3.1 Socio-demographic characteristics of respondents
A total of four hundred five (405) head of households were interviewed with a response rate of 97.2% for questioner interview. Twelve (12) community members and six (6) water sanitation and quality experts for key informant interview with 100% response rate were participated in the study. The mean age of the respondents were 38.58 (SD) (7.98) years, with 26 and 62 years minimum and maximum age respectively. More than halves of the respondents, 275 (67.5%) were married and 305(94.1%) live in rural area. One hundred eighty-three, (45.2 %) of the respondents were illiterate and 211 (52.1%) were orthodox religion followers (Table 1).
3.2 Fluoride filtered water Utilization Challenges
Two hundred twenty-eight (56.3%) of the interviewed households were used fluoride filtered water from community fluoride filter water schemes for drinking and cooking foods. The reaming 177 (43.7%) utilized water from non-fluoride filter water schemes. Three hundred twenty-five (80.2%) of interviewed households were traveled a distance less than 1.5km and only 80 (19.8%) traveled greater than 1.5km for collecting water for drinking. Two hundred eleven (52.1%) were regularly getting filtered water, 17(4.2%) get irregularly and 177(43.7%) not get filtered water at all. were as the minimum and maximum water tariff 258(63.7%) pay 0.50 birr and 80 (19.8) pay 0.75 birrs for 20 liter respectively. However, 89(22%) of the interviewed households did not afford to pay for water tariff. Three hundred sixty- one (89.1%) of the interviewed households used “Jerri cans” for water storage and 44(10.9%) used a clay pot to store drinking water in their home. Three hundred forty-eight (85.9%) of the interviewed households had good knowledge about community fluoride filter water schemes. Moreover more than three forth 321(79.3%) prefer to utilize filtered water from the newly established filtering techniques so-called (HAP), only 70(17, 3%), and 14(3.5%) prefer to utilize from bone char and Nalgonda filter techniques respectively. In practice only 181(44.7%), 47(11.6%) utilize their water from HAP and bone char filter techniques respectively. (Table2).
3.3 Factors associated with community fluoride filtered water utilization
3.3.1 Bivariate analysis
Socio-demographic factors: As it is presented in table 3 below; the bivariate logistic analysis of socio demographic characteristics with fluoride flirted water utilization revealed that age groups >45 [ (COR) = 0.31; 95% (CI) (0.19,0.53)],religion, [(COR) = 4.82; 95%(CI) (2.35,9.89)] level of education Illiterate [(COR) = 0.62; 95% (CI) (0.39,0.98)] and family income [ (COR) = 5.3; 95%(CI) (2.5, 11.3)] categories were significantly associated, while sex [COR = 0.815, 95% CI: (0.545, 1.22)], marital status, [(COR) = 1.056; 95%(CI) (0.69, 1.60)] another occupation [COR = 0.679, 95%CI: (0.363 1.272)] and place of residence [COR = 1.564, 95% CI: (0.683, 3.58)] did not show significant association with community fluoride filtered water utilization.
utilization challenge factors: The bivariate logistic analysis of socio demographic characteristics with fluoride flirted water utilization revealed that fluoride filtered water tariff [COR = 0.23 95%, CI 0.11. 0.45), H/H getting filtered water regularly [COR = 7.46, 95% CI: (4.46, 11.63], affordability [COR = 6.15, 95% CI: (3.58, 10.57)], distance travelled for water collection [COR = 1.88, 95% CI: (1.15, 3.10)].H/H who have family affected history[COR = 32.44, 95% CI: (18.58,56.66)], NO.times supply brace per week[COR = 6.66, 95% CI: (2.48, 17.90],were all significantly associated with community fluoride filtered water utilization.
Behavioural Factors: This study showed that behavioural factors such as H/H who have poor knowledge about fluorosis problem and CF. water schemes COR = 0.397, 95% CI: (0.22, 0.71], were significantly associated. No significant association showed for preference of community filtering schemes COR = 1.02, 95% CI: (0.63, 1.65] with community fluoride filtered water utilization in the bivariate analysis (Table 3).
3.3.2 Multivariable Analysis
As it is indicated in the above bivariate logistic regression table age, greater or equal to 45, illiteracy, family income, H/H get filtered water regularly, filtered water affordability, distance travelled less than 1.5km, water tariff less or equal to 0.50birr, H/H have history of affected family by fluorosis, H/H knowledge of CF, and number of times water supply break per week were variables with P- value less than 0.05, has taken as a candidate for multivariate analysis. In multivariate analysis, household who had no a history of the affected family in the last 10 years were 44.4 times [AOR = 44.4, 95% CI: (18.8, 104.74)] more likely utilize community fluoride filtered water compared to their counterparts of non-fluoride filtered water users. The fluoride filtered water utilization among those households who had family income less than 1000birr0.03 times [AOR = 0.03, 95% CI: (0.004, 0.226)], household who had not afford to pay for water tariff 0.28 times [AOR = 0.28, 95% CI: (0.004, 0.226)], and household who collect a 20 litter filtered water with great or equal to 0.50 birr 0.385 times [AOR = 0.385, 95% CI: (0.16, 0.91)].had all less likely utilize filtered water compared to their counterparts respectively.
Behavioural factors, the odds of utilized community fluoride filtered water among household had good knowledge about community fluoride filter schemes was 5.93 times [AOR = 5.93, 95%CI: (1.30, 26.95)] higher compared to their counterparts.
The likelihood of utilizing community fluoride filtered water was found to be significantly higher among household who had no a history of the affected family in the last 10 years 44.4times [AOR = 44.4, 95% CI: (18.8, 104.74)] more likely, as compared to their counterpart (Table 4).