Post-war status of water supply, sanitation, hygiene and related reported diseases in Tigray, Ethiopia: A community-based cross-sectional study

Water, sanitation and hygiene (WASH) associated diseases remain a global public health issue and linked with Sustainable Development Goal 6. In November 2020, a war broke out in Tigray, Ethiopia, resulting in a negative health consequence. The post war status of WASH and its associated diseases are not documented. The aim of this study was to assess the status of drinking water, sanitation and hygiene practices and the prevalence of WASH-associated diseases in Tigray, Ethiopia following the war. A community-based cross-sectional study was conducted in 24 randomly selected accessible districts of Tigray, Ethiopia. A standardized questionnaire was used to collect data from households in the study. Data was collected from 2338 households. Descriptive statistics and binary logistic regression were used to analyze the data. The average age of respondents was 28.7 years (SD = 6.2). The majority of respondents 2030 (86.8%) were married and 1698 (72.6%) were rural residents. Nearly one third of the respondents were uneducated and around 40% have either radio or TV as means of communication. More than half (55.2%) of the respondents had a family size of over 5.

A quarter (25%, 95% CI: 23.3, 26.8) of study participants had access to a basic water supply. Less than a tenth (7.7%, 95% CI: 6.6, 8.8) of households had access to basic sanitation. Basic hand washing was available in 2% of households. Malaria, diarrhoea, skin infection and eye infection were the common reported disease in the community. Marital status, family size, place of residence and liquid waste management were the most important predictors of reported diseases.

Access to basic water, sanitation and hygiene services was low, and the prevalence of malaria, diarrhoea and skin infections was higher. There were differences in WASH services and reported diseases according to zone and place of residence (urban-rural). Post war, improved access to basic water, sanitation and hygiene services is recommended to prevent WASH-associated diseases in Tigray, Ethiopia. Furthermore, the prevention oriented policy of the country needs better implementation to reduce preventable diseases and ensure better health status in the community.