In recent years, shared facilities have contributed substantially to increased access to sanitation in urban areas. While shared sanitation is often the only viable option in densely-populated, low-income urban areas, it is currently considered a "limited" solution by the international community. In this paper, we analyze the conditions under which shared sanitation could be considered of adequate quality and propose a set of indicators associated with sanitation quality to be included in national household surveys. We conducted a survey with 3600 households and 2026 observational spot-checks of shared and individual household toilets in Kisumu (Kenya), Kumasi (Ghana), and Dhaka (Bangladesh). We develop a composite sanitation quality outcome measure based on observational data. Using regression analysis, we identify self-reported indicators that correlate with the spot-checked composite measure and are, therefore, robust with regard to reporting bias. Results show that (pour-) flush toilets are a highly informative indicator for sanitation quality compared to other toilet technologies. In contrast to previous arguments and depending on the context, sharing a toilet has a comparatively lower correlation with sanitation quality. Toilets still show good quality if shared among only 2-3 households. Toilet location and lighting, as well as the presence of a lockable door, are equally strong indicators for sanitation quality and could serve as alternative indicators. The findings suggest that the sanitation service levels defined by the WHO and UNICEF might be reconsidered to better capture the quality of sanitation facilities in low-income urban settlements.

Shared sanitation has immensely contributed to sanitation access in urban areas. However, due to the lack of quality standards within Sustainable Development Goal #6 and the WHO/UNICEF Joint Monitoring Programme (JMP), which evaluates progress on the SDGs, shared sanitation is at best considered a 'limited' solution. This policy brief presents the main results of the Quality Indicators of Shared Sanitation (QUISS) project: a three-country comparative mixed-methods study that identifies the key criteria of what constitutes ‘acceptable quality’ shared toilets in low-income urban contexts and provides recommendations for strengthening the acceptability, functionality and sustainability of shared sanitation facilities.

Shared sanitation facilities (SSFs) have contributed considerably to sanitation access in many low-income settlements. While many SSFs are of unacceptable quality, others have been found to be a hygienically safe and a socially and economically viable sanitation option. Within its framework, the WHO/UNICEF Joint Monitoring Programme (JMP), evaluating progress on the Sustainable Development Goals, considers shared sanitation as 'limited sanitation'. Overall, there is uncertainty about the criteria to distinguish between unacceptable and acceptable quality of SSF. In our study, we used a user-centred qualitative approach in low-income urban settlements in Kumasi (Ghana), Kisumu (Kenya) and Dhaka (Bangladesh) and conducted 17 focus group discussions to evaluate how SSF users define the quality of an SSF and which aspects they consider as essential priorities for good-quality SSF. In descending order, the user priorities identified are: immediate water access, cleanliness, gender-separated toilets, flush toilets, lighting for use at night, lockable/functional doors, tiling, handwashing stations and privacy. This list can serve as input to the sanitation guidelines, local building codes and the establishment of minimum national sanitation standards. SSFs that meet these minimal criteria can then be promoted as an incremental step when individual household facilities are not feasible.

NoMix toilets separate urine and feces at the source and are a promising resource recovery technology. However, design issues hamper the transformation from unattractive to aspirational products. Little effort has been done to design toilets that account for physiological differences, leading to adverse effects on user-friendliness and urine separation efficiency. We used infrared recordings to assess gender-specific urination practices. Based on field data, we developed the Urinator, a simple device that allows simulating male and female urine streams. This supports engineers in developing more user- and gender-friendly and reuse-oriented sanitation technologies.

Shared sanitation has immensely contributed to sanitation access in urban areas, but is at best considered a "limited" solution due to the lack of quality standards within Sustainable Development Goal #6.
This policy brief presents the main results of the QUISS project (Quality Indicators of Shared Sanitation), a three-country com-parative mixed-methods study that identified the key criteria of what constitutes "accept-able quality" shared toilets in urban low-income contexts and provides recommen-dations for strengthening the acceptability, functionality and sustainability of shared sanitation facilities.

This policy brief presents the main results of a three-country study on Quality Indicators of Shared Sanitation (QUISS). QUISS assessed when shared sanitation is acceptable and what is needed to establish minimal acceptability requirements. Qualitative and quantitative data were collected in Ghana, Kenya and Bangladesh in 2019. This brief highlights the research findings for Bangladesh and provides recommendations for strengthening the acceptability, functionality and sustainability of Bangladesh’s shared sanitation facilities in low-income urban settlements.

This policy brief presents the main results of a three-country study on Quality Indicators of Shared Sanitation (QUISS). QUISS assessed when shared sanitation is acceptable and what is needed to establish minimal acceptability requirements. Qualitative and quantitative data were collected in Ghana, Kenya and Bangladesh in 2019. This brief highlights the research findings for Kenya and provides recommendations for strengthening the acceptability, functionality and sustainability of Kenya’s shared sanitation facilities in low-income urban settlements.

This policy brief presents the main results of a three-country study on Quality Indicators of Shared Sanitation (QUISS). QUISS assessed when shared sanitation is acceptable and what is needed to establish minimal acceptability requirements. Qualitative and quantitative data were collected in Ghana, Kenya and Bangladesh in 2019. This brief highlights the research findings for Ghana and provides recommendations for strengthening the acceptability, functionality and sustainability of Ghana’s shared sanitation facilities in low-income urban settlements.