Simiyu Sheillah N, Kweyu Raphael M, Antwi-Agyei Prince, Adjei Kwaku A
African Population and Health Research Center, P.O Box 10787-00100, Nairobi, Kenya.
Kenyatta University, P.O. Box 43844-00100, Nairobi, Kenya.
BMC Public Health. 2020 Oct 31;20(1):1632. doi: 10.1186/s12889-020-09768-1.
The sharing of sanitation facilities is a common practice in low-income areas in sub-Saharan Africa. However, shared sanitation is currently categorized as a limited sanitation service, and may therefore not count towards meeting the global goals. These shared facilities are often the only option available for most residents in low-income settlements, and improving their cleanliness and overall management is key to reducing open defecation and risk of disease. This study sought to investigate barriers and opportunities for improved cleanliness of shared sanitation facilities in low-income settlements of Kisumu city, Kenya.
Thirty-nine in-depth interviews and 11 focus group discussions were held with residents - mainly tenants and landlords - of a low-income settlement in Kisumu. Analysis followed a thematic approach to define the problem, specify the target behaviour and identify the changes needed.
Sanitation facilities were mainly pit latrines, typically shared among landlords and tenants. Participants singled out behavioural (poor use of the shared toilets) and social (lack of cooperation in cleaning) challenges that led to unclean shared toilets. Available opportunities for improvement included instituting clear cleaning plans, improving communication among users, and enhanced problem-solving mechanisms between landlords and tenants. These approaches could form the basis for designing intervention strategies for improving the cleanliness of shared sanitation facilities.
The results highlight the need to focus on social aspects for improvement of cleanliness in shared sanitation facilities in low-income settlements. Through a social approach, shared sanitation facilities can be managed appropriately to provide the millions of low-income residents in Kenya an opportunity to access sanitation. This study provides further evidence on approaches for improved management of shared sanitation facilities in line with the World Health Organization's (WHO) Joint Monitoring Program's (JMP) recommendation for high quality shared facilities.
在撒哈拉以南非洲的低收入地区，共用卫生设施是一种常见现象。然而，目前共用卫生设施被归类为有限的卫生服务，因此可能不计入实现全球目标的范畴。这些共用设施往往是低收入住区大多数居民的唯一选择，改善其清洁程度和整体管理是减少露天排便和疾病风险的关键。本研究旨在调查肯尼亚基苏木市低收入住区改善共用卫生设施清洁程度的障碍和机遇。
对基苏木一个低收入住区的居民（主要是租户和房东）进行了39次深入访谈和11次焦点小组讨论。分析采用主题方法来界定问题、明确目标行为并确定所需的改变。
卫生设施主要是坑式厕所，通常由房东和租户共用。参与者指出了导致共用厕所不清洁的行为（共用厕所使用不当）和社会（清洁方面缺乏合作）挑战。现有的改善机会包括制定明确的清洁计划、改善使用者之间的沟通以及加强房东与租户之间的问题解决机制。这些方法可为设计改善共用卫生设施清洁程度的干预策略奠定基础。
研究结果凸显了在低收入住区改善共用卫生设施清洁程度时关注社会层面的必要性。通过社会方法，可以对共用卫生设施进行适当管理，为肯尼亚数百万低收入居民提供获得卫生设施的机会。本研究为按照世界卫生组织（WHO）联合监测计划（JMP）关于高质量共用设施的建议改善共用卫生设施管理的方法提供了进一步证据。
