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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.

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.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

    ,

    Environmental Intervention Unit, Enteric and Respiratory Disease Program, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.

    ,

    Environmental Intervention Unit, Enteric and Respiratory Disease Program, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.

    ,

    Environmental Intervention Unit, Enteric and Respiratory Disease Program, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.

    ,

    Environmental Intervention Unit, Enteric and Respiratory Disease Program, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.

    ,

    Environmental Intervention Unit, Enteric and Respiratory Disease Program, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.

    ,

    Stanford University, Stanford, CA, USA.

    ,

    Environmental Intervention Unit, Enteric and Respiratory Disease Program, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.

    Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

    Source

    MeSH

    Adult
    Bangladesh
    Bathroom Equipment
    Child
    Communication
    Cooperative Behavior
    Female
    Focus Groups
    Humans
    Hygiene
    Male
    Pilot Projects
    Poverty Areas
    Residence Characteristics
    Sanitation
    Surveys and Questionnaires
    Toilet Facilities
    Urban Population
    Water

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    28656596

    Citation

    TY - JOUR T1 - 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. AU - Saxton,Ronald E, AU - Yeasmin,Farzana, AU - Alam,Mahbub-Ul, AU - Al-Masud,Abdullah, AU - Dutta,Notan Chandra, AU - Yeasmin,Dalia, AU - Luby,Stephen P, AU - Unicomb,Leanne, AU - Winch,Peter J, Y1 - 2017/07/25/ PY - 2017/6/29/pubmed PY - 2017/9/14/medline PY - 2017/6/29/entrez KW - Bangladesh KW - Bidonvilles urbains KW - barriadas urbanas KW - behaviour change KW - cambios de comportamiento KW - changement de comportement KW - escasez de agua KW - limpieza de sanitarios KW - propreté des toilettes KW - pénurie d'eau KW - sanitarios compartidos KW - shared toilet KW - toilet cleanliness KW - toilettes communes KW - urban slums KW - water scarcity SP - 1099 EP - 1111 JF - Tropical medicine & international health : TM & IH JO - Trop. Med. Int. Health VL - 22 IS - 9 N2 - 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. SN - 1365-3156 UR - https://www.unboundmedicine.com/medline/citation/28656596/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_ L2 - http://dx.doi.org/10.1111/tmi.12914 ER -