Determinants of Basic Sanitation Service Coverage Among Households in Shashogo District, Hadiya Zone, Central Ethiopia: A Case Control Study

Abstract

Background: Basic sanitation services and practices are crucial for the well-being and health of a community. However, little is known about the determinants of basic sanitation services in Ethiopia, particularly in the study area. Objectives: To identify the determinants of basic sanitation service coverage among households in the Shashogo district, Hadiya Zone, and Central Ethiopia in 2023. Methods: A case–control investigation was carried out in households in Shashogo District from August 8, 2023, to December 10, 2023. Ten Kebeles were chosen randomly from a total of 34 Kebeles in the district. A total of 579 households (193 cases and 386 controls) were included in the study. The data were gathered with pretested and structured questionnaires in digital form with a smartphone. The data were analyzed with SPSS. Independent t tests and regression models were used to determine predictors of basic sanitation services. Results: The mean (±SD) age of the study participants was 38.2 (±8.9) years. After controlling for confounders in the multivariate analysis, the adoption of improved latrine services among households was found to be associated with greater average monthly income (AOR = 1.841, 95% CI (1.043, 3.251)), the study respondents who had access to the necessary materials for latrine construction/upgrade were approximately 3.5 times more likely to adopt improved latrine services among households with (AOR = 3.477 (95% CI = 1.314, 9.202) than among those who lacked access to the necessary materials for latrine construction, the study respondents who had training in sanitation and hygiene (AOR = 4.744, 95% CI (2.984, 7.542)) and who had sufficient knowledge about the adoption of improved latrine services (AOR = 2.020, 95% CI (1.125, 3.628)) were found to be determinants of the adoption of improved latrine services among households. Conclusion: This study revealed that economics, knowledge, attitudes and practices, infrastructure, and culture were identified as determinants of the adoption of improved latrines in the study area. Poor sanitation significantly impacts economic, social, environmental and many other direct and indirect impacts on the well-being of citizens. Therefore, policies on sanitation and contextual initiatives and focused actions are needed by stakeholders and policy implementers to improve knowledge gaps, access to necessary materials and the income capacity of those lagging to adopt services.