This study examines the impacts of water scarcity and inadequate sanitation on public health outcomes in Mubi South Local Government Area of Adamawa State, Nigeria. A cross-sectional survey design was adopted, with data collected from residents through structured questionnaires, interviews, and field observations to evaluate access to water, sanitation practices, and health status. Binary logistic regression analysis was employed to determine the predictive effects of water, sanitation, hygiene (WASH), and socio-economic factors on health outcomes. Results indicate that access to improved water sources (Exp(B) = 1.963, p < 0.031), sanitation facilities (Exp(B) = 1.796, p < 0.000), and good hygiene practices (Exp(B) = 1.708, p < 0.002) significantly predicted better health conditions, highlighting the importance of WASH infrastructure in disease prevention. Education and income were also significant determinants, with higher education levels (Exp(B) = 3.832, p < 0.000) and improved water access (Exp(B) = 2.199, p < 0.016) showing strong positive associations. Model diagnostics, including the Hosmer and Lemeshow Test, confirmed the reliability of predictions, though classification accuracy was higher for unselected cases (76.05%) than selected ones (58.7%). The study concludes that mitigating water scarcity and strengthening sanitation through targeted infrastructure development and hygiene education are critical to improving public health outcomes in rural communities. Policy recommendations include rehabilitating water facilities, promoting community-led total sanitation, and implementing culturally appropriate hygiene awareness programs to reduce waterborne diseases and support sustainable development goals.
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