Open Defecation in Ghana: A Worrying Trend That Must End

The revelation that about 5.4 million Ghanaians, representing 18 per cent of the national population, still practise open defecation is deeply troubling. Mr. Yaw Attah Arhin, WASH Technical Specialist at World Vision Ghana, has described the situation as a national emergency, warning that it undermines public health, child survival, and national development.

Open defecation is no longer just a sanitation challenge; it reflects inequality, inadequate infrastructure, weak enforcement, and policy lethargy. The public health consequences are dire. Diarrhoea-related deaths claim the lives of 3,600 children annually, while infections linked to poor sanitation account for 15 per cent of maternal deaths. Cholera outbreaks, water contamination, malnutrition, stunting, and preventable illnesses are all direct outcomes of this persistent practice.

UNICEF research highlights the danger: one gram of human faeces can contain 10 million viruses, one million bacteria, 1,000 parasite cysts, and 100 parasitic eggs, underscoring the urgent need for action.

The economic cost is equally alarming. Open defecation and poor sanitation drain the nation’s resources, costing an estimated US$79 million annually, while Ghana loses a further US$290 million yearly to broader consequences of inadequate sanitation. Each unbuilt toilet or neglected latrine translates into lost productivity, higher healthcare expenditure, and environmental degradation.

The problem is compounded in educational institutions. Data from the Ministry of Education shows that 26 per cent of public basic schools lack toilet facilities, forcing pupils to resort to bushes or return home during school hours. Girls are particularly affected, often skipping school due to lack of privacy and hygiene, resulting in absenteeism, poor academic performance, and increased vulnerability to abuse.

Addressing open defecation requires more than infrastructure; it demands a shift in social norms. Cultural habits and lax community standards have normalised the practice for generations. Influencers, filmmakers, musicians, and media personalities can play a critical role by championing consistent sanitation messages, helping transform public attitudes, and promoting hygiene as a matter of pride and dignity.

Ghana can learn from peers such as Ethiopia, Kenya, and Rwanda, which have achieved significant progress through Community-Led Total Sanitation (CLTS) programmes, household incentives, by-law enforcement, and visible political leadership.

The government must elevate sanitation to a national emergency, with sustained financing, annual accountability mechanisms at the district level, and enforcement of existing laws requiring every household to have a toilet. Metropolitan, Municipal, and District Assemblies (MMDAs) must stop treating sanitation as optional. Community-led campaigns driven by chiefs, queen mothers, religious leaders, and youth groups are crucial to changing mindsets. Affordable, innovative household toilet models, especially in high-density urban areas, must be scaled up with private sector support.

Sanitation is as fundamental to development as roads, electricity, and healthcare. With 5.4 million citizens still practising open defecation, Ghana’s public health, dignity, and development are at risk. Ending this practice is not a dream; it is an urgent, achievable necessity if all stakeholders commit to decisive action. Ghana cannot continue to live with a problem that stains its environment, undermines its citizens’ dignity, and slows national progress. The time to act is now. Ending open defecation is not only a policy objective but a moral imperative for the health, prosperity, and future of the nation.

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