Increasing household toilet investments through CLUES: lessons from Ashaiman Municipal Assembly, Ghana

Community-Led Urban Environmental Sanitation (CLUES) is a planning approach piloted in Ghana as a sanitation demand creation and triggering method to increase household investment in toilet facilities. It is implemented by the Government of Ghana in Ashaiman Municipal Assembly with technical support from people's Dialogue on Human Settlements and funding from UNICEF-Ghana. This paper provides results from the implementation process. Within a year of actual implementation, over 800 households inAshaiman's largely informal settlements expressed interest in sanitation investment with over 300 already with complete functional toilets.

Gender and sanitation perspectives in Kampala's slums, Uganda

The perceived access to sanitation facilities for most urban slum dwellers in developing countries may have similar or varying viewpoints from the gender context. To comprehend such gender differentiations, this paper presents an analysis of results from a cross-sectional survey conducted in 2010 from 50 randomly chosen slums in Kampala. The findings show that sanitation has a greater effect on women than men. Gender positively correlated (Pearson chi-square values < 0.05) with the type of toilet facilities used (shared and private toilets) and satisfaction. The variables such as having separate toilet rooms for males and female, water for hand washing after using a toilet and a toilet room having a big space were also important gender attributes

Ecological sanitation uptake, knowledge, beliefs and practices in Kabale Municipality, Kabale District

Ecological sanitation is a promising novel innovation being promoted in many developing countries to boost sanitation coverage. This paper aims to share findings from a cross sectional study to assess ecological sanitation uptake, knowledge, beliefs and practices in Kabale Municipality, Uganda. A total of 806 respondents were interviewed, randomly selected from 32 of 77 (42%) villages in Kabale municipality. We held 6 focus group discussions and 10 key informant interviews. Ecosan coverage was found to be 20% (163/806) and 82% of the respondents knowledgeable. Factors reported for the uptake included education, occupation, religion, age, promotion methods, positive beliefs and the geological formation of the municipality

Customer perceptions and implementation of pro-poor safe water interventions in Uganda's urban areas

This paper presents findings from the study on water user customer perceptions and the implantation of pro-poor safe water interventions in Uganda’s urban areas. It was a cross-sectional study conducted in six urban towns. A total of 341 household respondents, mostly buying water from public water points participated. Most water consumers from public water points were satisfied with the sources and quality of water. Some perceived the water as safe to drink without first boiling it. However, some consumers believed their water was contaminated and others it being hard. Most water customers never participated in establishment of the sources and neither were they consulted in setting water tariffs. With regard to the pro-poor water and sanitation strategy, key informant respondents such as the private water operators were unaware of its existence while those who were knowledgeable were blunt about its content due to inadequate dissemination and clearly defined concepts. This study recommends that to any pro-poor strategies be well disseminated to all service providers and have clear implementation frameworks to track performance. In addition, of all service users at all stages of service provision, inclusive of setting tariffs to avoid exploitation from vendors at the public water points is fundamental

Behavioural factors for improved after-use cleaning habit of shared latrines in Kampala slums, Uganda

Access to clean shared facilities fundamental to health and social well-being to millions of people living in urban slums in most developing countries. This study assessed behavioural factors (risks, attitudes, norms, ability and self-regulation) for improved after-use cleaning habit of shared latrines in Kampala slums. A before-and-after study was conducted between 2012 and 2013 in three slums in Kampala, in which shared latrine user’s cleaning habit and the behavioural influencing factors were assessed. The findings after testing behavioural interventions consisting of discussions and commitment showed that there was an improvement in individuals’ after-use shared latrine cleaning habit from in the discussions (Mean difference = 0.26) and discussions plus commitment (Mean difference = 0.35) compared to the control population (Mean difference = 0.17). The improvement in cleaning habit was through individuals’ awareness of their vulnerability to getting diseases, involvement of latrine sharing families in cleaning, personal cleaning norm and commitment

Increasing household toilet investments through CLUES: lessons from Ashaiman Municipal Assembly, Ghana

Community-Led Urban Environmental Sanitation (CLUES) is a planning approach piloted in Ghana as a sanitation demand creation and triggering method to increase household investment in toilet facilities. It is implemented by the Government of Ghana in Ashaiman Municipal Assembly with technical support from People’s Dialogue on Human Settlements and funding from UNICEF-Ghana. This paper provides results from the implementation process. Within a year of actual implementation, over 800 households in Ashaiman’s largely informal settlements expressed interest in sanitation investment with over 300 already with complete functional toilets

Where do Kampala’s poor “go”? - Urban sanitation conditions in Kampala’s low-income areas

Results of a representative survey conducted with 1’500 poor households in Uganda’s capital during November 2010 show that the majority of Kampala’s urban poor have access to on-site sanitation facilities. Despite the widespread accessibility to sanitation, the conditions of many facilities are unsatisfactory due to the generally large number of users per stance. This leads to low hygienic standards and waiting times for toilet users. As a result, “flying toilets” is (at least occasionally) still a common practice among the urban poor, and many toilets are abandoned after a relatively short time - thus questioning the true level of sanitation access in Kampala’s low-income areas. Household investment in good-quality on-site facilities is discouraged by the lack of property rights and high prices, often exceeding the average annual per capita income in Kampala’s poor settlements

When is shared sanitation improved sanitation? - The correlation between number of users and toilet hygiene

The international debate on the question of whether shared and/or public sanitation facilities should be considered improved is still open. The concern is that a shared sanitation facility cannot be maintained in hygienic conditions when used by too many people. The analysis of 1’500 randomly selected toilets in the urban slums of Kampala showed that only 22 percent of households have access to private sanitation facilities; the remaining 78 percent share their toilet with an average of 6 households. There is a clear and strong correlation between number of users and the condition and cleanliness of a toilet stance. Less than 20 percent of private toilets are dirty, whereas 60 percent of sanitation facilities are dirty if they are shared by more than 10 households. This policy brief asserts that toilet facilities shared by not more than four households can be considered “acceptable” or improved, with “only” about 25 percent classified as dirty by an objective evaluation

Where Shared Sanitation is the Only Immediate Option: A Research Agenda for Shared Sanitation in Densely Populated Low-Income Urban Settings.

Shared sanitation is not currently accepted within the international normative definitions of "basic" or "safely managed" sanitation. We argue that pro-poor government strategies and investment plans must include high-quality shared sanitation as an intermediate step in some densely populated urban areas. User experience must be considered in establishing the definition of high quality. We call for additional research on effective interventions to reach these quality standards and for the development of rigorous measures applicable to global monitoring

Bridging Science and Practice-Importance of Stakeholders in the Development of Decision Support: Lessons Learned

User-friendly, evidence-based scientific tools to support sanitation decisions are still limited in the water, sanitation and hygiene (WASH) sector. This commentary provides lessons learned from the development of two sanitation decision support tools developed in collaboration with stakeholders in Uganda. We engaged with stakeholders in a variety of ways to effectively obtain their input in the development of the decision support tools. Key lessons learned included: tailoring tools to stakeholder decision-making needs; simplifying the tools as much as possible for ease of application and use; creating an enabling environment that allows active stakeholder participation; having a dedicated and responsive team to plan and execute stakeholder engagement activities; involving stakeholders early in the process; having funding sources that are flexible and long-term; and including resources for the acquisition of local data. This reflection provides benchmarks for future research and the development of tools that utilize scientific data and emphasizes the importance of engaging with stakeholders in the development process