An Annotated Bibliography on Shared Sanitation Studies Published in 2015

An Annotated Bibliography on Shared Sanitation Studies Published in 2015

Below are links to the abstracts or full-text of 4 studies on shared sanitation that were published in 2015. We will continue to update this bibliography with 2016 reports and studies so please send us an email if you have studies to contribute.

1 – Soc Sci Med. 2015 Dec;147:72-9. doi: 10.1016/j.socscimed.2015.10.059.

 Effectiveness of group discussions and commitment in improving cleaning behaviour of shared sanitation users in Kampala, Uganda slums. Authors: Tumwebaze IK, Mosler HJ. (Abstract)

RATIONALE AND OBJECTIVE: Access to and use of hygienic shared sanitation facilities is fundamental in reducing the high risk of diseases such as diarrhoea and respiratory infections. We evaluated the effectiveness of group discussions and commitment in improving the cleaning behaviour of shared sanitation users in three urban slums in Kampala, Uganda. The study follows the risk, attitudes, norms, abilities and self-regulation (RANAS) model of behaviour change and some factors of the social dilemma theory.

METHODS: A pre-versus post-intervention survey was conducted in three slums of Kampala, Uganda, between December 2012 and September 2013. From the pre-intervention findings, users of dirty sanitation facilities were randomly assigned to discussions, discussions + commitment and control interventions. The interventions were implemented for 3 months with the aim of improving cleaning behaviour. This paper provides an analysis of 119 respondents who belonged to the intervention discussion-only (n = 38), discussions + commitment (n = 41) and the control (no intervention, n = 40) groups.

RESULTS: Compared to the control, discussions and discussions + commitment significantly improved shared toilet users’ cleaning behaviour. The rate of improvement was observed through behavioural determinants such as cleaning obligation, cleaning ease, cleaning approval and affective beliefs.

CONCLUSION: Our study findings show that group discussions and commitment interventions derived from RANAS model of behaviour change are effective in improving the shared sanitation users’ cleaning behaviour.

2 – Trans R Soc Trop Med Hyg. 2015 Nov;109(11):690-9. doi: 10.1093/trstmh/trv082.

Neighbour-shared versus communal latrines in urban slums: a cross-sectional study in Orissa, India exploring household demographics, accessibility, privacy, use and cleanliness. Authors: Heijnen M, Routray P, Torondel B, Clasen T. (Full text)

INTRODUCTION: A growing proportion of the global population rely on shared sanitation facilities, despite their association with adverse health outcomes. We sought to explore differences between neighbour-shared and communal latrines in terms household demographics, accessibility, facilities and use.

METHODS: We conducted surveys among 295 households relying on shared sanitation in 30 slums in Orissa, India, 60.3% (178) of which relied on neighbour-shared latrines while the balance relied on communal latrines. We collected household demographic data, conducted latrine spot-checks and collected data on indicators of use, accessibility, privacy and cleanliness.

RESULTS: Compared to neighbour-shared facilities, households relying on communal facilities were poorer, larger, less educated, less likely to have access to piped water and more likely to have a member practicing open defecation. Communal latrines were also less accessible, less likely to have water or a hand washing station on site and cleaned less frequently; they were more likely to have visible faeces and flies present.

CONCLUSIONS: We found significant differences between neighbour-shared and communal facilities in terms of user demographics, access, facilities and cleanliness that could potentially explain differences in health. These findings highlight the need for a shared sanitation policy that focuses not just on the number of users, but also on maintenance, accessibility, cleanliness and provision of water and hand washing facilities.

3 – Am J Trop Med Hyg. 2015 Aug;93(2):263-8. doi: 10.4269/ajtmh.14-0812.

Shared Sanitation Versus Individual Household Latrines in Urban Slums: A Cross-Sectional Study in Orissa, India. Authors: Heijnen M, Routray P, Torondel B, Clasen T. (Full text)

A large and growing proportion of the global population rely on shared sanitation facilities despite evidence of a potential increased risk of adverse health outcomes compared with individual household latrines (IHLs). We sought to explore differences between households relying on shared sanitation versus IHLs in terms of demographics, sanitation facilities, and fecal exposure.

We surveyed 570 households from 30 slums in Orissa, India, to obtain data on demographics, water, sanitation, and hygiene. Latrine spot-checks were conducted to collect data on indicators of use, privacy, and cleanliness. We collected samples of drinking water and hand rinses to assess fecal contamination. Households relying on shared sanitation were poorer and less educated than those accessing IHLs. Individuals in sharing households were more likely to practice open defecation.

Shared facilities were less likely to be functional, less clean, and more likely to have feces and flies. No differences in fecal contamination of drinking water or hand-rinse samples were found. Important differences exist among households accessing shared facilities versus IHLs that may partly explain the apparent adverse health outcomes associated with shared sanitation. As these factors may capture differences in risk and promote sanitary improvements, they should be considered in future policy.

4 – Bull World Health Organ. 2015 Jul 1; 93(7): 509–510.

Redefining shared sanitation. Authors: Thilde Rheinländer, et. al, (Full text)

Key sanitation stakeholders and donors should recognize the potential of household shared sanitation as an important driver behind sanitation progress in African and Asian high-density areas and low-income populations. Accepting household shared sanitation as a suitable toilet type could have major implications. This would legitimize innovative funding mechanisms, shared maintenance schemes and upgrading of large numbers of existing shared toilets to acceptable standards.

We argue that the focus for future sanitation programmes should be on improving the hygienic standards of shared facilities to a level that satisfies and protects sanitation users – irrespective of the toilet design. If well managed, household shared sanitation can be a feasible, economical, practical and socially acceptable choice for millions of sanitation users.

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