Amlak Baye Tsegaye, Belay Daniel Gashaneh
Department of Nursing, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
PLoS One. 2025 Jan 13;20(1):e0315860. doi: 10.1371/journal.pone.0315860. eCollection 2025.
Limited or shared sanitation services are considered improved sanitation facilities, but they are shared between two or more households. Globally, 600 million people use shared toilet facilities. Although shared facilities are not classified as improved sanitation due to potential infection risks, inaccessibility, and safety concerns, this is a significant issue in developing countries like Ethiopia. Evidence on the distribution of shared sanitation services and their determinants in Ethiopia is limited. Therefore, this study aimed to assess the extent of shared toilet facilities and their determinants among households in Ethiopia.
The 2019 Ethiopian Demographic and Health Survey (EDHS) served as the basis for the cross-sectional secondary data analysis. The analysis included a total of 7,770 households from the weighted sample. STATA 14 software was used to clean, weigh, and analyze the data. To explore the distribution and determine the factors associated with shared toilet facilities in Ethiopia, both spatial and mixed-effect analyses were utilized. A p-value of less than 0.05 was used to display the relationships between the dependent and independent variables, employing adjusted odds ratios and 95% confidence intervals.
The magnitude of improved shared sanitation facilities among households in Ethiopia, according to the EDHS 2019, was 10.5% (95% CI: 9.88, 11.24). The prevalence was highest in Addis Ababa at 70.2% and lowest in the Southern Nations, Nationalities, and Peoples' Region at 2.4%. Individual-level variables significantly associated with the use of improved shared toilet facilities included being a household head aged 55 years or older [AOR = 0.48; 95% CI: 0.33, 0.71], having secondary education or higher [AOR = 2.43; 95% CI: 1.80, 3.28], and belonging to middle or rich wealth status [middle: AOR = 2.32; 95% CI: 1.35, 3.96; rich: AOR = 6.23; 95% CI: 3.84, 10.11]. Community-level characteristics such as residing in urban areas [AOR = 7.60; 95% CI: 3.47, 16.67], the metropolitan region [AOR = 25.83; 95% CI: 10.1, 66.3], and periphery regions [AOR = 5.01; 95% CI: 2.40, 10.48] were also associated with the use of shared toilet facilities.
The usage of improved shared toilet facilities among households in Ethiopia is relatively low. Significant factors related to the use of shared toilet facilities were being 55 years of age or older, possessing secondary or higher education, having a middle or rich wealth status, living in urban areas, and residing in metropolitan or peripheral regions. To improve access to and utilization of shared sanitation facilities, Ethiopian policy should emphasize user education and awareness.
有限或共享的卫生设施被视为改善后的卫生设施，但它们由两个或更多家庭共享。全球有6亿人使用共享厕所设施。尽管由于潜在的感染风险、不便使用和安全问题，共享设施未被归类为改善后的卫生设施，但在埃塞俄比亚等发展中国家，这是一个重大问题。关于埃塞俄比亚共享卫生服务的分布及其决定因素的证据有限。因此，本研究旨在评估埃塞俄比亚家庭中共享厕所设施的程度及其决定因素。
2019年埃塞俄比亚人口与健康调查（EDHS）作为横断面二次数据分析的基础。分析包括来自加权样本的总共7770户家庭。使用STATA 14软件清理、加权和分析数据。为了探索埃塞俄比亚共享厕所设施的分布并确定与之相关的因素，采用了空间分析和混合效应分析。使用小于0.05的p值来显示因变量和自变量之间的关系，采用调整后的比值比和95%置信区间。
根据2019年EDHS，埃塞俄比亚家庭中改善后的共享卫生设施的比例为10.5%（95%置信区间：9.88，11.24）。患病率在亚的斯亚贝巴最高，为70.2%，在南方各族州最低，为2.4%。与使用改善后的共享厕所设施显著相关的个体层面变量包括年龄在55岁及以上的户主[AOR = 0.48；95%置信区间：0.33，0.71]、具有中等教育或更高学历[AOR = 2.43；95%置信区间：1.80，3.28]以及属于中等或富裕财富状况[中等：AOR = 2.32；95%置信区间：1.35，3.96；富裕：AOR = 6.23；95%置信区间：3.84，10.11]。社区层面的特征，如居住在城市地区[AOR = 7.60；95%置信区间：3.47，16.67]、大都市地区[AOR = 25.83；95%置信区间：10.1，66.3]和周边地区[AOR = 5.01；95%置信区间：2.40，10.48]也与共享厕所设施的使用相关。
埃塞俄比亚家庭中改善后的共享厕所设施的使用率相对较低。与共享厕所设施使用相关的重要因素包括年龄在55岁及以上、拥有中等或更高学历、具有中等或富裕财富状况、居住在城市地区以及居住在大都市或周边地区。为了改善共享卫生设施的可及性和利用率，埃塞俄比亚政策应强调用户教育和意识。
