Community attitude towards sanitation practices during flooding in flood-prone informal settlement of Kisumu central sub-county, Kenya

Abstract

Flooding poses a significant challenge to safe sanitation management in informal settlements. While sanitation interventions often emphasise infrastructure and service provision, community attitudes may influence how households respond to sanitation risks during flood events. This study assessed community attitudes towards sanitation practices during flooding events in flood-prone informal settlements of Kisumu Central Sub-County, Kenya. A cross-sectional descriptive mixed-methods design guide by the Health Belief Model was employed with 395 households distributed across Nyalenda B, Manyatta A, Obunga and Bandani informal settlements. Household adults were selected using a combination of purposive and random sampling procedures. Quantitative data were collected using structured questionnaires, while qualitative information was obtained through eight key informant interviews with public health officers, community health promoters, local administrators and other relevant actors. Quantitative data were analysed using frequencies, percentages and binary logistic regression, while qualitative data were analysed thematically and triangulated with quantitative findings. The findings showed generally favourable attitudes towards individual aspects of sanitation during flooding. 74% of respondents agreed that flooding increased the risk of faecal contamination, 73.4% recognised increased household exposure, 79.4% considered children particularly vulnerable, and 74.6% agreed that proper sanitation was critical during floods. However, only 56% demonstrated an overall positive attitude towards sanitation practices. Regarding responsibility, 50.8% considered sanitation during floods an individual responsibility, while 73.6% agreed that the government should provide emergency support. Age was the only socio-demographic factor significantly associated with overall attitude, with respondents aged 45–64 years approximately three times more likely to have a positive attitude than those aged over 65 years (AOR = 3.04; 95% CI: 1.02–9.00; p = 0.05). Gender, location, household tenure, income, income regularity and receipt of support were not statistically significant predictors. The findings demonstrate a gap between awareness of sanitation risks and overall positive attitudes, suggesting that knowledge alone may be insufficient to promote resilient sanitation responses during floods. Strengthening flood-resilient sanitation infrastructure, institutional support, risk communication and community engagement is recommended.