Assessment of Health Risk Associated with Sanitation System: A case Study of Iten Municipality, Elgeiyo-Marakwet, Kenya

Sustainable Development Goal (SDGS) advocates for access to adequate sanitation and safe water, which are essential for public health. However, deficiencies in sanitation infrastructure remain a significant concern in many urban areas. The study examined the health risks associated with the existing sanitation service chain in Iten Municipality, Elgeiyo- Marakwet County, Kenya. A mixed-methods research design was employed to obtain quantitative data using structured questionnaires, water sampling forms, and qualitative data using interview guides. Purposive, Cluster, and proportionate simple random sampling were employed to identify 388 household heads, four community water points, and informants. Quantitative data was analyzed using Statistical Package for Social Sciences (SPSS) version 27 using descriptive statistics techniques and Pearson's R correlation, while qualitative data was analyzed through categorization into various themes. The findings revealed that only 69% of excreta was safely managed. Significant correlations were identified between inadequate waste management and sanitation-related illnesses (r = 0.30, p = 0.03), waterborne diseases (r = 0.33, p = 0.014), and contamination of water sources (r = -0.13, p < 0.003). Water quality testing showed that all sampled sources were contaminated with coliforms and E. coli. surpassing the World Health Organization (WHO) safety limits of zero E. coli and total coliforms per 100 mL. Qualitative data highlighted that inadequate waste collection and unsafe disposal practices were key drivers of disease spread. Informants pointed out that pest infestations, such as rodents and flies, and persistent odors from poorly maintained sanitation facilities, significantly exacerbated health risks. In conclusion, the study underscores the urgent need for improved sanitation infrastructure and management, as deficiencies contribute to significant public health risks, including sanitation-related illnesses, water contamination, and environmental hazards.The study recommends that sanitation stakeholders, such as the county government, improve sanitation infrastructure, implement routine water quality testing, and strengthen behaviour change communication campaigns on handwashing and sanitation.