A Community-Based Participatory Research (CBPR) approach to explore the knowledge, attitudes, and practice of water, sanitation, and hygiene in rural Ghana

Linnea Fletcher1, Samuel Thomas2, Alison Taylor2, Kory Fleming1, Amy Durstler1, Rachel Morse1

University of Utah1, University of Utah School of Medicine2

Background: Historically, health promotion projects in developing countries have failed to engage communities which have caused poor sustainability of the projects. Community-based participatory research (CBPR) is an alternative approach that has recently gained popularity.  This is the principle method employed by the University of Utah’s Global Public Health Initiative in the Barekuma communities of rural Ghana.  Following the CBPR approach, the Barekuma Collaborative Community Development Project (BCCDP) was designed to form collaborative partnerships between the Barekuma community leaders and members, local Ghanaian health care providers, Kwame Nkrumah University of Science and Technology (KNUST) medical students, and the University of Utah’s Division of Public Health with the main focus to improve the general health of community members over time. Through the principles of CBPR, a water, sanitation, and hygiene research project was carried out.

Methods: A 40 question survey was designed and administered to the members of the Barekuma communities to determine the knowledge, attitudes, and practices of the Barekuma community members towards water, sanitation, and hygiene. The project was evaluated on the adherence of the principles of CBPR.

Results: The survey was administered in order to find out information the partners of the BCCDP desired to know. Some of the questions were designed to follow up on projects that were carried out previously such as research and education about water, sanitation, and the construction of a toilet facility. The results from the survey have been determined and will be disseminated to the communities in the future. These results will also be used to develop further research projects and interventions in the communities.

Conclusion: Successful CBPR efforts have mutually benefited members of the BCCDP through combining knowledge with action to achieve social change.  Principles of CBPR efforts have improved the overall quality of health, leading to lasting improvements of health in the Barekuma communities.  This has become possible by researching concerns of the community leaders which has strengthened the partnership and engaged the community. Community engagement is vital to capacity building and ensuring the sustainability of a project. The dissemination of information to the communities increases community engagement and allows for lasting change.


  1. Black RE, Allen LH, Bhutta ZA, Caulfield LE, deOnis M, Mathers C, Rivera J. Maternal and child undernutrition: global and regional exposures and health consequences. Lancet 2008; 371: 243-260.

  2. Demographic and Health Survey (DHS). 2008 Demographic and Health Survey. 2008. Retrieved from http://www.meauredhs.com/pubs/pdf/GF14?GF14.pdf

  3. Demographic and Health Surveys (DHS).  Ghana: 2008 Demographic and Health Survey Key Findings. 2008. Retrieved from

Author contact: nealee2004@yahoo.com