ArticleOne health (Amsterdam, Netherlands)2026
Knowledge, attitudes, and practices of women related to human and animal feces management in Ethiopia: Evidence for strengthening water, sanitation, and hygiene (WaSH) initiatives.
Article in One health (Amsterdam, Netherlands), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Water, sanitation, and hygiene (WaSH) programs aim to prevent feco-oral disease transmission, but their effectiveness in low- and middle-income countries is often compromised by frequent exposure to animal feces. In Ethiopia, national initiatives such as the Health Extension Program and Community-Led Total Sanitation and Hygiene program have expanded WaSH coverage but do not currently address animal-associated risks. This study investigated knowledge, attitudes, and practices related to human and animal feces management in Butajira, Gilgel Gibe, and Kilite Awlaelo Health and Demographic Surveillance Sites (HDSS) in Ethiopia. Methods: A community-based, cross-sectional study was conducted through random sampling of households in selected kebeles across the three HDSS sites. Eligible households owned up to 60 livestock, including at least one head of cattle. Adult women ( Results: The median age of participants ranged from 35 to 45 years, with female-headed households most frequent in Butajira (42.2 %). Literacy levels were lowest in Gilgel Gibe (64.1 % illiteracy). Most households accessed improved water sources, though unimproved sources were important in Gilgel Gibe (16.3 %). Improved toilet facilities were most common in Gilgel Gibe (61 %). At least 79 % of respondents reported handwashing after toilet use, with moderate soap use (>73 %). Manure management was primarily the responsibility of adult women (>74 %), often using bare hands. Handwashing with soap after manure handling was common in Kilite Awlaelo (>97 %) but lower in Butajira (86.3 %) and Gilgel Gibe (74.8 %). Awareness of health risks from animal manure was lower than for human feces, especially in Gilgel Gibe (70 %) and Butajira (53.2 %). Similarly, awareness of the benefits of composting or drying manure to prevent germ spread was lower in these sites. Conclusions: Despite high awareness of WaSH-related risks, critical gaps exist in understanding manure-associated health risks, particularly in Butajira and Gilgel Gibe. Targeted interventions are needed to raise awareness and improve manure management, especially among women.
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