Systematic review and meta analysis on gaps in household waste management practices in urban Ethiopia for supporting the TSEDU Ethiopia initiative

Assessing pooled prevalence and contributing factors is vital for designing effective, sustainable interventions that improve waste management systems and promote healthier urban environments. We selected 26 studies using various databases and the JBI checklist. Heterogeneity was assessed with the I2 test, publication bias via a funnel plot, and pooled prevalence was calculated with the DerSimonian method. The findings revealed that only 32.06% (95% CI: 26.95, 37.15) of urban residents practiced proper waste management, with significant regional variations. Somalia region exhibited the highest proportion of proper waste management practices at 53.2%, while Addis Ababa had the lowest at 24.7%. Meta-regression analysis highlighted regions like South East and Western Ethiopia as having notably better waste management practices. Key factors influencing proper waste management included secondary education (OR = 1.56, 95% CI: 1.28–1.91), a positive attitude toward waste management (OR = 1.72, 95% CI: 1.41–2.10), awareness of waste management issues (OR = 1.64, 95% CI: 1.29–2.07), higher household income (OR = 1.48, 95% CI: 1.18–1.86), and legal enforcement of waste management policies (OR = 1.85, 95% CI: 1.48–2.33). The revealed poor waste management practices in urban Ethiopia, with Somalia region showing the highest prevalence and Addis Ababa lagging behind. Key factors influencing practices include education, income, and attitudes. Notably, the 2021 outlier showed a decline, with regional and temporal variations reflecting both progress and ongoing challenges. This highlights the ineffective implementation of the Total Sanitation to End open Defecation and Urination (TSEDU)-Ethiopia Initiative and calls for enhanced awareness, legal frameworks, and community-based interventions.