Department of Public Health, College of Health Sciences, Arsi University, Asela, Oromia Regional State, Ethiopia.
Department of Nursing, College of Health Science, Debre Berhan University, Debre Berhan, Amhara Regional State, Ethiopia.
PLoS One. 2021 Jan 19;16(1):e0243228. doi: 10.1371/journal.pone.0243228. eCollection 2021.
Handwashing is one of the most effective ways to prevent transmission of infectious diseases. A substantial body of research has examined the status and determinants of handwashing facilities in healthcare settings and schools. However, its status at home in the community, especially in developing countries, remains unclear. This study aimed to examine the availability and factors influencing basic handwashing facilities at households in Ethiopia.
We analysed the 2016 Ethiopian Demographic and Health Survey (EDHS) data. EDHS employed a two-stage stratified cluster sampling technique. Data were collected from the lowest administrative unit (kebele). A multivariable logistic regression model that allowed cluster-level random effects was employed to examine factors that affect the availability of basic handwashing facilities (water plus soap) at households. Estimates from the regression model are reported as odds ratios (ORs) with standard errors clustered at the DHS cluster level to account for a sampling methodology.
In our sample, only 1292 (8% [95% CI, 7.6%-8.4%]) of the households had basic handwashing facilities. Compared with head of household who had no formal education, the odds of having basic handwashing facilities was higher among head of household who completed secondary level of education (adjusted odds ratio [AOR] = 1.83; 95% CI: 1.35-2.49) and higher level of education (AOR = 2.35; 95% CI: 1.63-3.39). Odds of having basic handwashing facilities was increased with having radio (AOR = 1.32; 95% CI: 1.10-1.63) and television (AOR = 1.49; 95% CI: 1.10-2.02) at home. Households that had improved latrine were two times more likely to have basic handwashing facilities (AOR = 2.09; 95% CI: 1.56-2.80). Being at higher household wealth quintiles was associated with increased odds of having basic handwashing facilities.
Very low basic handwashing facilities was demonstrated by this study, whereas, awareness and socio-economic related factors were identified as a determinants for its availability in the household. Greater efforts are needed to increase the coverage of community-level handwashing facilities.
洗手是预防传染病传播最有效的方法之一。大量研究已经检查了医疗保健环境和学校中洗手设施的状况和决定因素。然而，在社区家庭中的状况，特别是在发展中国家，仍不清楚。本研究旨在检查埃塞俄比亚家庭中基本洗手设施的可用性及其影响因素。
我们分析了 2016 年埃塞俄比亚人口与健康调查（EDHS）数据。EDHS 采用两阶段分层集群抽样技术。数据来自最低行政单位（kebele）。采用允许集群水平随机效应的多变量逻辑回归模型，检查影响家庭基本洗手设施（水加肥皂）可用性的因素。回归模型的估计值报告为优势比（OR），并以 DHS 集群水平为单位进行聚类，以考虑抽样方法。
在我们的样本中，只有 1292 户（8%[95%置信区间，7.6%-8.4%]）家庭拥有基本的洗手设施。与没有正规教育的户主相比，完成中学教育（调整后的优势比[AOR] = 1.83；95%置信区间：1.35-2.49）和更高教育水平（AOR = 2.35；95%置信区间：1.63-3.39）的户主拥有基本洗手设施的可能性更高。拥有收音机（AOR = 1.32；95%置信区间：1.10-1.63）和电视（AOR = 1.49；95%置信区间：1.10-2.02）的家庭拥有基本洗手设施的可能性增加。拥有改良厕所的家庭拥有基本洗手设施的可能性增加两倍（AOR = 2.09；95%置信区间：1.56-2.80）。处于较高家庭财富五分位数与拥有基本洗手设施的可能性增加有关。
本研究表明，基本的洗手设施非常低，而意识和社会经济相关因素被确定为家庭中洗手设施可用性的决定因素。需要做出更大的努力来增加社区层面洗手设施的覆盖范围。
