Rural and remote health · 2026
Environmental and economic drivers of persistent open defecation in the rural state of Osun, Nigeria.
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Akindele Ajoke Fi, Odipe Oluwaseun E, Adeleke Akinrinade K, Iniaghe Paschal O
Аннотация
INTRODUCTION: Open defecation remains a major environmental health challenge in Sub-Saharan Africa, with Nigeria bearing one of the highest global burdens despite increasing access to improved water sources and widespread awareness of sanitation-related health risks in rural areas. Community-led total sanitation (CLTS) emphasizes behavioural change, prompting families to build their own latrines using local materials. CLTS drives community mobilization to stop open defecation collectively; the widespread prevalence of the practice in rural areas reveals a significant gap between sanitation knowledge and actual practice. Furthermore, very few empirical studies integrate the roles of environmental constraints, household financial choices, and sanitation behaviour gaps in under-resourced settings. This study addresses this gap by investigating the environmental and socioeconomic determinants of open defecation persistence through a baseline assessment conducted during CLTS in the rural state of Osun, Nigeria.
METHODS: A cross-sectional survey was conducted among 200 respondents across four rural villages in Osun between March and May 2023. Data on sanitation infrastructure, defecation practices, water access, hygiene behaviours, and household economic priorities were collected using semi-structured questionnaires. Associations were examined using χ2 tests, ANOVA, and multiple regression analyses.
RESULTS: A total of 91.5% of households practised open defecation, with only 5.5% owning improved toilet facilities, despite 89.5% having access to improved water sources. A pronounced knowledge-practice gap was observed: 51.5% of households practising handwashing before meals were still disposing of faeces in open spaces (χ²=36.4, p<0.01). Household income significantly influenced prioritization of mobile phone purchases over latrine construction (χ²=19.34, p=0.04), while education level correlated with toilet quality perceptions (χ²=41.36, p<0.01). Soil type significantly influenced flooding risk and latrine siting feasibility (χ²=8.51, p=0.004). Regression analysis revealed that household size, gender, and perceived importance of handwashing significantly predicted water storage expenditure (F=7.44, p<0.001, R²=0.188).
CONCLUSION: This study shows that awareness campaigns alone cannot stop open defecation in rural Nigeria, as knowledge and water access cannot overcome the structural barriers of extreme poverty and environmental constraints. Therefore, securing a nationwide open defecation-free status by 2030 requires a paradigm shift beyond behavioural interventions. In rural settings, sustainable progress depends on integrating subsidized financing mechanisms, conducting environmental feasibility assessments, and embedding sanitation initiatives within national poverty reduction frameworks. This comprehensive approach is necessary because current non-subsidized CLTS approaches are insufficient for rural communities facing extreme resource constraints.
METHODS: A cross-sectional survey was conducted among 200 respondents across four rural villages in Osun between March and May 2023. Data on sanitation infrastructure, defecation practices, water access, hygiene behaviours, and household economic priorities were collected using semi-structured questionnaires. Associations were examined using χ2 tests, ANOVA, and multiple regression analyses.
RESULTS: A total of 91.5% of households practised open defecation, with only 5.5% owning improved toilet facilities, despite 89.5% having access to improved water sources. A pronounced knowledge-practice gap was observed: 51.5% of households practising handwashing before meals were still disposing of faeces in open spaces (χ²=36.4, p<0.01). Household income significantly influenced prioritization of mobile phone purchases over latrine construction (χ²=19.34, p=0.04), while education level correlated with toilet quality perceptions (χ²=41.36, p<0.01). Soil type significantly influenced flooding risk and latrine siting feasibility (χ²=8.51, p=0.004). Regression analysis revealed that household size, gender, and perceived importance of handwashing significantly predicted water storage expenditure (F=7.44, p<0.001, R²=0.188).
CONCLUSION: This study shows that awareness campaigns alone cannot stop open defecation in rural Nigeria, as knowledge and water access cannot overcome the structural barriers of extreme poverty and environmental constraints. Therefore, securing a nationwide open defecation-free status by 2030 requires a paradigm shift beyond behavioural interventions. In rural settings, sustainable progress depends on integrating subsidized financing mechanisms, conducting environmental feasibility assessments, and embedding sanitation initiatives within national poverty reduction frameworks. This comprehensive approach is necessary because current non-subsidized CLTS approaches are insufficient for rural communities facing extreme resource constraints.