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Abstract Introduction The use of unimproved energy sources is associated with a range of health problems. However, in Ethiopia, studies focused on the utilization of unimproved energy sources and associated factors are limited. Therefore, this study aimed to close this gap. Methods In this community-based cross-sectional study, 5,350 participants were enrolled. Multivariable logistic regression analyses were employed to examine the associations between the utilization of unimproved energy sources and the predictor variables. Additionally, the chi-square test was used to examine the association between households' unimproved energy source utilization and the occurrence of health problems. Results In this study, 45% of households used unimproved energy sources. In the multivariable analysis, households headed by men (adjusted odds ratio [AOR] = 0.76; with 95% confidence interval [CI] 0.66, 0.87), households headed by illiterate heads (AOR = 1.77 with 95% CI 1.47, 2.14), household family size (AOR = 0.79 with 95% CI 0.79, 0.93), households headed with farmers (AOR = 3.33 with 95% CI 2.31, 4.81), households with low income (AOR = 3.41 with 95% CI 2.57, 4.51), rural households (AOR = 7.94 with 95% CI 6.76, 9.32), and households with regular coffee ceremony practices (AOR = 1.17 with 95% CI 1.00, 1.36) were significantly associated with the utilization of unimproved energy sources. Additionally, the results of the chi-square test revealed that households that relied on unimproved energy sources had a 1.5-fold greater risk of developing respiratory illnesses, an 8.5-fold greater risk of developing cataract disease, and a 5.2-fold greater risk of developing trachoma than households that used improved energy sources. Conclusion A significant proportion of households in Bishoftu town still rely on unimproved energy sources for cooking and other household needs. This indicates a substantial challenge in achieving universal access to clean and sustainable energy in the area. Several socioeconomic and demographic factors are associated with the use of unimproved energy sources, including male-headed households, illiteracy of household head, smaller family size, farming occupation, low income, rural residence, and regular coffee ceremony practices. Most importantly, the use of unimproved energy sources is associated with higher risks of respiratory illnesses, cataracts, and trachoma among household members. Therefore, the government should implement targeted interventions to promote the adoption of clean and improved energy sources among vulnerable households such as households headed by farmers, those with illiterate heads, households with low socioeconomic status, households with regular coffee ceremony practices, and those in rural areas. In addition, the local government should develop and implement educational campaigns to raise awareness about the health and environmental risks associated with the use of unimproved energy sources, particularly among households with high-risk factors identified in the study.

Abstract Access to basic water, sanitation and hygiene services is the most effective mechanism to reduce many infectious diseases. WASH in schools related to better educational outcomes although adequate water, sanitation, and hygiene services were unavailable to millions of school-age children in Ethiopia. Therefore, it is crucial to assess the level of WASH coverage and identify factors affecting access to basic water, sanitation, and hygiene services. A cross-sectional study was carried out among 82 school facilities. A structured questionnaire and an observational checklist were used to gather the data. Water samples were taken from the schools' water storage. Descriptive and multivariable logistic regression analyses were used to analyze the data. In this study, 74.7%, 61. 3% and 37.3% of the schools had access to basic drinking water, sanitation, and hygiene services, respectively. Additionally, 21.3%, 29.4%, and 30.7% of the schools had access to limited drinking water, sanitation, and hygiene services, respectively. However, 4%, 9.3%, and 32% of the schools lacked water, sanitation, and hygiene services, respectively. We discovered that schools with male heads were 7% less likely to have access to basic hygiene services (AOR = 0.07 with 95% CI 0.01–0.5) than those with female directors. In addition, schools with hygiene and environmental health clubs had an 11.8-fold higher access rate to basic hygiene services (AOR = 11.8 with 95% CI 1.35–104) than schools without such clubs. Besides, schools that conduct WASH lessons at least once a week were 8.63 times more likely to use basic hygiene services (AOR = 8.63; 95% CI 1.18–63.22) than schools that did not. This study offers scientific evidence that could be used for sound decisions to fill the school WASH gaps. This is a unique study in determining the level of WASH coverage and identifying factors affecting access to basic hygiene services. The investigation provides some insights into how access to WASH services can be improved at the grassroots level. Federal and regional governments should implement effective interventions that assist schools to attain Sustainable Development Goal 6 by 2030. School administrators and other partner organizations should take proactive measures to enhance and maintain the WASH services.