Behavioural changes and health impact related to rural enviromental sanitation programme in Sarawak : a comparative analysis between sub-urban and rural communities in Kuching district, Sarawak

Khamri, Katang (2006) Behavioural changes and health impact related to rural enviromental sanitation programme in Sarawak : a comparative analysis between sub-urban and rural communities in Kuching district, Sarawak. Masters thesis, Universiti Malaysia Sarawak,.

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Abstract

The present field investigation focused on the general extent of adaptation to health practices and knowledge by appraising the impact on behaviour of the respondents in selected localities in the rural and sub-urban areas. Respondents were the recipients of the Ministry of Health-sponsored sanitation projects under the Rural Health Environmental Health Programme (RESP) for the last three decades. The study was carried out in Kuching District at Kpg Bako in the Sub-urban area and Kpg Anna Rais and Kpg Bayor in Padawan Sub-district in the rural area of Kuching Division, Sarawak., Respondents were interviewed by using semi-structured closed and open-ended questionnaires that were selected by a remuneration system to present a 10 per cent samples size of all the localities selected. The localities were chosen at random from 205 rural villagers and sub-urban settlements in Kuching district simultaneously considering the number of houses and size of the population in order to come up with the required sample size. A total of 143 respondents were interviewed, 85 from the rural area and 58 from the sub-urban area. Small group discussions and personal observations were also conducted. Secondary data pertaining to the study were obtained from the records kept at Divisional Health Office, Health Services Headquarters, Kuching Water Board, Department of Public Works and the Local 6 Authorities in the area. After the data had been analysed, the study revealed that there were more small families in the sub-urban area. More female respondents were interviewed in both areas. Farming formed the major occupation of the respondents in the rural with an average monthly income of RM 500.00 a month. The majority of those in the suburban had no specific or permanent job but earned their living doing various works earning from RM 500.00 to RM 1,000.00 a month. A large majority of the respondents in both areas lived in village houses with clean and feasible water supply from KWB, PWD and MOH projects. All houses but six were having latrines. In the rural all (95%) but four respondents were using proper systems of waste water disposal compare to only 56.7% in the sub-urban area. House keeping and house compound cleanliness were better in the sub-urban. The majority of respondents in both areas were having high level of health knowledge with those in the sub-urban slightly higher. Good knowledge relating health and environment was higher among the respondents in the sub-urban area. About 90 per cents of the total respondents had good and better knowledge as regards to diseases preventions and awareness about the importance of personal hygiene. In both cases those in the sub-urban were slightly better. All the respondents were using their latrines either all the times or some times, but very high percentage (69.6%) of those in the rural did not know the health related reasons why they should use their latrines compare to nearly 90 percent of those in the sub-urban were well aware of the importance of using latrines. Opening burning practices were rampant in both areas that were 86.2 per cent of the respondents in both areas. All the respondents were not aware why they were restricted from such practice. Nearly all the respondents in the rural areas recycled their refuse and were aware of the benefits gained from practicing recycling. Relatively, more respondents in the rural area (93.3%) had better and positive views on sanitation projects compare to only 58.6% in the sub-urban area. Likewise more rural respondents agreed with the implementations of sanitation projects in their areas and they knew where to apply for such projects. Overall, 80 per cent agreed with the projects. On the other hand, the majority of the respondents from the sub-urban area preferred health related project while a good majority of 96.3% of those in the rural area need agricultural projects. As regards to the benefits, almost all the respondents were aware of what and how sanitation projects could benefit them. This study continues to discover that there was a significant relationship between health awareness and knowledge with education level of the respondents. The higher the level of education, the better health awareness and knowledge the respondents had. Unfortunately there was no significant relationship between level of health awareness and knowledge with the occupations and incomes of the respondents in both areas. The study came to a few conclusions that both rural and the sub urban community were generally unaware of the hazards caused by open burning. The rural communities clearly saw the importance of sanitation but remained undeterred from agricultural projects as their prime choice. Sanitation programmes and health promotion efforts had left significant impacts especially on the rural community in the study areas. Nonetheless, the study saw there are needs for further research and the needs to improve the intervention strategies to benefit not only the rural population but hose in the urban settlements.

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