American Journal of Public Health Research
ISSN (Print): 2327-669X ISSN (Online): 2327-6703 Website: Editor-in-chief: Apply for this position
Open Access
Journal Browser
American Journal of Public Health Research. 2017, 5(5), 163-169
DOI: 10.12691/ajphr-5-5-5
Open AccessArticle

Assessment of the Knowledge, Attitude and Practice Regarding Water, Sanitation and Hygiene among Mothers of Under-five Children in Rural Households of Saptari District, Nepal

Rima Kumari Sah1, Prem Kumar Sah2, , Jitendra Kumar Sah2, Sudip Chiluwal2 and Sanjeev Kumar Shah3

1Mahendra Bindeshwari Multiple Campus, Tribhuwan University, Rajbiraj, Nepal

2Nepal Public Health and Education Group, Kathmandu, Nepal

3Department of Public Health, National Open College, Sanepa, Lalitpur, Pokhara University, Nepal

Pub. Date: October 24, 2017

Cite this paper:
Rima Kumari Sah, Prem Kumar Sah, Jitendra Kumar Sah, Sudip Chiluwal and Sanjeev Kumar Shah. Assessment of the Knowledge, Attitude and Practice Regarding Water, Sanitation and Hygiene among Mothers of Under-five Children in Rural Households of Saptari District, Nepal. American Journal of Public Health Research. 2017; 5(5):163-169. doi: 10.12691/ajphr-5-5-5


Background: Safe drinking water and basic sanitation are crucial to the preservation of human health, especially among children. Water, sanitation and hygiene related issues are still a burning issue in the context of developing countries. Saptari district of Nepal, water supply coverage is 83% and sanitation coverage is only 25 % which is lower than national coverage. This could lead to poor hygienic practice in the community and it may adversely affect the health of vulnerable under-five children. Objective: To assess knowledge, attitude and practice on Water, Sanitation and Hygiene (WASH) among mothers of under-five children in rural households of Saptari district of Nepal. Methodology Cross sectional study was undertaken in 21 Village Development Communities of Saptari district of Nepal. Multistage sampling method was used and 420 mothers of under-five children were interviewed about their knowledge, attitude and practice regarding water, sanitation and hygiene. Results: Out of 420 mothers, majority of participants had appropriate knowledge (74.8%) and poor knowledge (25.71%) on water, Sanitation and hygiene. 57.14% participants had positive attitude on water, sanitation and hygiene while (42.85%) had negative attitude. Regarding practice, (60%) participants did good practice and (40%) did poor practice. Almost 94.3% of the respondents used hand pump as a source of drinking water, (34.8%) used latrine for defecation. More than half (56.19%) of respondents washed hand with soap and water after defecation. A statistically significant difference in the level of knowledge, attitude and practice of participants was seen according to their educational level at p<0.05. Conclusion: Present study showed that knowledge and attitude on safe practice of water, sanitation and hygiene among mothers were affected by their education level. Hence there is a need to spread information on the importance of proper practice on water, sanitation and hygiene in rural areas through available evidences based on BCC strategies and multiple dissemination channels.

knowledge water sanitation hygiene attitude practice mothers under five children

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit


[1]  World Water Assessment Programme. The United Nations World Water Development Report 3: Water in a Changing World. Paris: UNESCO, and London: Earthscan; 2009 [cited on 2014 Aug 4]. Available from:
[2]  WHO/UNICEF Program. Progress on drinking water and sanitation [Internet]. Geneva, Switzerland: WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation; 2012 [cited on 2014 Aug 4]. Available from:
[3]  Liu L, Johnson HL, Cousens S, Perin J, Scott S, Lawn JE, et al. Child Health Epidemiology Reference Group of WHO and UNICEF. Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet. 2012; 379(9832):2151-61.
[4]  NPC/UNCT. Nepal Millennium Development Goals Progress Report 2010. Kathmandu: National Planning Commission and United Nations Country Team; 2010.
[5]  Water supply & sanitation division sector efficiency improvement unit. Nepal wash sector status report. Kathmandu: Government of Nepal ministry of physical planning and works; 2011.
[6]  National Management Information Project (NMIP). Nationwide Coverage and Functionality Status of Water Supply and Sanitation in Nepal [Internet]. Panipokhari Kathmandu: Department of Water Supply and Sewerage; 2014[cited 2015 April 2]. 7-10. Available from:
[7]  Sabal Nepal. Water & sanitation hygiene [Internet]. Rajbiraj Saptari Nepal: 2011 [cited on June 32 2014]. Available from:
[8]  World water council. Water Supply and Sanitation [Internet]. France: Istanbul water consensus; 2012 [cited on 2014 Aug.4]. Available from:
[9]  R B Sah, D D Baral, A Ghimire, P K Pokharel. Knowledge & practice of water & sanitation application in Chandragadhi VDC of Jhapa District. Health Renaissance. 2013; 11(3):241-245.
[10]  Herbst S, Benedikter S, Koester U, Phan N, Berger C, Rechenburg A et al. Perceptions of water, sanitation and health: a case study from the Mekong Delta, Vietnam. Water Sci Technol. 2009; 60 (3): 699-707.
[11]  Linda Akuamoah Sarfo, Dorothy Awuah Peasah and Florence Asamoah. Millennium Development Goal 4 and the knowledge of mothers on the prevention of diarrhea among children under five years. International Research Journal of Medicine and Medical Sciences. 2013; 1(3): 80-84.
[12]  H. Blaise Nguendo Yongsi. Suffering for Water, Suffering from Water: Access to Drinking-water and Associated Health Risks in Cameroon. Journal of Health Population and Nutrition. 2010; 28(5): 424-435.
[13]  Kimongu Justus Kioko and John Festus Obiri. Household attitudes and knowledge on drinking water enhance water hazards in periurban communities in Western Kenya. Jàmbá. Journal of Disaster Risk Studies. 2012; 4(1).
[14]  Mubashir Zafar. Knowledge and Attitude towards and Preventive Practices Relating to Diarrhea among Mothers Under Five Years of Children: Findings of a Cross-Sectional Study in Karachi, Pakistan. Journal of Infectious Disease Therapy. 2014; 2(1).
[15]  Parker AA, Stephenson R, Riley PL, Ombeki S, Komolleh C, Sibley L, Quick R Sustained high levels of stored drinking water treatment and retention of hand-washing knowledge in rural Kenyan households following a clinic-based intervention. Epidemiol. Infect. 2006; 134: 1029-1036.
[16]  Bharti, Manisha Malik, Vijay Kumar, Ramesh Verma, Sumit Chawla and Sandeep Sachdeva. Knowledge Attitude and Practices Regarding Water Handling and Water Quality Assessment in a Rural Block of Haryana. International Journal of Basic and Applied Medical Sciences. 2013; 3(2): 243-247.
[17]  Kalyan Bandaa, Rajiv Sarkarb, Srila Gopala, Jeyanthi Govindarajana, Bhim Bahadur Harijana, Mary Benita Jeyakumara et al . Water handling, sanitation and defecation practices in rural southern India: a knowledge, attitudes and practices study. Transactions of the Royal Society of Tropical Medicine and Hygiene. 2007; 1124-1130.
[18]  Asekun Olarinmoye Esther O, Omobuwa Olubukola, and Adebimpe Wasiu O., Ifeoluwapo O. Hand Washing: Knowledge, Attitude and Practice amongst Mothers of Under-Five Children in Osogbo, Osun State, Nigeria. Journal of Biology, Agriculture and Healthcare. 2014; 4(16).
[19]  Stephen P. Luby, Amal K. Halder, Tarique Huda, Leanne Unicomb, Richard B. Johnston. The Effect of Hand washing at Recommended Times with Water Alone and With Soap on Child Diarrhea in Rural Bangladesh: An Observational Study. PLoS Medicine. 2011; 8(6).
[20]  Swati Kadam, Sanghamitra Pati, Abhimanyu Singh Chauhan. A Study on Knowledge and Practice of Hand Washing among Slum Children and their Mothers in Bhubaneswar, Odisha. Indian Journal of Public Health Research & Development. 2014; 5(3): 67-71.