Evaluating Water, Sanitation, and Hygiene (WaSH) Infrastructure and Behavioral Health Factors: A Community-Based Study in Mattu Town, Ethiopia in 2024

Abstract Background: Inadequate Water, Sanitation, and Hygiene (WaSH) infrastructure remains a significant public health challenge in urbanizing Ethiopia. This study evaluated WaSH facility status, environmental sanitation practices, and health-related behaviors in Kolo Korma Kebele, Mattu Town, to inform local interventions. Methods: A mixed-methods cross-sectional study was conducted among 347 randomly selected households. Data were gathered through structured questionnaires, focus group discussions, key informant interviews, and direct observations. Analysis was performed using SPSS version 21. Results: Although latrine coverage was high (94.2%), handwashing stations were critically scarce. Water security was a major concern: only 29.4% of households had piped municipal water, with 70.6% relying on unprotected springs. Notably, 79.7% of those using non-piped sources utilized no point-of-use treatment. Solid waste management was poor; 79.5% lacked municipal collection services, leading 52% of households to practice open-field dumping. While 93.7% of respondents understood disease transmission, this knowledge did not consistently translate into hygienic practices. Conclusion: High facility coverage is insufficient without improvements in water quality and waste infrastructure. The Mattu Town administration must prioritize spring protection and decentralized waste collection. Health initiatives should transition from general awareness to fostering specific behavioral changes, particularly household water treatment and handwashing maintenance.