An assessment of the water, sanitation and hygiene (WASH) situation in rural Volta Region, Ghana

Access to safe drinking water, sanitation and hygiene (WASH) is a fundamental human right. However, inadequate and unequal access prevail in resource-poor settings and contribute to morbidity/mortality from diarrhoeal and other diseases. WASH-related access has improved in some districts in Ghana but little is known about the situation in many other parts. The WASH situation in two rural districts of the Volta Region was assessed to help identify specific areas for support in a cross-sectional study. Seven hundred and twenty (720) households were randomly selected and their household heads or representatives interviewed using a structured questionnaire in the Ho West and Adaklu districts. Data were collected on respondents’ demographic characteristics including education level, household characteristics including type of toilet facility and sources of water, 2-week prevalence of symptoms of water-borne diseases and handwashing practices. Summary statistics were conducted and Chi-square analysis done for association between selected variables. Results with a p-value of <0.05 were considered statistically significant. Almost all households (97.9%, 706/720) had access to improved water sources with piped water and sachet water being the most common. Also, 73.3% (526/718) of respondents had access to improved sanitation facilities but many of these were shared. A third of respondents (33.4%, 240/718) practiced open defecation. Significant differences existed between the Ho West and Adaklu districts regarding use of improved toilet facilities (92.1% vs 50.5%; p<0.001), in-house location of toilet facilities (51.2% vs 41.9%; p = 0.013) and in-house water sources (32.4% vs 13.5%; p<0.001). Up to 95% (679/718) of respondents indicated that they washed their hands with soap and water after using the toilet, before cooking and on arrival home from outside but these were suspected to be influenced by COVID-19 risk perceptions. Households need support to own toilet facilities in adequate numbers for household sizes. This would assist in minimizing open defecation.