Water, Sanitation and Hygiene Determinants of Diarrheal Disease in Urban Slum Settings: A Cross-Sectional Analysis of 250 Households in West Point, Liberia
Amos Melish Franklins1, Diamond Fobo2, Alvan Corker3, Prince L. Fully4, Neima N. Candy5
1Amos Melish Franklins, Department of School of Public Health, University of Liberia, Monrovia, Liberia.
2Diamond Fobo, Student, Department of School of Public Health, University of Liberia, Monrovia, Liberia.
3Alvan Corker, Department of School of Public Health, University of Liberia, Monrovia, Liberia.
4Prince L. Fully, Department of School of Public Health, University of Liberia, Monrovia, Liberia.
5Neima N. Candy, Department of School of Public Health, University of Liberia, Monrovia, Liberia.
Manuscript received on 03 March 2026 | Revised Manuscript received on 09 May 2026 | Manuscript Accepted on 15 May 2026 | Manuscript published on 30 May 2026 | PP: 7-12 | Volume-6 Issue-4 May 2026 | Retrieval Number: 100.1/ijpmh.C114506030326 | DOI: 10.54105/ijpmh.C1145.06040526
Open Access | Ethics and Policies | Cite | Zenodo | OJS | Indexing and Abstracting
© The Authors. Published by Lattice Science Publication (LSP). This is an open-access article under the CC-BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
Abstract: Background: Diarrhoeal infections remain a serious public health problem in West Africa’s urban slums, where Water, Sanitation, and Hygiene (WASH) practices play an important role in disease transmission. This study investigates the sociodemographic factors that determine WASH practices and their impact on diarrhoeal disease in West Point, Liberia’s largest slum neighbourhood. Methods: A community-based cross-sectional study was conducted in West Point, Montserrado County, Liberia, between December 2024 and January 2025. Using systematic random selection, 250 households were selected from five geographic zones. WASH practices, socio-demographic variables, and the frequency of diarrhoeal disease were collected using standardised questionnaires based on WHO/UNICEF JMP standards. Statistical analysis included descriptive statistics, chisquare tests, odds ratio calculations, and multivariate logistic regression. Results: According to the survey, 27.2% of households had diarrhoea in the last three months, much higher than the national average of 22%. Households with no formal education had a 2.84-fold increased incidence of diarrhoea (AOR = 2.84). Access to improved water was 52.0%, sanitation was 25.6%, and hygiene was 11.2%, with just 1.6% of families having access to all three components. There were significant regional inequalities, with the South Zone and Coastal Zone having the highest diarrhoea rates. Inadequate formal education, low water availability, and open defecation behaviours all significantly predicted diarrhoea, according to a logistic regression analysis. Conclusions: West Point’s WASH practices are poor and are significantly associated with diarrhoea. Insufficient combined WASH access and high loads in certain areas underscore the need for tailored interventions. The findings suggest comprehensive strategies that prioritise improvements in water quality, sanitation infrastructure, and hygiene education, particularly in highburden areas and among people with low educational backgrounds.
Keywords: WASH, Diarrhoea, Urban Slums, Sanitation, Water Quality, Public Health, Liberia; West Africa.
Scope of the Article: Public Health