American Journal of Public Health Research, 2018, Vol. 6, No. 3, 134-138 Available online at http://pubs.sciepub.com/ajphr/6/3/2 ©Science and Education Publishing DOI:10.12691/ajphr-6-3-2 Effect of a Community Health Worker Led Health Education Intervention on Latrine Coverage in Mwingi West Sub-County; Kenya: A Quasi-Experiment Japheth Mativo Nzioki 1,* , Agnes Korir 2 1 Department of Environmental health, University of Kabianga, Kericho -Kenya 2 Department of Development Studies, Daystar University, Athi-River- Kenya *Corresponding author: nziokimativo@gmail.com Abstract It is estimated that globally 2.4 billion people still lack access to improved sanitation and 946 million still practice open defecation. Every Kenyan has a right to adequate sanitation and the government of Kenya is committed to ensure that Kenyans enjoy adequate sanitation by the year 2030. Despite this commitment, latrine coverage in many parts of Kenya is low and the result is a high prevalence of hygiene and sanitation related illnesses. In Kitui County, open defecation is high at 30.9%. The aim of this study was to assess effect of Community Healthy Strategy (CHS) on latrine coverage in Mwingi West sub county, Kitui County-Kenya. The study was a pretest-post- test experiment with intervention and control sites. Mwingi West and Mwingi North sub-counties were intervention and control sites respectively. Participants in intervention site received health education on importance latrine construction and safe fecal disposal while control site did not. In each site, 1 pre-intervention and 2 post-intervention surveys were conducted with each survey having a sample size of 422 households. An observation checklist and a questionnaire were the main data collection tools. In the intervention site, CHS significantly increased latrine coverage from baseline to midterm survey and from baseline to end-term survey by 21% (Z=7.0128, P=0.0001) and 27.6% (Z=9.7189, P=0.0001) respectively. Compared to baseline, households in intervention site-midterm survey and intervention site-endterm survey were 4 times more likely to have a latrine (adj. OR: 4.356, P<0.0001, 95% CI: 2.975-6.379 and 3 times more likely to have a latrine (adj. OR: 3.391, P<0.0001, 95% CI: 2.686-4.280) respectively. No significant difference was observed on latrine coverage in the control site. CHS significantly increased latrine coverage in Mwingi West Sub-county. To declare Kenya an Open Defecation Free country and help the country meet the global sanitation related Sustainable Development Goals by 2030, county governments need to scale up implementation of CHS to cover areas which have not been covered. Keywords: Community Health Strategy, Community Health Workers, latrine coverage, sanitation Cite This Article: Japheth Mativo Nzioki, and Agnes Korir, “Effect of a Community Health Worker Led Health Education Intervention on Latrine Coverage in Mwingi West Sub-County; Kenya: A Quasi-Experiment.” American Journal of Public Health Research, vol. 6, no. 3 (2018): 134-138. doi: 10.12691/ajphr-6-3-2. 1. Introduction Millennium Development Goal (MDG) 7, target 7C was to halve, by 2015, the proportion of the population without sustainable access to safe drinking water and basic sanitation by the year 2015 [1]. Between 1990 and 2015, the proportion of global population using improved sanitation facility increased from 54 % to 68 % [2]. Slightly over 2.1 billion people gained access to improved sanitation since 1990, and the proportion of people practicing open defecation globally fell almost by half, from 24 % to 13 % [2]. Caucasus and Central Asia, Eastern Asia, Northern Africa and Western Asia cut by half the proportion of the population without access to improved sanitation. While Southern Asia had the lowest baseline coverage in 1990, at 22 %, it recorded the largest increase in the proportion using improved sanitation, reaching 47 per cent in 2015 [2]. However, by 2015, estimated 2.4 billion people were still using unimproved sanitation facilities, and a staggering 1 billion people (14% of the world population) have no access to toilets, latrines or any form of sanitation facility at all and therefore practiced open defecation [2] and [3]. In Sub Saharan Africa, baseline latrine coverage in 1990 was 24% and the region recorded a marginal increment of only 30% by 2015 [2]. A joint monitoring program conducted in Kenya established that only 32 % of the rural population had access to improved sanitation [4]. Open defecation is still widely practiced in Kenya despite the government’s ambitious rural Kenya 2013 Open Defecation Free (ODF) campaign roadmap [4]. Though the overall national open defecation rate is about 14 percent, it masks massive regional disparities. In Turkana County open defecation is highest at 82.1%, Wajir-76.7%, Samburu 73.4%, West Pokot-67.1%, Mandera-66%, Marsabit-64.6%, Kwale 51.2%, Narok-48.4%,