

Munbutbo Kyaram Beribyang Hkantana

Gagdi

Kanam Dugub Gidgid Gyambar Jarmai Jom

PHC GC Dengi PHC Dengi PHC Kunkyam PHC Yipmong PHC Bagyar PHC Namggar PHC Kafel PHC Namran PHC Dutse Kura (WH) PHC Bankilong PHC Gargar Mban PHC Gargar Kufai PHC Lugur PHC Munbutbo PHC Kuyawa PHC Yamini PHC Sharuwa PHC Dogon Ruwa PHC Katana PHC Furyam PHC Tukur PHC Gagdi PHC Gagdi Town PHC Angwa Hakimi PHC Gwarlak PHC Gwanan PHC Kwalmiya PHC Takyiroh PHC Dugub PHC Gwamlar PHC Gidgid PHC Gyanggyang PHC Gyambar PHC Jarmai PHC Jom

PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC

State Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt.

NAME OF LGA: KANKE S/N

Name state

393 394 395 396 397 398 399 400 401 402 403 404 405 406 407 408 409 410 411 412 413 414 415 416 417 418 419 420 421 422 423 424

Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau

of

Name of LGA Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke

Political wards

Name of Health Facility

Kabwir Pada

Gen. Hospital PHC secretariat NPHC Kabwir PHC Myalche PHC Kwal PHC Lur PHC Kabwir PHC Garyang PHC Gyanggyang PHC Kabwir Gyangyang PHC Gomadaji PHC Mimyak Govt. College Clinic PHC Dangkang PHC Pire PHC Nyayit PHC Kurum Garam PHC Kom Garam PHC Tigya Garam PHC Leptul PHC Dun-garam PHC Nemel PHC Kulla Tabulung PHC Kazuk PHC Gakshat PHC Amper PHC Lerpye PHC Lumpye PHC Kagar PHC Mwel PHC Sharram

Kabwir Gyangyang

Amper Chika “B”

Garam

Nemel Tabulung

Amper Chika “A”

Ampang East

Antenatal (ANC) present

care facility

Category

Ownership

Secondary PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC

Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt.

194 427 428 429 430 431 432 433 434 435 436 437 438 439 440 441 442 443 444 445 446

Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau

Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke Kanke

Kangmun Langshi Kwarip

Kurum Gunji Shiwer Gugur Dawaki

Somji

Amper Seri

PHC Forkong PHC Tom-Tom PHC Munok PHC Langshi PHC Tuwan PHC Rong PHC Lebwit PHC Gunji PHC Kurrum Amper PHC Shiwer PHC Gugur PHC Myet PHC Bongah PHC Pukdi PHC Dawaki PHC Songsong PHC Somji PHC Jimi PHC Bolkon PHC Golbong

PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC

Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt.

Category

Ownership

Secondary Secondary Secondary Secondary Secondary PHC PHC PHC PHC PHC PHC PHC PHC PHC Secondary PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC

State Govt. Private Private Private Mission Local Govt. Local Govt. Private Private Private Private Private Private Mission Private Local Govt. Private Private Private Private Local Govt. Local Govt. Local Govt. Community Community Community Community Community Community Community Community Local Govt. Private Private Local Govt. Mission Local Govt. Community Community Local Govt. Local Govt. Private Private Private Local Govt. Local Govt. Local Govt. Private

NAME OF LGA: MANGU S/N

533 534 535 536 537 538 539 540 541 542 543 544 545 546 547 548 549 550 551 552 553 554 555 556 557 558 559 560 561 562 563 564 565 566 567 568 569 570 571 572 573 574 575 576 577 578 579 580

Name of state Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau

Name of LGA Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu

Political wards

Name of Health Facility

Mangu I

Gen. Hospital Medical centre Royal Medical Centre Allah Na Kowa Mangu Rehabilitation centre PHC Mangu PHC Barkin Gida Sauki Medical Laboratory Kingsway dispensary Godiya Clinic Julie Memorial clinic Nandi clinic Peoples clinic COCIN clinic Nisi Dominus Medial centre Mangu Dispensary Denis King clinic Tausayi clinic Nenman Family Health Jags clinic PHC Mangu Halle PHC Farin Kassa PHC Gyambwas Family Support Clinic Community clinic Bunga Community clinic Ruvwang Community Clinic Hiktup Community clinic Chisu Community Clinic Millet Community clinic Jakkom Community clinic Murish PHC Niyes Kwalandos Clinic Walshak clinic PHC Panyam Rural Health Centre Panyam PHC Ajing Community Clinic Washna Community clinic Telengteng Community Clinic Telengpat PHC Kereng PHC Fomulam Banyol Clinic Women in Health Gwet Women in Health Gohotkun PHC Kopshu PHC Fwam PHC Fwangkwap

Mangiu II

Halle

Panyam North

Kerang

Panyam South

Antenatal care (ANC) facility present

195 581 582 583 584 585 586 587 588 589 590 591 592 593 594 602 603 604 605 606 607 608 609 610 611 612 613 614 615 616 617 618 619 620 621 622 623 624 625 626

Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau

Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu Mangu

Ampang

Women in Health Ampang PHC Bwonpe Community Clinic Kombiring Community Clinic Dikibin PHC Mangun PHC Kaharyam PHC Nyemdung Ruzzco Clinic Alhei clinic Sekyen clinic PHC Kumbun Women in Health J-Maitumbi Women in Health Kwahas Women in Health J-Millet COCIN Gindiri Gaskiya clinic PHC Gindiri Juth CHC Artu Clinic Ahmadu clinic Bature Medical Clinic PHC Doss PHC Kadunu PHC Patiko PHC Langai Moses Dispensary Jamos Clinic Limak Dispensary PHC Chanso PHC Badni PHC Narahos PHC Chakfem PHC Manja PHC Wubel PHC Znakal PHC Jipal PHC Katul PHC Bul PHC Rundum

Bwonpe

Mangun

Kombun

Gindiri II

Kadunu

Langai

Chanso

Chakfem

Jipal

PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC

Local Govt. Community Community Local Govt. Local Govt. Local Govt. Private Private Private Private Local Govt. Community Community Community Mission Private Local Govt. Fed. Govt. Private Private Private Local Govt. Local Govt. Local Govt. Local Govt. Private Private Private Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt.

NAME OF LGA: PANKSHIN S/N

Name of state

Name of LGA

Political wards

Name of Health Facility

655 656 657 658 659 660 661 662 663 664 665 666 667 668 669 670 671 672 673 674 675 676 677 678 679 680 681 682 683

Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau

Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin

Pankshin

Gen. Hospital PHC Town Clinic Pankshin PHC Vel PHC Dilla PHC Wulmu Govt. College Clinic Pankshin GSS Clinic Pankshin St. Benedick Pankshin Medical Centre Pankshin Frank Clinic Pankshin Standard Medical Laboratory All Comfort Clinic Salam Dispensary Buns Clinic PHC Fwor PHC Chigwong PHC Shippang PHC Kalep PHC Wentul PHC Mudel PHC Dung-Wuseli PHC Wuseli central PHC Nyelleng PHC Mier PHC Gwabi Bok PHC Gasharak PHC Kadyis PHC Fumbis PHC Tambes

Wuchenbe

Wuseli Mukang Nyelleng

Kasgong

Antenatal care (ANC) facility present

Category

Ownership

Secondary PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC

State Govt. Local Govt. Local Govt. Local Govt. Local Govt. State Govt. Min. of Education Mission Private Private Private Private Private Private Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt.

196 684 689 690 691 692 693 694 695 696 697 698 699 700 701 702 703 704 705 706 707 708 709 710 711 712 713 714 715 716 717 718 719 720 724 725 726 727 728 729 730 731 732 733 734 735 736 737 738 739 740 741 742 743 744 745 746 747 748 749 750 751

Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau

Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin Pankshin

Wokkos

Lankan

Kadung

Longbam Dok-Pai

Chip central

Tal “A” Tal “B” Kangmun Jiblik

Fier

Jing Kagu

Kangshu

PHC Duk PHC Dungye PHC Kulingwong PHC Korlok COCIN Maternity PHC Tazuk PHC Kwalla Wokkos PHC Wokkos Central PHC Gile PHC Dang PHC Jimin PHC Lankan PHC Ninukut GSS Clinic Jak PHC Jivir Mwel PHC Gurup PHC Kumbul PHC Gilling COCIN Clinic Kumbul PHC Jibam Women in Health Kapil PHC Dok-Pai PHC Bwer PHC Nkup PHC Chip PHC Nadu PHC Shoro PHC Jepmidel PHC Hikmuram PHC Tal PHC Mungne PHC Mungkohort PHC Jiblik PHC Dyis PHC Guzah Retyil- Dyis PHC Fier PHC Kromlu PHC Mile 8 PHC Takkas PHC Posat PHC Fifen PHC Dungkwak PHC Bumnan PHC Jakwal Bony Dispensary COCIN Dispensary PHC Sihin PHC Jing PHC Kagu PHC Laplek PHC Dagmet PHC Guntong Baptish High Clinic COCIN Clinic Kagu PHC Kwanka PHC Jinjim PHC Janaret Goung Memorial clinic COCIN Maternity Janaret

PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC

Local Govt. Local Govt. Local Govt. Local Govt. Mission Local Govt. State Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Min. of Education Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Mission Local Govt. Community Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Private Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Private Mission Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Mission Mission Local Govt. Local Govt. Local Govt. Private Mission

SOUTHERN SENATORIAL ZONE ANCF BY LOCAL GOVERNMENT AREAS (LGA): LANGTANG NORTH S/N

Name state

447 448 449 450 451 452

Plateau Plateau Plateau Plateau Plateau Plateau

of

Name LGA

L/North L/North L/North L/North L/North L/North

of

Political wards

Name of Health Facility

Tabat

Gen. Hospital PHC Langtang PHC Mabe Timwat PHC & Maternity Pajat PHC & Maternity Pajat PHC Tancit Longbap

Antenatal care (ANC) facility present

Category

Ownership

Secondary PHC PHC PHC PHC PHC

State Govt. Local Govt. Local Govt. Private Private Private

197 453 454 455 456 457 458 459 460 461 462 463 464 465 466 467 468 469 470 471 472 473 474 475 476 477 478 481 482 483 484 485 486 487 488 489 490 491 492 493 494 495 496 497 498 499 500 501 502 503

Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau

L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North L/North

Warok

Reak

Jat

Lipchok

Funyallang Kuffeng “B” Kuffeng “C” Pilgani Keller

Mban Nyer Zamko

Kuffeng “A” Kwallak Kwanpe

PHC Alheri Shishiri PHC Nakowa Shishiri PHC & Maternity Tabat PHC Gazum PHC Kendong Gazum PHC Warok PHC Dibbar PHC Kona Zanzat PHC Mban PHC Dispensary Gazum PHC Reak PHC Dadur PHC Limun PHC Dadin Dadur PHC Zambau PHC Sabon Layi PHC Lohmak PHC Biller PHC Kunkwam PHC Lipchok PHC Zamzhimin PHC Ndingjor PHC Fun Yallang PHC Pangna PHC Bankun PHC Bapkwai PHC Yashi PHC Pilgani PHC Dispensary Pilgani PHC Tipsin PHC Zamkwar PHC Zakbai PHC Yakot PHC Dangyil PHC Gongbali PHC Mban PHC Nyer PHC Talbut DHO Zamko PHC Zamko PHC Nanbye Zamko PHC (JUTH) PHC School clinic PHC Kwallak PHC Kwanpe PHC Nanbye Kwanpe PHC Tancit Longbap PHC Tunkun PHC Julie Useni Tillam

PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC

Private Private Private Local Govt. Private Local Govt. Local Govt. Private Private Local Govt. Local Govt. Local Govt. Local Govt. Private Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Private Private Fed. Govt. Local Govt. Local Govt. Private Private Private Local Govt. Private

Category

Ownership

Secondary PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC

State Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt.

NAME OF LGA: LANGTANG SOUTH S/N 503 504 505 506 507 508 509 510 511 512 513 514 515 516 517 518 519 520 521

Name of state Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau

Name of LGA L/South L/South L/South L/South L/South L/South L/South L/South L/South L/South L/South L/South L/South L/South L/South L/South L/South L/South L/South

Political wards

Name of Health Facility

Mabudi

Gen. Hospital PHC Mabudi PHC Wubang PHC Lohkang PHC Sabon Gida PHC Gangnum PHC Turaki PHC Dorowa PHC Kanana PHC Magama PHC Barrack PHC Gamakai PHC Takalafiya PHC Ndingshan PHC Talgwang PHC Kamhun PHC Jemkur PHC Dadin Kowa PHC Gbaldum

Sabon Gida Turaki

Warok Magama Gamakai

Talwang Reak Dadin Kowa

Antenatal care (ANC) facility present

198 522 523 524 525 526 527 528 529 530 531

Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau

L/South L/South L/South L/South L/South L/South L/South L/South L/South L/South

532

Plateau

L/South

Bua Tahbol Jat timbol Lashe Nasarawa Lipchok Faya Fajul Lashel

PHC Bua Tahbol PHC Timbol PHC Tongshin PHC Lashe PHC Karkashi PHC Timshat PHC Faya PHC Fajul PHC Tackchang PHC Wubang

PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC

Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt.

PHC Zambang

PHC

Local Govt.

NAME OF LGA: MIKANG S/N 627 628 629 630 631 632 633 634 635 636 637 638 639 640 641 642 643 644 645 646 647 648 649 650 651 652 653 654

Name of state Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau

Name of LGA Mikang Mikang Mikang Mikang Mikang Mikang Mikang Mikang Mikang Mikang Mikang Mikang Mikang Mikang Mikang Mikang Mikang Mikang Mikang Mikang Mikang Mikang Mikang Mikang Mikang Mikang Mikang Mikang

Political wards Tunkus

Baltep Lalin

Luham Din Koenoe “C” Koenoe “B” Piapung “B” Kehil Voryoum Piapung “A” Koenoe “A” Piapung

Telkang Moedong Gadyoum Koenoemb

Name of Health Facility

Antenatal care (ANC) facility present

Gen. Hospital Ventex clinic PHC Yaro PHC Tunkus PHC Baltep PHC Lalin PHC Gbiet PHC Betilang PHC Luham PHC Din PHC Talme PHC Zomo PHC Lifidi PHC Piapung PHC Garkawa I PHC Jimakwi PHC Garkawa II PHC Gangovoel PHC Nwoop PHC Shamang Piapung Medical Centre St. More Dispensary Kopji Medical clinic PHC Pankai PHC Gwotkat PHC Govt. College Garkawa Alheri clinic J.J. Clinic

Category

Ownership

Secondary PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC

State Govt. Private Clinic Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Private Clinic Private Clinic Private Clinic Local Govt. Local Govt. Local Govt. Private Private

Category

Ownership

Secondary PHC PHC PHC PHC PHC PHC PHC Secondary Secondary PHC PHC PHC PHC PHC PHC Secondary PHC PHC PHC PHC PHC PHC

State Govt. Local Govt. Private Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Private Private Private Mission Private Private Private Local Govt. Private Local Govt. Local Govt. Local Govt. Local Govt. Local Govt.

SHENDAM S/N 870 871 872 873 874 875 876 877 878 879 880 881 882 883 884 885 886 887 888 889 890 891 892

Name of state Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau

Name of LGA Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam

Political wards

Name of Health Facility

Shedam “A”

Gen. Hospital PHC Shendam PHC Kurum Lazai PHC School Clinic PHC Kwansan Staff Clinic Shendam GGSS Clinic PHC Longkat Bene Hospital May Hospital Dilla Clinic COCIN PHC Goodnews Dispensary Zeh Clinic Protom Medial Laboratory PHC Total Comfort Hospital PHC Fet PHC Dokan Tofa PHC Poeship PHC Nder PHC Salama PHC Ango

Pangwasa Doka Poeship

Antenatal care (ANC) facility present

199 893 894 895 896 897 898 899 900 901 904 905 906 907 908 909 910 911 912 913 914 915 916 917 918 919 920 921 922 923 924 925 926 927

Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau

Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam Shendam

Yelwa East

Yelwa Medical Centre Medical Centre PHC Yelwa PHC Ajimakai PHC Dillori PHC Tamini PHC Shimmankar PHC Moekak PHC Npoll PHC Longvel PHC Dungba PHC Samlong PHC Lawur PHC Demshin PHC Angwa Dadi PHC Angwa Rina Chindong Dispensary PHC Lakushi PHC Sabon Layi PHC Yammini PHC Pedong PHC Kalong PHC Angwa Zam PHC Ndayak COCIN Dispensary PHC Kuka PHC Tudun Dorowa PHC Rijiya Giwa PHC Pebar Godiya Dispensary PHC Biembiem COCIN Dispensary PHC Derteng

Yelwa West Nyak

Menkat Moekat Kwapkilik Zemsuk Ngotlong

Kurumbo

Kalong

Jiban

Mambial Derteng

PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC Secondary PHC PHC PHC PHC PHC PHC PHC

Private Private Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Mission Local Govt. Local Govt. Local Govt. Private Private Local Govt. Mission Local Govt.

Category

Ownership

Secondary PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC Secondary PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC

Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt.

NAME OF LGA: WASE S/N 928 929 930 931 932 933 934 935 936 937 938 939 940 941 942 943 944 945 946 947 948 949 950 951 952 953 954 955 956 957 958 959

Name of state Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau

Name LGA Wase Wase Wase Wase Wase Wase Wase Wase Wase Wase Wase Wase Wase Wase Wase Wase Wase Wase Wase Wase Wase Wase Wase Wase Wase Wase Wase Wase Wase Wase Wase Wase

of

Political wards

Name of Health Facility

Garkuwa

Cottage Hospital PHC Emir Palace PHC Wase Town PHC GSS Wase PHC Govt. Science School VTC Clinic Wase PHC Mavo PHC Bakin Rijiya PHC Kanwa PHC Nyalum PHC Gimbi PHC Pinau PHC Yuli PHC Kadarko PHC Wadata PHC Duwi PHC Chapkwi PHC Kumbong PHC Kampani PHC Zak PHC Gudus PHC Kungurmi PHC Bunyun PHC Murai PHC Bashar PHC Jarmai PHC Lamba PHC Danyam PHC Gyambar PHC Nassarawa PHC Gaji Bashar PHC Safiyo

Danbiram Kuyambanin Mavo

Nyalum Gimba/Pinau Yuli Kadarko Wadata kumbong Kampani Gudus

Basher

Lamba

Gaji Gaji Bashar

Antenatal care (ANC) facility present

200 QUAAN-PAN S/N

Name state

752 753 754 755 756 757 758 759 760 761 762 763 764 765 766 767 768 769 770 771 772 773 774 775 776 777 778 779 780 781 782 786 787 788 789 790 791 792 793 794 795 796 797 798 799 800 801 802 803 804 805 806 807 808 809 810

Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau Plateau

of

Name of LGA

Political wards

Name of Health Facility

Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan Qua’an-Pan

Moeda/ Shangfuup

Cottage Hospital PHC Kwalla PHC Maramba PHC Demchin PHC Vutu PHC Bong PHC Pandam PHC Jenta PHC Hancin Kare PHC A/Latong PHC Yayil PHC Mangoro Uku PHC Koplong PHC Langkaku PHC Kwari PHC Duwe PHC Tuatdong PHC Tuatong Sua’as PHC Bwall PHC Dungras PHC Labi PHC Nakum PHC D/Kasuwa PHC Yilpia PHC Kwnoeng PHC Leet PHC Moedu’ut PHC Kwoor PHC Namu PHC Gung Sua’as PHC Gungleet Namoen PHC Staff Clinic Ba’ap PHC Lardang PHC Bonggolong PHC Kurgwi PHC Tim PHC Yillar PHC Kopfogoom PHC B/Ciyawa PHC Sabon Gida Gamji PHC Sabon Gida PHC Janyaro PHC Kwang II PHC Kwang I PHC Fujing PHC Koplong Kwang PHC Kwa PHC Koffier PHC Miket PHC Kwande PHC Gidan Dabat PHC Bakin Kande PHC Turniang PHC Angwan Dmen PHC Npap PHC Gamji Muudutdan

Latok Jenta/ Aningo

Njak/Shindai

Langkaku/Kwari

Bwall

D/Kasuwa East D/Kasuwa West

Kwoor Namu D/Goechim Larding Kurgwi West Yillar/Tim

Luukwo

Kwang

Kwa

Kwande

Antenatal care (ANC) facility present

Category

Ownership

Secondary PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC

State Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. State Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt. Local Govt.

201

Appendix H Population of Women who Attended ANC in 2014 in Plateau State Population of women who attended ANC in Plateau State as at 2014 was as follows: Barkin Ladi Bassa Bokkos Jos East Jos North Jos South Kanam Kanke Langtang North Langtang South Mangu Mikang Pankshin Qua’an Pan Riyom Shendam Wase Total

2014 11570 15979 4606 3039 18437 15263 6365 5226 6918 4762 11765 4717 8273 10681 6918 13391 4614 150913

Therefore, the above population of women who attended ANC in Plateau State in 2014 were 150913 (PSMH, Jos 2014).

202

Appendix I List of the antenatal care facilities (ANCF) and the stratum sample size

S/No

1 2 3 4 5 6

7 8 9 10 11

12 13 14 15 16 17

Plateau State Senatorial Zones

Northern Senatorial Zone Jos North LGA Jos South LGA Jos East LGA Riyom LGA Barkin-Ladi LGA Bassa LGA Central Senatorial Zone Mangu LGA Pankshin LGA Bokkos LGA Kanke LGA Kanam LGA Southern Senatorial Zone Langtang North LGA Mikang LGA Wase LGA Langtang South LGA Qua’an Pan LGA Shandam LGA

Stratum population of ANC facilities (ANCF)

Stratum population of ANCF / total population of ANCF

Weight Weight x sample size

Stratum sample size

35 50 29 19 43 38

35/496 50/496 29/496 19/496 43/496 38/496

.071 .101 .059 .038 .087 .077

.071(642) .101(642) .059(642) .038(642) .087(642) .077(642)

46 65 38 24 56 49

.37 31 34 26 16

37/496 31/496 34/496 26/496 16/496

.075 .063 .069 .052 .032

.075(642) .063(642) .069(642) .052(642) .032(642)

48 41 44 33 21

39 13 19 26 15 26 496

39/496 13/496 19/496 26/496 15/496 26/496 5%

.079 .026 .038 .052 .030 .052

.079(642) .026(642) .038(642) .052(642) .030(642) .052(642)

51 17 24 33 19 33 642

Therefore it implied that 278 women attending ANC were sampled from the northern senatorial zone, 187 from the central senatorial zone and 177 were from the southern senatorial zone giving a sum total of 642 women attending ANC in all.

203

Appendix J List of ANCF sampled and grand total S/No

1 2 3 4 5 6

7 8 9 10 11

12 13 14 15 16 17

Senatorial Zones Plateau North Senatorial Zone Jos North LGA Jos South LGA Jos East LGA Riyom LGA Barkin-Ladi LGA Bassa LGA Total Plateau Central Senatorial Zone Mangu LGA Pankshin LGA Bokkos LGA Kanke LGA Kanam LGA Total Plateau South Senatorial Zone Langtang North LGA Mikang LGA Wase LGA Langtang South LGA Qua’an Pan LGA Shandam LGA Total

Stratum Population

35 50 29 19 43 38 214

.37 31 34 26 16 144

39 13 19 26 15 26 138

G/total = 496

204

Appendix K List of ANCF sampled by ownership category and location S/No

Plateau State Senatorial Zones

Stratum population of ANCF

ANCF Ownership by Category Primary Health Care (PHC) Public

Private

Secondary Health Care (SHC) Public

Private

Location

Tertiary Health Care (THC) Public Priv ate

PHC Urban

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17

Northern Zone Jos North LGA Jos South LGA Jos East LGA Riyom LGA Barkin-Ladi LGA Bassa LGA Central Zone Mangu LGA Pankshin LGA Bokkos LGA Kanke LGA Kanam LGA Southern Zone Langtang North LGA Mikang LGA Wase LGA Langtang South LGA Qua’an Pan LGA Shendam LGA

SHC Rural

Urban

THC Rural

Urban

35 50 29 19 43 38

22 30 25 18 39 35

00 10 03 01 03 00

01 02 01 00 01 02

11 08 00 00 00 01

01 00 00 00 00 00

00 00 00 00 00 00

Pu blic 22 30 19 01 31 30

Priv ate 00 10 02 01 03 00

Pu blic 00 00 06 16 08 05

Priv ate 00 00 01 00 00 00

Pu blic 01 02 01 00 01 02

Priv ate 11 08 00 00 00 01

Pu blic 00 00 00 00 00 00

Priv ate 00 00 00 00 00 00

Public

.37 31 34 26 16

18 28 23 25 15

17 02 09 00 00

01 01 01 01 01

01 00 01 00 00

01 00 00 00 00

00 00 00 00 00

05 02 17 05 02

02 01 07 00 00

10 25 02 19 13

13 02 06 00 00

01 01 01 01 01

01 00 01 00 00

00 00 00 00 00

00 00 00 00 00

01 00 00 00 00

39

27

11

01

00

01

00

06

10

21

01

01

00

00

00

01

13 19 26

12 18 25

00 00 00

01 01 01

00 00 00

00 00 00

00 00 00

01 02 02

00 00 00

11 16 22

00 00 00

01 01 01

00 00 00

00 00 00

00 00 00

00 00 00

15 26

14 18

00 04

01 01

00 03

00 00

00 00

01 01

00 02

13 14

00 04

01 01

00 02

00 00

00 01

00 00

01 00 00 00 00 00

205

Appendix L LIST OF SAMPLED ANCF Northern Senatorial Zone LGAs 1. Barakin-Ladi 2. Jos East 3. Jos North Central Senatorial Zone LGAs 1. Bokkos 2. Mangu 3. Kanam Southern Senatorial Zone LGAs 1. Langtang North 2. Shendam 3. Wase