Water, Sanitation and Understanding of Germ Theory in Rural Ghana

Samuel Thomas1, Alison Taylor 1, Linnea Fletcher2, Kory Fleming2, Rachel Morse3, Amy Durstler4

University of Utah School of Medicine1, University of Utah Division of Public Health2, University of Utah Division of Occupational Therapy3,
University of Utah4

Efforts have been made to improve hygiene and access to clean water sources throughout the Barekuma region of Ghana.  Changes include access to cleaner water through boreholes and standpipes, building of toilet facilities and educating on proper hygiene techniques.  The Barekuma Collaborative Community Development Project (BCCDP), who partners with the University of Utah, has been heavily involved with implementing these changes.  A Knowledge, Attitudes, and Practice survey was undertaken in several rural Ghanaian communities to determine basic understanding of germ theory, utilization of clean water sources, access and utilization of soap and application of correct hygiene practices.  

This was a descriptive cross sectional survey of 178 individuals from several communities affiliated with the BCCDP. The individuals were interviewed in July 2012. The matriarch of each household was asked a 40 question survey regarding her knowledge, attitudes, and practice toward water, sanitation, and hand washing.

Some answers to survey questions were incongruent with modern germ theory.  However, when asked why it is important to wash hands with soap, or what may happen if they don’t wash their hands with soap after using the toilet, most answers were consistent with some infectious process, indicating a basic understanding of modern germ theory.  The vast majority of the women surveyed understand that drinking unclean water can cause health problems (93%).  Despite the fact that they have access to boreholes and pipes, 30% still obtain their water from unclean sources such as a river/stream, an uncovered well and rain water.  All of the women had some access to soap in their home whether local soap or factory soap, although 60% answered that there are times when they cannot afford to buy soap. 

Many of the villagers surveyed demonstrated a basic understanding of germ theory.  In addition, it was found that most have access to relatively clean water sources and soap.  However, many of their hygiene practices, including primary water source, reflect poorly on their application of this knowledge and utilization of resources.  Therefore, future efforts should be aimed not only at education, but researching possible cultural barriers to proper hygiene.

Author contact: Alison.taylor@hsc.utah.edu