Household Sanitation Practices and Their Association with Infant Diarrhoea: A Community Based Study in the West Gonja Municipality, Ghana

Abstract

Background: Infant diarrhoea remains a leading cause of morbidity in low- and middle-income countries, where inadequate household sanitation, unsafe disposal of child faeces, and limited access to safe drinking water continue to facilitate faecal -oral transmission of enteric pathogens. In northern Ghana, persistent gaps in sanitation infrastructure and environmental hygiene expose infants, who are biologically more vulnerable due to immature immune systems and frequent hand-to-mouth behaviours, to a heightened risk of diarrhoeal disease. However, there is limited municipality-level evidence on how specific household sanitation practices contribute to infant diarrhoea in these settings. Aim: This study aimed to assess the prevalence of diarrhoeal disease and examine its association with household sanitation and hygiene practices among infants in the West Gonja Municipality of the Savannah Region, Ghana. Methods: A community-based cross-sectional study was conducted among 424 caregiver–infant pairs using a multistage sampling technique. Data were collected through structured questionnaires to assess household sanitation practices and the occurrence of infant diarrhoea. Descriptive statistics, chi-square tests, and multivariable logistic regression analyses were performed to identify factors associated with infant diarrhoea. Results: The prevalence of diarrhoea among infants was 30.2%. Regarding sanitation practices, 56.8% of households used improved toilet facilities, yet 61.3% shared toilets with other households. Unsafe disposal of child faeces was reported by 38.4% of households, and 36.6% relied on unimproved drinking water sources. Multivariable analysis showed that infants from households sharing toilet facilities were more likely to experience diarrhoea (AOR = 1.89; 95% CI: 1.19–3.01). Similarly, unsafe disposal of child faeces (AOR = 1.76; 95% CI: 1.13–2.73), use of unimproved water sources (AOR = 1.69; 95% CI: 1.07–2.68), and the presence of visible faeces around the household (AOR = 2.87; 95% CI: 1.78–4.63) were significantly associated with diarrhoeal disease. Conclusion: Infant diarrhoea remains a significant public health challenge in the study area and is strongly linked to poor household sanitation and environmental contamination. Strengthening sanitation infrastructure, promoting safe disposal of child faeces, and improving access to clean water are critical strategies for reducing diarrhoeal morbidity among infants.