Prediction of Low Community Sanitation Coverage Using Environmental and Sociodemographic Factors in Amhara Region, Ethiopia

Abstract

Abstract. This study developed and validated a model for predicting the probability that communities in Amhara Region, Ethiopia, have low sanitation coverage, based on environmental and sociodemographic conditions. Community sanitation coverage was measured between 2011 and 2014 through trachoma control program evaluation surveys. Information on environmental and sociodemographic conditions was obtained from available data sources and linked with community data using a geographic information system. Logistic regression was used to identify predictors of low community sanitation coverage (< 20% versus ≥ 20%). The selected model was geographically and temporally validated. Modelpredicted probabilities of low community sanitation coverage were mapped. Among 1,502 communities, 344 (22.90%) had coverage below 20%. The selected model included measures for high topsoil gravel content, an indicator for low-lying land, population density, altitude, and rainfall and had reasonable predictive discrimination (area under the curve = 0.75, 95% confidence interval = 0.72, 0.78). Measures of soil stability were strongly associated with low community sanitation coverage, controlling for community wealth, and other factors. A model using available environmental and sociodemographic data predicted low community sanitation coverage for areas across Amhara Region with fair discrimination. This approach could assist sanitation programs and trachoma control programs, scaling up or in hyperendemic areas, to target vulnerable areas with additional activities or alternate technologies.

Community-Led Total Sanitation and the rate of latrine ownership

“…This is consistent with the finding in Hulet Eju Enessie district, Ethiopia that households in highland climatic zone were more likely to own latrines compared to their counterpart lowlanders [5]. This might be related to variations specifically in the soil and/or temperature in the climatic zones which are believed to affect the construction and durability of latrines [17–19]. Households whose kebeles were subjected to CLTS program were 1.78 times more likely to have latrines compared to those that did not part of the CLTS program.…”

Latrine Ownership and Its Determinants in Rural Villages of Tigray, Northern Ethiopia: Community-Based Cross-Sectional Study

“…However, slightly lower evidence was reported from Hullet Ejj Enese of the Amhara region of Northern Ethiopia (92%) and Nepal (94.3%) [ 17 , 29 ]. The discrepancy among the study findings might be related to climatic zones which are believed to affect the construction and durability of latrines for sustainable use [ 30 – 32 ]. Progressive sanitation facilities and good community awareness might be the reason in Nepal [ 29 ].…”

Exploring barriers to the adoption and utilization of improved latrine facilities in rural Ethiopia: An Integrated Behavioral Model for Water, Sanitation and Hygiene (IBM-WASH) approach

“…In many of the prior studies conducted in Ethiopia and other African nations having a larger family, an advanced education, and being male were associated with the increased adoption and utilization of latrines [16][17][18][19]. Also, Qualitative studies on sanitation have identified the un-affordability of building materials [20] and the lack of awareness of the health risks associated with open defecation as a hindrance to the adoption of sanitation facilities [21].…”