Household-level sanitation in Ethiopia and its influencing factors: a systematic review
Abstract Background Within the past two decades, Ethiopia has achieved one of the fastest reductions of open defecation worldwide. This change can be attributed to the implementation of a national sanitation strategy that focused on facilitating community demand for latrine adoption and use of basic...
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| Format: | Article |
| Language: | English |
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BMC
2022-07-01
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| Series: | BMC Public Health |
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| Online Access: | https://doi.org/10.1186/s12889-022-13822-5 |
| _version_ | 1818502434556739584 |
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| author | Josef Novotný Biruk Getachew Mamo |
| author_facet | Josef Novotný Biruk Getachew Mamo |
| author_sort | Josef Novotný |
| collection | DOAJ |
| description | Abstract Background Within the past two decades, Ethiopia has achieved one of the fastest reductions of open defecation worldwide. This change can be attributed to the implementation of a national sanitation strategy that focused on facilitating community demand for latrine adoption and use of basic self-constructed latrines but less on other preconditions of hygienic sanitation. Recognition of sanitation by policymakers also catalyzed primary research in this area. As such, the synthesis of the available evidence is both warranted and possible. In this article, we thus decided to assess available primary evidence on the household-level sanitation in Ethiopia and its influencing factors. Methods We searched primary studies that present findings on the role of factors influencing household-level sanitation outcomes in Ethiopia. We typologically classified sanitation outcomes analyzed in identified literature and computed pooled estimates for the most prevalent ones (measures of latrine availability and use). We characterized thematic types (themes and sub-themes) of influential sanitation drivers and used network analysis to examine the relational patterns between sanitation outcomes and their influencing factors. Findings We identified 37 studies that met our inclusion criteria—all but one published after 2009. The general latrine coverage pooled across 23 studies was 70% (95% CI: 62–77%), the share of improved latrines pooled across 15 studies was 55% (95% CI: 41–68%), and latrine use pooled across 22 studies was 72% (95% CI: 64–79%). Between-study heterogeneity was high, and no time trends were identified. The identified sanitation outcomes were classified into eight types and factors reported to influence these outcomes were classified into 11 broader themes and 43 more specific sub-themes. Factors around the quality of latrines represented the most frequent sub-theme of consequential drivers. We found that the available research focused predominantly on outcomes concerning the initial adoption and use of basic latrines, emulating the main focus of national sanitation strategy. By contrast, research on drivers of the sustainability of sanitation change and, in particular, on the upgrading of latrines, has been rare despite its urgency. There is a high need to redirect the focus of sanitation research in Ethiopia towards understanding these factors on both the demand and supply side. |
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| format | Article |
| id | doaj.art-73d3222c2faa401586de9036293c51e8 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-10T21:10:12Z |
| publishDate | 2022-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-73d3222c2faa401586de9036293c51e82022-12-22T01:33:30ZengBMCBMC Public Health1471-24582022-07-0122111510.1186/s12889-022-13822-5Household-level sanitation in Ethiopia and its influencing factors: a systematic reviewJosef Novotný0Biruk Getachew Mamo1Department of Social Geography and Regional Development, Faculty of Science, Charles UniversityDepartment of Social Geography and Regional Development, Faculty of Science, Charles UniversityAbstract Background Within the past two decades, Ethiopia has achieved one of the fastest reductions of open defecation worldwide. This change can be attributed to the implementation of a national sanitation strategy that focused on facilitating community demand for latrine adoption and use of basic self-constructed latrines but less on other preconditions of hygienic sanitation. Recognition of sanitation by policymakers also catalyzed primary research in this area. As such, the synthesis of the available evidence is both warranted and possible. In this article, we thus decided to assess available primary evidence on the household-level sanitation in Ethiopia and its influencing factors. Methods We searched primary studies that present findings on the role of factors influencing household-level sanitation outcomes in Ethiopia. We typologically classified sanitation outcomes analyzed in identified literature and computed pooled estimates for the most prevalent ones (measures of latrine availability and use). We characterized thematic types (themes and sub-themes) of influential sanitation drivers and used network analysis to examine the relational patterns between sanitation outcomes and their influencing factors. Findings We identified 37 studies that met our inclusion criteria—all but one published after 2009. The general latrine coverage pooled across 23 studies was 70% (95% CI: 62–77%), the share of improved latrines pooled across 15 studies was 55% (95% CI: 41–68%), and latrine use pooled across 22 studies was 72% (95% CI: 64–79%). Between-study heterogeneity was high, and no time trends were identified. The identified sanitation outcomes were classified into eight types and factors reported to influence these outcomes were classified into 11 broader themes and 43 more specific sub-themes. Factors around the quality of latrines represented the most frequent sub-theme of consequential drivers. We found that the available research focused predominantly on outcomes concerning the initial adoption and use of basic latrines, emulating the main focus of national sanitation strategy. By contrast, research on drivers of the sustainability of sanitation change and, in particular, on the upgrading of latrines, has been rare despite its urgency. There is a high need to redirect the focus of sanitation research in Ethiopia towards understanding these factors on both the demand and supply side.https://doi.org/10.1186/s12889-022-13822-5Environmental healthEthiopiaLatrine adoptionSanitationSystematic review |
| spellingShingle | Josef Novotný Biruk Getachew Mamo Household-level sanitation in Ethiopia and its influencing factors: a systematic review BMC Public Health Environmental health Ethiopia Latrine adoption Sanitation Systematic review |
| title | Household-level sanitation in Ethiopia and its influencing factors: a systematic review |
| title_full | Household-level sanitation in Ethiopia and its influencing factors: a systematic review |
| title_fullStr | Household-level sanitation in Ethiopia and its influencing factors: a systematic review |
| title_full_unstemmed | Household-level sanitation in Ethiopia and its influencing factors: a systematic review |
| title_short | Household-level sanitation in Ethiopia and its influencing factors: a systematic review |
| title_sort | household level sanitation in ethiopia and its influencing factors a systematic review |
| topic | Environmental health Ethiopia Latrine adoption Sanitation Systematic review |
| url | https://doi.org/10.1186/s12889-022-13822-5 |
| work_keys_str_mv | AT josefnovotny householdlevelsanitationinethiopiaanditsinfluencingfactorsasystematicreview AT birukgetachewmamo householdlevelsanitationinethiopiaanditsinfluencingfactorsasystematicreview |