The campaign for improved sanitation is increasingly threatened as people’s attitudes seem not to promote proper sanitation practices. The study examined attitudes of urban dwellers in some communities in Central Region of Ghana towards sanitation and their influence on sanitation practices. A cross sectional survey research design was adopted for the study. Simple random sampling technique was used to select 360 inhabitants in three urban communities. A structured questionnaire was used for data collection. Descriptive and inferential statistics were used to analyse the data. A significant number of respondents (76.4 %) had good attitudes towards sanitation whilst 58.0 % of respondents had good standard of sanitation practices. About half of the respondents (49.8 %) disposed of their solid waste daily through open dumping and three out of every ten persons disposed of their solid waste through open burning. Respondents’ attitudes towards sanitation weakly influenced their sanitation practices (r = 0.058, p = 0.269). This is because respondents’ attitudes towards sanitation contributed only by 5.8% in their sanitation practices. The findings of the study led to a conclusion that the high level of sanitation attitudes among urban dwellers in some communities in Central Region of Ghana could not be translated into actual practice. There was a gap between respondents’ attitudes towards sanitation and their standard of practices. It is recommended that the Central Regional Environmental Health and Sanitation Directorate should embark on a comprehensive campaign on health benefits of good sanitation practices and enforce a more robust environmental sanitation approach and health education to help translate the high sanitation attitudes among urban dwellers into actual practice.

1. Sanitation Attitudes of Urban Dwellers and their Influence on Sanitation Practices in Central Region of Ghana
Sanitation Attitudes of Urban Dwellers and their Influence
on Sanitation Practices in Central Region of Ghana
Godfred Safo-Adu
Department of Integrated Science Education, Faculty of Science Education, University of Education, Winneba, Ghana
Email: gsafoadu@gmail.com, Tel: +233541084097
The campaign for improved sanitation is increasingly threatened as people’s attitudes seem not
to promote proper sanitation practices. The study examined attitudes of urban dwellers in some
communities in Central Region of Ghana towards sanitation and their influence on sanitation
practices. A cross sectional survey research design was adopted for the study. Simple random
sampling technique was used to select 360 inhabitants in three urban communities. A structured
questionnaire was used for data collection. Descriptive and inferential statistics were used to
analyse the data. A significant number of respondents (76.4 %) had good attitudes towards
sanitation whilst 58.0 % of respondents had good standard of sanitation practices. About half of
the respondents (49.8 %) disposed of their solid waste daily through open dumping and three out
of every ten persons disposed of their solid waste through open burning. Respondents’ attitudes
towards sanitation weakly influenced their sanitation practices (r = 0.058, p = 0.269). This is
because respondents’ attitudes towards sanitation contributed only by 5.8% in their sanitation
practices. The findings of the study led to a conclusion that the high level of sanitation attitudes
among urban dwellers in some communities in Central Region of Ghana could not be translated
into actual practice. There was a gap between respondents’ attitudes towards sanitation and their
standard of practices. It is recommended that the Central Regional Environmental Health and
Sanitation Directorate should embark on a comprehensive campaign on health benefits of good
sanitation practices and enforce a more robust environmental sanitation approach and health
education to help translate the high sanitation attitudes among urban dwellers into actual
practice.
Key words: Open dumping, Practices, Sanitation attitudes, Urban dwellers, Waste disposal
INTRODUCTION
Kasapoglu (2010) defines attitude as a cognitive, affective
and behavioural response which is organized on the basis
of experience and knowledge of the individual or event
around the environment. Oskamp and Scshultz (2005)
define attitude as a predisposition to respond in a
favourable or unfavourable manner to a given situation or
object. Abudu and Gbadamosi (2014) also view attitude as
a hypothetical construct that indicates an individual like
and dislike towards an item. On the other hand, practice
refers to the ways in which people demonstrate their
knowledge and attitude through their actions
(Kaliyaperumal, 2004). There should be higher
relationship between sanitation attitudes of people and
their sanitation practices because both involve an
individual to have knowledge or event around the
environment. Mohd and Malik (2017) confirmed this
assertion that sanitation practices are heavily influenced
by people’s knowledge and attitudes towards it.
Inadequate sanitation is a major cause of diseases
worldwide, and improving sanitation is known to have a
significant beneficial impact on health both in households
and across communities (WHO, 2012). Sanitation related
diseases exacerbate poverty by diminishing productivity
and household income. In addition, the natural cost of lost
productivity, reduced educational potential and huge
curative health costs constitute a major drain on the local
and national economy (Ekong, 2015). Besides, a dirty
environment with its attendant health consequences, as
prevails in most cities, can discourage tourists and
investors and undermine economic benefits of tourism to
the country.
Research Article
Vol. 4(2), pp. 070-078, August, 2019. © www.premierpublishers.org. ISSN: 1822-424X
International Journal of Toxicology and Environmental Health

2. Sanitation Attitudes of Urban Dwellers and their Influence on Sanitation Practices in Central Region of Ghana
Safo-Adu G. 071
The deposition of faecal matter near homes,
contamination of drinking water sources, dumping of
refuse and sweeping into gutters, defecating and
disposing of faeces by street corners and waterways, and
selling of food stuffs and cooked food by the road side are
all unwholesome practices that pose potential risk to the
development of diseases (Ekong, 2015). Poor sanitation is
linked to transmission of diseases such as cholera,
diarrhoea, dysentery, hepatitis A, typhoid and
poliomyelitis. Sah et al. (2013) revealed that people
drinking untreated water suffered from diarrhoea (38.4 %)
followed by dysentery (9.8 %) whilst people devoid of
latrine facilities suffered from diarrhea (40.7 %) followed by
dysentery (12.0 %) respectively. UNICEF and WHO
(2017) reiterated that inadequate sanitation is estimated to
cause 280, 000 diarrhoeal deaths annually and it is a major
factor in several neglected tropical diseases including
schistosomiasis and trachoma.
Globally, 2.3 billion people still do not have basic sanitary
facilities such as toilet or latrines. Of these, 892 million still
defecate in the open, for example in street gutters, behind
bushes or into open bodies of water (UNICEF and WHO,
2017). An Analytical report on sanitation in Central Region
of Ghana revealed that 15 % of households had no toilet
facilities and 2,633 households still use buckets/pan toilet
facilities even though there is a ban on its use (Ghana
Statistical Service, 2013). The proportion of households
whose members use public toilet (39.5 %) was higher than
the national average which is 34.6 %. Also, 1 out of 20
dwelling units (5.4 %) dump solid wastes indiscriminately.
Moreover, 13.4 % of dwelling units burn their solid wastes.
The dumping of solid waste is the most common method
of waste disposal in the Central Region. About 2 out of 5
dwelling units (41.0 %) throw liquid waste onto their
compounds whiles 31.1 % throw liquid waste on the street
or outside the house or into gutters.
A study conducted by Duru et al. (2017) on the attitudes
and practices of sanitation in semi-urban communities in
Orlu, Imo State, Nigeria revealed that respondents’
attitudes (38.6 %) and practices (20.8 %) towards
sanitation were low, and the commonest solid waste
disposal practices among respondents was open dumping
(49.8 %). A research conducted by Osofo (2015) on
attitudes of traders towards environmental sanitation in
Hohoe market in the Volta Region of Ghana showed that,
the attitudes of traders towards sanitation was positive but
could be more favorable if they had been provided with
support systems. Also, a study carried out by Sah et al.
(2017) on sanitation attitudes and practices of urban
dwellers in Sapturi District, Nepal showed that about 57 %
of participants had positive attitude towards sanitation
while 43 % had negative attitudes towards sanitation. 60
% participants had good sanitation practices while 40 %
had poor sanitation practices. Attitude and practice
research approaches are used to understand what people
believe and do in relation to specific topics (WHO, 2008).
To effectively achieve sustainable behaviour change, it’s
necessary to understand how the people value and
perceive an environmental change. Hence, assessment of
attitudes and practices is particularly useful for this
research.
The menace of gutters chocked with garbage and plastics,
and the indiscriminate disposal of refuse at unauthorized
places in most communities in the Central Region and
Ghana as a whole is worrisome (Nsiah -Gyaabah, 2004)
and has become a great concern to many environmental
educators and public health advocates. Baseline data on
current attitudes about sanitation in the Central Region of
Ghana is scarce. As important as data on sanitation
attitudes is to healthcare planning, a search for the
available literature revealed that not much research has
been conducted to examine the attitudes of people
towards sanitation in the Central Region of Ghana. The
lack of appropriate information on attitudes of people
towards sanitation is an impediment to identify priority
needs. This study was designed to fill this gap.
The present work examined the attitudes of urban dwellers
in some communities in Central Region of Ghana towards
sanitation and their influence on sanitation practices.
Specifically, the study sought to identify methods
employed by urban dwellers in disposing of their solid
waste. It also aimed at assessing the attitudes of urban
dwellers in some communities in Central Region towards
sanitation and evaluating the influence of sanitation
attitudes on their sanitation practices.
The following questions guided the study:
1. What methods do urban dwellers in some
communities in Central Region of Ghana employ to
dispose of their solid waste?
2. What are the attitudes of urban dwellers in some
communities in Central Region of Ghana towards
sanitation?
3. What influence do sanitation attitudes among urban
dwellers in some communities in Central Region of
Ghana have on their sanitation practices?
The following null hypotheses were tested:
Ho 1: Attitudes of urban dwellers in some communities in
Central Region of Ghana has no influence on their
sanitation practice.
Ho 2: There is no relationship between the attitudes of
urban dwellers in some communities in Central Region of
Ghana and their demographic characteristics.
MATERIALS AND METHODS
The study was conducted in three urban communities,
Potsin, Asebu and Afransi, in the Central Region of Ghana.
The region occupies an area of 9, 826 square kilometers
and has a population of 2,201, 863 inhabitants which
accounts for 8.9 % of the population of Ghana (Ghana
Statistical Service, 2013). The Central Region shares

3. Sanitation Attitudes of Urban Dwellers and their Influence on Sanitation Practices in Central Region of Ghana
Int. J. Toxicol. Environ. Health 072
common boundaries with the Western Region on the west,
Ashanti Region and Eastern Region on the east. On the
south is the 168 kilometre length Atlantic Ocean coastline.
A cross sectional survey was adopted in the study.
According to Sedgwick (2014), a cross sectional survey is
generally quick, easy and cheap to perform. Also, it is
particularly suitable for estimating the prevalence of
behaviour in a population. A sample of 360 was estimated
for the study using StatCalc in Epi Info Version 7
developed by the American Center for Disease Control
and Prevention, Atlantic Georgia (2010). A random
sampling technique was employed to obtain 120
households from the three urban communities. Three
people (adult males and females and one youth) who
understood basic communication were randomly selected
from each selected household to answer a structured
questionnaire.
The questionnaire contained 22 items divided into three
sections (Sections A to C). Section A solicited the
demographic characteristics of the respondents. Section B
is comprised of 3 items to identify methods respondents
adopt in disposing of their solid waste. Section C is
comprised of 15 items to assess the sanitation attitudes of
respondents on effects of garbage pile in households,
indiscriminate dumping of refuse, health effects of
insanitary conditions and community sanitation exercise
participation. Section D is comprised of 15 items to assess
self-reported practices regarding sanitation like community
sanitation exercise participation, water purification, hand
washing, water storage, toilet cleaning and household
cleaning practices.
The instrument was reviewed by experts in the
Department of Integrated Science Education of University
of Education, Winneba to ensure its face and content
validity. Afterwards, it was pre-tested in urban
communities in Western Region with similar
characteristics of people in the urban communities of the
study area to estimate its reliability. The items were
subjected to item analysis in order to identify those items
whose removal or modification would enhance the internal
consistency of the instrument (Onwoioduokit, 2000). The
Statistical Package for Social Sciences (SPSS) was used
to determine the Cronbach alpha coefficient value for the
instrument which was of 0.87. The responses of
participants indicated that they understood the questions
and that the wordings of the items were appropriate. The
consent of the municipal assemblies and chiefs in the
study area were sought before collecting the data.
Respondents gave out the information voluntarily and
were assured that whatever information they gave out
would be treated confidentially. Five teaching assistants in
the Department of Integrated Science Education of
University of Education, Winneba (UEW) were trained and
engaged as research assistants. A day’s training was held
for the research assistants before data collection
commenced.
Respondent’s attitude towards sanitation was categorized
into five levels: Strongly agree, agree, not sure, disagree
and strongly disagree. For positive items, the scores were
scaled as follows: ‘Strongly agree’ 5, ‘Agree’ 4, ‘Not sure’
3, ‘Disagree’ 2 and ‘Strongly disagree’ 1. The opposite held
for negative items. The categories were re-categorised
into agree, neutral and disagree to ease interpretation of
the results. Strongly agree’ and agree were categorized as
‘agree’ whiles ‘strongly disagree’ and ‘disagree’ were
categorized as ‘disagree’. Respondent attitudes were
classified into three levels. ‘Good attitude’, moderate
attitude and bad attitude. The cut off points for ‘good
attitude’ was 70 % of 50 score and above, ‘moderate
attitude’ ranged from 50% to 70 % of 50 score and bad
attitude was 50 % of 50 score and below. The responses
of respondents’ practices regarding environmental
sanitation were categorized into four levels which were: All
the time, Most of the time, Sometimes and Never. The
levels were scored as follows: ‘All the time’ 3, ‘Most of the
time’ 2, ‘Sometimes’ 1 and ‘Never’ zero (0). The reverse
was true for negative items. The total possible scores for
respondents ranged from 45 to 0. Respondents’ practices
were put into three categories - good practice, moderate
practice and poor practice. The cut-off points for ‘good
practice’ was 70% of 45 score and above, ‘moderate
practice’ ranged from 50% of 45 score to 70% of 45 score
and ‘poor practice’ was 50% of 45 scores and below.
The responses of the participants were analysed using
Statistical Package for Social Sciences (SPSS) version 20.
Frequencies and percentages were computed for
categorical variables. Also, mean scores and standard
deviation of the sample responses were determined. Chi
square test was statistically used to test the hypothesis
that there is no relationship between the attitudes of urban
dwellers and their demographic characteristics. Also,
Pearson product moment correlation was used to examine
the influence of sanitation attitudes of urban dwellers on
their sanitation practices.
RESULTS
The results of demographic distribution of respondents
presented in Table 1 showed that out of the 360
respondents, who filled the questionnaire, 164
respondents (48.0%) were males and 178 respondents
(52.0%) were females. Few respondents (24.0 %) were
between 10 and 17 years, whilst the majority of the
respondents (76.0 %) were 18 years and above. Most of
the respondents were students (37.0%) and traders (31.1
%) whilst few were civil servants (8.1 %) and politicians
(0.8 %). About half of the respondents (49.7 %) had
secondary education as the highest level of education
whilst 34.2 % had primary education as their highest level
of education. Only 8.9 % and 7.2 % had tertiary education
and non-formal education, respectively.

4. Sanitation Attitudes of Urban Dwellers and their Influence on Sanitation Practices in Central Region of Ghana
Safo-Adu G. 073
Table 1. Demographic information of respondents (N = 360)
Variables Number of respondents Percentages (%)
Sex
Male
Female
173
187
48.0
52.0
Age
10 – 17
18 and above
86
274
24.0
76.0
Occupation
Student
Farmer
Civil Servant
Clergy
Politician
Trader
No Occupation
133
50
29
0
3
112
33
37.0
13.8
8.1
0
0.8
31.1
9.2
Educational status (Highest)
Primary
Secondary
Tertiary
None
123
179
32
26
34.2
49.2
8.9
7.7
The methods employed by respondents for solid waste
disposal presented in Table 2 showed that the majority of
the respondents (46.7 %) disposed of their solid waste
through open dumping. Also, about 31.0 % of the
respondents disposed of their waste through open
burning. Few respondents (20.2 %) disposed of their
waste by duping them into municipal waste containers or
skips. A significant number of respondents (77.2 %)
disposed of their solid waste daily. One out of 24 persons
disposed of their waste monthly. Moreover, few
respondents (17.7 %) disposed of their waste weekly.
Less than half of the respondents (48 %) temporarily
stored their solid waste in buckets/pans before disposing
them off. In addition, few respondents (24.2 %) temporarily
stored their solid waste in dustbins before disposal.
Table 2. Methods employed by respondents for solid waste disposal (N = 360)
Variable Number of Respondents Percentage (%)
Method of solid waste
disposal
Open burning
Open dumping
Burying
Municipal waste disposal
112
168
7
73
31.1
46.7
2.0
20.2
Regularity of waste
disposal
Daily
Weekly
Monthly
No specific time
278
63
15
4
77.2
17.7
4.1
1.1
Means of solid waste
storage
Dustbin
Polythene bags
Bucket/pan
87
100
173
24.2
27.8
48.0
The association between respondent regularity of solid
waste disposal and their demographic characteristics are
shown in Table 3. The analysis of the results indicated that
there was statistically no significant association between
regularity of solid waste disposal and sex (p = 0.225, p>
0.05) educational qualification (p = 0.741, p > 0.05) and
occupation (p = 0.650, p > 0.05).
Table 4 presents the results of respondents’ attitudes
towards sanitation in the study area. The majority of the
respondents (84.7 %) disagreed that ‘defecating in
bushes/fields and backyards has no adverse health effects
on people whilst few respondents (10.0 %) agreed.
Respondents (87.8 %) who believed that germs are easily
found in filthy places with a lot of garbage were more than
respondents (24.0 %) who never believed. Also, most
participants (93.0 %) indicated that garbage pile around
dustbin in a household invite houseflies and rodents into
houses. In addition, a significant proportion of respondents
(96.7 %) reported that stagnant waters around households
could serve as breeding grounds for mosquitoes. This
could pose health risks to inhabitants in the study area.
The participants who agreed that weeding surroundings
and keeping households clean protect the human body
against certain diseases were about 93.0 % which is more
than participants who disagreed. Moreover, a huge
number of respondents (84.7%) believed that it is the
responsibility of anyone who generates refuse to put it into
the dustbin.
The participants who disagreed that throwing faeces into
streams is a good sanitation practice were 54.8 % which is
more than participants who agreed. The number of
respondents who disagreed that community sanitation
exercise was not the responsibility of the youth was very
low (11.1 %) as compared to participants (84.7 %) who

5. Sanitation Attitudes of Urban Dwellers and their Influence on Sanitation Practices in Central Region of Ghana
Int. J. Toxicol. Environ. Health 074
Table 3. Univariate association between respondents’ regularities of solid waste disposal and their demographic
characteristics (N=360)
Demographic characteristics Daily
f(%)
Weekly
f(%)
Monthly
f(%)
NSP*
f (%)
Total
f(%)
𝝌 𝟐
f(%)
p-value
f(%)
Sex
Male
Female
Total
123(36.6)
142(40.4)
278(84.5)
34(9.4)
29(8.0)
63(17.4)
4(1.2)
11(3.0)
15(4.2)
2(0.6)
2(0.6)
4(1.2)
173 (48.3)
187 (52.0)
360 (100.0)
4.365 0.225
Occupation
Student
Farmer
Civil servant
Politician
Trader
No occupation
Total
90(29.2)
35(11.4)
22(7.1)
1(0.3)
87(28.2)
26(8.4)
261(84.7)
19(6.2)
4(1.3)
3(1.0)
0(0.0)
11(3.6)
2(0.6)
39(12.7)
2(0.6)
0(0.0)
0(0.0)
0(0.0)
1(0.3)
1(0.3)
4(1.2)
4(1.3)
0(0.0)
0(0.0)
0(0.0)
0(0.0)
0(0.0)
4(1.3)
115(37.3)
39 (12.7)
25(8.1)
1(0.3)
99(32.1)
29(9.4)
360(100.0)
12.382 0.650
Educational status (Highest)
Primary
Secondary
Tertiary
None
Total
118(32.7)
137(38.0)
21(5.8)
21(5.8)
297(82.3)
23(6.4)
27(7.5)
4(1.1)
1(0.2)
55(15.2)
1(0.2)
3(0.8)
0(0.0)
0(0.0)
4(1.0)
3(0.9)
1(0.2)
0(0.0)
0(0.0)
4(1.1)
145(40.2)
168(46.6)
25(6.9)
22(6.0)
360 (100)
5.985 0.741
*No Specific Time
Table 4. Results of respondents’ attitude towards sanitation (N= 360)
S/N
Statement
Agree Not Sure Disagree Mean SD*
1 It is the responsibility of anyone who generates refuse to put it into
the dustbin
305
(84.7%)
15
(4.2%)
40
(11.1%) 4.08 1.18
2 Community sanitation exercise is not the responsibility of the youth 93
(25.8 %)
15
(4.2 %)
252
(70.0 %) 2.28 1.35
3 Defecating in bushes/fields and backyard has no adverse health
effects on people
36
(10.0 %)
19
(5.3%)
305
(84.7 %)
1.76 1.05
4 Throwing refuse into gutters and on the street can cause flood. 305
(84.7 %)
20
(5.6%)
35
(9.7) 4.19 1.12
5 Always covering drinking water stored in containers does not
prevent contamination
111
(30.8 %)
60
(16.7%)
189
(52.5 %) 2.61 1.31
6 Improper disposal of waste is one of the environmental challenges
that needs to be solved urgently
305
(84.7 %)
20
(5.6%)
35
(9.7 %) 4.21 1.13
7 Leaving cooking utensils without washing for days after cooking is
not hygienic
303
(84.1 %)
13(3.6 %) 44
(12.3 %) 4.18 1.17
8 Weeding your surroundings and keeping your household clean
could protect the body against certain diseases
345
(95.9 %)
5
(1.4%)
10
(2.7 %) 4.42 0.70
9 Leaving stagnant waters around your household could serve as
breeding grounds for mosquitoes.
348
(96.7 %)
4
(1.1 %)
8
(2.2 %) 4.42 0.70
10 Treating water through disinfection kills the germs 261
(72.5 %)
84
(23.6%)
15
(4.0 %) 3.86 0.85
11 Throwing faeces into streams is a good sanitation and hygienic
practice
68
(18.9 %)
14
(3.8 %)
278
(77.3 %) 1.98 1.28
12 Frequent washing of hands with soap after visiting the toilet can
help in protecting the body from diseases
332
(92.2 %)
8
(2.2 %)
20
(5.6 %) 4.35 0.89
13 Garbage piled around a dustbin in a household can invite houseflies
and rodents into that house
334
(92.8 %)
9
(2.5%)
17
(4.7 %) 4.37 0.82
14 Burning garbage or refuse at backyards of households is not
environmentally sound
248
(68.9 %)
24
(6.7%)
88
(24.4 %) 3.67 1.28
15 Germs are easily found in filthy places with a lot of refuse/garbage. 316
(87.8 %)
20
(5.5%)
24
(6.7 %) 4.20 0.95
*SD – Standard Deviation

6. Sanitation Attitudes of Urban Dwellers and their Influence on Sanitation Practices in Central Region of Ghana
Safo-Adu G. 075
agreed. Again, many respondents (84.7 %) believed that
throwing refuse into gutters and on streets can cause
flood. and one out of every 24 persons never believed that
treating water through disinfection kills the germs in the
water. Furthermore, participants (52.5 %) who disagreed
that always covering drinking water stored in containers
does not prevent contamination were 21.7 % which is more
that participants (30.8 %) who agreed. It was agreed by
many respondents (84.1 %) that leaving cooking utensils
without washing for days after cooking is not hygienic. In
addition, most respondents (70.0 %) felt that community
sanitation exercise is the responsibility of the youth. Also,
it was reported by many participants (92. %) that frequent
washing of hands with soap after visiting the toilet can help
protect the body against diseases and about 69.0 % of
participants agreed to the fact that burning of garbage or
refuse at backyards of households is not environmentally
sound. 84.7 % of respondents reported that improper
disposal of waste is one of the environmental challenges
that need to be solved urgently.
The summary of results on respondents’ attitude towards
sanitation is shown in Table 5, as a significant number of
respondents (76.4 %) had good attitudes towards
sanitation. Few respondents (3.3 %) had bad attitudes
towards sanitation. Respondents who had moderate
attitude towards sanitation constituted 20.3 %.
Table 5. Summary of results on respondents’ attitude
towards sanitation and hygiene (N=360)
Attitude Frequency Percent
Good (> 52.5) 275 76.4
Moderate (37.5 ≤ v ≤ 52.5) 73 20.3
Bad (< 37.5) 12 3.3
Mean 2.73
Standard Deviation 0.51
The result of Chi- square test performed to examine the
relationship between respondents’ attitudes towards
sanitation and their demographic characteristics is
presented in Table 6. There was no significant
relationship between respondents’ attitudes towards
sanitation and their sex (𝜒2
= 3.11, p = 0.21), age (𝜒2
=
3.80, p = 0.15) occupation (𝜒2
= 13.38, p = 0.20) and
educational qualification ( 𝜒2
= 6.62, p = 0.36).
Table 6. Univariate association between respondents’ attitudes toward sanitation and their demographic characteristics
(N=360)
Demographic
characteristics
Respondents attitude Total
f(%)
𝜒2
f(%)
p-value
f(%)Bad f(%) Moderate f(%) Good f(%)
Sex
Male
Female
Total
6(1.8)
6(1.8)
12(3.5)
27(7.9)
43(12.6)
70(20.5)
131(38.3)
129(37.7)
260(76.0)
173(48.0)
187(52.0)
360(100.0)
3.105 0.212
Age Group
10 – 17
18 and above
Total
0(0.0)
12(3.5)
12(3.5)
15(4.3)
53(15.3)
68(19.7)
64(18.5)
202 (58.4)
266(76.9)
85(22.8)
275(77.2)
360(100.0)
3.801 0.149
Occupation
Student
Farmer
Civil servant
Politician
Trader
No occupation
Total
3(0.9)
1(0.3)
1(0.3)
0(0.0)
4(1.2)
2 (0.6)
11(3.4)
16(5.0)
10(3.1)
4(1.2)
1(0.3)
20(6.2)
10(3.1)
61(19.0)
100(31.2)
33(10.3)
21(6.5)
0(0.0)
77(24.0)
18(5.6)
249(77.6)
119(37.1)
44(13.7)
26(8.1)
1(0.3)
101(31.5
30(9.3)
360(100.0)
13.375 0.203
Educational
status(Highest)
Primary
Secondary
Tertiary
None
Total
3(0.9)
7(2.2)
2(0.6)
0(0.0)
12(3.8)
27(8.5)
24(7.6)
5(1.6)
6(1.9)
62(19.6)
78(24.7)
127(40.2)
21(6.6)
16(5.1)
242(76.6)
108(34.2)
158(50.0)
28(8.9)
22(7.0)
360(100.0)
6.615 0.358
Summary of the results of respondents’ sanitation
practices is shown in Figure 1. Most respondents (58 %)
had good sanitation practices. Few respondents (15.0 %)
had poor sanitation practices. Also, about 27 % of the
respondents had moderate standard sanitation practices.

7. Sanitation Attitudes of Urban Dwellers and their Influence on Sanitation Practices in Central Region of Ghana
Int. J. Toxicol. Environ. Health 076
Figure 1. Respondent’s sanitation practices
The Pearson product moment correlation conducted to
test the hypothesis that respondent’s attitudes towards
sanitation influence their sanitation practices is presented
in Table 7. The results indicated that statistically significant
weak positive correlation was recorded between
respondents’ attitudes towards sanitation and their
sanitation practices (r = 0.058, p = 0.269). Thus,
respondents’ attitudes towards sanitation contributed by
5.8% in their sanitation practices.
Table 7. Results of correlation analysis
Relationship Correlation value P – Value
Attitude and practices 0.058 0.269
.
DISCUSSION
This study examined the attitudes of urban dwellers in
some communities in Central Region of Ghana towards
sanitation and their influence on sanitation practices. The
study revealed that many respondents (46.7 %) disposed
of their solid waste through open dumping. This is in par
with the study conducted by Duru et al. (2017) in Orlu, Imo
State in Nigeria where the commonest solid waste
disposal practices among respondents was open dumping
(49.8 %). Also, 3 out of every 10 persons disposed of their
solid waste through open burning. This is in contrast with
the findings of the Ghana Statistical Service (2013) where
13.4 % of dwellings units burn their solid waste. Few
respondents (20.2 %) disposed of their waste by dumping
them into municipal waste containers or skips. A
significant number of respondents (77.2 %) disposed of
their solid waste daily whilst one out of 24 persons
disposed of their waste monthly. The finding of this study
is in contrast with the study conducted by Mohd and Malik
(2017) where 53.8 % of respondents disposed of solid
waste daily. Furthermore, few respondents (17.7 %)
disposed of their waste weekly. Few respondents (24.2 %)
temporarily stored their solid waste in dustbins before
disposal. Comparatively, respondents who temporarily
stored their solid wastes in buckets before disposal were
higher than respondents who stored their solid wastes
temporarily in dustbins. Also, the majority of the
respondents (84.7%) confirmed that improper disposal of
refuse is one of the environmental challenges that needs
to be solved urgently. This implies that respondents were
not satisfied with how solid waste was disposed in the
study area. Chi-square test results revealed that there was
no statistical significant association between respondents
regularity of solid waste disposal and their sex (p = 0.225,
p > 0.05), educational qualification (p = 0.741, p> 0.05) and
occupation (p = 0.650, p > 0.05). Similarly, a study
conducted by Ekong (2015) revealed that no significant
association was recorded between respondent’s regularity
of solid waste disposal and their sex (p = 0.722, p > 0.05)
and occupation (p = 0.111, p > 0.05). On the contrary,
there was significant association between respondent’s
regularity of solid waste disposal and educational
qualification (p = 0.0007, p <0. 05).
The study showed that significant proportion of
respondents (92.2 %) believed that garbage pile around
dustbin in households invites houseflies and rodents into
households. On this premise, most participants (84.7 %)
indicated that it is the responsibility of anyone who
generates solid waste to put it into the dustbin.
Furthermore, the majority of respondents (87.8 %)
reported that germs are easily found in filthy places with a
lot of garbage. This could be the reason why about 96.0 %
of respondents felt weeding surroundings and keeping
households clean protect the human body against certain
diseases. Furthermore, it also explains why a significant
number of respondents (92.2 %) believed that frequent
washing of hands with soap after visiting the toilet help
protect the body against diseases. The study revealed that
respondents had good views towards protecting the
environment. This is due to the fact that about 69.0 % of
participants believed that throwing faeces into streams is
not a good sanitation practice and most respondents (77.3
%) reported that burning of garbage or refuse at backyards
of households is not environmentally sound. Moreover,
respondents had encouraging views towards household
hygiene, as significant proportion of participants (84.1 %)
indicated that leaving cooking utensils without washing for
days after cooking is not hygienic whilst most participants
(72.5 5 %) believed that treating water through disinfection
kills the germs in the water. It was found that respondents
had positive views towards environmental health
protection, where participants (84.7 %) believed that
defecating in bushes/fields and backyards has adverse
health effects on people and also throwing refuse into
gutters and on the street can cause flood, which leads to
loss of lives and properties. Moreover, about 97.0 % of
participants indicated that stagnant waters around
household serve as breeding grounds for mosquitoes
which also pose high risk to malaria. Moreover,
participants (52.5 %) reported that covering drinking water
stored in containers always prevented contamination.
Furthermore, 7 out of 10 persons felt that community
sanitation exercise is the responsibility of the youth.
The study revealed that a significant number of
respondents (76.4 %) had good attitudes towards
sanitation. The finding of this study is in contrast with the
study conducted by Duru et al. (2017) where respondents’
attitude towards sanitation was low (38.6 %).

8. Sanitation Attitudes of Urban Dwellers and their Influence on Sanitation Practices in Central Region of Ghana
Safo-Adu G. 077
Respondents who had poor attitudes towards sanitation
were few constituting 3.3 %. Also, respondents who had
moderate attitude towards sanitation constituted 20.3 %.
All in all, urban dwellers in some communities in Central
Region of Ghana had good sanitation practices (58.0 %).
Again, this is in contrast with the study conducted by Duru
et al. (2017) where respondent’s sanitation practice was
low (20.8 %). The variations in findings may be due to
different study settings and population. Moreover, the
finding of this study is different from that of Aswathy (2015)
where 49 % participants had fair and good sanitation
practices. Statistically, no significant relationship was
found between respondents’ attitudes towards sanitation
and their sex (𝜒2
= 3.11, p = 0.21), age (𝜒2
= 3.80, p = 0.15),
educational qualification (𝜒2
= 6.62, p = 0.36) and
occupation (𝜒2
= 13.38, p = 0.20). Furthermore, a
significant weak positive correlation was recorded
between respondent’s attitudes towards sanitation and
their sanitation practices (r = 0.058, p = 0.269).
Respondents’ attitudes towards sanitation weakly
influenced their sanitation practices. This is because
respondent’s attitudes towards sanitation contributed only
by 5.8% in their sanitation practices.
CONCLUSION AND RECOMMENDATIONS
The improper disposal of solid waste is one of the
environmental challenges in Central Region of Ghana,
hence it needs to be urgently solved. About half of the
respondents (49.8 %) unwholesomely disposed of their
solid waste daily through open dumping. Most
respondents had good attitudes towards sanitation with
good sanitation practices (58 %). Respondents’ attitudes
towards sanitation weakly influenced their sanitation
practices(r = 0.058, p = 0.269). The findings of the study
leads to a conclusion that the high level of sanitation
attitudes among urban dwellers in some communities in
Central Region of Ghana could not be translated into
actual practice, hence there was a gap between
respondents attitudes towards sanitation and their actual
practice.
It is therefore recommended that:
1. The Central Regional Environmental Health and
Sanitation Directorate should embark on a
comprehensive campaign on health benefits of good
sanitation practices and enforce a more robust
environmental sanitation approach and health
education to help translate the high sanitation attitudes
among urban dwellers into actual practice.
2. The municipal and district assemblies within the
Central Region of Ghana should educate households
on the need to temporarily put their solid waste in
dustbins, encourage households to dump solid
wastes into municipal waste containers and
discourage open dumping and burning of solid waste
as this negatively affects the environment.
ACKNOWLEDGEMENTS
I would like to thank the 2018 National Service personnel
in the Department of Integrated Science Education of
University of Education, Winneba who helped in the data
collection during the study.
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Accepted 21 June 2019
Citation: Safo-Adu G (2019). Sanitation Attitudes of Urban
Dwellers and their Influence on Sanitation Practices in
Central Region of Ghana. International Journal of
Toxicology and Environmental Health, 4(2): 070-078.
Copyright: © 2019 Safo-Adu G. This is an open-access
article distributed under the terms of the Creative
Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium,
provided the original author and source are cited.