Access to Water, Sanitation and Hygiene (Wash) Programmes in Ghana: A Case Study of Three Districts in the Volta Region

Abstract

The Water Access, Sanitation and Hygiene (WASH) sector focuses on improving water access and enhanced sanitation and hygiene services for public health gains. The sector also deals with dignity in the case of sanitation, ensuring the right to water and sanitation services, enhancing better education and health outcomes at schools and health facilities, and reducing water pollution for poverty reduction and socio-economic development. Access to WASH services therefore is critical for sustainable development, and essential for supporting the acceleration of achieving targets 1 and 2 of Sustainable Development Goals (SDG) 6 thus Safe & affordable drinking water and All have access to adequate sanitation & hygiene and eliminate open defecation respectively including SDG 3 which aims at promoting good health and well-being in Ghana. This research aimed to investigate the implementation of Ghana's Water Access, Sanitation, and Hygiene (WASH) intervention programs in three districts of the Volta Region—Adaklu, Agotime-Ziope, and Ho West. It specifically aims at; (1) to ascertain the availability and accessibility of WASH facilities. (2) To assess the state of WASH facilities in households, schools, and healthcare facilities. (3) To examine the use of WASH facilities in households, schools, and healthcare facilities. (4) To investigate Open Defecation Free (ODF) relapse. The study began with a comprehensive review of the policies and institutional frameworks governing WASH in Ghana, emphasizing the importance of community engagement and the challenges faced in sustaining Open Defecation Free (ODF) status. A descriptive quantitative approach was employed with a limited number of qualitative data from interviews, focus group discussions, and direct observations. Statistical analyses, including descriptive statistics, correlation, regression analysis, and ANOVA, were used to interpret the data and identify factors influencing the success and sustainability of WASH interventions. The study revealed that while significant progress had been made in improving access to WASH facilities in the study areas, challenges remained, particularly in rural areas. In the Adaklu District, 45% of households had access to improved water sources, while in Agotime Ziope and Ho West Districts, the figures were 50% and 55%, respectively. The study highlighted the critical role of affordability, cultural practices, and community engagement in the adoption and maintenance of improved sanitation and hygiene facilities. Among households with flushed toilets, 23.6% reported their toilets were functional, while 41.7% reported non-functional toilets, and 34.7% did not know. Households with KVIP toilets had 66.7% reporting functional toilets and 33.3% reporting non-functional toilets. Segregation of waste in healthcare facilities was generally rated as poor. Most clinical waste was unsecured thus stored in open spaces (50%), and 50% had secured storage. Training of healthcare workers on clinical waste management was lacking, with about 25% of respondents having received training. Regarding water access in schools, 90% had water facilities sourced from boreholes, mechanized boreholes, or piped water, with 80% confirming the water was potable. Factors contributing to ODF relapse were identified, including inadequate post triggering support and insufficient hygiene promotion. Notably, 30% of previously ODF communities experienced relapse within two years. This research therefore concludes that, though significant progress has been made in improving the availability and accessibility of WASH facilities across the study areas, challenges remain in ensuring their consistent use and functionality. To enhance sustainability of WASH interventions, it is recommended to include strengthening post-triggering support, promoting equitable access to sanitation, investing in robust monitoring and evaluation systems, and fostering knowledge sharing and learning among communities. By addressing these challenges, the research aimed to contribute to the achievement of Sustainable Development Goals (SDG) 6 and 3, ensuring access to clean water and sanitation for all, and promoting good health and well-being.