Assessing the implications of access to toilet and water facilities on the health of households in the Sunyani Municipality, Ghana

Background Uncontaminated water and adequate sanitation facilities are of major importance for limiting the incidence of infectious diseases. In Ghana, about 80% of people still do not have access to proper sanitation, including latrines, which have dramatic consequences on human health, dignity, security and the environment. Potable water coverage in the Sunyani municipality stands at 47 percent in the urban areas and 33.5 percent in the rural areas. Many of the households in the Sunyani Municipality do not have toilet facilities, putting pressure on the few existing public toilet facilities available. Methods Using a simple random sampling technique, a total of 500 households were selected for the study. Structured questionnaires were used to collect quantitative data. In addition, a hand-held global positioning system (GPS) receiver was used to pick geographic coordinates of various water and toilet facilities. Quantitative data were analyzed using SPSS version 25. Results The results indicate inconsistencies in the spatial distribution of toilet and water facilities with an average distance of 33 meters. The study further revealed the current system of public toilets operating in the towns cannot be resource intensive to meet households’ targets because they do not satisfy sanitation needs (p<0.001). On the contrary, it tends to rather create even more problems, thereby encouraging open defecation. Also, their impact on human and environmental health needs to be taken into account. Conclusion Access to potable water and improved toilet facility remains a challenge as most households do not have toilets within their homes. Financial constraints, distance travelled and poor condition of public toilets were the main factors determining utilization of public toilet facilities. The types of toilet facilities used in the Municipality influence disease prevalence. The prevalence of cholera, diarrhoea, typhoid, skin rashes and eye infections were as a result of improper or no washing of hands. ### Competing Interest Statement The authors have declared no competing interest. ### Clinical Protocols N/Ap ### Funding Statement The author(s) received no specific funding for this work. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Not Applicable The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ghana Health Service Ethics Review Committee with approval number GHS-ERC 509/02/22 I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Not Applicable I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Not Applicable I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Not Applicable All relevant data are within the manuscript and its Supporting Information files.