Rural-Urban Disparities in Household Access to Improved Hand Hygiene Facilities in Somalia: Application of the Fairlie Decomposition Technique

Somalia has developed its first National WASH Sector Policy to increase equitable access to sustainable sanitation facilities, promote large-scale hygiene behavior change, and eliminate open defecation, in alignment with national priorities and the Sustainable Development Goals, notably Target 6.2, to ensure universal access to adequate and equitable sanitation and hygiene facilities. Therefore, this study aims to evaluate the disparities in access to improved hygiene facilities between rural and urban households. The study used cross-sectional data from the Somali Integrated Household Budget Survey (SIHBS) 2022, which analyzed a total of 7,212 households. The Pearson Chi-square test for independence was adopted to assess the association between predictor and outcome variables. The Fairlie decomposition assessed how much rural-urban disparities in access to improved hygiene facilities are explained by the predictors. The multivariate logistic regression was applied to determine if the predictors are significantly associated with the outcome variable. This study reveals that 32.5% of households had access to improved hygiene facilities. Based on logit model, sex (AOR: .844, 95% CI [.767, .929]), education of the household head (AOR: .881, 95% CI [.777, .999]), household water treatment (AOR: .775, 95% CI [.703, .855]), poverty status of the household (AOR: .636, 95% CI [.579, .699]) and type of residence (AOR: .861, 95% CI [.779, .952]) were all significant predictors associated with access to improved hygiene facilities. This highlights a lack of understanding of education, water treatment, and financial constraints as structural barriers to accessing improved hygiene facilities in rural areas. Addressing these concerns is crucial for improved hygiene facilities.