Prevalence and Determinants of Household Access to Improved Latrine Utilization in Somalia: Health Demographic Survey (SHDS) 2020.

The aim of this research paper is to determine the prevalence of improved household latrine utilization and its determinants in Somalia, using the Somali Health Demographic Survey (SHDS) 2020 dataset. Limited sanitation is a major global problem mainly for the poor and disadvantaged. According to the SHDS 2020 report, around 22.3% of households in Somalia utilize unimproved toilet facilities. In this study, a secondary data analysis was carried out on the SHDS 2020 dataset. The study included 15 826 households weighted for representativeness. Four models were constructed after identifying relevant factors for the outcome variable. The first model, null (empty), had no independent variables. The second model assessed the effect of individual-level determinants on the outcome. The third model determined how community-level variables influenced on the response variable. Finally, a multilevel multivariable logistic regression model examined the combined impact of individual- and community-level factors on the outcome variable. The prevalence of improved latrine utilization in Somalia was (41.1%). The factors: educational status (AOR: 1.899 (1.598, 2.258)), wealth index (AOR: 7.815 (6.990, 8.736)), urban residence (AOR: 2.467 (2.262, 2.690)), households living in various regions/states, including Hirshabelle, Galmudug, Southwest, Puntland, Jubaland, and Somaliland, indicate statistically significant findings and were more likely to utilize improved latrines (AOR: 0.259 (0.229, 0.294)), (AOR: 0.223 (0.196, 0.254)), AOR: 0.196 (0.168, 0.230)), (AOR: 0.220 (0.194, 0.251)), (AOR: 0.204 (0.180, 0.232)), (AOR: 0.086 (0.077, 0.095)). Hirshabelle had a 0.259 times more likelihood of improved latrine utilization than the rest of the regions/states, (AOR: 0.259 (0.229, 0.294)). The prevalence of improved latrine utilization was quite low in Somalia. Higher wealth index, living in more urbanized areas, and the household head's educational status were all significant predictors of improved latrine utilization. The finding implies a need to increase household's access to latrine facilities and improve latrine utilization, particularly for rural households in the country.

Ahmed HA ，Ali DA 《-》

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

Lack of sanitation is a major global problem mainly for the poor and disadvantaged. According to the 2016 Ethiopian Demographic and Health Surveys (EDHS) report, one out of every three households lack a toilet in Ethiopia and about 56% of rural households use unimproved toilet facilities. We aimed to determine the magnitude of improved household latrine utilization and its determinants in Ethiopia using the mini-Ethiopian Demographic Health Survey (EDHS) 2019 data set. A secondary data analysis was conducted based on the mini 2019 EDHS data set. A total weighted sample of 8663 households were involved in analysis. After selecting the relevant variables for the outcome variable, we have fitted four different models. The null (empty) model with no independent variables and the second model contained the effects of the individual-level factors on the outcome variable. The third model included the influence of the community-level factors on the response variable, and the final multilevel multivariable logistic regression model examined the effects of individual-level and community-level variables on the outcome variable. The measure of variation was quantified using Intra-Class Correlation (ICC), Median Odds Ratio, and Proportional Change in Variance (PCV). The Adjusted Odds Ratio (AOR) with a 95% Confidence Interval (CI) was used to show the strength of association and statistical significance was declared at p value < 0.05. The magnitude of improved latrine utilization in Ethiopia was 19.5% with 95% CI (18.6%, 20.3%). The factors: educational status (AOR = 1.67; 95% CI: (1.10, 2.55), highest wealth index (AOR = 3.73; 95% CI: (2.73, 5.12), urban residence (AOR = 3.09; 95% CI: (1.68, 5.67), living in Addis Ababa (AOR = 4.08; 95% CI: (1.03, 16.2) and Dire Dawa (AOR = 8.22; 95% CI: (2.46, 27.42) and Somali regions (AOR = 3.11; 95% CI: (1.15, 8.42) were significantly associated to improved latrine utilization in Ethiopia. The magnitude of improved latrine utilization was quite low in Ethiopia. Higher wealth index, living in more urbanized areas, and the household head's educational status were all significant predictors of improved latrine utilization. The finding implies a need to increase household's access to latrine facilities and improve latrine utilization, particularly for rural households in the country.

Tesfaw A ，Tiruneh M ，Mamuye M ，Walle Z ，Teshager W ，Teshome F ，Taye A ，Dessalegn W ，Walle G ，Gebeyehu AA ... -  《PLoS One》

Household latrine utilization and associated factors in semi-urban areas of northeastern Ethiopia.

Asnake D ，Adane M 《PLoS One》

Open defecation practice among households with latrines in rural communities of Ararso District, Somali Region, Eastern Ethiopia.

Open defecation contributes to the spread of different feco-oral diseases. Therefore, access to a latrine is strongly recommended, as it considerably reduces the risks. Even though provision of latrine facilities alone does not guarantee the desired health benefits, they should be integrated with behavior change. In Ethiopia, efforts have been made to increase the coverage of latrine facilities. However, evidence on how consistently households use it is limited. Most prior studies focused on latrine utilization among households, and limited evidence is available about open defecation practices among households with latrines and associated factors. Thus, this study is critical for developing effective intervention approaches to prevent open defecation among households with latrines. The aim of this study was to assess the open defecation practice and associated factors among households with latrines in rural communities of Ararso District, Somali Region, Eastern Ethiopia, 2023. A community-based, cross-sectional study design was employed among households with latrines in the district. A total of 632 households latrines were selected using a systematic sampling technique. Data were collected using a structured questionnaire and an observational checklist. The questionnaire was designed in KoboTool box, Humanitarian Response software, and the data were collected using the Kobo Collect version 2023.2.4 mobile application. The data were downloaded from the server in the Microsoft Excel format for data cleaning before being exported to STATA version 14 for analysis. Bivariate and multivariable analyses were employed to investigate the relationship between outcome and independent variables. Odd ratios with 95% confidence intervals were utilized to assess the association between the outcome and the predictor variables. A P-value of <0.05 was used as the threshold point for statistical significance. In this study, the prevalence of open defecation practice among households with latrines was 32.4% (95% CI: 28.1, 35.9). Sex of the household (AOR = 1.60, 95% CI: 1.06, 2.4), educational status (AOR = 2.40, 95% CI: 1.08, 5.53), family size (AOR = 1.62, 95% CI: 1.22, 2.78), the presence of under-5-year-old children in the house (AOR = 1.84, 95% CI: 1.19, 2.75), the need for latrine maintenance (AOR = 2.37.95% CI: 1.62, 3.48), current status of the latrine (AOR = 2.37, 95% CI: 1.62, 3.48), and latrine cleanness status (being unclean) (AOR = 1.91, 95% CI: 1.29, 2.81) were significantly associated with open defecation practice among households with latrine. The study concluded that open defecation was significantly practiced by households with latrines. This revealed that the presence of a latrine alone was insufficient to considerably reduce open defecation. To alleviate this problem, the government and health workers, in collaboration with the health bureau, should promote frequent sanitation and hygiene education in the communities.

Ismail AM ，Ibrahim MA ，Abdi MM ，Geremew A ，Mulugeta Y ，Ayele DM ，Cheru A ... -  《Frontiers in Public Health》

Latrine Utilization and Its Associated Factors Among Community Led Total Sanitation Implemented and Non-Implemented Kebeles of Tullo District, West Hararge, Eastern Ethiopia.

Improper human waste management is a major health problem in most developing countries, including Ethiopia. In Ethiopia, the majority of the population used unimproved sanitation facilities and practiced open defecation. This problem is significantly higher in the rural parts of the country. The aim of this study was to assess latrine utilization and associated factors among Community Led Total Sanitation (CLTS) implemented and non-implemented kebeles in Tullo District, West Hararghe, and Eastern Ethiopia. A community-based comparative cross-sectional study design was conducted in 740 households in 3 kebeles Community Led Total Sanitation implemented and 3 kebeles non-Community Lead Total Sanitation implemented for comparison. Study units were selected using a multi-stage sampling technique. The data was cleaned and coded before being entered into Epi-data version 3.1 and analyzed with the Statistical Package for the Social Sciences version 20. Logistic regression analysis was used to assess the association between dependent and independent variables. In this study, the overall prevalence of latrine utilization in the study area was 415 (56.1%) (95% CI = 52.6%, 59.9%). Of them, 243 (65.7%) (95% CI = 60.4%, 70.3%) and 172 (46.5%) (95% CI = 41.3%, 51.7%) of participants in the CLTS and non CLTS kebeles were utilized latrine, respectively. In CLTS implemented kebeles, literate (AOR = 3.66; 95% CI: 1.53, 8.73), households being visited by health extension worker (AOR = 11.72; 95% CI: 4.01, 34.31), households being graduated as model family(AOR = 7.56, 95% CI: 2.79, 20.44), ⩾2 years by years of latrine owning (AOR = 12.10, 95% CI: 3.21, 45.64), >6 meters distance of toilet to home (AOR = 27.43, 95%CI: 8.43, 89.29),Latrine with hand washing (AOR = 2.93, 95%CI: 1.19, 7.17), latrine with superstructure (AOR = 6.54, 95% CI: 2.04, 20.98) were significantly associated with latrine utilization, while in non CLTS implemented kebeles, literate (AOR = 25.78, 95% CI: 13.35, 49.78), medium wealth status(AOR = 4.87, 95% CI: 2.10, 11.29), poor wealth status(AOR = 2.51, 95% CI: 1.26, 5.01) were significantly associated with latrine utilization. The findings of this study revealed that more of the rural households had utilized latrines in CLTS implemented kebeles than non-CLTS implemented' kebeles. So, it is recommended that the district health office increase the latrine utilization rate through the effective and sustainable implementation of the CLTS approach.

Murad M ，Ayele DM ，Gobena T ，Weldegebreal F ... -  《-》