School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
Amir Nur District Health Office, Harar, Ethiopia.
Front Public Health. 2024 Nov 13;12:1438748. doi: 10.3389/fpubh.2024.1438748. eCollection 2024.
Understanding the level of inadequate water, sanitation, and hygiene (WaSH) services in urban and rural settlements is crucial for prioritizing community interventions and resource allocation. However, there is a lack of evidence regarding discrepancies in WaSH services across rural and urban slum communities in Ethiopia.
This study aims to assess inequalities in households' WaSH services and their associated factors among urban slums and rural communities in Eastern Ethiopia from February to April 2024.
A comparative community-based cross-sectional study design was conducted, with study participants selected through stratified random sampling using proportional-to-size allocation. Data were entered into Epi Data version 3.1 and then exported to STATA version 17 for analysis. Bi-variable and multivariable logistic regression was conducted, and associations were reported as odds ratios (ORs) with 95% confidence intervals (CI), using a value less than 0.05 as the significance threshold.
A total of 278 urban and 301 rural households participated in the study, with a response rate of 94%. Key indicators showed that WaSH services were significantly better in urban areas compared to rural households. For example, 98% (95% CI: 96, 99) of urban households had access to an improved water source compared to 76% (95% CI: 71, 80) of rural households. The proportion of households with improved latrines was 44% (95% CI: 38, 50) in urban areas and only 14% (95% CI: 11, 19) in rural areas. Handwashing practices at all five critical times were reported by 52% (95% CI: 46, 58) of urban household heads, compared to 22% (95% CI: 18, 27) of rural households. Additionally, occupation (such as being a farmer, = 0.000) and water service satisfaction ( = 0.000) were significantly associated with these key WaSH outcomes.
The study revealed that the WaSH services in urban slums are considerably better than in rural households. Socioeconomic factors significantly influence the existing disparities in WaSH services. Stakeholders should focus on providing targeted, strategic support to communities to address the challenges in WaSH service provision.
了解城市和农村住区供水、环境卫生和个人卫生（WASH）服务不足的程度，对于确定社区干预措施和资源分配的优先次序至关重要。然而，在埃塞俄比亚农村和城市贫民窟社区，WASH 服务方面的差异证据不足。
本研究旨在评估 2024 年 2 月至 4 月期间，埃塞俄比亚东部城市贫民窟和农村社区家庭 WASH 服务及其相关因素的不平等情况。
采用基于社区的比较性横断面研究设计，通过按比例大小分配的分层随机抽样选择研究参与者。数据输入 Epi Data 版本 3.1，然后导出到 STATA 版本 17 进行分析。采用双变量和多变量逻辑回归，关联以比值比（OR）和 95%置信区间（CI）表示，采用 0.05 作为显著性阈值。
共有 278 户城市家庭和 301 户农村家庭参加了研究，应答率为 94%。主要指标表明，城市地区的 WASH 服务明显优于农村家庭。例如，98%（95%CI：96，99）的城市家庭可以获得改良水源，而 76%（95%CI：71，80）的农村家庭可以获得改良水源。城市地区有 44%（95%CI：38，50）的家庭使用改良厕所，而农村地区只有 14%（95%CI：11，19）。报告所有五个关键时间点进行洗手的城市家庭户主占 52%（95%CI：46，58），而农村家庭只有 22%（95%CI：18，27）。此外，职业（如农民， = 0.000）和对供水服务的满意度（ = 0.000）与这些关键 WASH 结果显著相关。
研究表明，城市贫民窟的 WASH 服务明显优于农村家庭。社会经济因素对 WASH 服务方面现有的差异有重大影响。利益攸关方应专注于为社区提供有针对性的战略支持，以解决 WASH 服务提供方面的挑战。
