Regional Centre of Energy and Environmental Sustainability (RCEES), Civil and Environmental Engineering Department, School of Engineering, University of Energy and Natural Resources (UENR), P.O. Box 214, Sunyani BS0061, Ghana.
Department of Environmental Health and Sanitation Education, Akenten Appiah-Menka University of Skills Training and Entrepreneurial Development, P.O. Box M40, Mampong 3JG3+PFQ, Ghana.
Int J Environ Res Public Health. 2022 Apr 2;19(7):4271. doi: 10.3390/ijerph19074271.
Shared sanitation facilities are not considered as basic sanitation owing to cleanliness and accessibility concerns. However, there is mounting evidence that some shared household toilets have a comparable level of service as private toilets. This study examined the factors that contribute to the quality of shared household toilets in low-income urban communities in Ghana and Kenya. The study design comprised household surveys and field inspections. Overall, 843 respondents were interviewed, and 838 household shared sanitation facilities were inspected. Cleanliness scores were computed from the facility inspections, while a total quality score was calculated based on 13 indicators comprising hygiene, privacy, and accessibility. Regression analyses were conducted to determine predictors of cleanliness and the overall quality of the shared sanitation facilities. More than four out of five (84%) shared toilets in Ghana (N = 404) were clean, while in Kenya (N = 434), nearly a third (32%) were clean. Flush/pour-flush toilets were six times (p < 0.01 aOR = 5.64) more likely to be clean. A functional outside door lock on a toilet facility and the presence of live-in landlords led to a threefold increase (p < 0.01 aOR = 2.71) and a twofold increase (p < 0.01 aOR = 1.92), respectively in the odds of shared sanitation cleanliness. Sanitation facilities shared by at most five households (95% CI: 6−7) were generally clean. High-quality shared toilets had live-in landlords, functional door locks, and were water-dependent. Further studies on innovative approaches to maintaining the quality of these high-quality shared toilets are needed to make them eligible for classification as basic sanitation considering the increasing reliance on the facilities.
由于清洁和可及性问题，共享卫生设施不被视为基本卫生设施。然而，越来越多的证据表明，一些共享家庭厕所的服务水平与私人厕所相当。本研究考察了导致加纳和肯尼亚低收入城市社区共享家庭厕所质量的因素。研究设计包括家庭调查和现场检查。共有 843 名受访者接受了访谈，838 个家庭共享卫生设施接受了检查。从设施检查中计算出清洁度得分，同时根据包括卫生、隐私和可及性在内的 13 项指标计算出总质量得分。进行回归分析以确定清洁度和共享卫生设施整体质量的预测因素。加纳（N=404）超过五分之四（84%）的共享厕所是干净的，而肯尼亚（N=434），近三分之一（32%）是干净的。冲洗/倾倒是更有可能清洁的六倍（p<0.01 aOR=5.64）。厕所设施上功能正常的外部门锁和常住房东的存在使共享卫生清洁的几率分别增加了三倍（p<0.01 aOR=2.71）和两倍（p<0.01 aOR=1.92）。最多五个家庭共享的卫生设施（95%CI：6-7）通常是干净的。高质量的共享厕所都有常住房东、功能门锁，且依赖水。需要进一步研究创新方法来维护这些高质量共享厕所的质量，以便考虑到对这些设施的日益依赖，使它们有资格被归类为基本卫生设施。
