The prevalence, spatial distribution and geographic weighted regression of open defecation practice in sub-Saharan Africa using demographic and health survey (DHS) data

This study reveals a high prevalence of open defecation (23.24%) in Sub-Saharan Africa with significant geographic clustering, particularly in East, Central, and West Africa. This estimate is higher than the 18% reported by the 2021 WHO/UNICEF Joint Monitoring Programme (JMP). Novel spatial and GWR analyses uncovered associations with poverty, lack of education, water access, age of household heads, and wealth status. These findings underscore the need for geographically targeted, multi-sectoral sanitation interventions that address underlying socio-demographic disparities. Future research should explore the effectiveness of spatially tailored programs and integrate behavioral insights to accelerate progress toward Sustainable Development Goal 6.