Bathing Facilities
Bathing facilities used in the Region are primarily of three main types: shared bathroom in the same house (30.4%), bathroom for exclusive use (23.0%), and shared open bathing cubicle (22.4.0%). One in three dwellings units have a separate bathroom shared with other non-household members. The proportion of dwelling units that share an open cubicle as a bathroom with others in the compound is 22.4 percent. At the National level, 3.5 percent of dwellings use bathroom in another house compared with 7.3 percent in the Central Region. Open space around the house is used as a bathroom by 6.8 percent of dwelling in the Region.

There are differentials across districts in the types of bathing facilities used by households. The lowest proportion of dwelling units with bathrooms for the exclusive use of household members is recorded in Agona West (17.2%), and the highest is in Assin South District (31.5%). Sharing of bathing facilities is highest in two Districts: Cape Coast (43.6%) and Agona West (40.5%). About 17% of dwelling units in the Region have no bathing facilities. Household members use an open space around the house (6.8%), facilities in another house (7.3%), public bath house (2.4%), or rivers, lakes, dams and ponds (0.3%).

 Toilet Facilities
The type of toilet facility available in a dwelling unit is an important indicator of the sanitary condition of the unit as well as an indirect measure of the poverty status of a household. Arranged in order of availability for household members, they are the public toilet (39.5%), the pit latrine (23.1%), the Kumasi Ventilated Improved Pit Latrine (KVIP) [11.8%] and the water closet (WC) [(9.2%]. In Region, the proportion of households whose members use public toilet (39.5%) is higher than the national average of 34.6 percent.

In 2010, about 15 percent of dwelling units had no toilet facilities. The high use of shared bathrooms, public bathrooms and toilets are indications of poverty. Household members who have no toilet facilities use the bush/beach and open fields. The use of the bucket/pan toilet is almost out of use (0.5%), as a result of a ban on its use. Although the proportion of households use the pan toilet has declined, 2,633 households are still using the bucket/pan toilet facilities, even though its use has been declared illegal by law. 

The proportion of households with no toilet facilities is slightly higher in rural (16.1%) than in urban areas (14.6%). While the proportions using the W.C (15.1% urban, 3.6% rural) and KVIP (14.2% urban, 9.5% rural) are higher in urban areas, pit latrines and public toilets are more common in rural areas.

The type of toilet facilities varies considerably by Districts. One-third of dwelling units in Gomoa East (32.6%) and 23.5 percent in Abura-Asebu-Kwamankese have no toilet facilities, in contrast with only 5.4 percent in Upper Denkyira East. As noted earlier, the public toilet is the single most common type of toilet facility in the Region, with 39.5 percent of all dwelling units using this facility. The proportion is lowest in Ewutu-Senya (25.3%). 

In contrast about 52 percent of dwellings in Asikuma-Odoben-Brakwa, Agona East, and Komenda-Edina-Eguafo-Abirem use public toilet facilities. The second most common type of toilet facility is the pit latrine. At least one-third of all dwelling units in the following five Districts use the public toilet: Twifo-Hemang-Lower Denkyira (40.3%), Upper Denkyira West (36.5%), Assin South (36.0%), Assin North (35.4%) and Upper Denkyira East (34.8%). Nearly one-quarter of households (23.8%) in Ewutu-Senya and 17.6 percent in Assin North use KVIP. In contrast it is used by only 4.4 percent of dwelling units in Upper Denkyira West.

 Disposal of Solid Waste
One of most intractable challenges of both urban and rural areas in Ghana, and in the Central Region in particular, is efficient solid waste (refuse) disposal.The most popular means of disposing solid waste (refuse) in the Region is by public dump, either dumping in a container (18.7%) or dumping unto open dump site (53.8%). Routine collection of waste from houses is hardly practiced. It is in only in 3.9 percent of dwellings units in the Region that solid wastes are collected from the homes.

 About 1 in 20 dwelling units (5.4%) dump solid wastes indiscriminately compared with 13.4 percent of dwelling units burning solid waste generated by them. Although the proportions are very different, the dumping of solid waste in open spaces is the most common method of waste disposal in both rural (72.2%) and urban areas (34.3 percent) in the Region.There are only very little differentials in the disposal of solid waste across Districts.

 In Ewutu-Senya apparently because of its proximity to Accra, 16.9 percent of dwelling units have their solid wastes collected from houses, the corresponding proportions are less than two percent in Gomoa West, Ajumako-Enyan-Essiam, Abura-Asebu-Kwamankese, Asikuma-Odoben-Brakwa, Komenda-Edina-Eguafo-Abirem, and Agona East. In all Districts, except Gomoa East and Ewutu-Senya, over 70 percent of dwelling units dispose solid wastes by either dumping them in a container or dumping unto open dump site.

At least three in ten dwelling units in Gomoa East (31.8%) and Ewutu-Senya Districts dispose of their solid wastes by burning them. Indiscriminate dumping of refuse is the main means of solid waste disposal in at least one-tenth of dwelling units in five districts; the highest proportions are recorded in Upper Denkyira East (15.4%) and Assin South District (12.5%). The practice of indiscriminate dumping of refuse has potential negative health implications such as the breeding of mosquitoes.

Disposal of Liquid Waste
In the majority of dwelling units in the Central Region, liquid waste is disposed of by either throwing it onto the compound or throwing it onto the street or outside the house. About 2 out five dwelling units (41.0%) throw liquid waste onto the compound while 31.1 percent throw liquid waste onto the street or outside the house; or into a gutter (16.9%). One in 10 dwelling units (6.7%) dispose of liquid waste through a drainage system into a gutter and another 1.7 percent have drainage into a pit (or soak away system). In the region the percentage of dwelling units connected to a central sewage system is only 1.3 percent. The current proportion is far below the national average of 3.4 percent. Nearly one-half of dwelling units in rural areas (49.1%), and one third in urban areas (32.5%) dispose of liquid waste by throwing unto the compound.

Over one-half of dwellings in five Districts, Twifo-Hemang-Lower Denkyira (56.2%), Ewutu-Senya (55.5%), Upper Denkyira West (54.9%), Assin North (52.8%), Assin South (50.8%) and Gomoa East (50.6%), dispose of liquid waste by throwing onto the compound. Throwing liquid waste onto the street or outside the house is the most popular method of liquid waste disposal in Gomoa West (43.7%), Ajumako-Enyan-Essiam (43.3%), and Mfantsiman (40.5%). The proportion of dwelling units with liquid waste drainage connected to a gutter is relatively high in predominantly urban Districts of Cape Coast (25.6%), Effutu (13.7%) and Agona West (12.8%). 

Disposal of liquid waste through a formal or public sewage system is very low in all the Districts including the most urbanised Districts, 3.5 percent in Cape Coast Metropolis and 3.0 percent in Effutu. It is pertinent to note that the proportion is as low as 1.8 percent in Ewutu-Senya, given that the District is the fastest growing and consists of relatively new houses.

Main Source of Drinking Water
The source of water supply particularly for drinking has tremendous effect on the burden of disease in a community. The main health benefit of clean water supply is a reduction in diarrhea disease, although the effects on other diseases are also substantial. Water is often classified as „improved? or „unimproved?. Sources considered as improved are household connection to public pipe borne water supply system, public standpipe, borehole, protected (lined) dug well, protected spring, and rainwater collection. Unprotected wells and springs, vendors, and tanker-trucks are considered unimproved.

 Household drinking water in Central region is obtained from six main sources as follows: public standpipe (23.3%), pipe-borne water outside the dwelling unit (20.9%), borehole or pump tube well (18.3%), pipe-borne water inside the dwelling (9.3%), sachet water (8.1%), and rivers and streams (7.8%).

Altogether, over-half (53.6%) of dwelling units in the Region obtain their main source of water from pipe-borne source. This is above the national average of 46.5%. It is important to note that about 8.1 percent of dwelling units in the Region use sachet water as the main source of drinking water, a practice which was hardly known in 2000. While the production of sachet water may provide jobs, the challenges posed by sachet water are worth mentioning. Issues of unhygienic production and disposal of plastic are a nightmare in most big cities and towns in the country. Finally, about 10 percent of dwelling units obtain water from springs, rivers, streams, ponds and lakes- sources considered as „unprotected?.


There are differentials at the District level in the main source of drinking water. In two Districts, Assin North (14.1%) and Assin South, (22.2%) of dwelling units obtain water from a piped source. Thirty-three percent in Cape Coast and 28.4 percent in Effutu obtain their drinking water from pipe-borne connection inside the dwelling, while the proportions are only 0.5 percent in Assin North, 1.0 percent in Upper Denkyira West, and 1.7 percent in Asikuma-Odoben-Brakwa. Harvested rain water is the main source of drinking water in 10.0 percent of dwelling units in Gomoa West, and 3.0 percent in Ewutu-Senya District, but in all other districts the proportions are below 2.0 percent. 

The following four Districts have the highest proportions of dwelling units whose main source of drinking water are rivers and streams: Asikuma-Odoben-Brakwa (18.2%), Assin South (16.5%), Twifo-Hemang-Lower Denkyira (15.6%) and Upper Denkyira East (14.0%). While in 13 out of the 17 Districts one percent or less of dwelling units obtain drinking from water tanker services, the proportions are 13.9 percent in Gomoa West and 12.8 percent in Gomoa East. Sachet water, a product hardly unknown a decade ago, is now the main source of water for nearly one-quarter of dwelling units (23.2%) in Ewutu-Senya, 16.8 percent in Gomoa East, 14.3 percent in Cape Coast , and 10.0 percent in Effutu