Date of Award

January 2025

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Michael Cappello

Abstract

Introduction: Soil-transmitted helminth (STH) infections affect more than 1 billion people globally, particularly in low-income areas with poor sanitation. While mass drug administration is a common control strategy, long-term elimination requires a broader, integrated approach with an emphasis on sustainable water, sanitation and hygiene (WASH) practices, community-led initiatives, and economic development. Currently, there are critical gaps in understanding the impacts of WASH infrastructure in households, healthcare facilities, and schools on hookworm prevalence, specifically in rural Ghana. Methods: Using qualitative surveys, we characterized the current WASH landscape among households, healthcare facilities and schools in the Bono East region of Ghana. Hookworm prevalence among community members was evaluated in an ongoing longitudinal cohort study. Access and knowledge of WASH infrastructure was assessed in 79 households, 34 healthcare workers across four facilities, and 86 school employees across twelve schools. Our findings indicate households, health facilities, and schools have limited access to WASH services. Furthermore, within a single facility or school, staff responded with a variety of different answers to questions about available WASH infrastructure, such as primary source of drinking water or functionality of sanitation facilities, demonstrating a lack of communication among staff. Results: This study highlighted opportunities for improvements in WASH services across a large catchment area and illustrates the importance of open communication amongst healthcare and school staff to effectively utilize existing WASH infrastructure. Ultimately, this work provides a baseline for future studies evaluating the impact of improved WASH on STH transmission and community health in rural, high burden settings.

Comments

This is an Open Access Thesis.

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