A lack of quality standards means shared sanitation is regarded as a limited solution, despite the great contribution it can make. Recent policy briefs based on evidence gathered from Kenya, Ghana and Bangladesh by the Quality Indicators of Shared Sanitation project have set out criteria for what represents acceptable quality.
Sanitation shared by more than one household provides sanitation access in urban areas, but is, at best, considered a ‘limited’ solution because of the lack of quality standards within SDG6.
The Quality Indicators of Shared Sanitation (QUISS) project identified key criteria for what constitutes ‘acceptable quality’ for shared toilets in low-income urban contexts. This work involved a three-country comparative, mixed-methods study.
After the project, and to communicate the research findings, generic and country specific policy briefs have been prepared and were released earlier this year. The policy briefs are built on the evidence gathered during the QUISS project, translate the study findings into actionable knowledge, and provide recommendations for strengthening the acceptability, functionality and sustainability of shared sanitation facilities.
Quality Indicators of Shared Sanitation (QUISS)
In recent years, shared sanitation has contributed immensely to sanitation access in urban areas. However, while often the only viable option in densely populated low-income urban areas, the lack of quality standards within Sustainable Development Goal 6 (SDG6) means that shared sanitation is, at best, considered a ‘limited’ solution. The reason is that, especially with regard to global monitoring purposes, it is challenging to differentiate between shared toilets that are hygienic, accessible and safe, and the more common ones, which are poorly designed and managed.
QUISS project results comprise quality indicators from a large-scale quantitative assessment, as well as qualitatively evaluated criteria from a user perspective, including gender differences and particularities. In 2019, six community meetings, 17 focus group discussions, a survey of 3600 households, and 2026 observational spot-checks of shared and private household toilets were carried out in Ghana, Kenya and Bangladesh. A detailed description of QUISS can be found at www.sandec.ch/quiss and in the country-specific policy briefs.
Users and their perspectives on sanitation priorities are fundamental aspects to consider in order to meet their needs with public investments, ensure user acceptance, and achieve the success of sanitation interventions. To evaluate user perspectives, a qualitative approach was used and 17 focus group discussions analysed. In descending priority, the quality priorities from a user perspective are:
• Water availability in close proximity
• A gender-separated toilet
• Flush WC
• A lockable/functional door
• A handwashing station
Indicators for shared sanitation quality
Currently, the Joint Monitoring Programme’s (JMP’s) sanitation service levels are used to evaluate progress towards SDG6 regarding access to safe sanitation, and to benchmark and compare service levels across countries. Given the outlined challenges to differentiate between adequate and non-adequate shared toilets, we analysed the 3600 household surveys and 2026 observational spot-checks of shared and private household toilets to identify potential indicators to measure urban sanitation quality.
The study showed that the current sanitation service levels for shared sanitation provide insufficient information regarding sanitation quality. Toilets shared by two to three households are mostly cleaner, safer and more private than toilets shared by four or more households. Other, strongly significant, indicators included the toilet’s location, lighting, and a lockable door (from the in- and outside).
We therefore suggest a review of the JMP service levels and to establish refined indicators to determine adequate quality. According to our findings, a number of indicators should be applied to distinguish between adequate (defined as available and accessible, safe and secure, private and hygienic) and non-adequate shared toilets in low-income urban settings – see box, ‘Indicators to distinguish between adequate and non-adequate shared toilets’.
To give guidance in terms of the future direction needed, the policy briefs provide main recommendations to steer policy development and implementation and outline supporting essential requirements. Overall, an approach aligned with citywide inclusive sanitation (CWIS) principles should be adopted that aims at safely managed sanitation access for everyone, specifically targeting unserved and under-served groups. To this end, shared sanitation has to be acknowledged as an adequate (intermediate) sanitation solution for low-income urban settings, provided quality standards are met. •
For project partner details, final report and policy briefs, see www.sandec.ch/quiss
Information provided by
Vasco Schelbert (Eawag/Sandec, Switzerland, email@example.com), Dario Meili (ETH Nadel, Switzerland), Mahbub-Ul Alam (icddr,b, Bangladesh), Sheillah Simiyu (Great Lakes University of Kisumu, Kenya), Prince Antwi-Agyei (University of Energy and Natural Resources, Ghana), Christoph Lüthi (Eawag/Sandec)
Indicators to distinguish between adequate and non-adequate shared toilets
Technology: Flush or pour-flush toilet technology where water is available and, if not available, construct improved toilets.
Numbers of users: Up to three households per facility.
Accessibility/availability: Toilet located inside dwelling/inside compound/on plot, no restrictions of use – e.g., reported use 24/7, including at night.
Safety/security: Solid floor and superstructure without cracks/holes, and functional lighting
Adequate privacy: Availability of gender-separate toilets (whenever multiple cubicles are feasible/available) and lockable/functional doors.
Acceptable cleanliness: No solid waste, no visible faeces/blood stains/sputum; no insects.
Offer functional handwashing stations (soap and water).