If I do not have enough water, then how could I bring additional water for toilet cleaning?! Addressing water scarcity to promote hygienic use of shared toilets in Dhaka, Bangladesh

Ronald E. Saxton, Farzana Yeasmin, Mahbub Ul Alam, Abdullah Al-Masud, Notan Chandra Dutta, Dalia Yeasmin, Stephen P. Luby, Leanne Unicomb, Peter J. Winch

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: Provision of toilets is necessary but not sufficient to impact health as poor maintenance may impair toilet function and discourage their consistent use. Water in urban slums is both scarce and a prerequisite for toilet maintenance behaviours. We describe the development of behaviour change communications and selection of low-cost water storage hardware to facilitate adequate flushing among users of shared toilets. Methods: We conducted nine focus group discussions and six ranking exercises with adult users of shared toilets (50 females, 35 males), then designed and implemented three pilot interventions to facilitate regular flushing and improve hygienic conditions of shared toilets. We conducted follow-up assessments 1 and 2 months post-pilot including nine in-depth interviews and three focus group discussions with adult residents (23 females, 15 males) and three landlords in the pilot communities. Results: Periodic water scarcity was common in the study communities. Residents felt embarrassed to carry water for flushing. Reserving water adjacent to the shared toilet enabled slum residents to flush regularly. Signs depicting rules for toilet use empowered residents and landlords to communicate these expectations for flushing to transient tenants. Residents in the pilot reported improvements in cleanliness and reduced odour inside toilet cubicles. Conclusions: Our pilot demonstrates the potential efficacy of low-cost water storage and behaviour change communications to improve maintenance of and user satisfaction with shared toilets in urban slum settings.

Original languageEnglish (US)
Pages (from-to)1099-1111
Number of pages13
JournalTropical Medicine and International Health
Volume22
Issue number9
DOIs
StatePublished - Sep 2017

Keywords

  • Bangladesh
  • behaviour change
  • shared toilet
  • toilet cleanliness
  • urban slums
  • water scarcity

ASJC Scopus subject areas

  • Parasitology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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