Only 59.3 percent of households have access to improved toilet facilities, the Ministry of Local Government, Chieftaincy and Religious Affairs has disclosed.

To address the challenge, the Ministry has called for accelerated investment in sanitation infrastructure, wastewater management and solid waste disposal.

The Ministry made the revelation on Monday, August 10, ahead of Ghana joining other African Union member states to mark the 2026 African Day for Decentralisation and Local Development.

This year’s commemoration is on the theme, “Empowered Local Governments for Sustainable Water and Sanitation: Advancing Resilient, Inclusive and Sustainable Cities and Territories towards Agenda 2063.”

Last year, a study by the International Organization for Migration (IOM) highlighted the widespread issue of open defecation in the Ada East District, where 77% of 437 surveyed households lack access to proper sanitation.

The study revealed that most households in the district do not have toilets or pit latrines, leaving them with no choice but to defecate in open spaces such as fields, bushes, and canals. In contrast, only 23% of the sampled homes have access to appropriate toilet facilities.

Conducted as part of the IOM Ghana Mission’s Population Mobility Mapping for Cholera Response, the survey covered 10 communities, including Azizanya, Totope, Pute, Otrokpe, and Azizakpe.

The findings indicated that areas along key trade routes and fishing hubs—such as Totope, Pute, and Azizanya are at higher risk of cholera outbreaks due to the frequent movement of traders, fishermen, and seasonal workers.

The report further noted that large public gatherings, including markets and festivals, have contributed to the spread of cholera through contaminated food and water.

Poor sanitation and inefficient waste disposal in highly mobile areas have worsened environmental contamination, increasing the risk of disease transmission.

“Additionally, the presence of large gatherings, including markets and festivals, has facilitated the spread of cholera through contaminated water and food sources. Limited access to proper sanitation in these high-mobility areas further exacerbates the challenge, as open defecation and poor waste management contribute to environmental contamination,” the report stated.

According to the IOM, climate-related vulnerabilities, economic hardships, and complex migration patterns are key factors intensifying the cholera crisis. Displacement from the October 2023 Volta Basin floods, the effects of the Sahel crisis, and commercial activities along the Abidjan-Lagos corridor have all played a role in worsening sanitation conditions.

Among the communities surveyed, Pute had the highest proportion of households without toilet facilities at 17%, followed by Azizanya (12%), Otrokpe (11%), Kasseh (7%), and Foah Zongo (5%). Additionally, no households in Azizakpe, Azizanya, and Kewunor reported having access to latrines.

Meanwhile, President John Dramani Mahama has called on district assemblies to assist the government in combating open defecation.

Speaking at the launch of the Sustainable Development Goal (SDG) Voluntary National Report, President Mahama cautioned district assemblies against approving building permits for construction plans that omit sanitation facilities.

According to him, all new residential, commercial, and public structures must follow a thorough sanitation and compliance process.

“It is unacceptable that in 2025, open defecation persists in parts of Ghana. This is not just a public health issue; it is a matter of dignity and equity. Our sanitation crisis is not caused by a lack of knowledge, but by gaps in investment, enforcement, and community engagement. We must act decisively to end this practice.

“All district assemblies have in their by-laws that you can’t obtain a building permit without providing sanitation facilities. So, how is it that people are still defecating in the open—what many jokingly refer to as ‘free range’? The most disturbing part is that some say they prefer it because they get ‘air conditioning at their rear end,” he added.

Access to sanitation remains limited in Ghana; more than 57% of the population relies on communal or public toilets, and 18% continue to practice open defecation.

Out of all regions, the Greater Accra Region records 40% access to sanitation facilities, with the Savannah Region still struggling with very low access.

25% of households, or one in every four in Ghana, still practice open defecation, according to the Ghana Statistical Service (GSS).

Under the Sustainable Development Goal (SDG), the international community is working toward ending open defecation by 2030.

Rural areas report more cases of open defecation, with 39% of households practicing it compared to 12% in urban areas.

Nearly 1.8 billion people globally engage in open defecation as per the World Health Organisation (WHO) and UNICEF's findings.

The UN, in 2023, described the country's sanitation situation as dire, calling for a lasting solution.