Utilization of Latrine and Associated Factors among Residents in Tourism Destination Area of Debark Town, Northwest Ethiopia: A community-based Cross-Sectional Study

Background: Though the Ethiopian government continues to support increased access to improved latrine facilities, high access rates to household latrines are often not matched by high usage rates and open defecation still remains the predominant practice in rural and pre-urban households. However, little research has been conducted to identify potential factors associated with low latrine use. Therefore, the purpose of this study was to assess latrine utilization and its associated factors in Debark town, northwest Ethiopia.
Methods: A community-based cross-sectional study was employed to collect data from 5-17 June 2016. A simple random sampling technique was used to select a total of 383 households that were included in the study. The data were collected using a pretested structured questionnaire and observational checklists through face-to-face interviews. The completed data were analyzed using SPSS version 20. A binary logistic regression model was used to compute bivariate and multivariable analysis of the data. An adjusted odds ratio with 95% CI was used for the interpretation of the data after controlling the confounders. In addition, P-value <0.05 was used to declare statistically significant associations.
Results: Among the residents in Debark town, the utilization of latrine was 80.5% with 95% CI: (76.3, 84.4%). The head of households having a diploma and above (AOR: 2.40, 95%CI: (1.54, 10.71)), households whose service year of latrine was less than two years (AOR: 2.46, 95%CI: (1.13, 5.35)), absence of flies (AOR: 3.24, 95%CI: (1.23, 8.69)) and cleanliness of the slab (AOR: 4.96, 95%CI (1.76-13.94) were significantly associated predictors for higher latrine utilization. However, lack of regular cleaning of the latrine hindered its utilization (AOR: 0.18, 95%CI (0.05, 0.73)),
Conclusion: Latrine utilization is found to be substantially high among residents in Debark town. Better educational levels, no visible nuisance flies in the latrine and no faeces on the latrine floor, short years of use, and frequency of latrine cleaning were the five statistically associated factors for effective utilization of latrines. To maintain consistent latrine utilization, health education through urban health extension programs could be strengthened. However, additional measures could also be recommended to address households without latrines.