Spatial variation and factors associated of solid fuel use in Ethiopia a multilevel and spatial analysis based on EDHS 2016.

Cooking and heating using solid fuels, such as dung, wood, agricultural residues, grass, straw, charcoal, and coal, is a main source of household air pollution. This indoor combustion encompasses a diversity of health detrimental pollutants, especially for people from low-income countries like Ethiopia since solid fuels are accessible easily at a lesser cost. Limited studies done showing factors affecting in choosing fuel type and no study, which revealed spatial heterogeneity of solid fuel used based on such nationally representative data. Therefore, this study, aimed at investigating spatial variation and determinants of solid fuel use in Ethiopia. This study was done using the data from the Ethiopian Demographic and Health Survey 2016, a national representative sample (16,650) households were included. Spatial and Multi-level logistic regression analysis was done by considering the DHS data hierarchal nature. Variables in the final model with a p-value < 0.05 were reported as significant predictors of using solid fuel. All analyses were done using ArcGIS V.10.7.1 and STATA V.14 software. The finding of this study revealed that 90.8% (95% CI (87.9%, 91.2%)) of households depend on solid fuel for cooking. Based on the final model ;Male household head (AOR 1.38, 95% CI (1.12-1.71)), age of household head (AOR 1.61, 95% CI (1.20, 2.17)), and 1.49 (OR 1.49, 95% CI (1.12, 1.99)) respectively for the age classes of < 30, and 30-40, education attainment no education (OR 3.14, 95% CI (1.13, 8.71)) and primary education (AOR 2.16, 95% CI (2.78, 5.96), wealth index Poorest (AOR 11.05, 95% CI (5.68, 15.78)), Poorer (OR 5.19, 95% CI (5.43, 13.19)), Middle (OR 3.08, 95% CI (2.44, 8.73)), and Richer (OR 1.30, 95IC (1.07, 13.49)) compared to richest, and not accessibility of electricity (AOR 31.21, 95% CI (35.41, 42.67)), were individual-level factors significantly associated with using solid fuel. Community-level factors like households found at large city (AOR 2.80, 95CI (1.65, 4.77)), small city (AOR 2.58, 95% CI (1.55, 4.32)) town (AOR 4.02, 95% CI (2.46, 6.55)), and countryside (AOR 14.40, 95% CI (6.23, 21.15)) compared households found in capital city, community level media exposure (AOR 6.00, 95% CI (4.61, 7.82)) were statistically predictors in using solid fuel for cooking. This finding revealed that a large proportion of households in Ethiopia heavily depend on biomass, especially wood, for cooking. There was a greater disparity on solid fuel use for cooking in Ethiopia. Implementing major policy interventions should be introduced to reduce solid fuel use for cooking and inequalities in accessing clean fuel in Ethiopia.