Community‐Based Assessment of Water Safety Awareness, Sanitation Attitudes, and Hygiene Behaviours Among Households in Mogadishu, Somalia: A Cross‐Sectional Study

Introduction Access to safe water, adequate sanitation, and basic hygiene remains a major public health challenge in Mogadishu, where protracted conflict, displacement, and fragile infrastructure heighten the risk of waterborne and environmentally transmitted diseases. This community‐based cross‐sectional study assessed knowledge, attitudes, and practices (KAP) related to water, sanitation, and hygiene (WASH) among 354 randomly selected households in eight districts of Mogadishu, Somalia. Methods A cross‑sectional design with multistage cluster sampling of households in eight districts of Mogadishu, Banadir Region, Somalia. A total of 354 households were included in the final analysis. Data were collected between 8 February 2025 and 4 April 2025 using a structured, interviewer‐administered, pretested questionnaire and observational checklist adapted from validated WASH‐KAP tools. Results Overall WASH knowledge was very high (98.0% classified as good), while 55.1% had a positive attitude and 91.2% reported good practice on composite scores. Nearly all respondents recognised that unsafe water, liquid waste, and animal faeces can cause disease, yet 46.9% of households lacked a handwashing facility and 38.1% used water only for handwashing. Knowledge showed a small but significant correlation with practice ( r = 0.208, p < 0.01), whereas attitude was not significantly correlated with either knowledge or practice. In multivariable models, absence of proper waste disposal bins was associated with poorer WASH practices (aOR = 0.18, 95% CI: 0.07–0.49), while absence of animal faeces in the living environment was associated with markedly better practices (aOR = 4.32, 95% CI: 1.39–13.42) but lower odds of positive attitudes (aOR = 0.56, 95% CI: 0.35–0.90). Conclusions These findings reveal a pronounced knowledge‐practice gap and emphasise the importance of basic environmental infrastructure, particularly solid waste management and animal faeces control, in enabling safe WASH behaviours in urban Mogadishu.