BATHI, LCHUMARI SYLVESTER2026-05-262026-05-262025-07http://41.89.96.81:4000/handle/123456789/3748Inadequate Water, Sanitation, and Hygiene (WASH) practices significantly contribute to the global burden of fecal-oral diseases, particularly in urban informal settlements like Setegn Meda in Addis Ababa, Ethiopia. With over two billion people lacking safe drinking water and 3.5 billion without adequate sanitation, these challenges are acute in Ethiopia, where only 57% of the population access basic water services, and diarrheal diseases claim numerous lives annually, especially among children under five. This study aimed to assess WASH practices and their impact on fecal-oral disease prevalence in Setegn Meda, addressing water accessibility, sanitation and hygiene practices, and disease prevalence. A cross-sectional research design was employed, targeting 600 households in Setegn Meda. Using stratified random sampling, 240 household heads were selected via Slovin’s formula with a 5% margin of error. Data were collected through semistructured interview questions, validated by experts at Addis Ababa University and pre-tested for reliability (Cronbach Alpha 0.713). Descriptive statistics (means, frequencies) and inferential statistics (chi-square tests) were used for analysis in SPSS. Results aligned with the specific objectives revealed: (1) 93.3% of households rely on tap water, but variable distances (mean 59.38 meters, up to 2000 meters) and poor perceived water quality (28.9% rated "poor") hinder accessibility; (2) 91.6% have toilet access, predominantly pit latrines (82%), yet 44.8% report poor toilet cleanliness, and 85.4% lack handwashing areas; (3) 59.4% of households reported fecal-oral diseases in the past six months, primarily typhoid fever (77%), significantly linked to untreated water (p=0.021) and water sources (p=0.010). The study concludes that inadequate water quality, poor sanitation infrastructure, and deficient hygiene practices drive the high disease burden, necessitating urgent interventions. Key recommendations include infrastructure upgrades by the Addis Ababa Water and Sewerage Authority, community-led sanitation committees, and Ministry of Health-led hygiene campaigns to promote water treatment and handwashing, ensuring sustainable WASH improvements in Setegn Meda.enThesis