Shared sanitation has immensely contributed to sanitation access in urban areas. The global percentage of users has increased from 5.4% in 2000 to 8.3% in 2017. However, while often the only viable option in densely populated low-income urban areas, shared sanitation is at best considered a “limited” solution within Sustainable Development Goal #6 due to the lack of quality standards. While many SSF are of unacceptable quality, there are no clear criteria to distinguish between unacceptable and acceptable quality. There is no set of indicators at present for the monitoring and evaluation of the quality of SSF.
Eawag’s department Sandec partnered with the ETH Nadel Center for Development (Switzerland), the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), NHance Development Partners Ltd. (Ghana) and the Great Lakes University of Kisumu (Kenya).
Based on an extensive survey of shared toilets and their users across cities in Bangladesh, Ghana and Kenya, as well as qualitative studies, the QUISS project (Quality Indicators of Shared Sanitation) identified the key criteria of what constitutes “acceptable quality” shared toilets in urban low-income contexts and derived recommendations for strengthening the acceptability, functionality and sustainability of shared sanitation facilities.
QUISS research strategy
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, 6 community meetings, 17 focus group discussions, a survey of 3600 HHs and 2026 observational spot-checks of SSF and private household toilets were done in Ghana, Kenya and Bangladesh. A detailed description of QUISS is presented in Schelbert V., Meili, D., et al. (2020), Meili D., Schelbert, V. et al. (2021) and in the country specific policy briefs (download under «Key QUISS Project Documents» on the right).
User perspectives on acceptable sanitation and quality criteria
Users and their perspectives on sanitation priorities are fundamental 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, we used a qualitative approach and analysed 17 focus group discussions, eight of which were women-only, five were mixed and four were men-only. Each had eight to twelve participants between 18–65 years of age. In descending priority based on their score, the SSF quality priorities from a user perspective are:
1. Water availability in close proximity 6. A lockable/functional door
2. Cleanliness 7. Tiling
3. A gender-separated toilet 8. A handwashing station
4. Flush WC 9. Privacy
Indicators for assessing and monitoring SSF quality
To identify potential indicators to measure urban sanitation quality, we developed the Sanitation Quality Index (SQI). It comprises three quality dimensions: the hygiene, safety, and privacy of sanitation facilities.
The study showed that the current JMP sanitation service levels for SSF, which are exclusively based on (improved) technology and sharing, provide insufficient information regarding sanitation quality. Toilets shared by two to three HHs are mostly cleaner, safer and more private than toilets shared by four or more HHs. Other strongly significant indicators included the toilet’s location, lighting, and a lockable door (from the in- and outside).
We therefore suggest to review the JMP service levels and establish refined indicators to determine adequate quality. We therefore suggest the following indicators to distinguish between adequate (defined as available and accessible, safe and secure, private and hygienic) and non-adequate SSF in low-income urban settings:
- 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).
QUISS was commissioned by Water & Sanitation for the Urban Poor (WSUP) under the Urban Sanitation Research Initiative, funded by UK Aid from the British People.