Open defecation free status and its determinants in rural Uganda: a cross-sectional survey

Abstract Introduction Globally, the progress to attain the open defecation free (ODF) environment has remained very slow. This study examined context specific factors influencing household open defecation free status in Uganda. Methods A cross-sectional study was conducted in Kabale district in sout...

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Main Authors: Moses Ntaro, John Bosco Isunju, Edgar Mulogo, John C. Ssempebwa
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-23208-y
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author Moses Ntaro
John Bosco Isunju
Edgar Mulogo
John C. Ssempebwa
author_facet Moses Ntaro
John Bosco Isunju
Edgar Mulogo
John C. Ssempebwa
author_sort Moses Ntaro
collection DOAJ
description Abstract Introduction Globally, the progress to attain the open defecation free (ODF) environment has remained very slow. This study examined context specific factors influencing household open defecation free status in Uganda. Methods A cross-sectional study was conducted in Kabale district in southwestern Uganda and 492 participants were randomly selected at household level. Data was obtained through conducting a face-to-face interview using the mobile data collection software KoBoCollect v2021.3.4 installed on tablet devices. Using the Firth’s penalized logistic regression, bivariate and multivariate analysis was conducted to determine if there existed significant associations between the outcome Household Open Defecation (HODF) status and independent variables. Variables with P < 0.2 at bivariate analysis comprised the global model for the multivariate analysis. Results The average age of the participants was 49 (SD 23.4) years. Most (67.68%) of the study participants, were females while 144 (29.27%) of the participants had no formal education. The households that were open defecation free were as few as 15 (3%). At multivariable analysis, gender of the participants, remembering handwashing, latrine and household cleanliness factors were significantly association with HODF status. Male participants had more odds of having open defecation free households (aOR: 3.89; 95% CI: 1.26–12.06) compared to female participants. Households with clean compounds, with latrines not having their holes soiled with feces and where respondents always remembered to wash hands after visiting latrine had high odds of being open defecation free (aOR: 3.15; 95% CI: 1.03–9.66, aOR: 10.56; 95% CI: 1.87–59.63 and aOR: 3.96; 95% CI: 1.24–12.68, respectively). Conclusion The prevalence of HODF was very low and factors associated with it were; the gender of the participants, the latrine and household cleanliness and the behavioral factor of remembering handwashing. We propose behavioral change interventions that empower communities to adapt improved sanitation behavior, such as Community Led Total Sanitation and Hygiene (CLTSH) in order to increase households with the Open Defecation Free status.
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spelling doaj-art-da0014ba3f16401daaeb5d7f3fc8220b2025-08-20T02:03:34ZengBMCBMC Public Health1471-24582025-05-012511910.1186/s12889-025-23208-yOpen defecation free status and its determinants in rural Uganda: a cross-sectional surveyMoses Ntaro0John Bosco Isunju1Edgar Mulogo2John C. Ssempebwa3School of Public Health, College of Health Sciences, Makerere UniversityDepartment of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere UniversityDepartment of Community Health, Faculty of Medicine, Mbarara University of Science and TechnologyDepartment of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere UniversityAbstract Introduction Globally, the progress to attain the open defecation free (ODF) environment has remained very slow. This study examined context specific factors influencing household open defecation free status in Uganda. Methods A cross-sectional study was conducted in Kabale district in southwestern Uganda and 492 participants were randomly selected at household level. Data was obtained through conducting a face-to-face interview using the mobile data collection software KoBoCollect v2021.3.4 installed on tablet devices. Using the Firth’s penalized logistic regression, bivariate and multivariate analysis was conducted to determine if there existed significant associations between the outcome Household Open Defecation (HODF) status and independent variables. Variables with P < 0.2 at bivariate analysis comprised the global model for the multivariate analysis. Results The average age of the participants was 49 (SD 23.4) years. Most (67.68%) of the study participants, were females while 144 (29.27%) of the participants had no formal education. The households that were open defecation free were as few as 15 (3%). At multivariable analysis, gender of the participants, remembering handwashing, latrine and household cleanliness factors were significantly association with HODF status. Male participants had more odds of having open defecation free households (aOR: 3.89; 95% CI: 1.26–12.06) compared to female participants. Households with clean compounds, with latrines not having their holes soiled with feces and where respondents always remembered to wash hands after visiting latrine had high odds of being open defecation free (aOR: 3.15; 95% CI: 1.03–9.66, aOR: 10.56; 95% CI: 1.87–59.63 and aOR: 3.96; 95% CI: 1.24–12.68, respectively). Conclusion The prevalence of HODF was very low and factors associated with it were; the gender of the participants, the latrine and household cleanliness and the behavioral factor of remembering handwashing. We propose behavioral change interventions that empower communities to adapt improved sanitation behavior, such as Community Led Total Sanitation and Hygiene (CLTSH) in order to increase households with the Open Defecation Free status.https://doi.org/10.1186/s12889-025-23208-yHousehold open defecation free (HODF) statusDeterminantsOpen defecation (OD)CLTSH
spellingShingle Moses Ntaro
John Bosco Isunju
Edgar Mulogo
John C. Ssempebwa
Open defecation free status and its determinants in rural Uganda: a cross-sectional survey
BMC Public Health
Household open defecation free (HODF) status
Determinants
Open defecation (OD)
CLTSH
title Open defecation free status and its determinants in rural Uganda: a cross-sectional survey
title_full Open defecation free status and its determinants in rural Uganda: a cross-sectional survey
title_fullStr Open defecation free status and its determinants in rural Uganda: a cross-sectional survey
title_full_unstemmed Open defecation free status and its determinants in rural Uganda: a cross-sectional survey
title_short Open defecation free status and its determinants in rural Uganda: a cross-sectional survey
title_sort open defecation free status and its determinants in rural uganda a cross sectional survey
topic Household open defecation free (HODF) status
Determinants
Open defecation (OD)
CLTSH
url https://doi.org/10.1186/s12889-025-23208-y
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