Prevalence and Determinants of Household Access to Improved Latrine Utilization in Somalia: Health Demographic Survey (SHDS) 2020.

The aim of this research paper is to determine the prevalence of improved household latrine utilization and its determinants in Somalia, using the Somali Health Demographic Survey (SHDS) 2020 dataset. Limited sanitation is a major global problem mainly for the poor and disadvantaged. According to the SHDS 2020 report, around 22.3% of households in Somalia utilize unimproved toilet facilities. In this study, a secondary data analysis was carried out on the SHDS 2020 dataset. The study included 15 826 households weighted for representativeness. Four models were constructed after identifying relevant factors for the outcome variable. The first model, null (empty), had no independent variables. The second model assessed the effect of individual-level determinants on the outcome. The third model determined how community-level variables influenced on the response variable. Finally, a multilevel multivariable logistic regression model examined the combined impact of individual- and community-level factors on the outcome variable. The prevalence of improved latrine utilization in Somalia was (41.1%). The factors: educational status (AOR: 1.899 (1.598, 2.258)), wealth index (AOR: 7.815 (6.990, 8.736)), urban residence (AOR: 2.467 (2.262, 2.690)), households living in various regions/states, including Hirshabelle, Galmudug, Southwest, Puntland, Jubaland, and Somaliland, indicate statistically significant findings and were more likely to utilize improved latrines (AOR: 0.259 (0.229, 0.294)), (AOR: 0.223 (0.196, 0.254)), AOR: 0.196 (0.168, 0.230)), (AOR: 0.220 (0.194, 0.251)), (AOR: 0.204 (0.180, 0.232)), (AOR: 0.086 (0.077, 0.095)). Hirshabelle had a 0.259 times more likelihood of improved latrine utilization than the rest of the regions/states, (AOR: 0.259 (0.229, 0.294)). The prevalence of improved latrine utilization was quite low in Somalia. Higher wealth index, living in more urbanized areas, and the household head's educational status were all significant predictors of improved latrine utilization. The finding implies a need to increase household's access to latrine facilities and improve latrine utilization, particularly for rural households in the country.