Latrine Utilization and Associated Factors among Households in Honkolo Wabe District, Arsi Zone, Oromia, Ethiopia

Abstract

Abstract Background: Access to proper sanitation is crucial for public health, but over 3.5 billion people globally lack it, exposing communities to preventable diseases such as diarrhea, which causes significant morbidity and mortality, especially among young children. Although some households have latrines, open defecation remains a challenge due to socio-cultural beliefs, economic limitations, and poor infrastructure. Objectives: This study assessed latrine utilization and associated factors in Honkolo Wabe District, Oromia Region, Ethiopia. Methods: A mixed study design was conducted among 502 households in Honkolo Wabe district from August 25, to September 25, 2025. A multi-stage sampling method was used to recruit study participants. Semi-structured questionnaires were used to collect data. Data were entered into the Kobo Toolbox software and analyzed by SPSS version 25. Variables with p-value ≤ 0.25 were entered into a multivariable logistic regression model. A p-value < 0.05 and adjusted odds ratio (AOR) with 95% confidence interval (CI) were considered significant. For qualitative data, four focus group discussions (FGDs) were held with eight purposively chosen participants from kebeles. Data were transcribed, translated into English, and thematically analyzed by using open code software 4.03. Results: Latrine utilization in this study was 31.4% (95%CI: 27.3%-35.7%). Significant factors associated with increased latrine use included being female (AOR = 2.03, 95%CI: 1.28–3.21), having at least secondary education (AOR = 4.42, 95%CI: 1.91–10.23), absence of children under five years (AOR = 1.87, 95%CI: 1.16–3.01), smaller family size (AOR = 2.44, 95%CI: 1.41–4.21), safe latrine access at night (AOR = 5.95, 95%CI: 3.48–10.16), and presence of a privacy wall or door (AOR = 1.63, 95%CI: 1.02–2.61). FGDs confirmed barriers: child fall fears prompting open defecation, unsafe bush-covered paths, and privacy deficits due to costs. Conclusion: Latrine utilization in Honkolo Wabe District households was low (31.4%) compared to other studies and SDG targets. Significant factors included female sex, maternal secondary education, family size <5, absence of under-5 children, safe nighttime access, and privacy walls/doors, with FGDs confirming child fall fears, unsafe paths, and privacy/cost barriers. Therefore, health education should be given on associated findings to get full coverage latrine utilization in this District.