Accessibility of WASH facility and associated factors among students with disabilities: A Mixed method study at University of Gondar, Northwestern Ethiopia, 2024

Accessibility of WASH facility and associated factors among students with disabilities: A Mixed method study at University of Gondar, Northwestern Ethiopia, 2024 | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Accessibility of WASH facility and associated factors among students with disabilities: A Mixed method study at University of Gondar, Northwestern Ethiopia, 2024 Amanuel Mamo, Hailemariam Feleke, Mastewal Endalew, Mengesha Genet, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9112220/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 4 You are reading this latest preprint version Abstract Introduction : Limited access to clean water, sanitation, and hygiene services perpetuates poverty, illness, and a reduced quality of life, especially for disabled individuals who encounter significant barriers to essential facilities. Understanding the factors that influence the accessibility of WASH facilities is essential for developing inclusive policies and interventions. This study was aimed to assess the accessibility of WASH facility and associated factor among students with disabilities at University of Gondar, North west Ethiopia. Methods : An institution-based mixed cross-sectional study was conducted among students with disabilities at the University of Gondar from May 20 to June 20, 2024. A survey of 406 participants was included in the quantitative data using structured and pretested interviewer-administered questionnaires. The data were cleaned, coded, entered, and then analyzed using SPSS version 27 software. A binary logistic regression model was used, and a p-value of less than 0.05 was considered statistically significant in the model. Qualitative data were collected from eight purposefully selected participants through in-depth interviews using open-ended questions until data saturation point was reached. The data were subsequently analyzed thematically using Open Code 4.02 software. Results : The accessibility of WASH facilities for students with disabilities was found to be 40.9%. Physical disability (AOR = 5.95, 95% CI: 2.60, 13.58), being not members of a disability organization (AOR = 3.10, 95% CI: 1.73, 5.54), poor personal hygiene (AOR = 1.71, 95% CI: 1.05, 2.78), and a negative psychosocial perspective (AOR = 6.10, 95% CI: 3.74, 9.93) were factors contributing to the low accessibility of WASH facilities. As qualitative findings showed, barriers that hinder the accessibility of WASH facilities were environmental barriers, dependency on others, stigma and discrimination, impact on health and education, and recommendations for improvement. Conclusion : The accessibility of WASH facilities for students with disabilities was found to be low. Visual impairment, being membership in a disability organization, personal hygiene practice and positive psychosocial perspectives contributed to the inadequate accessibility of WASH facilities. Accessibility Students with disabilities WASH University of Gondar 1. Introduction Sustainable Development Goal 6 highlights the critical importance of safe and affordable access to water, sanitation, and hygiene (WASH) for all by 2030. However, people with disabilities, who make up 15% of the global population, often struggle to meet their WASH needs( 1 ). Moreover, an estimated 80% of disabled people live in the developing countries( 2 ). In Ethiopia, around 7.8 million or 9.3% of the populations are disabilities, with approximately 2.2 million or 2.4% experiencing severe difficulties( 3 ). In the year 2018, globally, over 110 million people with disabilities were not able to access WASH facilities( 4 ). Persons with disabilities are known to have more difficulty accessing WASH services, and countries with lower economic status have both restricted WASH access and greater disability prevalence( 5 ).Unsafe WASH services contribute to a substantial disease burden, with estimates indicating that in 2019, the adoption of safe WASH practices could have prevented at least 1.4 million deaths and 74 million disability-adjusted life years. This represents 2.5% of all deaths and 2.9% of all disability-adjusted life years globally( 6 ).Ethiopia, as a signatory of SDGs, recognizes the importance of disability inclusion in achieving universal access to water and sanitation by 2030. Regardless, studies have shown that the availability of suitable sanitation facilities for people with physical disabilities in Ethiopia is relatively low( 7 , 8 ). Sustainable Development Goal 4 (SDG4) requires inclusive and quality education with safe learning environments for all. Access to WASH facilities in schools is vital for attendance, health, and the right to education. Without these infrastructures, enrollment decreases and absenteeism rises, hindering student progress( 9 ). Prioritizing WASH services is crucial for achieving SDG4 and ensuring equal opportunities for all students, including those with disabilities, who deserve a future full of hope, opportunity, and appropriate support to reach their potential without discrimination or exclusion( 10 ). Students with disabilities also encounter technical obstacles when accessing water and sanitation facilities, such as physical barriers which include inaccessible entrances, narrow doorways, uneven surfaces, and lack of ramps or elevators, water taps may be too high and inadequate bathroom fixtures that are not designed to accommodate their specific needs( 11 ). People with disabilities encounter significant challenges to meeting their WASH needs, especially in using services independently, consistently, hygienically, accessing services while maintaining their dignity, privacy, safety, and without pain or fear of abuse( 12 ). The lack of water and sanitation access has significant implications, especially for individuals with disabilities. They face barriers in educational settings without accessible toilets, which is particularly challenging for girls managing menstrual hygiene( 13 ).The risk of infections for disabled individuals is significantly higher when using latrines that are not appropriately designed to accommodate their needs( 14 ). Students with disabilities faces significant challenges and gaps in accessibility of WASH facilities, leading to inadequate access in educational settings ( 15 , 16 ). This directly impacts not only students' health but also their school attendance and educational performance( 17 ). However, the implications of limited access to clean water and basic sanitation among disabilities, who already face physical and visual impairments are often overlooked and not adequately addressed( 18 ).Inadequate and inaccessible WASH facilities for these students contribute to low utilization rates, impacting their health, hygiene, and educational experience. Urgent research and practical measures are required to address barriers and improve access to WASH facilities for individuals with disabilities in educational settings, especially in low- and middle-income countries( 16 , 19 ). Despite the assumed right to free movement on university campuses, the provision of essential accessibility elements, such as WASH facilities, is insufficiently provided in various areas including classrooms, dormitories, dining areas, recreational spaces, and libraries( 20 ). In response to this issue, institutions of higher education are expanding and reorganizing their support services to cater to the needs of students with disabilities and other special needs( 21 ).Many interventions are planned for a general population, only few focuses to people with disabilities( 22 ). Inclusive WASH programming in all institutions including in higher education institutions is very crucial to protect the public from communicable diseases associated with poor hygiene and sanitation practices and lack of access to water supplies( 23 , 24 ). It contributes to achieving Millennium Development Goals like universal primary education, gender equality, and child mortality reduction. They are also aligned with Sustainable Development Goal 6, which targets clean water and sanitation by 2030( 25 ). This survey study provides an overview of the accessibility of WASH facilities for students with disabilities at the University of Gondar. The findings offer valuable insights for policymakers, researchers, disability organizations, and the university itself. Additionally, the study informs the development of inclusive and equitable policies and interventions aimed at promoting the overall well-being and participation of students with disabilities in the university life. 1 Methods 1.1 Study design, Period, and Setting An institution-based cross-sectional mixed study was conducted from May 20 to June 20, 2024, in the University of Gondar city, which is located 180 km from Bahir Dar, capital city of Amhara regional state, and 748 km from Addis Ababa, the capital city of Ethiopia. The university has five campuses, those are: the college of medicine and health sciences and referral teaching hospital campus, the Atse Tewodros Campus which is the university’s main campus, Maraki Campus, Atse Fasil Campus, and the Tseda Campus. The university currently has an enrollment of between 35,000 and 39,999 students. Among these, 420 students are enrolled in various programs and have disabilities, including visual and physical disabilities. Of these, 209 students were being benefited from support provided by the Master Card Foundation. 1.2 Source and study population The source population for this survey study comprised all students with disabilities currently enrolled at the University of Gondar, while the study population specifically included students with visual and physical impairments from each campus. 1.3 Eligibility criteria 1.3.1 Inclusion criteria This study included all regular students with visual and physical disabilities who have been attending their education at the University of Gondar. 1.3.2 Exclusion criteria This study excluded students with disabilities who were experiencing severe health problems and hospitalized during the research period. 1.4 Sample size determination Currently, there were 420 students with disabilities attending their class in different programs at Gondar University. Since the population size was relatively small, it was feasible to include the entire population as the sample. Therefore, the total population of 420 students with disabilities was included in the study. The sample size for the qualitative study was based on the level of data saturation. Data saturation occurred when no new information or themes emerged from the interviews, and the collected data was sufficient to address the research objectives and answer the research questions. 1.5 Sampling technique procedure The quantitative study surveyed 420 participants. The purposive sampling method was employed across all campuses until data saturation point was achieved to ensure a comprehensive selection of participants for in-depth interviews. 1.6 Variable of the study 1.6.1 Dependent variables Accessibility of WASH facility 1.6.2 Independent variables Socio-demographic variables (Age, Sex, Religion, Education level, income, Year of living in the campus, Membership to disability association) Environmental Factors (Distance to latrines, Narrow entrances, Steps to latrines, slippery floors, Cleanliness of latrine, Difficulty squatting, Inconvenient heights of hygiene facilities and water pumps/taps) Psychosocial factors (Stigma, discrimination, privacy) Personal factors ( Knowledge, hygiene practices) 1.7 Operational definition Water facility: a physical infrastructure or system designed and constructed to manage, distribute, or store water for various purposes, including but not limited to drinking water supply( 26 ). Sanitation facility: a facilities or system designed and used to hygienically separate human excreta from human contact ( 27 , 28 ). Hand washing accessible to the disabled: - Facilities can be accessed via a clear path without stairs that is free of obstructions, the tap, and soap are reachable from a seated position and can be operated by feet, or 1 closed fist with minimal effort ( 29 ). Access to safe water: Water with a distance of up to 100 m and the facility should be accessible for all ( 29 ). Latrine accessible to the disabled: the access to latrines should allow individuals to reach, enter, and use the facilities without difficulty. This includes having latrines located within 6 m of their home, with a pathway that is free of steps for wheelchair users. The path must be at least 1 meter wide, and the door should have a minimum width of 1 m. Additionally, the latrine room should provide a minimum space of 1 square meter, equipped with handrails and grab bars ( 14 , 29 ). Accessible Shower/bathing: includes a shower which can manipulate by disable individual and it has a continuous water supply when they want to bath ( 14 ). Access/accessibility: this will include the possible means of students with disabilities entering and utilize water, sanitation and hygiene facilities. It involves making structural adaptations and designing fundamental fixtures and buildings, as well as developing aids and equipment specifically created to enable access of WASH facilities ( 30 , 31 ). Cleanliness of latrine: A latrine is considered clean when the floor is well swept and there are no visible traces of feces or urine ( 32 ). Good accessibility of WASH facility: mean accessibility score of > 0.50 was considered as good accessibility. Poor accessibility of WASH facility: mean accessibility score of ≤ 0.50 was considered as poor accessibility. Hygiene practice: Maintaining cleanliness involves both personal hygiene and the care of clothing. Poor hygiene practices include individuals washing their hands with water alone, neglecting to use soap after using toilet, and infrequently washing their clothes and bath ( 33 , 34 ). Students with multiple disability: refers to a condition where an individual has two or more significant disabilities that together create unique challenges that cannot be adequately addressed by services designed for just one of the disabilities ( 35 ). Students with physical disabilities: persons who cannot walk and may use a wheelchair or can walk with difficulty and need support or can walk, but experience other physical weakness or lack of coordination including weakness in legs and limb loss (limited arm/hand movements) ( 5 , 31 ). Students with vision impairments: include blindness or low vision, requiring additional support or accommodations for effective access to WASH facilities ( 36 ). 1.8 Data collection methods and procedure Data were collected using face-to-face interviews by employing structured questionnaires prepared in English and translated into Amharic. These questionnaires were used to assess factors influencing the accessibility of WASH facility, including sociodemographic characteristics, psychosocial factors, knowledge, and hygiene practices. The data was collected using Kobo Toolbox, a mobile data collection platform, specifically the Kobo Collect version 2024.1.3 application on Android mobile phones. The questionnaire was adopted from a review of different kinds of literature and used for data collection. Semi-structured open ended interview guides facilitated in-depth interviews, exploring participant’s experience, perspective, challenges, and suggestions to gain detailed insights into the barriers and factors related to the accessibility of WASH facility followed by probing questions. These insights were extracted from previous studies ( 13 , 26 , 37 ). Qualitative data collection continued until theme saturation was reached during the interviews. All conversations during in-depth interviews were recorded and documented using an audio recorder and notebooks throughout the event with the consultation of the participants. The data collection included three environmental health professionals as data collectors and two public health officers as supervisors. 1.9 Data quality control A 5% pre-test was conducted at Debretabor University, and necessary corrections were made based on the observations. Training was provided on the questionnaire content, interviewing techniques, the purpose of the study, and how the principal investigator approached and maintained respondents' confidentiality. The consistency and completeness of the questionnaire were cross-checked, and any incomplete questionnaires were addressed and filled out on the spot. The control of data quality was carried out during the data collection by the interviewers and supervisors. The questionnaire was prepared in English and translated into the local language (Amharic) for communication with the study population, and then it was translated back into English to check for consistency. Trustworthiness was verified by addressing the dimensions of credibility, transferability, dependability, and confirmability ( 38 ). To ensure transferability, interviews were recorded and transcribed in Amharic, translated into English by the principal investigator, and accompanied by a comprehensive description of participants, research context, setting, sample, data collection procedure, and underlying assumptions. This allowed readers to assess the transferability of findings, while strengths and limitations were clearly outlined. Dependability was strengthened through continuous input from advisors and evaluators during data analysis, with deep communication establishing trust with participants. Credibility was maintained through confidential and prolonged engagement, establishing intimacy. The interview guide was evaluated by experts to minimize bias. Confirmability was ensured with rich participant quotes and a reflective journal documenting interview activities and study procedures in detail. 1.10 Data management and Analysis The data were entered, cleaned, coded, and then analyzed with SPSS version 27, statistical software. The data were ensured to be complete, consistent, and valid. Categorical variables were summarized with frequencies and percentages, while continuous variables were summarized with means (standard deviation). Descriptive statistics were computed, and the results were presented in tables. Bivariable logistic regression was performed, including variables with a p -value < 0.2 in the final multivariable logistic regression to adjust for potential confounders and identify the determinants of WASH facility accessibility. In the final model, variables with a p -value < 0.05 were considered statistically significant. Multicollinearity was assessed using the variance inflation factor (VIF), with all variables showing VIF values < 10. Model fit was evaluated using the Hosmer-Lemeshow test, which indicated good fit (p = 0.804). The qualitative data were intelligently transcribed into English. The transcribed contents were manually read several times, then coded and grouped into categories using open code 4.02 software. Finally, themes were developed. The results of the thematic analysis were presented in the form of a narrative with supporting quotes. At the end, the findings of the qualitative study were triangulated with the quantitative ones 2 Ethical consideration Ethical clearance letter and approval were obtained from the Institutional Review board of Public Health, College of Medicine and Health Sciences on 22/05/2024, with the reference number IPH/2882/2024. Participants were informed that the study process would not harm them and that their information would be kept confidential. The importance of the study, anticipated benefits from the results, and its objectives were explained before the subsequent activities were implemented. Individuals who did not volunteer for the study were not enforced to participate. 3 Results 3.1 Socio-demographic characteristics of students with disabilities A total of 406 students with disabilities participated in the study, resulting in a 96.7% response rate. The data revealed a slight skew towards males, who represented 63.8% of the respondents. The mean age of the respondents was 25.30 years (± 2.66). The religious composition showed that the majority identified as Orthodox, making up 84.2% of the participants. In terms of academic progression, students in their 1st and 5th years were almost equally represented at 23.4% and 19.5%, respectively. Most students live on the Maraki campus, with a significant 96.5% of respondents studying there compared to other campuses. In terms of monthly income, the largest group in the third quartile earned between 8,501-9,200, comprising 35.5% of the participants. Regarding the types of disabilities reported by the respondents, visual impairments were the most prevalent, affecting 350 individuals (86.2%). Among the participants, 66.3% were members of disability associations or organizations, with Mastercard being the most commonly associated organization at 74.7%, followed by Ethiopian national association of blind (ENAB) at 22.7%, as shown in Table 1 below. Table 1 Socio-demographic characteristics of students with disabilities at the University of Gondar, Northwestern Ethiopia, 2024 Variables Categories Frequency Percentile Sex Female 147 36.2 Male 259 63.8 Age ≤ 25 234 57.6 > 25 172 42.4 Religion Orthodox 339 83.5 Muslim 23 5.7 Catholic 13 3.2 Protestant 31 7.6 Number of years stayed 1st year 95 23.4 2nd year 81 20.0 3rd year 74 18.2 4th year 77 19.0 5th year 79 19.5 Campus Maraki 392 96.6 Tewodros 4 1.0 Fasil 4 1.0 Gc 6 1.5 Monthly income 9200 59 14.5 Type of disability Visual 350 86.2 Physical 48 11.8 Multiple 8 2.0 Membership of disability organization Yes 269 66.3 No 137 33.7 If yes, name of the organization Master card 201 74.7 ENAB 61 22.7 Other 7 2.6 *Others=Yalem tila association; Ethiopian disability federation; ELDA; and Handicap national 3.2 Accessibility of WASH facility for students with disabilities As shown in Table 2 below, the survey provided valuable insights into the accessibility of WASH facilities. A majority of respondents (88.4%) reported that water was not accessible where needed at all times. Additionally, 67% respondents indicated that water pumps and taps were positioned at inconvenient heights. The presence of handrails or grab bars for accessing water facilities was also lacking, with 85% respondents reporting their absence. In terms of latrine facilities, pit latrines were the most common type. Most latrines were located within 6 m (81%) of dormitories, and the entrances were wider than 1 m in 73.6% of cases. The cleanliness of latrines raised concerns, as 73.9% of the respondents reported unsatisfactory conditions. Furthermore, 68.5% respondents indicated that latrines lacked appropriate hand washing facilities, and 69.2% noted that bathing facilities were not positioned at accessible height. Table 2 Accessibility of WASH facility for students with disabilities at the University of Gondar, Ethiopia, 2024. Variables Categories Frequency Percentile Accessibility of water where needed at all times Yes 47 11.6 No 359 88.4 Water pumps/taps positioned at a height that facilitates easy for access Yes 134 33.0 No 272 67.0 Handrails/grab bars for accessing water facilities Yes 61 15.0 No 345 85.0 Accessibility of water dispensers in learning areas Yes 44 10.8 No 362 89.2 Type of latrine facilities is available Pit latrine 275 67.74 Cistern-flush toilet 33 8.13 Pour Flush 79 19.46 Don’t know 19 4.67 Handrails/grab bars for using latrine facilities Yes 70 17.2 No 336 82.8 Distance of latrine equal or 6 meters 77 19.0 Latrine entrance width less than 1 meter 107 26.4 equal or more than 1 meter 299 73.6 Presence of steps leading to latrines Yes 122 30.0 No 284 70.0 Slippery of floors inside latrines Yes 265 65.3 No 141 34.7 Cleanliness of latrine Yes 106 26.1 No 300 73.9 Difficulty squatting in latrines Yes 189 46.6 No 217 53.4 Latrines equipped with appropriate handwashing facilities Yes 128 31.5 No 278 68.5 Placement of bathing facilities at accessible heights Yes 125 30.8 No 281 69.2 Handrails/grab bars for accessing handwashing facilities Yes 124 30.5 No 282 69.5 Placement of hand washing facilities at convenient heights Yes 259 63.8 No 147 36.2 Handrails/grab bars for accessing bathing facilities Yes 51 12.6 No 355 87.4 Accessibility of WASH facility Good 166 40.9 Poor 240 59.1 3.3 Knowledge of students with disabilities As shown Table 3 below, respondent’s knowledge of WASH is highlighted. A significant majority (91.4%) of the respondents correctly recognized that unsafe water could cause diarrheal diseases, demonstrating strong awareness. However, only 15.8% of respondents had received WASH information in the past 6 months, with mass media being the main source of information (14%). The information received covered topics such as personal hygiene (14.5%), water quality (8.9%), and sanitation (12.3%). Most respondents (93.3%) understood that not washing hands could lead to various diseases and knows that institutions need to have access to disability-friendly facilities. Nonetheless, there were significant knowledge gaps: only 25.9% knew the correct steps for hand washing, and while 56.2% were aware of the critical times for hand washing. Table 3 Knowledge of students with disabilities about Water, Sanitation and Hygiene facilities at the University of Gondar, Ethiopia, 2024. Variables Categories Frequency Percentile Can unsafe water cause diarrheal diseases? Yes 371 91.4 No 35 8.6 Have you got information on WASH in the last 6 months? Yes 64 15.8 No 342 84.2 Source of information about WASH? Mass media 57 14.0 Health workers 5 1.2 Others 13 3.2 What was the information received on WASH about? Hand hygiene 59 14.5 Water quality 36 8.9 Sanitation 50 12.3 What are the consequences of not washing hands? Expose to various diseases 379 93.3 Does not expose to diseases 27 6.7 Do you know that all institutions should be required to have disability-friendly facilities? Yes 379 93.3 No 27 6.7 Do you know about steps of hand washing? Yes 105 25.9 No 301 74.1 Do you know about the critical periods for hand washing? Yes 228 56.2 No 178 43.8 Over all Knowledge of Participants Poor 140 34.5 Good 266 65.5 *Other; NGOs workers, Relatives/family, Friends, and Disability associations 3.4 Hygiene practice of students with disabilities As Table 4 below, handwashing habits after using the toilet, the majority of respondents 265 (65.3%) reported washing their hands with soap. Concerning bathing frequency, responses varied, with 38.4% indicating bathing every 2 to 3 days. As for washing clothes, the majority (68.5%) reported washing them weekly, while 31.5% mentioned a monthly washing frequency. Table 4 Hygiene practice of students with disabilities at the University of Gondar, Ethiopia, 2024. Variables Categories Frequency Percentile Do you wash your hand with soap after using toilet Yes 265 65.3 No 141 34.7 How often do you usually bathe Every 2/3-days 156 38.4 Weekly 228 56.2 Monthly 22 5.4 How often do you usually wash your Clothes Weekly 278 68.5 Monthly 128 31.5 Over all personal hygiene practice of participants Poor 236 58.1 Good 170 41.9 3.5 Psychosocial perspective of students with disabilities Table 5 below showed respondents' perspective towards WASH facilities at the university revealed several critical insights. The data showed that 23.4% of respondents had faced stigma and discrimination in WASH facilities, particularly in water and sanitation areas (15% each). Despite this, 70.9% felt uncomfortable in using these facilities. Privacy was a concern for 47.3% of respondents. Additionally, 53% believed that they spent more time on WASH activities than others, and 22.2% feared abuse while using these facilities. Moreover, 74.4% thought university staffs were not well-trained to assist students with disabilities. Table 5 Psychosocial perspective of students with disabilities at the University of Gondar, Ethiopia, 2024. Variables Categories Frequency Percentile Personal experiences of stigma and discrimination when utilizing WASH facilities Yes 95 23.4 No 311 76.6 Facilities where stigma and discrimination were experienced Water facility 61 15.0 Sanitation facility 61 15.0 Hygiene facility 13 3.2 Feel comfort in using the WASH facilities at the university Yes 118 29.1 No 288 70.9 Privacy during defecation compared to other Yes 214 52.7 No 192 47.3 spend a similar amount of time on using WASH facilities compared to others Yes 191 47 No 215 53 Fear of physical/verbal abuse or violence when accessing WASH facility Yes 90 22.2 No 316 77.8 Adequacy of university staff training to assist students with disabilities in accessing WASH facilities Yes 104 25.6 No 302 74.4 Psychosocial perspective of participants Negative 234 57.6 Positive 172 42.4 3.6 The factors associated with the accessibility of WASH facility A logistic regression analysis was conducted to determine the factors influencing the accessibility of WASH facilities for students with disabilities living at the University of Gondar. Predictor variables with a p-value less than 0.20 from the bivariable regression analysis (including religion, income, type of disability, membership of disability organization, knowledge, personal hygiene practice, and psychosocial perspective) were included in a multivariable logistic regression analysis to examine the associations between the dependent and independent variables. In the multivariable logistic regression analysis, type of disability, membership in a disability organization, personal hygiene practice, and psychosocial perspective were the only factors found to be significantly associated with the accessibility of WASH facilities, using a p -value of 0.05. The odds of students with visual disabilities were 5.95 times more likely to have good accessibility to WASH facilities compared to those with physical disabilities (AOR = 5.95, 95% CI: 2.60, 13.58). Students who are members of a disability organization were 3.1 times more likely to have good access to WASH facilities compared to those who are not members (AOR = 3.10, 95% CI: 1.73, 5.54). The odds of student with good personal hygiene practices were about 1.71 times more likely to have good access to WASH facilities compared to those with poor hygiene practices (AOR = 1.71, 95% CI: 1.05, 2.78). Students with a positive psychosocial perspective were 6.1 times more likely to have good access to WASH facilities compared to those with a negative psychosocial perspective (AOR = 6.10, 95% CI: 3.74, 9.93). Table 6 Logistic regression of factors associated with the accessibility of WASH facility for students with disabilities at the University of Gondar, Ethiopia, 2024 Factors Accessibility of WASH facility COR 95% Cl AOR 95% Cl p-value Good Poor Religion Orthodox 129 210 1 1 Muslim 22 14 2.56 (1.26, 5.18) 2.01 (0.88, 4.58) protestant 15 16 1.53 (0.73, 3.19) 1.45 (0.62, 3.36) Monthly income 9200 28 31 1.56 (0.81, 3.00) 1.36 (0.60, 3.07) Type of disability Visual 157 193 4.25 (2.02, 8.94) 5.95 (2.60, 13.58) 0.001** physical 9 47 1 1 Membership of disability association/organization No 38 99 1 1 Yes 128 141 2.37 (1,52, 3.69) 3.10 (1.73, 5.54) 0.001** Knowledge on WASH Poor 55 95 1 1 Good 111 145 1.32 (0.87, 2.00) 1.32 (0.82, 2.15) Hygiene practice Poor 89 147 1 1 Good 77 93 1.37 (0.92, 2.04) 1.71 (1.05, 2.78) 0.030* Psychosocial perspective Poor 64 186 1 1 Good 102 54 5.49 (3.55, 8.48) 6.10 (3.74, 9.93) 0.001** *Significant at p-value < 0.05, **strongly significant at p-value < 0.001 , 1 = Reference 3.7 Qualitative result This qualitative analysis was based on interviews conducted with eight participants, whose ages ranged from 23 to 30, with a mean age of 26.62 ± 2.2 years (SD). Five themes were identified from the in-depth interview data to explore the barriers and challenges related to the accessibility of WASH facilities for students with disabilities using qualitative methods. Table 7 Types of disabilities of students with disabilities at University of Gondar, North western Ethiopia, 2024. No Sex Age Type of disability 1 Female 25 Visual 2 Male 28 Visual 3 Female 27 Physical 4 Male 30 Visual 5 Female 23 Physical 6 Male 28 Physical 7 Male 25 Visual 8 Male 27 Physical 3.7.1 In-depth interviews Theme 1: Environmental Barriers Students with disabilities often face challenges in accessing WASH facility when needed. These challenges arise from various environmental factors, including inconsistent supply, physical barriers, and a lack of assistive features. Therefore, the presence of WASH facilities does not guarantee that these students can utilize them effectively. This highlights the importance of not only having WASH facilities but also ensuring that they are accessible and functional at all times. Infrequent Supply A 30-year-old, second-year student, with a visual impairment, said, “Due to the scarce of water, I cannot bathe whenever I want. When I want to bathe, I have to rely on other students to volunteer to carry water to me in jerrycans and sometimes I even have to pay money to import water for bathing.” Physical Barriers A 28-year-old, first-year, male student who uses a wheelchair, said, “After entering the main door of the toilet, the individual door is very narrow. This does not allow enough space for a wheelchair to pass through. As a result, I cannot enter by myself unless someone physically carries me in. Even if I do manage to enter, the height of the toilet is too low. Because of this, I am often forced to defecate in my room using a bucket.” Absence of Assistive Features A 27-year-old fourth-year female student, who uses crutches, stated, "Overall, the shower and hand wash basin do not meet my needs. When I take a shower and want to wash my hands, I have to sit down to wash myself, as there are no suitable facilities unless I purchase plastic seats. Additionally, the heights of the shower and hand wash basin openings are not appropriate for my seated position. I cannot open or close them independently, which means I require assistance from others to use them." Theme 2: Dependency on Others Students with disabilities face multiple challenges related to their disabilities, the inaccessibility of WASH facilities, and other factors. Consequently, they often cannot use these facilities independently and require support from others to utilize them effectively. A 27-year-old, first-year male student who uses a wheelchair, said, “I don't know what kinds of challenges I would face if I didn't have friends to help me. Water is only available once a week or every two weeks, and we can only get it from the dining hall, which is too far from my dormitory for me to carry as much as I need on my own. In addition, most of the time, my friends wash my clothes for me because the washing facilities are too high, so I can't wash them myself. Similarly, they open and close the faucets in the shower when I want to use them because they are not at a suitable height for me.” Theme 3: Stigma and Discrimination Students with disabilities often face stigma and discrimination, particularly when trying to use WASH facilities, which can lead them to isolate themselves from these essential resources. Such negative experiences may discourage them from utilizing these facilities, ultimately having significant implications for their overall well-being. Social Stigmatization A 28-year-old fourth-year male student, with a visual impairment, said, “I feel stigmatized and discriminated against. When we went to request repairs for the toilets and showers, we were met with abuse and harassment. Additionally, the cleaners are also not happy with us because we can't see them, our use annoys them and sometimes they say bad words to us.” Self- isolation (Self- stigmatization) A 30-year-old, second-year male student, with a visual impairment, said, “I feel bad having to step on the toilet to use it, and it often gets very dirty. Sometimes it even becomes wet, forcing me to wipe my shoes on the road afterward.” A 28-year-old, fourth-year male student, with a visual impairment, mentioned, “The cleaning situation of toilets was very challenging, making it inconvenient to use. Whenever we did use them, we felt embarrassed and worried about the smell when we left, leading to many instances where I wanted to use them but refrained from doing so.” Theme 4: Impact on Health and Education Students with disabilities encounter numerous challenges arising from their disabilities, the inaccessibility of WASH facilities, and various other factors, all of which negatively impact their health and education. A 23-year-old, second-year female student, with a mobility impairment, said, “The toilet floor is slippery because water spills outside from blind students not using the system properly. This causes me to fall many times because I can't keep my balance, and I experience severe injuries as a result. I couldn't move because it hurt so much, and because of this, I missed an exam and a lot of lessons.” A 25-year-old, third-year male student, with a visual impairment, stated, “To be honest, the lack of water has significantly impacted me. For example, I have experienced stomach pain due to the water scarcity and I have missed classes because the toilets are usually not cleaned. As a result, I often spend time waiting to use the restroom, which interferes with my reading and studying. There are many times when I need to use the toilet, but I sometimes hold back due to my strong desire to focus on learn.” Theme 5: Recommendation for Improvement The study participants were advised to improve the accessibility of WASH facilities to ensure their effective use, in line with the recommendations. A 27-year-old, fourth-year female student, who uses crutches, stated, “If a shower is made wider to allow for easier movement, essential shower and handwashing basin features, such as seating and handrails, should also be incorporated. It's crucial to consider user needs when designing the height and accessibility of water facilities in any bathroom.” A 25-year-old third-year male student, with a visual impairment, stated, "I believe it would be convenient if there was a way to identify the toilet stalls/seats so that visually impaired students could use the toilets easily and systematically. Additionally, having the toilets cleaned in a special manner three or four times a day would be beneficial." 4 Discussion SDG 4 emphasizes the need for inclusive and quality educationin safe learning environments for all students, including those with disabilities, making access to WASH facilities essential for attendance, health, and the right to education ( 9 ). Implementing inclusive WASH programs in all educational institutions, including higher education, is crucial for preventing communicable diseases linked to poor hygiene ( 23 , 24 ) and, while also supporting SDG 6, which aims for clean water and sanitation by 2030( 25 ). Therefore, this study aimed to assess the accessibility of WASH facilities and associated factors among students with disabilities at the University of Gondar, highlighting the significant challenges and gaps of students with disabilities, which contribute to inadequate access to WASH facilities in educational settings. The findings showed that 40.9%, indicated that the accessibility of WASH facilities was poor, suggesting that a significant portion of the population experiences challenges in accessing these essential facilities, which can include physical inaccessibility, negative social attitudes, and lack of appropriate facilities designed for their needs. This finding aligns with previous research, which indicated that 58.2% of respondents also reported a lack of water facility for students with disabilities ( 29 ). In comparison, study by ( 39 ) found that approximately 52.9% of schools had accessible sanitation facilities for disabled students, while only 35.5% of handwashing facilities were accessible. Similarly, study conducted in Ghana ( 40 ) reported that 65% of toilets were not disability-friendly. These low accessibility rates across various contexts highlighted the significant barriers that students with disabilities encountered when trying to access and effectively use hygiene and sanitation facilities, underscoring the urgent need for improvements in accessibility and design to promote better hygiene practices and overall well-being. This was also supported by IDI finding: A 28-year-old, first-year male student, who uses a wheelchair, stated, “Since upgrading the existing building is not feasible, the university should construct a new, stand-alone facility in front of the current structures. This facility should include all necessary accessibility features for students with disabilities, such as fully equipped restrooms and shower areas. Furthermore, providing each disabled student with their own key or access card to this dedicated facility would allow them to use it independently, without needing assistance. This would enable all students with disabilities to access and utilize these facilities freely.” The accessibility of WASH facilities for students with disabilities at the University of Gondar was influenced by various factors, such as the type of disability, membership in a disability organization, personal hygiene practices, and the psychosocial perspectives of the respondents. In this study, the odds of students with visual disabilities were 5.9 times more likely to have good accessibility to WASH facilities compared to those with physical disabilities. This result was further supported by studies ( 41 ) and ( 42 ), which indicate that individuals with physical disabilities faces significant challenges in using sanitation facilities due to environmental barriers, such as steps and uneven terrain. These obstacles were less likely to affect those with visual impairments, who may navigate their surroundings differently. Additionally, physical impairments may present unique challenges, such as mobility issues, that can hinder the ability to access sanitation facilities or maintain hygiene practices effectively ( 43 , 44 ). The stark difference in the accessibility of WASH facility between students with physical impairments and those with visual impairments suggested that the nature of a disability significantly influences access to and use of WASH facilities. This finding was also supported by IDI finding: “The toilet seat is not comfortable for me, due to my physical disability, making it difficult for me to squat when using the toilet.” (A 23-year-old second-year female student, with a mobility impairment) Students who were members of a disability organization were 3 times more likely to have good access to WASH facilities compared to those who were not members. This finding was consistent with studies conducted in Kombolcha Town and Gondar City, which revealed that persons with disabilities without membership in a disability association faced a higher risk of latrine inaccessibility than those with membership ( 5 , 14 ). This suggested that students with disabilities who were members of the association had better access to information regarding accessibility and had received financial support. Additionally, the organization had provided assistance to help members access WASH facilities. And this also supported by IDI finding: “I can't collect as much water as I would like on my own. However, there is someone has been hired by the MasterCard Foundation to assist me, even if it is not what I want, as they are the ones who bring me water.” ( A 27-year-old fourth-year, female student, who uses crutches) Students with good hygiene practices were approximately 1.7 times more likely to have good access to WASH facilities, a finding supported by research in Guinea which revealed that inadequate WASH coverage led to poor hygiene practices among students, contributing to higher incidences of diseases such as diarrhea and malaria ( 45 ). Moreover, study in Nigeria ( 46 ) demonstrated that none of the facilities met WHO standards for WASH, highlighting the critical need for improved hygiene practices to enhance access to basic services. Similarly, another study ( 47 ) suggested that better access to hygiene and sanitation facilities in educational setting could be associated with better hygiene practices and educational outcomes. These findings collectively underscored the importance of promoting good hygiene practices as a pathway to improving access to essential WASH facilities, ultimately contributing to better health outcomes in students. The current study showed that, the odds of students with a positive psychosocial perspective were 6 times more likely to have good access to WASH facilities compared to those with a negative psychosocial perspective. This disparity may be attributed to the stigma and discrimination they frequently faced when using these facilities ( 37 ). As a result, individuals who depend on others for assistance with inaccessible water and sanitation facilities often experienced low self-esteem and a lack of dignity, as indicated by studies conducted by ( 48 ). And this also supported by IDI finding: "When I need to use the toilet, I feel embarrassed because it is so dirty. I have to ask someone who can see to help me use it, but most of the time, I get tired of bothering them." (A 25-year-old, third-year, male student with a visual impairment) Additionally, findings from study conducted in Nepal ( 47 ), indicate that attitude towards school WASH facilities had a significant impact on educational achievements. However, study conducted by UNICEF ( 4 ) highlights the need for clear guidance on effective strategies to change attitudes and ensure WASH access for all in different contexts. 4.1 Strengths and limitations A major strength of this study was the use of quantitative and qualitative study methods. This mixed study approach allowed for a broad assessment of the accessibility of WASH facility for students with disabilities, with qualitative research to triangulate findings across methodologies and instruments, which strengthens the validity of the results. This study was conducted at the University of Gondar, one of Ethiopia's 48 governmental higher education institutions, which may affect the generalizability of the findings to other contexts. However, the study did not employ an observational checklist, and no additional studies were conducted on these individuals, which limits the potential for comparison. 5 Conclusion and Recommendation 5.1 Conclusion These findings indicated that the accessibility of WASH facilities for students with disabilities was significantly inadequate, highlighting systemic barriers that prevent equitable access to essential services. This inadequacy suggested that various factors, including the type of disability and membership in disability organizations, play crucial roles in determining accessibility. Additionally, personal hygiene practices and psychosocial perspectives demonstrated that individual behaviors and societal attitudes can influence how effectively students with disabilities were able to utilize these facilities. The lived experiences of students with disabilities showed critical issues, including environmental barriers, dependency on others, stigma and discrimination, and the negative effects on their health and education. These factors underscored the complex challenges that students with disabilities faced when accessing WASH facilities. 5.2 Recommendation Based on the finding of the study the following key ideas were recommended: Recommendations for Disability Organizations/NGOs The Disability organizations should collaborate with the university to develop and implement projects that focus on improving WASH facility accessibility for students with disabilities. This collaboration could involve joint initiatives, research projects, or awareness-raising activities. Recommendations for the University of Gondar The university of Gondar should develop and implement inclusive intervention that adhere to universal design principles, addressing the specific WASH-related needs of students with disabilities. These interventions aim to ensure that facilities are accessible, safe, and accommodating for everyone, regardless of their type of disability. It should provide training programs for university staff and students focused on disability awareness, inclusive practices, and support strategies for helping students with disabilities effectively use WASH facilities. These programs could also address the psychosocial needs of students, fostering a sense of comfort and confidence in utilizing these facilities. For future researchers Researchers should conduct further investigations by expanding the sample size to encompass a broader range of higher educational settings. Declarations Author Contribution AM conceived and designed the study, collected the data, performed the data analysis, interpreted the results, and drafted the manuscript. HF, ME, MG, and HT provided supervision, contributed to the interpretation of the findings, and critically reviewed and commented on the manuscript. All authors read and approved the final manuscript. Data Availability Data Availability StatementThe datasets generated and/or analyzed during the current study are not publicly available due to privacy and ethical restrictions but are available from the corresponding author on reasonable request. References Banks LM, White S, Biran A, Wilbur J, Neupane S, Neupane S, et al. Are current approaches for measuring access to clean water and sanitation inclusive of people with disabilities? Comparison of individual-and household-level access between people with and without disabilities in the Tanahun district of Nepal. PLoS ONE. 2019;14(10):e0223557. Jones H, Reed B. Water and sanitation for disabled people and other vulnerable groups: Designing services to improve accessibility: WEDC. Loughborough University; 2005. UNICEF. Situation and access to services of persons with disabilities in Addis Ababa. Briefing Note Addis Ababa [available at https://www unicef org/ethiopia/media/3016/file/3 Situation% 20and% 20access% 20to% 20services% 20of% 20persons% 20with% 20disabilities% 20in% 20Addis% 20Ababa% 20Briefing% 20Note pdf]. Accessed. 2022;3. UNICEF. The Case for Investment in Accessible and Inclusive WASH. 2018. Getahun A, Kassie GG, Bunare TS. Latrine access and factors associated with it among people with physical disability in Kombolcha Town, Northeast Ethiopia: A mixed cross-sectional study. PLoS ONE. 2022;17(6):e0270395. Organization WH. Burden of disease attributable to unsafe drinking-water. sanitation and hygiene: World Health Organization; 2023. Asfaw B, Azage M, Gebregergs GB. Latrine access and utilization among people with limited mobility: A cross sectional study. Archives Public Health. 2016;74:1–8. Cf O. Transforming our world: the 2030 Agenda for Sustainable Development. New York, NY, USA: United Nations; 2015. WaterAid. Ensuring clean water and decent toilets in schools: links between SDG 6 and SDG 4. Policy brief for the 2019 High Level Political Forum. 2019. Dash N. Support Services for Children with Special Needs in the State of Sikkim Lovely Professional University, Phagwara, Punjab, India. Anuradha Rai, Research Scholar, Deptt of Education. Punjab: Lovely Professional University, Phagwara; 2009. White S, Kuper H, Itimu-Phiri A, Holm R, Biran A. A qualitative study of barriers to accessing water, sanitation and hygiene for disabled people in Malawi. PLoS ONE. 2016;11(5):e0155043. Mactaggart I, Schmidt W-P, Bostoen K, Chunga J, Danquah L, Halder AK, et al. Access to water and sanitation among people with disabilities: results from cross-sectional surveys in Bangladesh, Cameroon, India and Malawi. BMJ open. 2018;8(6):e020077. KAZEMBE DRA. Exploring Barriers to Accessing Water, Sanitation and Hygiene for Disabled People in Chiradzulu. 2017. Mamaye Y, Gelleta A, Guadu T, Eyachew D. Access to Sanitation Services and Associated Factors among People with Physical Disability in Gondar Town, North west Ethiopia. Eur J Biol Sci. 2018;10(2):52–63. Organization WH. World report on disability 2011. World Health Organization; 2011. Enfield S. Mainstreaming disability and making WASH programmes inclusive. K4D Helpdesk Report. 2018. University TO. Ethiopia’s One WASH National Programme. 2016. Groce N, Bailey N, Lang R, Trani J-F, Kett M. Water and sanitation issues for persons with disabilities in low-and middle-income countries: a literature review and discussion of implications for global health and international development. J Water Health. 2011;9(4):617–27. Dassah E, Bisung E. Access to water, sanitation and hygiene (WASH) for persons with disabilities in school settings: A call for research. Disabil Soc. 2023;38(5):893–8. Tirussew T, Daniel D, Alemayehu T, Fantahun A, Sewalem T, Tilahun A et al. Assessment of the situation of students with disabilities in the Ethiopian Universities. Unpublished research) done in collaboration Addis Ababa and Vienna Universities Sponsored by Appear Austrian Development Cooperation. 2014. Los Santos D, Bain S, Kupczynski L, Mundy M-A. Determining academic success in students with disabilities in higher education. Int J High Educ. 2019;8(2):16–38. Mohamed H, Wamera E, Malima W. Access to water, sanitation and hygiene services and other preventive measures against COVID-19 among people with disabilities, Dodoma, Tanzania. Am J Trop Med Hyg. 2022;107(3):527. UNICEF, Disability Inclusive WASH. Practices. Including people with disabilities in UNICEF Water, Sanitation and Hygiene (WASH) Programming. Health TMo. National WASH and Environmental Health Strategy (2021–2025). April 19, 2022 Addis Ababa, Ethiopia:13. Antwi-Agyei P, Mwakitalima A, Seleman A, Tenu F, Kuiwite T, Kiberiti S, et al. Water, sanitation and hygiene (WASH) in schools: results from a process evaluation of the National Sanitation Campaign in Tanzania. J Water Sanitation Hygiene Dev. 2017;7(1):140–50. LAW OF MONGOLIA ON WATER, May. 17, 2012. WHO. Improved sanitation facilities and drinking-water sources. WHO. GUIDELINES ON SANITATION AND HEALTH. 2018. Melaku A, Mengistie B, Addis T. The Status of School Water, Sanitation, and Hygiene Services in Addis Ababa, Ethiopia: Progress Towards Achieving the SDG 6. Environ Health Insights. 2023;17:11786302231199003. Guide T. The Convention On The Rights Of Persons With Disabilities. New York and Geneva United Nations of Human Rights; 2014. Jones H, Parker K, Reed R. Water supply and sanitation access and use by physically disabled people. Leicestershire, United Kingdom: Loughborough University; 2003. Sonego IL, Mosler H-J. Why are some latrines cleaner than others? Determining the factors of habitual cleaning behaviour and latrine cleanliness in rural Burundi. J water sanitation hygiene Dev. 2014;4(2):257–67. WHO. Water Sanitation and Health. CDC. Handwashing in Communities: Clean Hands Save Lives. Downing JE. Including students with severe and multiple disabilities in typical classrooms: Practical strategies for teachers. 1996. WHO, Disabilities. Definition, Types and Models of Disability. 2023. Daniel D, Nastiti A, Surbakti HY, Dwipayanti NMU. Access to inclusive sanitation and participation in sanitation programs for people with disabilities in Indonesia. Sci Rep. 2023;13(1):4310. Gunawan J. Ensuring trustworthiness in qualitative research. Belitung Nurs J. 2015;1(1):10–1. Ahmed J, Wong LP, Chua YP, Hydrie MZI, Channa N. Drinking water, sanitation, and hygiene (WASH) situation in primary schools of Pakistan: the impact of WASH-related interventions and policy on children school performance. Environ Sci Pollut Res. 2022;29(1):1259–77. Tiswin TN. Assessing the availability and utilisation of water, SANlTATION and hygiene (wash) facilities in public primary schools in the ZABZUGU district of Ghana. 2016. Wilbur J. What do we know in general about disability, ageing and WASH access? 2024. Fund, UNCs. MAKE IT COUNT: Guidance on disability inclusive WASH programme data collection, monitoring and reporting UNICEF, New York, 2021. 2021. Tan KS, Norman W, Knepper S, Kamban N. Access to water, sanitation and hygiene: A survey assessment of persons with disabilities in rural Mali. 2013. Desye B, Keleb A, Berhanu L, Ebrahim AM, Natnael T, Wagaye B, et al. Access to basic water, sanitation, and hygiene (WASH) facilities and associated factors in Ethiopia: evidence from demographics and health surveys. J Water Sanitation Hygiene Dev. 2023;13(1):39–49. Bah A, Diallo A, Bah A, Li F. Water, sanitation, and hygiene (WASH) coverage and practices of children from five public primary schools in Guinea. J Water Sanitation Hygiene Dev. 2022;12(7):555–62. Arowosegbe AO, Ojo DA, Shittu OB, Iwaloye O, Ekpo UF. Water, sanitation, and hygiene (WASH) facilities and infection control/prevention practices in traditional birth homes in Southwest Nigeria. BMC Health Serv Res. 2021;21:1–10. Sharma MK, Adhikari R, van Tejlingen E, Devkota B, Khanal SP. Improved water, Sanitation and Hygiene Facilities at School and their effect on educational achievement in basic level students in Nepal. Int J Health Promotion Educ. 2024:1–12. Jones H, Reed R, Bevan J, editors. Water and sanitation for the disabled in low-income countries. Proceedings of the Institution of Civil Engineers-Municipal Engineer; 2011: Thomas Telford Ltd. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9112220","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":605520458,"identity":"bf1d1728-9020-4f68-89e0-13cbe7e1546f","order_by":0,"name":"Amanuel Mamo","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABA0lEQVRIiWNgGAWjYPACCxDB+PjvPxsQ3XiACC0SIILZgIctDaSlgWgtbBI8bIfBXLxa+KcdfvaYp0IiGsg4JiHBc95ubfthoC01NtE4jb+dZm7Mc0Yid8bttGQLA4nbydvOJAK1HEvLbcCl53aCmTRvm0Ruw+0cwxsJBreTzQ4AtTA2HMapRf52+jdp3n8SufNv5xhIHEg4l2x2/iF+LQa3c4C2NEjkbridYyTZcOCAndkNArYY3s4pk5xzTCJ3I9AvxowNyQlmN4C2JODxi9zt9G0Sb2pscufdTj74mLHBzt7sfPrDBx+AIji9jw4SwSoTiFUOAvakKB4Fo2AUjIKRAQDQmmQh0PL9gQAAAABJRU5ErkJggg==","orcid":"","institution":"University of Gondar","correspondingAuthor":true,"prefix":"","firstName":"Amanuel","middleName":"","lastName":"Mamo","suffix":""},{"id":605520459,"identity":"665d50df-53be-481f-a670-ffe306c4bab5","order_by":1,"name":"Hailemariam Feleke","email":"","orcid":"","institution":"University of Gondar","correspondingAuthor":false,"prefix":"","firstName":"Hailemariam","middleName":"","lastName":"Feleke","suffix":""},{"id":605520460,"identity":"722de6ac-6330-4f00-a711-26fff97ce4e9","order_by":2,"name":"Mastewal Endalew","email":"","orcid":"","institution":"University of Gondar","correspondingAuthor":false,"prefix":"","firstName":"Mastewal","middleName":"","lastName":"Endalew","suffix":""},{"id":605520461,"identity":"b2ec3b96-17d9-4bfd-afcd-d944d2ee799f","order_by":3,"name":"Mengesha Genet","email":"","orcid":"","institution":"University of Gondar","correspondingAuthor":false,"prefix":"","firstName":"Mengesha","middleName":"","lastName":"Genet","suffix":""},{"id":605520462,"identity":"3429c576-c44e-444c-8f15-18a7676181e2","order_by":4,"name":"Haymanot Tsegaw","email":"","orcid":"","institution":"Addis Ababa University","correspondingAuthor":false,"prefix":"","firstName":"Haymanot","middleName":"","lastName":"Tsegaw","suffix":""}],"badges":[],"createdAt":"2026-03-13 08:25:10","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9112220/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9112220/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":104782549,"identity":"b4bb9fca-7686-4a78-a2d9-65297ced8dfc","added_by":"auto","created_at":"2026-03-17 07:57:30","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1579281,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9112220/v1/e01f133d-d2ac-4bdc-babe-a087edacdbc5.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Accessibility of WASH facility and associated factors among students with disabilities: A Mixed method study at University of Gondar, Northwestern Ethiopia, 2024","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eSustainable Development Goal 6 highlights the critical importance of safe and affordable access to water, sanitation, and hygiene (WASH) for all by 2030. However, people with disabilities, who make up 15% of the global population, often struggle to meet their WASH needs(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Moreover, an estimated 80% of disabled people live in the developing countries(\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). In Ethiopia, around 7.8\u0026nbsp;million or 9.3% of the populations are disabilities, with approximately 2.2\u0026nbsp;million or 2.4% experiencing severe difficulties(\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). In the year 2018, globally, over 110\u0026nbsp;million people with disabilities were not able to access WASH facilities(\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Persons with disabilities are known to have more difficulty accessing WASH services, and countries with lower economic status have both restricted WASH access and greater disability prevalence(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e).Unsafe WASH services contribute to a substantial disease burden, with estimates indicating that in 2019, the adoption of safe WASH practices could have prevented at least 1.4\u0026nbsp;million deaths and 74\u0026nbsp;million disability-adjusted life years. This represents 2.5% of all deaths and 2.9% of all disability-adjusted life years globally(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e).Ethiopia, as a signatory of SDGs, recognizes the importance of disability inclusion in achieving universal access to water and sanitation by 2030. Regardless, studies have shown that the availability of suitable sanitation facilities for people with physical disabilities in Ethiopia is relatively low(\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eSustainable Development Goal 4 (SDG4) requires inclusive and quality education with safe learning environments for all. Access to WASH facilities in schools is vital for attendance, health, and the right to education. Without these infrastructures, enrollment decreases and absenteeism rises, hindering student progress(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Prioritizing WASH services is crucial for achieving SDG4 and ensuring equal opportunities for all students, including those with disabilities, who deserve a future full of hope, opportunity, and appropriate support to reach their potential without discrimination or exclusion(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eStudents with disabilities also encounter technical obstacles when accessing water and sanitation facilities, such as physical barriers which include inaccessible entrances, narrow doorways, uneven surfaces, and lack of ramps or elevators, water taps may be too high and inadequate bathroom fixtures that are not designed to accommodate their specific needs(\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). People with disabilities encounter significant challenges to meeting their WASH needs, especially in using services independently, consistently, hygienically, accessing services while maintaining their dignity, privacy, safety, and without pain or fear of abuse(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). The lack of water and sanitation access has significant implications, especially for individuals with disabilities. They face barriers in educational settings without accessible toilets, which is particularly challenging for girls managing menstrual hygiene(\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e).The risk of infections for disabled individuals is significantly higher when using latrines that are not appropriately designed to accommodate their needs(\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eStudents with disabilities faces significant challenges and gaps in accessibility of WASH facilities, leading to inadequate access in educational settings (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). This directly impacts not only students' health but also their school attendance and educational performance(\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). However, the implications of limited access to clean water and basic sanitation among disabilities, who already face physical and visual impairments are often overlooked and not adequately addressed(\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e).Inadequate and inaccessible WASH facilities for these students contribute to low utilization rates, impacting their health, hygiene, and educational experience. Urgent research and practical measures are required to address barriers and improve access to WASH facilities for individuals with disabilities in educational settings, especially in low- and middle-income countries(\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eDespite the assumed right to free movement on university campuses, the provision of essential accessibility elements, such as WASH facilities, is insufficiently provided in various areas including classrooms, dormitories, dining areas, recreational spaces, and libraries(\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). In response to this issue, institutions of higher education are expanding and reorganizing their support services to cater to the needs of students with disabilities and other special needs(\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e).Many interventions are planned for a general population, only few focuses to people with disabilities(\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). Inclusive WASH programming in all institutions including in higher education institutions is very crucial to protect the public from communicable diseases associated with poor hygiene and sanitation practices and lack of access to water supplies(\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). It contributes to achieving Millennium Development Goals like universal primary education, gender equality, and child mortality reduction. They are also aligned with Sustainable Development Goal 6, which targets clean water and sanitation by 2030(\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThis survey study provides an overview of the accessibility of WASH facilities for students with disabilities at the University of Gondar. The findings offer valuable insights for policymakers, researchers, disability organizations, and the university itself. Additionally, the study informs the development of inclusive and equitable policies and interventions aimed at promoting the overall well-being and participation of students with disabilities in the university life.\u003c/p\u003e"},{"header":"1 Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e1.1 Study design, Period, and Setting\u003c/h2\u003e \u003cp\u003e An institution-based cross-sectional mixed study was conducted from May 20 to June 20, 2024, in the University of Gondar city, which is located 180 km from Bahir Dar, capital city of Amhara regional state, and 748 km from Addis Ababa, the capital city of Ethiopia. The university has five campuses, those are: the college of medicine and health sciences and referral teaching hospital campus, the Atse Tewodros Campus which is the university\u0026rsquo;s main campus, Maraki Campus, Atse Fasil Campus, and the Tseda Campus. The university currently has an enrollment of between 35,000 and 39,999 students. Among these, 420 students are enrolled in various programs and have disabilities, including visual and physical disabilities. Of these, 209 students were being benefited from support provided by the Master Card Foundation.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e1.2 Source and study population\u003c/h2\u003e \u003cp\u003eThe source population for this survey study comprised all students with disabilities currently enrolled at the University of Gondar, while the study population specifically included students with visual and physical impairments from each campus.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e1.3 Eligibility criteria\u003c/h2\u003e \u003cdiv id=\"Sec6\" class=\"Section3\"\u003e \u003ch2\u003e1.3.1 Inclusion criteria\u003c/h2\u003e \u003cp\u003eThis study included all regular students with visual and physical disabilities who have been attending their education at the University of Gondar.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section3\"\u003e \u003ch2\u003e1.3.2 Exclusion criteria\u003c/h2\u003e \u003cp\u003eThis study excluded students with disabilities who were experiencing severe health problems and hospitalized during the research period.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e1.4 Sample size determination\u003c/h2\u003e \u003cp\u003eCurrently, there were 420 students with disabilities attending their class in different programs at Gondar University. Since the population size was relatively small, it was feasible to include the entire population as the sample. Therefore, the total population of 420 students with disabilities was included in the study.\u003c/p\u003e \u003cp\u003eThe sample size for the qualitative study was based on the level of data saturation. Data saturation occurred when no new information or themes emerged from the interviews, and the collected data was sufficient to address the research objectives and answer the research questions.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e1.5 Sampling technique procedure\u003c/h2\u003e \u003cp\u003eThe quantitative study surveyed 420 participants. The purposive sampling method was employed across all campuses until data saturation point was achieved to ensure a comprehensive selection of participants for in-depth interviews.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003e1.6 Variable of the study\u003c/h2\u003e \u003cdiv id=\"Sec11\" class=\"Section3\"\u003e \u003ch2\u003e1.6.1 Dependent variables\u003c/h2\u003e \u003cp\u003eAccessibility of WASH facility\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section3\"\u003e \u003ch2\u003e1.6.2 Independent variables\u003c/h2\u003e \u003cp\u003eSocio-demographic variables (Age, Sex, Religion, Education level, income, Year of living in the campus, Membership to disability association)\u003c/p\u003e \u003cp\u003eEnvironmental Factors (Distance to latrines, Narrow entrances, Steps to latrines, slippery floors, Cleanliness of latrine, Difficulty squatting, Inconvenient heights of hygiene facilities and water pumps/taps)\u003c/p\u003e \u003cp\u003ePsychosocial factors (Stigma, discrimination, privacy)\u003c/p\u003e \u003cp\u003ePersonal factors \u003cb\u003e(\u003c/b\u003eKnowledge, hygiene practices)\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003e1.7 Operational definition\u003c/h2\u003e \u003cp\u003eWater facility: a physical infrastructure or system designed and constructed to manage, distribute, or store water for various purposes, including but not limited to drinking water supply(\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eSanitation facility: a facilities or system designed and used to hygienically separate human excreta from human contact (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eHand washing accessible to the disabled: - Facilities can be accessed via a clear path without stairs that is free of obstructions, the tap, and soap are reachable from a seated position and can be operated by feet, or 1 closed fist with minimal effort (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAccess to safe water: Water with a distance of up to 100 m and the facility should be accessible for all (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eLatrine accessible to the disabled: the access to latrines should allow individuals to reach, enter, and use the facilities without difficulty. This includes having latrines located within 6 m of their home, with a pathway that is free of steps for wheelchair users. The path must be at least 1 meter wide, and the door should have a minimum width of 1 m. Additionally, the latrine room should provide a minimum space of 1 square meter, equipped with handrails and grab bars (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAccessible Shower/bathing: includes a shower which can manipulate by disable individual and it has a continuous water supply when they want to bath (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAccess/accessibility: this will include the possible means of students with disabilities entering and utilize water, sanitation and hygiene facilities. It involves making structural adaptations and designing fundamental fixtures and buildings, as well as developing aids and equipment specifically created to enable access of WASH facilities (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eCleanliness of latrine: A latrine is considered clean when the floor is well swept and there are no visible traces of feces or urine (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eGood accessibility of WASH facility: mean accessibility score of \u0026gt;\u0026thinsp;0.50 was considered as good accessibility.\u003c/p\u003e \u003cp\u003ePoor accessibility of WASH facility: mean accessibility score of \u0026le;\u0026thinsp;0.50 was considered as poor accessibility.\u003c/p\u003e \u003cp\u003eHygiene practice: Maintaining cleanliness involves both personal hygiene and the care of clothing. Poor hygiene practices include individuals washing their hands with water alone, neglecting to use soap after using toilet, and infrequently washing their clothes and bath (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eStudents with multiple disability: refers to a condition where an individual has two or more significant disabilities that together create unique challenges that cannot be adequately addressed by services designed for just one of the disabilities (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eStudents with physical disabilities: persons who cannot walk and may use a wheelchair or can walk with difficulty and need support or can walk, but experience other physical weakness or lack of coordination including weakness in legs and limb loss (limited arm/hand movements) (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eStudents with vision impairments: include blindness or low vision, requiring additional support or accommodations for effective access to WASH facilities (\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003e1.8 Data collection methods and procedure\u003c/h2\u003e \u003cp\u003eData were collected using face-to-face interviews by employing structured questionnaires prepared in English and translated into Amharic. These questionnaires were used to assess factors influencing the accessibility of WASH facility, including sociodemographic characteristics, psychosocial factors, knowledge, and hygiene practices. The data was collected using Kobo Toolbox, a mobile data collection platform, specifically the Kobo Collect version 2024.1.3 application on Android mobile phones. The questionnaire was adopted from a review of different kinds of literature and used for data collection.\u003c/p\u003e \u003cp\u003e Semi-structured open ended interview guides facilitated in-depth interviews, exploring participant\u0026rsquo;s experience, perspective, challenges, and suggestions to gain detailed insights into the barriers and factors related to the accessibility of WASH facility followed by probing questions. These insights were extracted from previous studies (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e). Qualitative data collection continued until theme saturation was reached during the interviews. All conversations during in-depth interviews were recorded and documented using an audio recorder and notebooks throughout the event with the consultation of the participants. The data collection included three environmental health professionals as data collectors and two public health officers as supervisors.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003e1.9 Data quality control\u003c/h2\u003e \u003cp\u003eA 5% pre-test was conducted at Debretabor University, and necessary corrections were made based on the observations. Training was provided on the questionnaire content, interviewing techniques, the purpose of the study, and how the principal investigator approached and maintained respondents' confidentiality. The consistency and completeness of the questionnaire were cross-checked, and any incomplete questionnaires were addressed and filled out on the spot. The control of data quality was carried out during the data collection by the interviewers and supervisors. The questionnaire was prepared in English and translated into the local language (Amharic) for communication with the study population, and then it was translated back into English to check for consistency.\u003c/p\u003e \u003cp\u003eTrustworthiness was verified by addressing the dimensions of credibility, transferability, dependability, and confirmability (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eTo ensure transferability, interviews were recorded and transcribed in Amharic, translated into English by the principal investigator, and accompanied by a comprehensive description of participants, research context, setting, sample, data collection procedure, and underlying assumptions. This allowed readers to assess the transferability of findings, while strengths and limitations were clearly outlined. Dependability was strengthened through continuous input from advisors and evaluators during data analysis, with deep communication establishing trust with participants. Credibility was maintained through confidential and prolonged engagement, establishing intimacy. The interview guide was evaluated by experts to minimize bias. Confirmability was ensured with rich participant quotes and a reflective journal documenting interview activities and study procedures in detail.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003e1.10 Data management and Analysis\u003c/h2\u003e \u003cp\u003eThe data were entered, cleaned, coded, and then analyzed with SPSS version 27, statistical software. The data were ensured to be complete, consistent, and valid. Categorical variables were summarized with frequencies and percentages, while continuous variables were summarized with means (standard deviation).\u003c/p\u003e \u003cp\u003eDescriptive statistics were computed, and the results were presented in tables. Bivariable logistic regression was performed, including variables with a \u003cem\u003ep\u003c/em\u003e-value\u0026thinsp;\u0026lt;\u0026thinsp;0.2 in the final multivariable logistic regression to adjust for potential confounders and identify the determinants of WASH facility accessibility. In the final model, variables with a \u003cem\u003ep\u003c/em\u003e-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 were considered statistically significant. Multicollinearity was assessed using the variance inflation factor (VIF), with all variables showing VIF values\u0026thinsp;\u0026lt;\u0026thinsp;10. Model fit was evaluated using the Hosmer-Lemeshow test, which indicated good fit (p\u0026thinsp;=\u0026thinsp;0.804).\u003c/p\u003e \u003cp\u003eThe qualitative data were intelligently transcribed into English. The transcribed contents were manually read several times, then coded and grouped into categories using open code 4.02 software. Finally, themes were developed. The results of the thematic analysis were presented in the form of a narrative with supporting quotes. At the end, the findings of the qualitative study were triangulated with the quantitative ones\u003c/p\u003e \u003c/div\u003e"},{"header":"2 Ethical consideration","content":"\u003cp\u003e Ethical clearance letter and approval were obtained from the Institutional Review board of Public Health, College of Medicine and Health Sciences on 22/05/2024, with the reference number IPH/2882/2024. Participants were informed that the study process would not harm them and that their information would be kept confidential. The importance of the study, anticipated benefits from the results, and its objectives were explained before the subsequent activities were implemented. Individuals who did not volunteer for the study were not enforced to participate.\u003c/p\u003e"},{"header":"3 Results","content":"\u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003e3.1 Socio-demographic characteristics of students with disabilities\u003c/h2\u003e \u003cp\u003eA total of 406 students with disabilities participated in the study, resulting in a 96.7% response rate. The data revealed a slight skew towards males, who represented 63.8% of the respondents. The mean age of the respondents was 25.30 years (\u0026plusmn;\u0026thinsp;2.66). The religious composition showed that the majority identified as Orthodox, making up 84.2% of the participants. In terms of academic progression, students in their 1st and 5th years were almost equally represented at 23.4% and 19.5%, respectively. Most students live on the Maraki campus, with a significant 96.5% of respondents studying there compared to other campuses. In terms of monthly income, the largest group in the third quartile earned between 8,501-9,200, comprising 35.5% of the participants. Regarding the types of disabilities reported by the respondents, visual impairments were the most prevalent, affecting 350 individuals (86.2%). Among the participants, 66.3% were members of disability associations or organizations, with Mastercard being the most commonly associated organization at 74.7%, followed by Ethiopian national association of blind (ENAB) at 22.7%, as shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e below.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSocio-demographic characteristics of students with disabilities at the University of Gondar, Northwestern Ethiopia, 2024\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercentile\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e147\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e36.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e259\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e63.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e234\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e57.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e172\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e42.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eReligion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOrthodox\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e339\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e83.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMuslim\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCatholic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eProtestant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eNumber of years stayed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1st year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2nd year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3rd year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4th year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e19.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5th year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e19.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eCampus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMaraki\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e392\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e96.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTewodros\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFasil\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGc\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eMonthly income\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;775\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e101\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e24.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e776\u0026ndash;8500\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e102\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e25.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8501\u0026ndash;9200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e144\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e35.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;9200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eType of disability\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVisual\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e350\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e86.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePhysical\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMultiple\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMembership of disability organization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e269\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e66.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e137\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e33.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eIf yes, name of the organization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMaster card\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e201\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e74.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eENAB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e22.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003e*Others=Yalem tila association; Ethiopian disability federation; ELDA; and Handicap national\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003e3.2 Accessibility of WASH facility for students with disabilities\u003c/h2\u003e \u003cp\u003eAs shown in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e below, the survey provided valuable insights into the accessibility of WASH facilities. A majority of respondents (88.4%) reported that water was not accessible where needed at all times. Additionally, 67% respondents indicated that water pumps and taps were positioned at inconvenient heights. The presence of handrails or grab bars for accessing water facilities was also lacking, with 85% respondents reporting their absence. In terms of latrine facilities, pit latrines were the most common type. Most latrines were located within 6 m (81%) of dormitories, and the entrances were wider than 1 m in 73.6% of cases. The cleanliness of latrines raised concerns, as 73.9% of the respondents reported unsatisfactory conditions. Furthermore, 68.5% respondents indicated that latrines lacked appropriate hand washing facilities, and 69.2% noted that bathing facilities were not positioned at accessible height.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAccessibility of WASH facility for students with disabilities at the University of Gondar, Ethiopia, 2024.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercentile\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAccessibility of water where needed at all times\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e359\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e88.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eWater pumps/taps positioned at a height that facilitates easy for access\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e134\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e33.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e272\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e67.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHandrails/grab bars for accessing water facilities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e345\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e85.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAccessibility of water dispensers in learning areas\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e362\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e89.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eType of latrine facilities is available\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePit latrine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e275\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e67.74\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCistern-flush toilet\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8.13\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePour Flush\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e19.46\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDon\u0026rsquo;t know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.67\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHandrails/grab bars for using latrine facilities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e336\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e82.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDistance of latrine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eequal or \u0026lt;\u0026thinsp;6meters\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e329\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e81.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;6 meters\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e19.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eLatrine entrance width\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eless than 1 meter\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e107\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e26.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eequal or more than 1 meter\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e299\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e73.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePresence of steps leading to latrines\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e122\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e30.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e284\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e70.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSlippery of floors inside latrines\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e265\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e65.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e141\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e34.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCleanliness of latrine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e106\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e26.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e300\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e73.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDifficulty squatting in latrines\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e189\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e46.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e217\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e53.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eLatrines equipped with appropriate handwashing facilities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e128\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e31.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e278\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e68.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePlacement of bathing facilities at accessible heights\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e125\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e30.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e281\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e69.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHandrails/grab bars for accessing handwashing facilities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e124\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e30.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e282\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e69.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePlacement of hand washing facilities at convenient heights\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e259\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e63.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e147\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e36.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHandrails/grab bars for accessing bathing facilities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e355\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e87.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAccessibility of WASH facility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e166\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e40.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e240\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e59.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec21\" class=\"Section2\"\u003e \u003ch2\u003e3.3 Knowledge of students with disabilities\u003c/h2\u003e \u003cp\u003eAs shown Table \u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e below, respondent\u0026rsquo;s knowledge of WASH is highlighted. A significant majority (91.4%) of the respondents correctly recognized that unsafe water could cause diarrheal diseases, demonstrating strong awareness. However, only 15.8% of respondents had received WASH information in the past 6 months, with mass media being the main source of information (14%). The information received covered topics such as personal hygiene (14.5%), water quality (8.9%), and sanitation (12.3%). Most respondents (93.3%) understood that not washing hands could lead to various diseases and knows that institutions need to have access to disability-friendly facilities. Nonetheless, there were significant knowledge gaps: only 25.9% knew the correct steps for hand washing, and while 56.2% were aware of the critical times for hand washing.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eKnowledge of students with disabilities about Water, Sanitation and Hygiene facilities at the University of Gondar, Ethiopia, 2024.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercentile\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCan unsafe water cause diarrheal diseases?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e371\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e91.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHave you got information on WASH in the last 6 months?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e342\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e84.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eSource of information about WASH?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMass media\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHealth workers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eWhat was the information received on WASH about?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHand hygiene\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWater quality\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSanitation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eWhat are the consequences of not washing hands?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eExpose to various diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e379\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e93.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDoes not expose to diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDo you know that all institutions should be required to have disability-friendly facilities?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e379\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e93.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDo you know about steps of hand washing?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e105\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e25.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e301\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e74.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDo you know about the critical periods for hand washing?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e228\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e56.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e178\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e43.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eOver all Knowledge of Participants\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e140\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e34.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e266\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e65.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003e*Other; NGOs workers, Relatives/family, Friends, and Disability associations\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003e3.4 Hygiene practice of students with disabilities\u003c/h2\u003e \u003cp\u003eAs Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e below, handwashing habits after using the toilet, the majority of respondents 265 (65.3%) reported washing their hands with soap. Concerning bathing frequency, responses varied, with 38.4% indicating bathing every 2 to 3 days. As for washing clothes, the majority (68.5%) reported washing them weekly, while 31.5% mentioned a monthly washing frequency.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eHygiene practice of students with disabilities at the University of Gondar, Ethiopia, 2024.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercentile\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDo you wash your hand with soap after using toilet\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e265\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e65.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e141\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e34.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eHow often do you usually bathe\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEvery 2/3-days\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e156\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e38.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWeekly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e228\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e56.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMonthly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHow often do you usually wash your Clothes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWeekly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e278\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e68.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMonthly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e128\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e31.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eOver all personal hygiene practice of participants\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e236\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e58.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e170\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e41.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec23\" class=\"Section2\"\u003e \u003ch2\u003e3.5 Psychosocial perspective of students with disabilities\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e below showed respondents' perspective towards WASH facilities at the university revealed several critical insights. The data showed that 23.4% of respondents had faced stigma and discrimination in WASH facilities, particularly in water and sanitation areas (15% each). Despite this, 70.9% felt uncomfortable in using these facilities. Privacy was a concern for 47.3% of respondents. Additionally, 53% believed that they spent more time on WASH activities than others, and 22.2% feared abuse while using these facilities. Moreover, 74.4% thought university staffs were not well-trained to assist students with disabilities.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePsychosocial perspective of students with disabilities at the University of Gondar, Ethiopia, 2024.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategories\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003ePercentile\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePersonal experiences of stigma and discrimination when utilizing WASH facilities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e23.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e311\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e76.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eFacilities where stigma and discrimination were experienced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWater facility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSanitation facility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHygiene facility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eFeel comfort in using the WASH facilities at the university\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e118\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e29.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e288\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e70.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePrivacy during defecation compared to other\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e214\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e52.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e192\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e47.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003espend a similar amount of time on using WASH facilities compared to others\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e191\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e47\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e215\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eFear of physical/verbal abuse or violence when accessing WASH facility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e22.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e316\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e77.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAdequacy of university staff training to assist students with disabilities in accessing WASH facilities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e104\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e302\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e74.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePsychosocial perspective of participants\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e234\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e57.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e172\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e42.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec24\" class=\"Section2\"\u003e \u003ch2\u003e3.6 The factors associated with the accessibility of WASH facility\u003c/h2\u003e \u003cp\u003eA logistic regression analysis was conducted to determine the factors influencing the accessibility of WASH facilities for students with disabilities living at the University of Gondar. Predictor variables with a \u003cem\u003ep-value\u003c/em\u003e less than 0.20 from the bivariable regression analysis (including religion, income, type of disability, membership of disability organization, knowledge, personal hygiene practice, and psychosocial perspective) were included in a multivariable logistic regression analysis to examine the associations between the dependent and independent variables. In the multivariable logistic regression analysis, type of disability, membership in a disability organization, personal hygiene practice, and psychosocial perspective were the only factors found to be significantly associated with the accessibility of WASH facilities, using a \u003cem\u003ep\u003c/em\u003e-value of 0.05.\u003c/p\u003e \u003cp\u003eThe odds of students with visual disabilities were 5.95 times more likely to have good accessibility to WASH facilities compared to those with physical disabilities (AOR\u0026thinsp;=\u0026thinsp;5.95, 95% CI: 2.60, 13.58). Students who are members of a disability organization were 3.1 times more likely to have good access to WASH facilities compared to those who are not members (AOR\u0026thinsp;=\u0026thinsp;3.10, 95% CI: 1.73, 5.54). The odds of student with good personal hygiene practices were about 1.71 times more likely to have good access to WASH facilities compared to those with poor hygiene practices (AOR\u0026thinsp;=\u0026thinsp;1.71, 95% CI: 1.05, 2.78). Students with a positive psychosocial perspective were 6.1 times more likely to have good access to WASH facilities compared to those with a negative psychosocial perspective (AOR\u0026thinsp;=\u0026thinsp;6.10, 95% CI: 3.74, 9.93).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eLogistic regression of factors associated with the accessibility of WASH facility for students with disabilities at the University of Gondar, Ethiopia, 2024\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eFactors\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eAccessibility of WASH facility\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCOR 95% Cl\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAOR 95% Cl\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003ep-value\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e \u003cp\u003eReligion\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOrthodox\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e129\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e210\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMuslim\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.56 (1.26, 5.18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.01 (0.88, 4.58)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eprotestant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.53 (0.73, 3.19)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.45 (0.62, 3.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMonthly income\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;775\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e776\u0026ndash;8500\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.21 (0.69. 2.13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.55 (0.79, 3.06)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8501\u0026ndash;9200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.20 (0.71, 2.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.39 (0.72, 2.71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;9200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.56 (0.81, 3.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.36 (0.60, 3.07)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eType of disability\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVisual\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e157\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e193\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.25 (2.02, 8.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5.95 (2.60, 13.58)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.001**\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ephysical\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMembership of disability association/organization\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e128\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e141\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.37 (1,52, 3.69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.10 (1.73, 5.54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.001**\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eKnowledge on WASH\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e111\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e145\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.32 (0.87, 2.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.32 (0.82, 2.15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHygiene practice\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e147\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.37 (0.92, 2.04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.71 (1.05, 2.78)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.030*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePsychosocial perspective\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e186\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e102\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.49 (3.55, 8.48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6.10 (3.74, 9.93)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.001**\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003e*Significant at \u003cem\u003ep-value\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05, **strongly significant at \u003cem\u003ep-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e, \u003cb\u003e1\u003c/b\u003e\u0026thinsp;=\u0026thinsp;Reference\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec25\" class=\"Section2\"\u003e \u003ch2\u003e3.7 Qualitative result\u003c/h2\u003e \u003cp\u003eThis qualitative analysis was based on interviews conducted with eight participants, whose ages ranged from 23 to 30, with a mean age of 26.62\u0026thinsp;\u0026plusmn;\u0026thinsp;2.2 years (SD). Five themes were identified from the in-depth interview data to explore the barriers and challenges related to the accessibility of WASH facilities for students with disabilities using qualitative methods.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eTypes of disabilities of students with disabilities at University of Gondar, North western Ethiopia, 2024.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eType of disability\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eVisual\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eVisual\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePhysical\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eVisual\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePhysical\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePhysical\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eVisual\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePhysical\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cdiv id=\"Sec26\" class=\"Section3\"\u003e \u003ch2\u003e3.7.1 In-depth interviews\u003c/h2\u003e \u003cp\u003e \u003cb\u003eTheme 1: Environmental Barriers\u003c/b\u003e \u003c/p\u003e \u003cp\u003eStudents with disabilities often face challenges in accessing WASH facility when needed. These challenges arise from various environmental factors, including inconsistent supply, physical barriers, and a lack of assistive features. Therefore, the presence of WASH facilities does not guarantee that these students can utilize them effectively. This highlights the importance of not only having WASH facilities but also ensuring that they are accessible and functional at all times.\u003c/p\u003e \u003cp\u003e \u003cb\u003eInfrequent Supply\u003c/b\u003e \u003c/p\u003e \u003cp\u003eA 30-year-old, second-year student, with a visual impairment, said, \u003cem\u003e\u0026ldquo;Due to the scarce of water, I cannot bathe whenever I want. When I want to bathe, I have to rely on other students to volunteer to carry water to me in jerrycans and sometimes I even have to pay money to import water for bathing.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e \u003cp\u003e \u003cb\u003ePhysical Barriers\u003c/b\u003e \u003c/p\u003e \u003cp\u003eA 28-year-old, first-year, male student who uses a wheelchair, said, \u003cem\u003e\u0026ldquo;After entering the main door of the toilet, the individual door is very narrow. This does not allow enough space for a wheelchair to pass through. As a result, I cannot enter by myself unless someone physically carries me in. Even if I do manage to enter, the height of the toilet is too low. Because of this, I am often forced to defecate in my room using a bucket.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e \u003cp\u003e \u003cb\u003eAbsence of Assistive Features\u003c/b\u003e \u003c/p\u003e \u003cp\u003eA 27-year-old fourth-year female student, who uses crutches, stated, \u003cem\u003e\"Overall, the shower and hand wash basin do not meet my needs. When I take a shower and want to wash my hands, I have to sit down to wash myself, as there are no suitable facilities unless I purchase plastic seats. Additionally, the heights of the shower and hand wash basin openings are not appropriate for my seated position. I cannot open or close them independently, which means I require assistance from others to use them.\"\u003c/em\u003e\u003c/p\u003e \u003cp\u003e \u003cb\u003eTheme 2: Dependency on Others\u003c/b\u003e \u003c/p\u003e \u003cp\u003eStudents with disabilities face multiple challenges related to their disabilities, the inaccessibility of WASH facilities, and other factors. Consequently, they often cannot use these facilities independently and require support from others to utilize them effectively.\u003c/p\u003e \u003cp\u003eA 27-year-old, first-year male student who uses a wheelchair, said, \u003cem\u003e\u0026ldquo;I don't know what kinds of challenges I would face if I didn't have friends to help me. Water is only available once a week or every two weeks, and we can only get it from the dining hall, which is too far from my dormitory for me to carry as much as I need on my own. In addition, most of the time, my friends wash my clothes for me because the washing facilities are too high, so I can't wash them myself. Similarly, they open and close the faucets in the shower when I want to use them because they are not at a suitable height for me.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e \u003cp\u003e \u003cb\u003eTheme 3: Stigma and Discrimination\u003c/b\u003e \u003c/p\u003e \u003cp\u003eStudents with disabilities often face stigma and discrimination, particularly when trying to use WASH facilities, which can lead them to isolate themselves from these essential resources. Such negative experiences may discourage them from utilizing these facilities, ultimately having significant implications for their overall well-being.\u003c/p\u003e \u003cp\u003e \u003cb\u003eSocial Stigmatization\u003c/b\u003e \u003c/p\u003e \u003cp\u003eA 28-year-old fourth-year male student, with a visual impairment, said, \u003cem\u003e\u0026ldquo;I feel stigmatized and discriminated against. When we went to request repairs for the toilets and showers, we were met with abuse and harassment. Additionally, the cleaners are also not happy with us because we can't see them, our use annoys them and sometimes they say bad words to us.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e \u003cp\u003e \u003cb\u003eSelf- isolation (Self- stigmatization)\u003c/b\u003e \u003c/p\u003e \u003cp\u003eA 30-year-old, second-year male student, with a visual impairment, said, \u003cem\u003e\u0026ldquo;I feel bad having to step on the toilet to use it, and it often gets very dirty. Sometimes it even becomes wet, forcing me to wipe my shoes on the road afterward.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e \u003cp\u003eA 28-year-old, fourth-year male student, with a visual impairment, mentioned, \u003cem\u003e\u0026ldquo;The cleaning situation of toilets was very challenging, making it inconvenient to use. Whenever we did use them, we felt embarrassed and worried about the smell when we left, leading to many instances where I wanted to use them but refrained from doing so.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e \u003cp\u003e \u003cb\u003eTheme 4: Impact on Health and Education\u003c/b\u003e \u003c/p\u003e \u003cp\u003eStudents with disabilities encounter numerous challenges arising from their disabilities, the inaccessibility of WASH facilities, and various other factors, all of which negatively impact their health and education.\u003c/p\u003e \u003cp\u003eA 23-year-old, second-year female student, with a mobility impairment, said, \u003cem\u003e\u0026ldquo;The toilet floor is slippery because water spills outside from blind students not using the system properly. This causes me to fall many times because I can't keep my balance, and I experience severe injuries as a result. I couldn't move because it hurt so much, and because of this, I missed an exam and a lot of lessons.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e \u003cp\u003eA 25-year-old, third-year male student, with a visual impairment, stated, \u003cem\u003e\u0026ldquo;To be honest, the lack of water has significantly impacted me. For example, I have experienced stomach pain due to the water scarcity and I have missed classes because the toilets are usually not cleaned. As a result, I often spend time waiting to use the restroom, which interferes with my reading and studying. There are many times when I need to use the toilet, but I sometimes hold back due to my strong desire to focus on learn.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e \u003cp\u003e \u003cb\u003eTheme 5: Recommendation for Improvement\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe study participants were advised to improve the accessibility of WASH facilities to ensure their effective use, in line with the recommendations.\u003c/p\u003e \u003cp\u003eA 27-year-old, fourth-year female student, who uses crutches, stated, \u003cem\u003e\u0026ldquo;If a shower is made wider to allow for easier movement, essential shower and handwashing basin features, such as seating and handrails, should also be incorporated. It's crucial to consider user needs when designing the height and accessibility of water facilities in any bathroom.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e \u003cp\u003eA 25-year-old third-year male student, with a visual impairment, stated, \u003cem\u003e\"I believe it would be convenient if there was a way to identify the toilet stalls/seats so that visually impaired students could use the toilets easily and systematically. Additionally, having the toilets cleaned in a special manner three or four times a day would be beneficial.\"\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"4 Discussion","content":"\u003cp\u003eSDG 4 emphasizes the need for inclusive and quality educationin safe learning environments for all students, including those with disabilities, making access to WASH facilities essential for attendance, health, and the right to education (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Implementing inclusive WASH programs in all educational institutions, including higher education, is crucial for preventing communicable diseases linked to poor hygiene (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e) and, while also supporting SDG 6, which aims for clean water and sanitation by 2030(\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). Therefore, this study aimed to assess the accessibility of WASH facilities and associated factors among students with disabilities at the University of Gondar, highlighting the significant challenges and gaps of students with disabilities, which contribute to inadequate access to WASH facilities in educational settings.\u003c/p\u003e \u003cp\u003eThe findings showed that 40.9%, indicated that the accessibility of WASH facilities was poor, suggesting that a significant portion of the population experiences challenges in accessing these essential facilities, which can include physical inaccessibility, negative social attitudes, and lack of appropriate facilities designed for their needs. This finding aligns with previous research, which indicated that 58.2% of respondents also reported a lack of water facility for students with disabilities (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). In comparison, study by (\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e) found that approximately 52.9% of schools had accessible sanitation facilities for disabled students, while only 35.5% of handwashing facilities were accessible. Similarly, study conducted in Ghana (\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e) reported that 65% of toilets were not disability-friendly.\u003c/p\u003e \u003cp\u003eThese low accessibility rates across various contexts highlighted the significant barriers that students with disabilities encountered when trying to access and effectively use hygiene and sanitation facilities, underscoring the urgent need for improvements in accessibility and design to promote better hygiene practices and overall well-being. This was also supported by IDI finding:\u003c/p\u003e \u003cp\u003eA 28-year-old, first-year male student, who uses a wheelchair, stated, \u003cem\u003e\u0026ldquo;Since upgrading the existing building is not feasible, the university should construct a new, stand-alone facility in front of the current structures. This facility should include all necessary accessibility features for students with disabilities, such as fully equipped restrooms and shower areas. Furthermore, providing each disabled student with their own key or access card to this dedicated facility would allow them to use it independently, without needing assistance. This would enable all students with disabilities to access and utilize these facilities freely.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e \u003cp\u003eThe accessibility of WASH facilities for students with disabilities at the University of Gondar was influenced by various factors, such as the type of disability, membership in a disability organization, personal hygiene practices, and the psychosocial perspectives of the respondents.\u003c/p\u003e \u003cp\u003eIn this study, the odds of students with visual disabilities were 5.9 times more likely to have good accessibility to WASH facilities compared to those with physical disabilities. This result was further supported by studies (\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e) and (\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e), which indicate that individuals with physical disabilities faces significant challenges in using sanitation facilities due to environmental barriers, such as steps and uneven terrain. These obstacles were less likely to affect those with visual impairments, who may navigate their surroundings differently. Additionally, physical impairments may present unique challenges, such as mobility issues, that can hinder the ability to access sanitation facilities or maintain hygiene practices effectively (\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e). The stark difference in the accessibility of WASH facility between students with physical impairments and those with visual impairments suggested that the nature of a disability significantly influences access to and use of WASH facilities. This finding was also supported by IDI finding:\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;The toilet seat is not comfortable for me, due to my physical disability, making it difficult for me to squat when using the toilet.\u0026rdquo;\u003c/em\u003e (A 23-year-old second-year female student, with a mobility impairment)\u003c/p\u003e \u003cp\u003eStudents who were members of a disability organization were 3 times more likely to have good access to WASH facilities compared to those who were not members. This finding was consistent with studies conducted in Kombolcha Town and Gondar City, which revealed that persons with disabilities without membership in a disability association faced a higher risk of latrine inaccessibility than those with membership (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). This suggested that students with disabilities who were members of the association had better access to information regarding accessibility and had received financial support. Additionally, the organization had provided assistance to help members access WASH facilities. And this also supported by IDI finding:\u003c/p\u003e \u003cp\u003e \u003cem\u003e\u0026ldquo;I can't collect as much water as I would like on my own. However, there is someone has been hired by the MasterCard Foundation to assist me, even if it is not what I want, as they are the ones who bring me water.\u0026rdquo;\u003c/em\u003e( A 27-year-old fourth-year, female student, who uses crutches)\u003c/p\u003e \u003cp\u003eStudents with good hygiene practices were approximately 1.7 times more likely to have good access to WASH facilities, a finding supported by research in Guinea which revealed that inadequate WASH coverage led to poor hygiene practices among students, contributing to higher incidences of diseases such as diarrhea and malaria (\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e). Moreover, study in Nigeria (\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e) demonstrated that none of the facilities met WHO standards for WASH, highlighting the critical need for improved hygiene practices to enhance access to basic services. Similarly, another study (\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e) suggested that better access to hygiene and sanitation facilities in educational setting could be associated with better hygiene practices and educational outcomes.\u003c/p\u003e \u003cp\u003eThese findings collectively underscored the importance of promoting good hygiene practices as a pathway to improving access to essential WASH facilities, ultimately contributing to better health outcomes in students.\u003c/p\u003e \u003cp\u003eThe current study showed that, the odds of students with a positive psychosocial perspective were 6 times more likely to have good access to WASH facilities compared to those with a negative psychosocial perspective. This disparity may be attributed to the stigma and discrimination they frequently faced when using these facilities (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e). As a result, individuals who depend on others for assistance with inaccessible water and sanitation facilities often experienced low self-esteem and a lack of dignity, as indicated by studies conducted by (\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e). And this also supported by IDI finding:\u003c/p\u003e \u003cp\u003e \u003cem\u003e\"When I need to use the toilet, I feel embarrassed because it is so dirty. I have to ask someone who can see to help me use it, but most of the time, I get tired of bothering them.\"\u003c/em\u003e (A 25-year-old, third-year, male student with a visual impairment)\u003c/p\u003e \u003cp\u003eAdditionally, findings from study conducted in Nepal (\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e), indicate that attitude towards school WASH facilities had a significant impact on educational achievements. However, study conducted by UNICEF (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e) highlights the need for clear guidance on effective strategies to change attitudes and ensure WASH access for all in different contexts.\u003c/p\u003e \u003cdiv id=\"Sec28\" class=\"Section2\"\u003e \u003ch2\u003e4.1 Strengths and limitations\u003c/h2\u003e \u003cp\u003eA major strength of this study was the use of quantitative and qualitative study methods. This mixed study approach allowed for a broad assessment of the accessibility of WASH facility for students with disabilities, with qualitative research to triangulate findings across methodologies and instruments, which strengthens the validity of the results.\u003c/p\u003e \u003cp\u003eThis study was conducted at the University of Gondar, one of Ethiopia's 48 governmental higher education institutions, which may affect the generalizability of the findings to other contexts. However, the study did not employ an observational checklist, and no additional studies were conducted on these individuals, which limits the potential for comparison.\u003c/p\u003e \u003c/div\u003e"},{"header":"5 Conclusion and Recommendation","content":"\u003cdiv id=\"Sec30\" class=\"Section2\"\u003e \u003ch2\u003e5.1 Conclusion\u003c/h2\u003e \u003cp\u003eThese findings indicated that the accessibility of WASH facilities for students with disabilities was significantly inadequate, highlighting systemic barriers that prevent equitable access to essential services. This inadequacy suggested that various factors, including the type of disability and membership in disability organizations, play crucial roles in determining accessibility. Additionally, personal hygiene practices and psychosocial perspectives demonstrated that individual behaviors and societal attitudes can influence how effectively students with disabilities were able to utilize these facilities. The lived experiences of students with disabilities showed critical issues, including environmental barriers, dependency on others, stigma and discrimination, and the negative effects on their health and education. These factors underscored the complex challenges that students with disabilities faced when accessing WASH facilities.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec31\" class=\"Section2\"\u003e \u003ch2\u003e5.2 Recommendation\u003c/h2\u003e \u003cp\u003eBased on the finding of the study the following key ideas were recommended:\u003c/p\u003e \u003cp\u003e \u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eRecommendations for Disability Organizations/NGOs\u003c/span\u003e \u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eThe Disability organizations should collaborate with the university to develop and implement projects that focus on improving WASH facility accessibility for students with disabilities. This collaboration could involve joint initiatives, research projects, or awareness-raising activities.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003e \u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eRecommendations for the University of Gondar\u003c/span\u003e \u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eThe university of Gondar should develop and implement inclusive intervention that adhere to universal design principles, addressing the specific WASH-related needs of students with disabilities. These interventions aim to ensure that facilities are accessible, safe, and accommodating for everyone, regardless of their type of disability.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eIt should provide training programs for university staff and students focused on disability awareness, inclusive practices, and support strategies for helping students with disabilities effectively use WASH facilities. These programs could also address the psychosocial needs of students, fostering a sense of comfort and confidence in utilizing these facilities.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003cdiv class=\"BlockQuote\"\u003e \u003cp\u003e \u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eFor future researchers\u003c/span\u003e \u003c/p\u003e \u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eResearchers should conduct further investigations by expanding the sample size to encompass a broader range of higher educational settings.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eAM conceived and designed the study, collected the data, performed the data analysis, interpreted the results, and drafted the manuscript. HF, ME, MG, and HT provided supervision, contributed to the interpretation of the findings, and critically reviewed and commented on the manuscript. All authors read and approved the final manuscript.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eData Availability StatementThe datasets generated and/or analyzed during the current study are not publicly available due to privacy and ethical restrictions but are available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eBanks LM, White S, Biran A, Wilbur J, Neupane S, Neupane S, et al. Are current approaches for measuring access to clean water and sanitation inclusive of people with disabilities? Comparison of individual-and household-level access between people with and without disabilities in the Tanahun district of Nepal. 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BMC Health Serv Res. 2021;21:1\u0026ndash;10.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSharma MK, Adhikari R, van Tejlingen E, Devkota B, Khanal SP. Improved water, Sanitation and Hygiene Facilities at School and their effect on educational achievement in basic level students in Nepal. Int J Health Promotion Educ. 2024:1\u0026ndash;12.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJones H, Reed R, Bevan J, editors. Water and sanitation for the disabled in low-income countries. Proceedings of the Institution of Civil Engineers-Municipal Engineer; 2011: Thomas Telford Ltd.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Accessibility, Students with disabilities, WASH, University of Gondar","lastPublishedDoi":"10.21203/rs.3.rs-9112220/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9112220/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eIntroduction\u003c/strong\u003e: Limited access to clean water, sanitation, and hygiene services perpetuates poverty, illness, and a reduced quality of life, especially for disabled individuals who encounter significant barriers to essential facilities. Understanding the factors that influence the accessibility of WASH facilities is essential for developing inclusive policies and interventions. This study was aimed to assess the accessibility of WASH facility and associated factor among students with disabilities at University of Gondar, North west Ethiopia.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e: An institution-based mixed cross-sectional study was conducted among students with disabilities at the University of Gondar from May 20 to June 20, 2024. A survey of 406 participants was included in the quantitative data using structured and pretested interviewer-administered questionnaires. The data were cleaned, coded, entered, and then analyzed using SPSS version 27 software. A binary logistic regression model was used, and a p-value of less than 0.05 was considered statistically significant in the model. Qualitative data were collected from eight purposefully selected participants through in-depth interviews using open-ended questions until data saturation point was reached. The data were subsequently analyzed thematically using Open Code 4.02 software.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: The accessibility of WASH facilities for students with disabilities was found to be 40.9%. Physical disability (AOR = 5.95, 95% CI: 2.60, 13.58), being not members of a disability organization (AOR = 3.10, 95% CI: 1.73, 5.54), poor personal hygiene (AOR = 1.71, 95% CI: 1.05, 2.78), and a negative psychosocial perspective (AOR = 6.10, 95% CI: 3.74, 9.93) were factors contributing to the low accessibility of WASH facilities. As qualitative findings showed, barriers that hinder the accessibility of WASH facilities were environmental barriers, dependency on others, stigma and discrimination, impact on health and education, and recommendations for improvement.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: The accessibility of WASH facilities for students with disabilities was found to be low. Visual impairment, being membership in a disability organization, personal hygiene practice and positive psychosocial perspectives contributed to the inadequate accessibility of WASH facilities.\u003c/p\u003e","manuscriptTitle":"Accessibility of WASH facility and associated factors among students with disabilities: A Mixed method study at University of Gondar, Northwestern Ethiopia, 2024","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-16 03:52:31","doi":"10.21203/rs.3.rs-9112220/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-03-19T12:11:34+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-03-18T08:59:46+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-03-18T08:59:43+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2026-03-13T08:10:02+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b5400dc3-d599-42a1-93a4-07cbdaf6484d","owner":[],"postedDate":"March 16th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-22T07:23:53+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-16 03:52:31","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9112220","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9112220","identity":"rs-9112220","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}