Understanding sanitation behaviour in Ghana: the impact of wealth and residential contexts on Ghanaian women’s choices

Abstract

Access to adequate sanitation remains a critical challenge in Ghana, with significant disparities driven by socio-economic and geographical factors. This study examines the determinants of sanitation facility choices among Ghanaian women, focusing on wealth status and place of residence. Using data from the last four Ghana Demographic and Health Surveys (2003, 2008, 2014, and 2022), covering responses from 33,092 women, we apply the multipopulation Curie–Weiss model to analyse both private and social incentives influencing sanitation behaviour. Results indicate that 54.09% of women use improved sanitation facilities, while 45.91% rely on unimproved facilities. Improved facilities are predominantly used by urban residents (87.9% rich, 12.1% poor), whereas rural residents are more likely to use unimproved facilities, particularly those in the poor category (75.2%). Among urban users of unimproved facilities, the majority (82.2%) are classified as rich. Model estimates reveal that, in the absence of social interaction, women in rural poor and rural rich groups have negative private incentive sums, suggesting a preference for unimproved facilities. Conversely, urban groups display positive sums, indicating a tendency toward improved facilities. When social incentives are incorporated, interaction effects vary considerably: imitation is discouraged among rural poor women ( $$J_{11} = -0.1100$$ ) but strongly encouraged among urban poor women ( $$J_{44} = 0.3473$$ ). Additionally, wealthy urban women exert a positive influence on wealthy rural women ( $$J_{32} = 0.1512$$ ). These findings highlight the need for targeted interventions such as infrastructure investment, community engagement, and education campaigns, especially in rural areas. The study offers actionable insights for policymakers working toward Sustainable Development Goal 6, which seeks universal and equitable access to sanitation by 2030.