Prevalence and factors associated with open defecation practices among household population in Tanzania

In Tanzania, limited scientific evidence exists regarding the national prevalence of households practicing open defecation (OD) and its associated factors. This analytical cross-sectional study used secondary data from the 2022 Tanzania Demographic and Health Survey and Malaria Indicator Survey (TDHS-MIS). A weighted sample of 70,615 households was included in the analysis. Descriptive and inferential analyses were conducted to estimate the prevalence of open defecation and identify associated factors. Multivariable logistic regression analysis was used to assess the association between open defecation and selected covariates, including age, education level, wealth status, and place of residence. Statistical significance was determined at a p-value of < 0.05 with a 95% confidence level. The proportion of households practicing open defecation was 9.7%. The multivariable logistic regression results showed that households headed by individuals aged 15-24 years (AOR = 1.91; 95% CI: 1.39-2.62), those residing in rural areas (AOR = 2.52; 95% CI: 1.56-4.07), households headed by individuals with informal education (AOR = 2.59; 95% CI: 1.97-3.41) or primary education (AOR = 1.36; 95% CI: 1.14-1.63), households with low economic status (AOR = 3.62; 95% CI: 2.50-5.23), households with nine or more members (AOR = 1.70; 95% CI: 1.17-2.46), and households without a radio (AOR = 1.27; 95% CI: 1.05-1.53) or television (AOR = 1.59; 95% CI: 1.32-1.93) had significantly higher odds of practicing open defecation compared with their counterparts. Addressing open defecation in Tanzania requires a combined approach that includes sanitation infrastructure development, targeted behavior change communication, socioeconomic empowerment, and expanded dissemination of sanitation messages through mass media. Strengthening outreach in underserved rural communities and prioritizing households with limited educational and informational resources will be critical for accelerating progress toward open-defecation-free status and achieving national and global sanitation goals.