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Exploring associations between household environmental factors and handwashing with essential agents in sub-Saharan Africa

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  • Aiggan Tamene
  • Aklilu Habte
  • Mihretu Tagesse
  • Fitsum Endale
  • Tamirat Melis
  • Zablon Wale Sewalem
  • Abel Afework

Abstract

Background: 3 billion people lack proper home hand hygiene facilities globally. Of these, 1.4 billion (18%) lack soap or water, while 1.6 billion (22%) have neither. This analysis explores the link between living conditions and the use of essential agents in sub-Saharan Africa. This secondary data analysis examines potential associations between the domiciliary environment and the use of essential agents in sub-Saharan Africa. Methods: Eighteen demographic and health surveys were used to analyze the association between household environmental factors and handwashing with essential agents. STATA version 16 was used to analyze data from 203,311 households across weighted samples. Using a multivariable multilevel mixed effect logistic regression analysis, it was possible to determine how each independent factor affected the outcome while taking the data clustering into account. The adjusted odds ratio and its associated 95% confidence interval were used to assess the independent factors’ statistical significance. Result: Only one in three households 34.84%, practiced handwashing with essential agents, with the highest prevalence in Angola (70.2%) and the lowest in Malawi (6.5%). Educational status [aOR = 1.77; 95%(CI = 1.68–1.86)], female headship[aOR = 1.09; 95%(CI = 1.06–1.2)], household wealth[aOR = 4.08; 95%(CI = 3.84–4.33)], not sharing toilets with other homes[aOR = 1.13; 95%(CI = 1.10–1.17)], having a fixed place for hand washing[aOR = 1.49; 95%(CI = 1.45–1.54)], not having regular access to water [aOR = 0.09; 95%(CI = 0.095–0.10)]and being a rural resident [aOR = 0.85; 95%(CI = 0.82–0.88)] were associated with handwashing. Conclusion: sub-Saharan nations are failing to demonstrate advancements in handwashing practices. There are still a lot of homes without access to basic infrastructure for handwashing and household water sources. For essential agent adoption programs to be successful in an environment with limited resources, Water, Sanitation, and Hygiene measures must be implemented. Furthermore, it is critical to include contextual factors from the current study as well as socio-cultural and psychological characteristics that dissuade people from using essential agents in intervention strategies.

Suggested Citation

  • Aiggan Tamene & Aklilu Habte & Mihretu Tagesse & Fitsum Endale & Tamirat Melis & Zablon Wale Sewalem & Abel Afework, 2023. "Exploring associations between household environmental factors and handwashing with essential agents in sub-Saharan Africa," PLOS ONE, Public Library of Science, vol. 18(6), pages 1-18, June.
    • Handle: RePEc:plo:pone00:0286735
    DOI: 10.1371/journal.pone.0286735
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    References listed on IDEAS

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    1. Hugh Ellis & Erica Schoenberger, 2017. "On the Identification of Associations between Five World Health Organization Water, Sanitation and Hygiene Phenotypes and Six Predictors in Low and Middle-Income Countries," PLOS ONE, Public Library of Science, vol. 12(1), pages 1-19, January.
    2. Ellis Adjei Adams & Daniel Sambu & Sarah L. Smiley, 2019. "Urban water supply in Sub-Saharan Africa: historical and emerging policies and institutional arrangements," International Journal of Water Resources Development, Taylor & Francis Journals, vol. 35(2), pages 240-263, March.
    3. A. Skrondal & S. Rabe-Hesketh, 2014. "Protective estimation of mixed-effects logistic regression when data are not missing at random," Biometrika, Biometrika Trust, vol. 101(1), pages 175-188.
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