Evidence on Wash Interventions in Negelle-Arsi District, Oromia Regional State, Ethiopia: a Cross-Sectional Data Analysis

Abstract

Walelign Fetahei and Birhanu Yadete

Background: Integrated WASH interventions play a vital role in addressing public health challenges in communities. Governments and development partners work collaboratively to improve access to safe water, sanitation, and hygiene services in order to mitigate these challenges. This study assesses the impact of WASH intervention on water access and supply, as well as changes in participants’ knowledge, attitudes, and practices in rural communities, using cross- sectional data by comparing treatment and control groups.

Methods: The study used cross-sectional data collected in May 2025 from six KAs, three intervention and three non- intervention areas, through a structured household questionnaire. A total of 396 households with children under five were included in the survey, equally divided between the treatment and control groups. Descriptive analysis was used to assess the differences among the groups in water access and supply as well as to examine the differences in knowledge, attitudes, and practices of households participating in the study.

Results: The prevalence of diarrhea among children under five years old in the rural setting during the two weeks prior to data collection showed that approximately 69 children (34.9 percent) in the control group and 5 children in the treated group (2.5 percent) experienced diarrhea. Treated households had better child health: more facility births (88.9% vs. 63.6%), higher breastfeeding (98% vs. 89.9%) and vaccination coverage (78.8% vs. 59.1%), and lower diarrhea incidence (8.1% vs. 37.4%). Water access was improved, with all treated households using protected sources, shorter collection times (13.85 vs. 55.84 minutes), and higher consumption (20.6 vs. 10.5 liters/day). Safely managed water services were 59.6% in treated vs. 1% in control households. Sanitation and hygiene also improved: latrine access (95% vs. 78.3%), open defecation (23.2% vs. 52%), and handwashing with soap (48.5% vs. 12.1%). Knowledge, attitudes, and practices were higher in treated households: good WASH knowledge (91.4% vs. 70%), favorable attitudes (99% vs. 74.8%), and proper WASH practices (85.4% vs. 26.3%).

Conclusion: The findings confirm that integrated WASH interventions, combining improved water infrastructure with sanitation promotion, hygiene education, and community engagement, can substantially improve household WASH conditions and reduce waterborne diseases. Sustaining these gains will require continued investment in water infrastructure, strengthening community awareness, and expanding behavior change initiatives to other communities.

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