Shared but Clean Household Toilets: What Makes This Possible? Evidence from Ghana and Kenya
Shared but Clean Household Toilets: What Makes This Possible? Evidence from Ghana and Kenya
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Date
2022-03-02
Authors
Antwi-Agyei, Prince
Monney, , Isaac
Adjei, Kwaku Amaning
Kweyu, Raphael
Simiyu, Sheillah
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Journal ISSN
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Publisher
International Journal of Environmental Research and Public Health
Abstract
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
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Citation
Antwi-Agyei, P., Monney, I., Amaning Adjei, K., Kweyu, R., & Simiyu, S. (2022). Shared but Clean Household Toilets: What Makes This Possible? Evidence from Ghana and Kenya. International Journal of Environmental Research and Public Health, 19(7), 4271.