Burden and Determinants of Open Defecation: The Reality across the Rural and Urban Areas of Osun State, Southwest Nigeria

Abstract

The burden of open defecation remains a challenge in Nigeria despite various interventions targeted at ensuring uptake of sanitary means of sewage disposal. This study aimed at determining the factors that influence the practice of open defecation in the rural and urban communities of Osun State. A comparative cross-sectional study design was employed. Two hundred and ninety-nine households were enrolled in the rural and 299 households from urban local government, using multistage sampling technique. Data were collected using an interviewer-administered questionnaire and a checklist was used to assess the sanitation of the house. Determinants of open defecation were assessed using binary logistic regression. The burden of open defecation is more in rural areas both at home and when away from home 31.1% and 37.8% respectively; compared with urban areas, indoor, 8.4%, and away from home, 11.7%. Households in rural areas are four times more likely to practice open defecation than those in the urban area (Odds ratio = 3.9, p <0.001). Likelihood of practice of open defecation declined with level of education of male head and increase in wealth index of households. House ownership reduced the likelihood of practicing open defecation by 2.5 (odds ratio = 0.4, p = 0.015). There is a need for more efforts focused especially on the rural areas to achieve the eradication of open defecation in Nigeria. There is a need to promote having toilets in the house especially in rural areas where a significant proportion still lacks access to toilets.