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 Table of Contents  
ORIGINAL ARTICLE
Year : 2019  |  Volume : 16  |  Issue : 3  |  Page : 101-114

Family health practices regarding household waste management in El-Zawia El-Hamra District


Department of Community Health Nursing, Faculty of Nursing, Ain Shams University, Cairo, Egypt

Date of Submission03-Nov-2019
Date of Decision15-Nov-2019
Date of Acceptance19-Nov-2019
Date of Web Publication20-Aug-2020

Correspondence Address:
Wafaa K Ibrahim
Lecturer of Community Health Nursing, Faculty of Nursing Ain Shams University, Cairo, 11511
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ENJ.ENJ_7_19

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  Abstract 


Background Household waste management is attracting growing attention, as it can be readily noted that too much trash lies uncollected on the roads, causing inconvenience, pollution of the environment, and posing a threat to public health.
Aim The study aimed to evaluate the effect of a health awareness program on family knowledge and health practices regarding household waste management.
Design A quasi-experimental design was used.
Setting The study was conducted in El-Zawia El-Hamra District.
Sample The number of families in El-Zawia El-Hamra District is ∼11 350 families. Overall, 2% of the total number of families was recruited in this study. The sample number is equal to 228 families (200+28 for pilot study) from the total actual sample. Purposive sample comprised 200 families in this study.
Tools A structured interview questionnaire was used for data collection. It was divided into five parts: the first part included family’s sociodemographic data, the second part included the medical history of head of the family, the third part included family’s knowledge regarding household waste in El-Zawia El-Hamra area, the fourth part included family’s reported practices toward household waste management, and the fifth part included satisfaction of the family regarding El-Zawia El-Hamra District services and cleaning work in the region.
Results The current study showed highly statistically significant differences between the families’ total knowledge and their reported practices before and after implementation of the health awareness program.
Conclusion The application of health awareness program improved the families’ knowledge and their reported practices regarding household waste management.
Recommendations Conducting of continuous health awareness programs for families on how to manage waste healthily in the larger neighborhoods of Greater Cairo the usage of the media, especially television, as it is the most effective means of information for families.

Keywords: family health practices, household waste management


How to cite this article:
Ibrahim WK, Abd Ellatef MA, Mohamed AT. Family health practices regarding household waste management in El-Zawia El-Hamra District. Egypt Nurs J 2019;16:101-14

How to cite this URL:
Ibrahim WK, Abd Ellatef MA, Mohamed AT. Family health practices regarding household waste management in El-Zawia El-Hamra District. Egypt Nurs J [serial online] 2019 [cited 2020 Oct 20];16:101-14. Available from: http://www.enj.eg.net/text.asp?2019/16/3/101/292497




  Introduction Top


Waste management is a global issue, and most countries are finding best ways to deal with it. Waste management has recently become important, as waste has become a problem in every region of the world. Unsuccessful waste management presents a danger to people’s health as well as to the environment and the economy, which if addressed properly increases the quality of life by decreasing its adverse effect (Ferronato and Torretta, 2019).

Home waste includes trash and rubbish (e.g. bottles, cans, apparel, compost, disposables, food packaging, food scraps, newspapers, magazines, and yard trimmings) from personal households or flats. It may also contain household hazardous waste. Moreover, it is called domestic wastes or residential waste (Yoada et al., 2014).

Globally, millions of tons of municipal solid waste (MSW) is generated every day. Urban waste management is attracting more attention, as too much waste lies uncollected on the roads, causing inconvenience and environmental pollution and posing a public health risk (Owusu et al., 2012). The typical MSW composition contains food and kitchen waste, green waste, glass, paper, plastics, as well as other recyclable materials (Eurostat, 2012).

Household waste is categorized with respect to several respects. The following list is typical: biodegradable waste (such as meals, cooking waste, green waste, and paper), recyclable materials (such as paper, cardboard, glass, bottles, jars, tin boxes, aluminum boxes, foil, metals, plastics, fabrics, clothing, tires, and batteries), inert waste (waste building demolition, dirt, rocks, and debris), electrical and electronic waste (e.g. electrical appliances, light bulbs, washing machines, televisions, computers, screens, cell phones, alarm clocks, and watches), composite waste (waste clothing and waste plastics such as toys), which includes hazardous waste (most paints, chemicals, tires, batteries, light bulbs, electrical appliances, fluorescent lamps, aerosol spray boxes, and fertilizers), and lastly, toxic waste (including pesticides, herbicides, and fungicides), which includes biomedical waste (expired drugs) (Kumar et al., 2016).

Household waste poses significant or potential health and environmental threats because of their constituents, which may be hazardous. The household waste component is hazardous if it contains one of the following characteristics: ignitability, corrosivity, reactivity, and toxicity. It can lead to health issues such as skin, eye, or throat irritation; headaches; and even cancer [Central Public Health & Environmental Engineering Organization (CPHEEO), 2014).

Waste management or disposal includes all the activities and actions needed to handle waste from its creation to its final disposal, including, among others, waste collection, transportation, treatment, and disposal along with surveillance and regulation (JnNurm, 2012).

Main principles of waste management include prevention of the creation of waste in product design and packaging; reduction of the toxicity and/or adverse effects of waste generated; reuse of the materials recovered from waste streams in their present form; recycle, compost, and/or recover materials used as direct or indirect inputs into new products; recover energy through incineration; anaerobic digestion and/or other similar processes; and dispose of waste in an environmentally sound manner, generally in sanitary landfills (Gunsilius, 2010).

Lack of education and awareness of effective waste management practices is one of the significant issues in developing countries. Most people lack interest in environmental issues. It means that they are not well informed, which affects their actions. It also makes them feel not included in decision making on waste management. Proper public education, provision of more municipal waste bins, and the collection of waste by private contractors could help prevent exposing the public in municipalities to diseases (Dahlin et al., 2017).

Waste handling in developing countries is mostly a two-system approach, which is the formal and informal system. The government manages the system. The responsibilities delegated to the municipalities are to ensure safe, reliable, and cost-effective collection, and disposal of solid waste. It often requires substantial financial resources, making it very difficult to deal with waste management issues (Chu et al., 2016).

Significance of the problem

Cairo is one of the largest cities in the world. It is home to more than 15 million inhabitants. Like other mega cities, the municipality of Cairo and other stakeholders face an enormous challenge in waste management. Every day the town generates more than 15 000 tons of waste that put tremendous pressure on the infrastructure of the town. The waste management situation in Cairo is at a severe juncture. Concerted efforts are required to improve waste collection and disposal services across the city. The involvement of Zabbaleen is essential to the success of any waste management plan. The Egyptian government must involve all stakeholders in developing a sustainable waste management system for Cairo (Zafar, 2018).

El-Zawia El-Hamra district is one of the largest urban slums in Cairo, with an area of about 8.86 km and a population of about 318 170 people in the year 2017, for a manned space of 1.698 km (Ministry of Planning and Follow-up and Administrative Reform, 2018). El-Zawia El-Hamra is divided into several areas, such as interior, El Kosayareen, Ard El Genenah, El Waili, Ezbt Abo Lilah, Madent El Noor, and Madent El Ahlam. Within the year 2012, 120 000 m of waste was removed from El-Zawia El-Hamra District, and this district suffers from some health problems related to health habits and health practices (Cairo Governorate Electronic gate, 2018).

Awareness programs provide a base of knowledge to the families regarding healthy management of household waste and enable them to effective deal with all types of the waste products, without causing harmful effects on the family members and the surrounding environment.

The family can play an essential role in protecting and promoting the health of the community and the environment. The family can manage hazardous wastes properly by proper planning. They can prevent from producing a considerable amount of leachate by separating the household hazardous wastes at the site of production and collecting them separately (Amouei et al., 2016).


  Aim Top


This study aimed to evaluate the effect of the health awareness program on family health practices regarding household waste management in El-Zawia El-Hamra District through the following:
  1. Assessing families’ knowledge regarding household waste management.
  2. Assessing families’ practices regarding the healthy management of household waste.
  3. Designing and implementing a health awareness program on the management of household waste.
  4. Evaluating the effect of the health awareness program on family knowledge and health practices regarding household waste management.


Research hypothesis

The health awareness program will improve family knowledge and health practices regarding household waste management.


  Patients and methods Top


Research design

A quasi-experimental design was used to achieve the aim of the study.

Setting

This study was conducted in El-Zawia El-Hamra District through cooperation with the Presidency of El-Zawia El-Hamra District and the local nongovernmental association (NGOs) in the region: El-Salam Association, Noor Al-Islam Association, Al-Huda Islamic Society, and Usama Bin Zaid Association.

Patients

A purposive sample included 200 families. The sample was chosen randomly, consisting of all families available at the time of study conduction and families who agreed to participate in the study. Every family had the same chance to be included in the study from the previously mentioned settings under the following criteria:
  1. Individuals should have the desire to participate in the study.
  2. Individuals are older than 18 years.
  3. The number of families in El-Zawia El-Hamra District is about 11 350 families. Overall, 2% of the total number of families was recruited in this study. The sample number is equal to 228 families (200) from the total actual sample. Twenty-eight families were excluded as a pilot sample. The study sample size was calculated using the formula, N=(Z2 P(1P))/e2) (Thrusfield, 2005).
  4. Z=value from standard normal distribution corresponding to the desired confidence level (Z=1.96 for 95% confidence interval).
  5. P is expected a true proportion.
  6. E is the desired precision (half desired CI width).
  7. The final sample size required for specified inputs was 228 families.


Study tool

A structure interviewing questionnaire was developed by the researchers based on the recent literature, experts’ opinion, and researchers’ experience.

Tools of data collection

Structured interview questionnaire

It is developed by the researchers in Arabic form after reviewing the related literature to assess the demographic characteristics of the families. The questionnaire was divided into five parts and consisted of multiple-choice questions as well as close and open-ended questions. It involves five parts as follows.

Part I

This part assessed the sociodemographic characteristics of the family. It included five closed-ended questions regarding home responsibility, educational level, family types, monthly income, and crowding index. Crowding index is based on quantitative analysis of the crowding data published by the Central Agency for Public Mobilization and Statistics (CAPMAS, 2006), and according to the international definitions and measurement tools of crowding. It was found that the acceptable crowding standard in Egypt would be less than 1.5 persons per room; medium crowding to be between 1.5 and 1.7 persons per room, and overcrowding to be more than 1.8 persons per room.

Part II

This part assessed the medical history of each member of the family. It is used once, and it included comorbid disease, infectious disease, vaccination, health services, exposure to prick needle, source of prick needle, and the leading causes for the accumulation of garbage in the area of El-Zawia El-Hamra area.

Part III

This part was designed to assess a family’s knowledge regarding household waste in El-Zawia El-Hamra area. It was adapted from Gunsilius (2010), and Kumar et al. (2016). It is used before and after health awareness program implementation. It consisted of 24 items as MCQs (before and after health awareness programs on family health practices regarding household waste management). It includes concepts related to household waste; causes of accumulation of household waste; types of waste; problems resulting from household waste and its risks to humans, environment, and economy; proper ways to collect household waste; and household information on the management or recycling of waste.

Scoring system

For the knowledge items, correct response scored 1, and incorrect scored 0 for each area of knowledge. The scoring of the item was summed up, and the total score was 42, which equaled 100%; 50% and more was considered satisfactory and less than 50% was considered unsatisfactory.

Part IV

This part was designed to assess family-reported practices regarding household waste management. It was used before and after health awareness program implementation. It was adapted from Economic and Social Commissions Asia and Pacific (ESCAP, 2010). It includes general health practices for disposal of household waste (14 items), disposal of organic waste (four items), disposal of inorganic waste (four items), disposal of hazardous waste (two items), and disposal of electronic waste (two items), as reported (before and after health awareness program).

Scoring system for practices

The scoring system ranged from two scores for always, one score for sometimes, and zero for never. The cumulative grades were 52 for 26 statements, equal to 100%. The families’ practices were categorized into acceptable practices, if the percent score was 60% or more, and unacceptable practices if less than 60%.

Part V

This part was designed to assess the level of satisfaction of the families in El-Zawia El-Hamra District. It was used once. It assesses family satisfaction regarding neighborhood services, cleaning work, and garbage workers. It was adapted from David and Olson (1989).

Scoring system

For the satisfactory level, the scoring system was divided into satisfied, somewhat satisfied, not satisfied, and does not know. The cumulative grades were 36 for 12 statements, equal to 100%. The families’ satisfactory level was categorized into 50% or more if the family was satisfied and less than 50% if the family does not feel satisfied or does not know.

Validity

Five experts ascertained the validity of the tools (three of them were from Community Health Nursing, Faculty of Nursing, and another two were from Environmental and Community Medicine, Faculty of Medicine, Ain Shams University). They reviewed the instruments for content accuracy.

Reliability

The reliability test of the translated version was established by using the Cronbach alpha and Pearson correlation, which showed good internal consistency and construct validity (Cronbach alpha=0.887).

Ethical considerations

The necessary approval was obtained from the administrative authority of the Presidency of El-Zawia El-Hamra District. The study participants’ consent to participate in the study was obtained. The researchers clarified the objectives of the study to the study participants. The researcher ensured complete privacy and total confidentiality of any information. The study participants were allowed to participate or withdraw from the study at any time.

Operational design

A pilot study

A pilot study was performed on 2% of the total number of families (28 families) to evaluate the tools’ clarity, objectivity, and feasibility of the study process and also to estimate the time needed for data collection. These families in the pilot study were excluded from the study sample related to modifications made.

Preparatory phase

A review of the past and currently available related literature covering all aspects of the research participants using the available articles, periodicals, internet, journals, and books in order to get a clear picture of the research problem, as well as to design the study tools for data collection was done.

Field work

Data were collected before the implementation of the program during June 2018. After that, the awareness program on the health management of household waste was implemented. Then, the initial data were collected from the families. The results were analyzed statistically and manually prepared, and the program was implemented for the families residing in El-Zawia El-Hamra based on the educational needs of the research sample on health practices toward household waste management.

The families assembled in private halls of the aforementioned NGOs. Posters, brochures, and a manual were distributed over 6 months from July to the end of December 2018. After completion of the program implementation, the evaluation of the families was carried out using the same research tools during January 2019.

Health awareness program construction

This study was conducted in three phases: preparatory, implementation, and evaluation phase.

Program development phases

  1. Preparatory phase: the program was designed by the investigator and was based on the results obtained from the study tools. Moreover, a review of recent, current, national, and international related literature in the health management of household waste was done. This program’s content was revised and validated by experts in the faculty of Nursing, Community Health Nursing Department.
  2. Development and implementation phase:

    The development of the guidelines based on family assessment needs and the objective was done.


General objective

At the end of the health awareness program, the families will be able to improve their knowledge and health practices regarding household waste management.

The content of the program included the following:
  1. Definition of household waste products.
  2. Source of household waste.
  3. Classification of waste products.
  4. Effect of the household waste product on family health.
  5. Family health practices toward household waste.
  6. Family roles in a healthy home environment.


Teaching methods

Discussion, demonstration, redemonstration, and group discussion were conducted.

Media: suitable teaching aids were prepared, especially for the program, such as printed materials, posters, a guiding Arabic booklet, PowerPoint presentations, and videos using a laptop. A booklet was constructed for family according to their educational level and needs assessment. It was prepared in simple Arabic language.

Program implementation phase

  1. The first session began with an orientation about the program and its purposes, and the participants were informed about the time of program sessions.
  2. The actual work started by meeting the head of the families in the previously mentioned settings. First, the researcher introduced herself to the participant and gave them a brief idea about the study and its purpose.
  3. days/week, 3 h/day in June 2018 (9 am : 2 pm) were allocated for data collection (pretest), which was carried out through 1 month. The average time consumed to fill tools was 30–45 min (∼5–6 families/day).
  4. The session plan used different educational methods and media in addition to the use of a guiding booklet, especially designed and developed based on family assessment needs. Implementation of the program took 6 months through visiting the prementioned setting 2 days/week (Monday and Wednesday) 2–3 h/day. The number of hours was different from one session to another to accomplish awareness program sessions and practice training.
  5. The program was applied in six sessions (two sessions for theory and four sessions for practices) lasting for 12 h. From 1 to 2 h is the time required for each session; it included 4 h theory and 8 h practices.


Evaluation phase

Evaluation of the health awareness program was done immediately after completing the program implementation by using the same preprogram tools to evaluate the effect of the health awareness program on family knowledge and health practices regarding household waste management.

Statistical analysis

Data entry was done using Epi-info (U.S. Department of Health & Human Services, USA), version 6.04, computer software packages, whereas statistical analysis was done using the statistical package for social sciences (SPSS), version 21.0. Quality control was done at the stages of coding and data entry. Data were presented using descriptive statistics in the form of frequencies and percentages for qualitative variables. Qualitative variables were compared using the χ2 test and r test. The significance of the results was considered as not significant, if P value more than 0.05; significant, if P value less than 0.05; and highly significant, if P value less than 0.001.


  Results Top


[Table 1] shows that 85% of home responsibility was on the mothers. Regarding educational level, 43% could not read and write, and 72% of them were extended families. Regarding family income, 76.5% of them reported it was not enough. According to the crowding index, 57.5% of families were overcrowded.
Table 1 Frequency and percentage distribution of the studied sample families according to their sociodemographic characteristics (N=200)

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[Table 2] shows that 37.6% of mothers had diabetes, whereas 2.9% of fathers had diabetes. According to infectious disease, 4.7% of mothers had hepatitis C, whereas 43.3% of fathers had hepatitis C, and 63.3% of fathers were exposure to prick needle.
Table 2 Frequency and percentage distribution of head of the families according to their medical history (N=200)

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[Figure 1] reveals that 13% of families have been exposed to prick needles in the street.
Figure 1 Percentage distribution of families according to their exposure to prick needles (N=200).

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[Figure 2] illustrates that there was a highly statistically significant relation between total satisfactory knowledge regarding household waste and waste management before and after program implementation, with P value less than 0.001.
Figure 2 Distribution of the studied sample according to their total satisfactory knowledge regarding household waste and waste management before and after implementation of health awareness program (N=200).

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[Table 3] shows that 99% of families throw garbage out boxes in the streets; 86% of causes of throw garbage out boxes was the spread of garbage around the box. Overall, 69.5% reported the distance between the home and garbage collection place was 10 to <50 m. Overall, 53.5% of families agreed regarding the adequate distance for not contracting any disease or being infected.
Table 3 Frequency and percentage distribution of the studied sample according to their opinion about district status related to causes and distances at El-Zawia El-Hamra District regarding household waste (N=200)

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As seen in [Figure 3], 73% of them reported that their source of information was television.
Figure 3 Distribution of the studied sample according to their sources of information related to management household waste (N=200).

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[Figure 4] indicates that regarding the causes of garbage accumulation, 71% reported no cooperation between people, and 56% was neglect of officials in the neighborhood.
Figure 4 Distribution of the families according to their answer regarding causes of garbage accumulation at El-Zawia El-Hamra District (N=200).

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[Table 4] shows that there were statistically significant differences between preprogram and postprogram implementation assessments. Concerning families’ practices related to general health practices for the disposal of household waste, there was a statistically significant difference between the total scores before and after implementation of health awareness programs according to their always reported practices with respect to the disposal of inorganic waste.
Table 4 Distribution of the families according to their always reported practices regarding household waste management preimplementation/postimplementation of health awareness program (N=200)

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This table shows statistically significant differences between the total scores of the studied families according to their always reported practices regarding the disposal of hazardous waste management before and after program implementation. There was a statistically significant difference between the total score of the families according to their always reported practices regarding the disposal of electronic waste management before and after program implementation.

χ2=24.70, P value less than 0.001 (HS).

[Figure 5] illustrates that there was a highly statistically significant relation between total acceptable practices of the families regarding household waste management before and after program implementation, with P value less than 0.001.
Figure 5 Distribution of the families according to their total practices regarding household waste management before and after program implementation (N=200).

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[Figure 6] shows that 76% of families had a satisfactory level regarding neighborhood services and garbage workers at El-Zawia El-Hamra District.
Figure 6 Distribution of the families according to their satisfactory level regarding neighborhood services and garbage workers at El-Zawia El-Hamra District (N=200).

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[Table 5] shows a highly statistically significant relation between postprogram total families’ knowledge and total practices regarding household waste management, with P value less than 0.001.
Table 5 Statistical association between postprogram total families’ knowledge and total practices regarding household waste management (N=200)

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[Table 6] reflects a statistically significant correlation between families regarding their exposure sources of prick needle and causes of garbage accumulation at El-Zawia El-Hamra District needles, with P value less than 0.05.
Table 6 Correlation between families according to their exposure sources of prick needle and causes of garbage accumulation at El-Zawia El-Hamra District needles (N=200)

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  Discussion Top


Household hazardous waste has the characteristics of flammability, corrosively, reactivity, and toxicity. Nonsystematic household hazardous waste management can generate a potential danger for people and the environment (Barloa et al., 2016).

Regarding home responsibility, most were mothers. These results are supported by Abdoliman et al. (2016), who studied knowledge, attitude, and practice of Iranian urban residents regarding the management of household hazardous solid wastes and reported that more than two-fifth of participants were housewives. In the Egyptian culture, mothers are the main responsible person with respect to the household work and responsibilities because fathers are always busy in their work.

According to the educational level, less than half of families could not read and write, and less than three-quarters of them were extended families, and more than three-quarters of the families had not enough family income. These results agreed with Mamady (2016), who studied factors influencing attitude, safety behavior, and knowledge regarding household waste management in Guinea. The study reported that 28.2% of the families had secondary education; however, these results contradicted Yoada et al. (2014), who studied domestic waste management practices and perceptions in the Metropolitan Accra and reported that only 12.6% of families had no formal education. The results revealed that the majority of families were not working, which leads to that the majority of them had insufficient family income.

According to the crowding index, the current study revealed that more than half of the families were overcrowded. In this respect, Yoada et al. (2014) argued that roughly four (39.6%) out of 10 respondents lived in compound houses (a common type of housing in Ghana). Moreover, 50.0% of participants reported having five to nine individuals living in the same house, whereas 31.9% reported having one to four individuals living in the same room. These results contradict Sivakumar and Sugirtharan (2010), who studied the effect of family income and size on per capita solid waste generation in the Manmunai North Divisional Secretariat Division of Batticaloa and reported that less than a quarter of families had three members in the household. Differences in the demographic characteristics of individuals can be owing to cultural, social, economic, and political conditions, among others.

According to medical history for the head of the families, more than one-third of mothers had diabetes, and also, very few fathers had diabetes. According to infectious disease, few mothers had hepatitis C, whereas less than half of the fathers had hepatitis C, and less than two-thirds of fathers were exposed to prick needle. This result goes in line with a descriptive cross-sectional study in Ismailia Governorate, Egypt, conducted by Sameh et al. (2013), who showed a favorable history of chronic illnesses (15.2% had diabetes mellitus and 36.8% of them had hypertension). This may be owing to poor health education and low educational levels.

According to the source of prick needles, the current study results showed that more than one-tenth of studied families were exposed to the sources of prick needles in the street. These results are supported by Emilia et al. (2017), who conducted a study ‘solid medical waste: a cross-sectional study of household disposal procedures and reported harm in Southern Ghana’ and showed that 4.8% of solid management waste (SMW)-related harm was in the household, whereas 16 participants reported 2.7% of SMW-related harm was in the society they lived in. Moreover, this result was supported by Amouei et al. (2016), who reported a more significant proportion of households 35% discarded sharp objects loosely (not placed in a container) in household bins. From the researchers’ point of view, this could pose a danger to unsupervised young children or other unsuspecting household members who may come in contact with the waste containing contaminated sharp objects. Young children may get pricked from used needles discarded around the household or within the community.

Regarding knowledge of families about household waste and waste management, the present study illustrated a highly statistically significant relation between total satisfactory knowledge regarding household waste and waste management before and after program implementation, with P value less than 0.001. This results of the study were in agreement with Karout and Altuwaijri (2012), who studied ‘the impact of health education on community knowledge, attitudes, and behavior towards solid waste management in Al Ghobeiry, Beirut’ and reported that a higher percentage of study group participants scored correctly after intervention, with significantly higher percentage for all knowledge items, compared with the control group, in addition when compared with the total group score before intervention (all at P<0.005). In this respect, Abdoliman et al. (2016) argued that the knowledge of 0.9, 24.1, and 75% households was ‘weak,’ ‘medium,’ and ‘good,’ respectively, in the household hazardous waste management. Therefore, it is necessary to implement the training programs, enhance the knowledge of households in the management of such wastes, change their attitudes, and increase their practices.

Regarding household waste management at El-Zawia El-Hamra District, most of the families threw garbage out boxes. The majority of causes of threw garbage out of the boxes in the streets were the spread of garbage around the box, less than three-quarters due to the distance between home and garbage collection place was 10<50 meter. More than half of families agreed regarding the adequate distance for not contracting any disease or being infected. This result agreed with Trasias et al. (2016), who studied the practices, concerns, and willingness to participate in solid waste management in two urban slums in Central Uganda. The study revealed that most households stored their wastes in polythene bags and sacks before disposal, and 10.3% of the families had no containers for waste storage and retained their waste in open areas outside the house. Most participants reported some household-level waste segregation. This finding could be an indication that community members lack sufficient knowledge of the causal relationships between poor household waste management and its related consequences. Thus, there is a need to create awareness among slum residents on the importance of proper household waste management.

About the information sources of the household presented, less than three-fourth of them declared that the television was their source of information. These results follow the study of Abdoliman et al. (2016), who showed that 56.4% of participants said that the mass media, especially radio and televisions, are the best option to aware people of hazardous waste management. Only 16.4% of the households stated that they got information through the media and books on household hazardous waste management, and 86.7% of them believed that they needed to get the information in this regard. It seems that the workshops or training classes about the environment and training through the mass media increase the knowledge level of people.

Concerning the causes of garbage accumulation, more than two-thirds of them reported that there was no cooperation between people, and more than half reported was neglect of officials in the neighborhood. The results of this study were consistent with Yoada et al. (2014), who mentioned that 39.0% of households disposed of the waste in gutters, roads, holes, and neighboring bushes. This scenario generates an appropriate environment for the reproduction of disease vectors, such as mosquitoes and cockroaches, and rodent proliferation, such as rats and mice.

Regarding families’ practices about household waste management, the current study showed statistically significant differences between preprogram and postprogram implementation assessments. Concerning families’ practices related to general health practices for disposal of household waste, disposal of inorganic waste, hazardous waste management, and electronic waste management, there were significant statistical differences between preprogram and postprogram implementation about families’ always practices regarding the disposal of organic waste. This result may be related to that the health awareness program contains the vital practices regarding health management of household waste and the families committed to following the program instruction. This outcome was consistent with Ali et al. (2019), who evaluated Kermanshahi women’s understanding, attitude, and practice of decreasing, recycling, and reusing the MSW in Iran and indicated that there are no robust legislation and no grounds for separating household hazardous waste. The research findings stated that owing to the absence of appropriate techniques, the production of these materials should be decreased by providing a suitable management plan in an attempt to enhance public participation and to create a proper waste management system in this city. So, there is a need for time to review this serious situation. With collective efforts from the part of the government, educational institutions, and NGOs, proper guidance can be given in this neglected area of waste management. So it is clear that the research hypothesis was supported.

The relation between families’ knowledge related to household waste management and total acceptable practices in preimplementation/postimplementation of the health awareness program was significant. The result of this study also revealed a highly statistically significant relation between total acceptable practices of the families in preimplementation/postimplementation of health awareness program and a highly statistically significant relation related to post-total families’ knowledge and a total of their acceptable practices regarding household waste management. This result means that the health awareness program was effective in improving the family’s knowledge and health practices regarding household waste management.

This result is in line with Christensen et al. (2014), who studied the partnerships for development: MSW management in Uganda and revealed that there was a highly statistically significant difference between families’ knowledge and a total of their acceptable practice regarding household waste management (P<0.001).

The current study result agreed with another study done by Ghanbari et al. (2016), who studied the strategic factors of household solid waste segregation at source program, awareness, and participation of citizens of the three municipality district of Tehran. The study reported that there was a highly statistically significant concerning practices and awareness of participants.

Regarding satisfaction toward neighborhood services and garbage workers at El-Zawia El-Hamra District, the current study revealed that more than three-fourths of families had a satisfactory level toward neighborhood services and garbage workers at El-Zawia El-Hamra District. This result may be related to that the effort done by the local unit in the region at El-Zawia El-Hamra District, and the neighborhood cleaned continuously and the presence of cleaners daily throughout the day to clean the neighborhood.

These findings were inconsistent with Yukalang et al. (2018), who reported that the majority of participants were unhappy with the leadership of waste collection facilities undertaken by this research in Thailand on solid waste management alternatives for a quickly urbanizing region.

Finally, there was a statistically significant correlation between families according to their exposure sources of prick needle and causes of garbage accumulation at El-Zawia El-Hamra District needles (P<0.05). This result agreed with Ramatta et al. (2014), who studied the domestic waste management practices and perceptions of private sector waste management in the Metropolitan Accra. The study showed that most participants were conscious that improper waste management contributes to the causation of disease; most of the respondents thought that improper waste management, especially solid waste could lead to prick of many people with sharp tools. Therefore, sharps were a significant problem and accounted for harm connected with household waste both inside and outside of the house.


  Conclusion Top


This study concluded that there was a highly statistically significant relation between total satisfactory knowledge regarding household waste and waste management before and after program implementation. The study also revealed that there was a highly statistically significant relation between total acceptable practices of the families regarding household waste management preimplementation/postimplementation of the health awareness program. There was also a highly statistically significant relation related to post-total families’ knowledge and a total of their practice regarding household waste management, preprogram/postprogram implementation, with P value less than 0.001. The current study findings support the research hypothesis that the program improved family knowledge and health practices regarding household waste management.

Recommendations

Based on the results of the present study, and the research hypothesis, the following recommendations are suggested:
  1. Conduct continuous health awareness programs for families on how to manage waste healthily in the larger neighborhoods of Greater Cairo using the media, especially television, as it is the most effective means of information and practices of families in order to:
    1. Encourage families to dispose of the waste in return for symbolic material revenue or replace it with food items.
    2. Reduce the adverse effects on human health and controlling the percentage of environmental pollution and also in agreement with the district presidency will be the work of kiosks for the purchase of solid and electronic waste.
    3. Dissemination of health awareness programs among shop owners to control and prevent the accumulation of waste products in the pubic area and educate them on the health management practices regarding waste products.
    4. Increase health awareness in all communities and families regarding healthy household waste management to prevent children from transporting solid waste and only the father and mother made responsible for transporting them abroad to prevent their accumulation around containers.
[31]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]



 

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