Hygiene and Sanitation Practices and Their Association with Health Outcomes among Residents of Informal Settlements in Ibadan, Nigeria

Abstract

Introduction: Inadequate water, sanitation, and hygiene (WASH) conditions remain major drivers of preventable infectious diseases in urban informal settlements. Residents of such environments are disproportionately exposed to waterborne diseases due to poor infrastructure and suboptimal hygiene practices. This study assessed hygiene and sanitation practices and their association with health outcomes among residents of informal settlements in Ibadan, Nigeria. Aim: The study aimed to examine WASH practices and determine their relationship with health outcomes among households in selected informal settlements in Ibadan. Methods: A community-based cross-sectional design was employed among households in informal settlements. Data were collected using a structured interviewer-administered questionnaire covering socio-demographic characteristics, water access and treatment practices, sanitation facilities, environmental hygiene conditions, and self-reported health outcomes. Descriptive statistics were used to summarize variables, while chi-square tests and multivariate logistic regression were used to assess associations between WASH practices and health outcomes at p < 0.05 significance level. Results: A substantial proportion of respondents relied on unimproved water sources, shared sanitation facilities, and inadequately managed environmental conditions. Poor WASH practices were significantly associated with higher health risk. Use of unimproved water sources (p = 0.006), lack of water treatment (p < 0.001), unsafe water storage (p = 0.002), unimproved sanitation facilities (p < 0.001), and poor environmental hygiene indicators such as blocked drainage and stagnant water (p < 0.01) were all significantly associated with adverse health outcomes. Multivariate analysis further identified knowledge level and housing conditions as key predictors of health risk, while better housing type was protective. Conclusion: The study demonstrates that inadequate WASH conditions significantly increase health risks among residents of informal settlements in Ibadan. Addressing these challenges requires integrated interventions combining improvements in water supply, sanitation infrastructure, and environmental management alongside sustained hygiene promotion. Structural investment, rather than behavior change alone, is essential for reducing the burden of waterborne diseases in urban informal settlements.