Socio-economic factors associated with open defecation among agricultural households: a cross-sectional study in Haiti.

Background: Open defecation (OD) is recognised as an important public health challenge in low-income and middle-income countries. Although agriculture is the main occupation in these countries, few if any study on OD has focused on agricultural households. In order to enhance the prevention of OD and contribute to a better understanding of this health-threatening behaviour, this paper analyses the socio-economic factors associated with OD practice among agricultural households in Haiti. Methods: The study used primary data from 1269 households selected in 5 out of 10 geographic departments of Haiti surveyed in 2020-2021. Descriptive statistics and bivariate analysis were used to identify households' characteristics that were significantly associated with OD. In addition, a multivariate analysis was performed using binary logistic regression to study the factors associated with the probability to defecate in the open. Results: Findings show that one out of five (20.1%) agricultural households in Haiti practices OD. More than 26% of the households did not have any member with secondary school education level. Multivariate analysis revealed that in addition to the location, the probability of OD practices among agricultural households was correlated with socio-economic factors such as education, access to the media, plot number and livestock, level of specialisation in the agriculture, agricultural income and participation in local organisations. Conclusion: While Haiti is struggling with cholera among other health issues, this paper sheds light on factors associated with OD, a health-threatening and unsustainable sanitation behaviour. According to the results, in addition to toilet acquisition subsidies, awareness campaigns need to make use of mass media and local organisations particularly women and community ones. Elimination of OD among agricultural households is of great significance for better quality of foods and vegetables at watershed level.