Moving Up the Sanitation Ladder: A Study of the Coverage and Utilization of Improved Sanitation Facilities and Associated Factors Among Households in Southern Ethiopia

Abstract

Background: Improved sanitation facilities offer numerous advantages, ranging from the reduction of diarrheal illnesses and helminth infections to the improvement of psychosocial well-being. At the household level, attaining universal access to improved sanitation facilities demands a thorough understanding of the factors that influence their adoption and use. As a result, the purpose of this study was to assess the availability and utilization of improved sanitation facilities, as well as the factors that influence the adoption and proper use of such a facility among households in the Gedeb district of Southern Ethiopia. Methods: A community-based cross-sectional household survey was conducted from March to April 2019. A systematic random sampling technique was used to select 630 households at random. A pre-tested questionnaire was used to collect the respondents’ self-reported data, which comprised socio-demographic, home characteristics, behavioral, and environmental elements. The factors related to the availability and utilization of improved sanitation facilities were identified using multivariable logistic regression. Result: Improved sanitation facilities were present in 172 (27.3%) of the 630 households surveyed, with 111 (64.5%) of them being used properly. The availability of improved sanitation was associated with educational status [AOR = 2.73, 95% CI (1.59, 4.67)], upper wealth quintile [AOR = 2.18, 95% CI (1.21, 3.93)], ever hearing educational messages about latrines [AOR = 3.9, 95% CI (1.86, 8.18)], favorable attitude toward latrine construction [AOR = 2.81, 95% CI (1.67, 4.74)], and receiving support during construction [AOR = 3.78, 95% CI (2.15, 6.65)]. Furthermore, utilization was associated with the absence of children under the age of 5, knowledge of sanitation-related diseases, and a positive attitude toward latrine use. Conclusion: Both the availability of improved sanitation facilities and the rate at which they were used properly fell far short of the National Hygiene and Environmental Health Strategy’s goals. This study contributes to the body of knowledge on how to improve the availability of improved sanitation in Ethiopia.

Spatial and multilevel analysis of sanitation service access and related factors among households in Ethiopia: Using 2019 Ethiopian national dataset

“…Rich households were 1.7 times more likely to access sanitation services than poor households. This finding is supported by studies done in Southern Ethiopia [ 36 ], the 2016 EDHS analysis report [ 23 ], and Zambia [ 51 ]. This could be due to the high cost of constructing a latrine, households’ inability to pay for labour and construction materials [ 52 ], and government policy that does not provide subsidies for residential latrines in comparison to other countries [ 53 ].…”

“…This finding is higher than reports in rural Ethiopia (5%) [ 31 , 32 ], the 2016 EDHS report (6%) [ 33 ], and Western Africa (8.7%) [ 34 ]. However, the finding is lower than studies done in Gondar town (29.2%) [ 15 ], Bahir Dar (34%) [ 35 ], southern Ethiopia (27.1%) [ 36 ], rural Mali (42%) [ 37 ], and developing countries (28%) [ 38 ]. Generally, there was low sanitation service access among households in Ethiopia.…”

Magnitude and determinants of improved household latrine utilization in Ethiopia: Multilevel analysis of the mini Ethiopian Demographic Health Survey (EDHS) 2019

“…■ Improved sanitation facilities : Households who had a private improved pit latrine with a slab or vented improved pit latrine or composting toilet, flush or pour/flush facility connected to a piped sewer system/ septic tank/pit, regardless of whether it is shared with other households [ 25 ].…”

Key Considerations: Social, Structural and Community Dynamics of Cholera Transmission and Mortality in Ethiopia

“…Controlling cholera in the long term requires sustainable and country-wide improvements in water and sanitation infrastructure. 10,[22][23][24] These measures include: constructing and maintaining continuous piped and/or treated water supplies; providing acceptable water purification technologies; building proper toileting and wastewater disposal systems and constructing and maintaining clean spaces for handwashing with soap. While these measures are all expensive and time-consuming, they can dramatically reduce the risk of infection from cholera and other water-and food-borne pathogens.…”

“…6,26,32,33 Thanks to community-based education efforts around the country (particularly through the HEW programme), many Ethiopians have participated in health communication initiatives where they have learnt about the importance of handwashing with soap, using latrines or toilets instead of open defecation, and ensuring drinking water is piped or treated. 13,23,[34][35][36] People who fail to properly wash their hands with soap or use latrines or toilets typically either lack access to these facilities, or these facilities are inadequately designed, cleaned or maintained.…”