Understanding Household Behavioral Risk Factors for Diarrheal Disease in Dar es Salaam: A Photovoice Community Assessment

Abstract

Whereas Tanzania has seen considerable improvements in water and sanitation infrastructure over the past 20 years, the country still faces high rates of childhood morbidity from diarrheal diseases. This study utilized a qualitative, cross-sectional, modified Photovoice method to capture daily activities of Dar es Salaam mothers. A total of 127 photographs from 13 households were examined, and 13 interviews were conducted with household mothers. The photographs and interviews revealed insufficient hand washing procedures, unsafe disposal of wastewater, uncovered household drinking water containers, a lack of water treatment prior to consumption, and inappropriate toilets for use by small children. The interviews revealed that mothers were aware and knowledgeable of the risks of certain household practices and understood safer alternatives, yet were restricted by the perceived impracticality and financial constraints to make changes. The results draw attention to the real economic and behavioral challenges faced in reducing the spread of disease.

Picturing waters: a review of Photovoice and similar participatory visual research on water governance

“…Articles have been grouped according to: (1) water governance themes and concerns addressed, identified under the category ‘specific objective of the study,’ and (2) geographical focus, identified under the categories ‘participants (place)’ and ‘urban/rural.’ The four groups thus identified are:Projects identifying issues and concerns in water and health, sanitation, hygiene (six articles27, 28, 29, 30, 31, 32 and five projects): these studies have been undertaken in Sub‐Saharan Africa (South Africa, Mozambique, Kenya, and Tanzania) by researchers based in Canada and the United States with local African partners.Projects promoting participation in water resources management (eight articles19, 33, 34, 35, 36, 37, 38, 39 and eight projects), in Australia and New Zeeland undertaken by national research groups, and in India by an international consortium of Australian and Indian researchers.Projects aiming at understanding experiences and perceptions of landscapes and water spaces (five articles40, 41, 42, 43, 44 and four projects): these projects have been undertaken in Canada (2) and Japan (1) by national research groups and in Sierra Leone (1) by a researcher based in Canada.Projects aiming to explore the link between domestic water and urban water management (four articles20, 45, 46, 47 and three projects) undertaken in Australia (2) and New Zeeland (1) by national research groups. …”

“…Projects identifying issues and concerns in water and health, sanitation, hygiene (six articles27, 28, 29, 30, 31, 32 and five projects): these studies have been undertaken in Sub‐Saharan Africa (South Africa, Mozambique, Kenya, and Tanzania) by researchers based in Canada and the United States with local African partners.…”

“…In this respect, Photovoice facilitated to highlight the complexity of water issues, by revealing the consequences of power relations linked to socioeconomic factors27, 29 or gender 43. Participatory visual research also elicited reflections and awareness about the need for a holistic approach in water‐health interventions to address political, ecological and social (micro and macro) factors,27, 28 as well as the need for transdisciplinary work to address such complexity 36…”

Defining and measuring water access: lessons from Tanzania for moving forward in the post-Millennium Development Goal era

“…57 of my respondents in 2014 spent at least 5 minutes queuing at their primary water sources, with some spending over 30 min. Badowski et al (2011) found waiting time could be up to 30 min. Acknowledging the burden that walking and waiting can have on households, the Tanzanian Government has a long-term goal of a 5-min roundtrip water collection time (MoWLD, 2002).…”

“…Nearly half of my respondents had longer walks to their back-up sources. Badowski et al (2011) found water collection times in Dar es Salaam to be less than 20-min roundtrip, but noted that households make between 2 and 5 trips each day. In Buguruni, households spend an average of thirty minutes fetching water, but half spend considerably more -over an hour (Kyessi, 2005).…”