Barriers and opportunities for cleanliness of shared sanitation facilities in low-income settlements in Kenya

Abstract

Background: Sharing of sanitation is commonly being practiced in low income areas in Sub Saharan Africa. However, shared sanitation is categorized as a limited sanitation service, and they may therefore not count towards achieving 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 in low income settlements of Kisumu in Kenya. Methods: Thirty-nine In-depth interviews and 11 focus group discussions were held with residents, who were mainly tenants and landlords. Analysis followed a thematic approach to define the problem, specify the target behaviour and define what needs to change. Results: Sanitation facilities were mainly pit latrines commonly 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. Conclusion: The results highlight the need to focus on social aspects for improvement of shared sanitation cleanliness in low income settlements. Through a social approach, shared sanitation facilities can be managed appropriately to afford the millions of low income residents an opportunity to access sanitation. This study provides further evidence on approaches for improved management of shared sanitation facilities in line with the JMP’s recommendation for high quality shared facilities.

Developing and Testing Strategies for Improving Cleanliness of Shared Sanitation in Low-Income Settlements of Kisumu, Kenya

“…Previously identified strategies from the qualitative stage included use of restrictions, environmental restructuring, enablement, enhancing education and training, and improving sanitation technologies. 17 These strategies tallied with the newly codesigned strategies, namely: development and use of cleaning plans; restricting against poor use through rules and monitoring; and discussions in the compound as a form of enablement. The proposed package of strategies entailed discussions with compound members, introduction of a cleaning plan and selection of a representative within the compound who would be in charge of monitoring the cleaning of the toilet as well as coordinating the compound meetings.…”

“…Initial results highlighted the barriers and opportunities for improving the cleanliness of shared sanitation in the two cities. 17,18 In this article, we detail how we developed and tested contextually relevant strategies aimed at improving the cleanliness of shared sanitation facilities. We specifically document the various strategies that were proposed and implemented by users of shared sanitation facilities in the low-income settlements of Kisumu City in Kenya.…”

“…19 Our earlier manuscript detailed the results from the first stage which entailed characterizing and understanding existing behavior, as well as identification of what needs to change. 17 For development and testing of the interventions, we adopted the Trials of Improved Practices (TIPs) approach. The TIPs approach uses a participatory methodology and aims to design feasible interventions and then test whether these interventions are acceptable.…”

“…4,25 Previous studies indicated that majority of these latrines were dirty, mainly because users did not participate in their cleaning. 4,17 The study was conducted in Nyalenda A, which is further divided into four clusters/villages, commonly called units: Western A, Kanyakwar, Dago, and Central units METHODS An initial qualitative phase of the study provided insights on opportunities, barriers, and motivations for improving the hygiene conditions of the shared facilities. These have been summarized in an earlier manuscript.…”

“…These have been summarized in an earlier manuscript. 17 The results identified possible strategies for improving the cleanliness of the toilets which were improved behaviors and practices among facility users, as well as social collective efforts implemented by compound members.…”