Knowledge, attitudes, and practices of women related to human and animal feces management in Ethiopia: Evidence for strengthening water, sanitation, and hygiene (WaSH) initiatives

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...

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Main Authors: Hadush, B., Fikru, C., Kebede, G., Guesh, S., Kassaye, E., Redae, G., Amenu, Kebede, Cavalerie, Lisa, Mor, Siobhan M.
Format: Journal Article
Language:Inglés
Published: Elsevier 2026
Subjects:
Online Access:https://hdl.handle.net/10568/179413
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author Hadush, B.
Fikru, C.
Kebede, G.
Guesh, S.
Kassaye, E.
Redae, G.
Amenu, Kebede
Cavalerie, Lisa
Mor, Siobhan M.
author_browse Amenu, Kebede
Cavalerie, Lisa
Fikru, C.
Guesh, S.
Hadush, B.
Kassaye, E.
Kebede, G.
Mor, Siobhan M.
Redae, G.
author_facet Hadush, B.
Fikru, C.
Kebede, G.
Guesh, S.
Kassaye, E.
Redae, G.
Amenu, Kebede
Cavalerie, Lisa
Mor, Siobhan M.
author_sort Hadush, B.
collection Repository of Agricultural Research Outputs (CGSpace)
description 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 (n = 1129) were interviewed using a structured questionnaire on WaSH and livestock husbandry, including manure management. Descriptive statistics were used to summarise practices across sites. 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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spelling CGSpace1794132026-01-19T08:10:16Z Knowledge, attitudes, and practices of women related to human and animal feces management in Ethiopia: Evidence for strengthening water, sanitation, and hygiene (WaSH) initiatives Hadush, B. Fikru, C. Kebede, G. Guesh, S. Kassaye, E. Redae, G. Amenu, Kebede Cavalerie, Lisa Mor, Siobhan M. health sanitation water women 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 (n = 1129) were interviewed using a structured questionnaire on WaSH and livestock husbandry, including manure management. Descriptive statistics were used to summarise practices across sites. 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. 2026-06 2026-01-06T07:11:54Z 2026-01-06T07:11:54Z Journal Article https://hdl.handle.net/10568/179413 en Open Access Elsevier Hadush, B., Fikru, C., Kebede, G., Guesh, S., Kassaye, E., Redae, G., Amenu, K., Cavalerie, L. and Mor, S.M. 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. One Health 22:101311.
spellingShingle health
sanitation
water
women
Hadush, B.
Fikru, C.
Kebede, G.
Guesh, S.
Kassaye, E.
Redae, G.
Amenu, Kebede
Cavalerie, Lisa
Mor, Siobhan M.
Knowledge, attitudes, and practices of women related to human and animal feces management in Ethiopia: Evidence for strengthening water, sanitation, and hygiene (WaSH) initiatives
title Knowledge, attitudes, and practices of women related to human and animal feces management in Ethiopia: Evidence for strengthening water, sanitation, and hygiene (WaSH) initiatives
title_full Knowledge, attitudes, and practices of women related to human and animal feces management in Ethiopia: Evidence for strengthening water, sanitation, and hygiene (WaSH) initiatives
title_fullStr Knowledge, attitudes, and practices of women related to human and animal feces management in Ethiopia: Evidence for strengthening water, sanitation, and hygiene (WaSH) initiatives
title_full_unstemmed Knowledge, attitudes, and practices of women related to human and animal feces management in Ethiopia: Evidence for strengthening water, sanitation, and hygiene (WaSH) initiatives
title_short Knowledge, attitudes, and practices of women related to human and animal feces management in Ethiopia: Evidence for strengthening water, sanitation, and hygiene (WaSH) initiatives
title_sort knowledge attitudes and practices of women related to human and animal feces management in ethiopia evidence for strengthening water sanitation and hygiene wash initiatives
topic health
sanitation
water
women
url https://hdl.handle.net/10568/179413
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