Achieving universal sanitation in Ghana: An analysis of key drivers of toilet ownership among property owners in Urban areas.

Access to safe sanitation facilities remains a critical public health concern, especially in rapidly urbanizing countries like Ghana. This study investigates the determinants of household toilet ownership among property owners in three urban districts in Ghana. Using a cross-sectional survey design, data were collected from 1,256 property owners selected through a multi-stage stratified sampling procedure. Logistic regression analysis revealed that toilet ownership is significantly associated with the age and education level of property owners, community classification, building characteristics, and household income. Older property owners were more likely to own toilets (OR = 1.014 per year increase), as were those with higher education levels (OR = 1.752 for secondary, OR = 4.489 for tertiary education). Medium-class communities (OR = 2.013) completed buildings (OR = 2.625), and those constructed with sandcrete (OR = 12.755) were more likely to have toilets. Higher household income (OR = 1.00) correlated positively with toilet ownership. We conclude that enforcing building regulations requiring toilet facilities in all properties is crucial for improving sanitation in urban Ghana. Additionally, innovative sanitation financing interventions that subsidize the costs of sanitation facilities can be effective in addressing financial barriers and increasing household toilet ownership.