Household access and utilization of improved latrines: an analysis using Somaliland nationwide survey data within the SDG 6 framework

Lack of access to adequate sanitation contributes to environmental pollution and diarrheal diseases. This study assessed household access to, and regular use of, improved latrines in Somaliland using Somaliland health and demographic survey (SLHDS) 2020 data. The study analyzed secondary data from 2806 households selected through multi-stage sampling, covering urban, rural, and nomadic areas across six regions. Logistic regression models assessed factors influencing latrine utilization, such as gender of the household head, region, and wealth. Male-headed households had higher latrine utilization (AOR = 1.45, 95% CI [1.30, 1.60], p < 0.001). Households in Sanaag had greater odds of using latrines compared to Awdal (AOR = 1.72, 95% CI [1.50, 1.94], p < 0.001). Urban households had better access than rural (AOR = 2.34, 95% CI [2.10, 2.58], p < 0.001) and nomadic households (AOR = 3.56, 95% CI [3.10, 4.02], p < 0.001). Wealthier households were more likely to use improved sanitation facilities (AOR = 2.89, 95% CI [2.50, 3.28], p < 0.001). The study identifies significant disparities in access to sanitation facilities, influenced by socioeconomic status and regional factors. These findings underscore the need for targeted interventions to improve sanitation access in underserved communities.