The dynamics of household sanitation services and faeco-oral diseases externalities in Osun State, southwest Nigeria.

Background: Maintaining human dignity through sanitation is a perennial challenge and highlights the externalities of sanitation and hygiene services (SHS). In Nigeria, 23.2% practise open defecation, and 45.5% use basic sanitation services, although conventional sewerage systems are rare. This study determines SHS and their predictors in the context of local governance in southwest Nigeria.

Methods: The cross-sectional study applied a five-stage sampling technique and elicited information from 542 respondents using a validated semistructured questionnaire. The study results are presented by descriptive and inferential statistics.

Results: The mean age of respondents was 48.2±0.8 y. Of these, 64.2% were homeowners, and 40.0% were in the lower wealth quartiles. While 76.9% of respondents had access to toilets, only 16.6% and 18.1% benefitted from safely managed and basic sanitation services, respectively, with 21.2% practising open defecation. Open defecation (42.6%) was prevalent primarily in the Ayedaade local government area (LGA), while safely managed sanitation services (27.6%) and limited sanitation services (54.1%) were predominant in the Olorunda and Ilesa-West LGAs. The predictors influencing household sanitation services included residence, ethnicity and wealth.

Conclusions: There were significant inequalities in sanitation access and critical infrastructure, and sanitation quality gaps exist among respondents. The prevalence of open defecation was high, and there was variation in access to sanitation services across different LGAs.