Sanitation Facilities in Somali Households: Evidence From a Multilevel Analysis of the 2020 Health and Demographic Survey

Household sanitation facilities are vital for national development, disease prevention, and health. Despite some progress, many countries, including Somalia, cannot meet Sustainable Development Goals (SDGs) by 2030. This study aims to identify the potential factors of utilising sanitation facilities in Somalia using Somalia Health and Demographic Surveys (SHDS)-2020 data. Chi-square test and multilevel models were employed in this study to determine the risk factors of utilising sanitation facilities. Findings revealed that about 41.35% of the respondents lived in urban areas, 46.80% of households were classified as poor, and 87.02% had no education. Several factors significantly influenced access to appropriate sanitation services, including educational level, gender of the household head, family size, and wealth status. Affluent households were 1.11 times more likely to access sanitation than poor, while female-headed households had 1.1 times higher odds than male-headed ones. Findings depict disparities in sanitation access among Somali households, driven by factors such as wealth, gender, and education. Targeted interventions, including financial support for poor households and empowerment initiatives for female heads, are essential. A focus on community education and infrastructure investment is crucial for improving health outcomes in Somalia.