Association of Women’s Empowerment With Water, Sanitation, and Hygiene (Wash) Services in Ethiopia: A Cross-sectional Analysis

Abstract Background: Access to safe drinking water, sanitation, and hygiene (WASH) services is vital for human health and well-being. In Ethiopia, lack of improved WASH services has existed as a health problem for many years. Empowering women is among the most important factors for improving WASH services, but research-based evidence is lacking in this regard. The present study was designed to analyse the association between women’s empowerment and WASH services in Ethiopia.Methods: This analysis is based on the 2016 Ethiopian Demographic and Health Survey (EDHS). The survey-based Women’s emPowERment (SWPER) index approach is used to develop women’s empowerment indices. The three empowerment domains used by the SWPER authors include attitude to violence, social independence, and decision-making. Multilevel logistic regression was used to assess the association between these domains of women’s empowerment and WASH services. Estimates were presented as odds ratio (OR) and expressed per one standard deviation (SD) with significance levels set at the 5% level. Results: Overall, 90.9%, 78.4%, and 50.3% of the households included in this analysis had no basic handwashing facility, improved sanitation facility, and improved water source, respectively. A one SD increase in the social independence domain was associated with 16% higher odds of having basic handwashing facility (AOR: 1.16; 95%CI: 1.02, 1.33). As women’s attitude to violence increased by one SD, the odds of having improved sanitation facility is increased by 22% (AOR: 1.22; 95%CI: 1.05, 1.42). Also, a SD increase in social independence domain was associated with 18% higher odds of having improved sanitation facility (AOR: 1.18; 95% CI: 1.04, 1.34). There was no statistically significant association between domains of women’s empowerment and source of water.Conclusions: This study has shown that most of the households in Ethiopia had no access to improved WASH services. Multiple regression analyses revealed that empowering women had association with having basic handwashing and improved sanitation facility. The findings of this study have suggestive evidence that empowering women could improve WASH cervices.