Date of Conferral





Health Services


James Goes


The lack of access to improved toilet sanitation remains a major health and environmental hazard in developing nations in the world. Despite global leadership efforts at the level of the United Nations and nongovernmental organizations around the world, diarrhea-related diseases disproportionately affect children. Evidence from the literature suggests that competent and sustained leadership is central to resolving the problem. From a historical perspective, leadership advocacy and engagement prompted the sanitary revolution in the West in the 18th and 19th century that led to the eradication of preventable infectious diseases such as cholera. Integrated leadership that made use of sanitation and water institutions at the national, state, and local levels and structured, skilled, and financial capability helped create an enabling environment for better and sustainable hygiene sanitation in the West. A qualitative approach was used to explore the role of collaborative leadership in enhancing the demand for toilet hygiene in rural Njinikom and the community's perception of the state of sanitation. One-on-one interviews were conducted with 25 adults aged 18 years and above with knowledge and exposure to poor toilet sanitation. Content analysis was used to develop themes and patterns from the data. The findings revealed barriers such as inefficient leadership and limited financial resources that impede adequate feces disposal and motivating factors for better sanitation. The results provided support for a partnership approach that is inclusive, relevant, useful, and sustainable. The implication of the study includes renewed interest in improving toilet sanitation and health and increase understanding of the importance of adequate feces disposal in preventing and eliminating associated fecal-oral diseases.