Examining households’ expenditure patterns on water, sanitation, and hygiene services in urban slums in Southeast Nigeria

Objectives Access to safe water, sanitation, and hygiene (WASH) is essential for human health and wellbeing. However, many households in slum settlements lack access to WASH and are exposed to adverse health effects. Understanding household expenditure and equality in access to WASH is crucial for developing effective policies and interventions to improve access to such services. This paper offers new insights into household expenditures and equality in access to WASH services in urban slums in Nigeria. Methods A cross-sectional study was conducted in two urban slums in Anambra State, Nigeria. An interviewer-administered questionnaire was used to collect data on household expenditures on WASH services from 421 purposively selected households. Household expenditures on WASH were computed. Multiple regression was used to investigate associations between WASH expenditures and socioeconomic characteristics. Principal component analysis was used to create wealth quintiles. Concentration indices were used to assess equality in expenditures. Results The average monthly and yearly household expenditure on WASH were US$19.9 and US$168.6, respectively. WASH spending accounts for 11.3% of the household expenditure. The mean annual expenditure on hygiene accounted for 57.9% of total expenditures on WASH services, followed by water (36.9%) and sanitation (5.6%). Expenditure on water (CI: −0.019, p -value: 0.637) and sanitation services (CI: −0.011, p-value: 0.800) was slightly concentrated among the poorer population, while expenditure on hygiene services (CI: −0.012, p -value: 0.561) was slightly concentrated among the wealthier population. Expenditures on WASH services were equitable across wealth quintiles (CI: −0.001, p -value: 0.946). Larger household size (mean difference: 80,874; 95% CI: 50,621; 111,127) and respondents older than 38 years (mean difference: 37,679; 95% CI: 7,137–68,220) were associated with higher expenditures. Conclusion This study highlights the significant financial burden that households in urban slums face in accessing WASH, which can lead to a decrease in their use. Decision-makers should consider targeted subsidies for water and sanitation services, promote hygiene awareness in low-income households, and invest in affordable WASH infrastructure.