Health Risk Perceptions Are Associated with Domestic Use of Basic Water and Sanitation Services. Evidence from Rural Ethiopia

Activity: Talk or presentationOral presentation


Background: Evaluations of water, sanitation, and hygiene (WaSH) programmess in low- and middle-income countries typically examine technical aspects of implementation, while sociological and psychological aspects receive less attention. We examined health (mis)beliefs associated with the use of basic water supply and sanitation services in an integrated WaSH and nutrition programme.

Methods: Data were collected by a cross-sectional survey of 3200 households in WaSH intervention and control areas in Amhara, Oromia, Tigray regions and SSNRP regions in Ethiopia in 2017, and analyzed using bivariate and multivariable regression.

Results: Awareness of risk factors related to inadequate WaSH was high and was associated with the use of basic services. Perceiving the water quality as good and believing that drinking unsafe water was the main cause for diarrhoea significantly increased the odds of using basic water services. The use of basic sanitation was significantly more likely in households of the intervention group than the control group and among those who had previously received a sanitation training. Belief that a dirty space was the main cause of diarrhea and privacy when using a latrine were associated with higher odds of using a latrine. Households that indicated a disadvantage of owning a latrine were maintenance costs were significantly less likely to have basic sanitation.

Conclusions: Health beliefs were important determinants of use of basic services, while formal education played a smaller role. The findings point to (i) risk perceptions adequately reflecting real risks and (ii) being closely linked to and potentially motivating the application of positive WaSH-related and health-protective behaviours. This suggests that well-designed communication strategies and health messaging may be an effective approach for engaging households to use basic services.
Period30 Oct 2018
Event titleUNC Water and Health: Where Science Meets Policy 2018
Event typeConference
LocationChapel Hill, United States, North CarolinaShow on map
Degree of RecognitionInternational


  • behaviour change
  • WASH intervention
  • SDG 6
  • rural water supply
  • health belief
  • risk communication
  • health knowledge
  • diarrhoeal diseases