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International journal of hygiene and environmental health
Jul, 2024;260 114392.

Shared sanitation in informal settlements: A systematic review and meta-analysis of prevalence, preferences, and quality.

Lauren Sprouse, Sarah Lebu, Jackqueline Nguyen, Chimdi Muoghalu, Andromede Uwase, Jiahui Guo, Carrie Baldwin-SoRelle, Carmen Anthonj, Sheillah N Simiyu, John Apambilla Akudago, Musa Manga
Author Information
  1. Lauren Sprouse: Department of Environmental Sciences and Engineering, The University of North Carolina at Chapel Hill, 4114 McGavran Greenberg Hall, Campus Box # 7431, NC, 27599, Chapel Hill, NC, USA.
  2. Sarah Lebu: Department of Environmental Sciences and Engineering, The University of North Carolina at Chapel Hill, 4114 McGavran Greenberg Hall, Campus Box # 7431, NC, 27599, Chapel Hill, NC, USA.
  3. Jackqueline Nguyen: Department of Environmental Sciences and Engineering, The University of North Carolina at Chapel Hill, 4114 McGavran Greenberg Hall, Campus Box # 7431, NC, 27599, Chapel Hill, NC, USA.
  4. Chimdi Muoghalu: Department of Environmental Sciences and Engineering, The University of North Carolina at Chapel Hill, 4114 McGavran Greenberg Hall, Campus Box # 7431, NC, 27599, Chapel Hill, NC, USA.
  5. Andromede Uwase: Department of Environmental Sciences and Engineering, The University of North Carolina at Chapel Hill, 4114 McGavran Greenberg Hall, Campus Box # 7431, NC, 27599, Chapel Hill, NC, USA.
  6. Jiahui Guo: Department of Environmental Sciences and Engineering, The University of North Carolina at Chapel Hill, 4114 McGavran Greenberg Hall, Campus Box # 7431, NC, 27599, Chapel Hill, NC, USA.
  7. Carrie Baldwin-SoRelle: Health Sciences Library, University of North Carolina at Chapel Hill, USA.
  8. Carmen Anthonj: Faculty of Geo-Information Science and Earth Observation, ITC, University of Twente, Enschede, the Netherlands.
  9. Sheillah N Simiyu: African Population and Health Research Center, Manga Close, Off Kirawa Road, P.O Box 10787-00100, Nairobi, Kenya.
  10. John Apambilla Akudago: Global Programs, Habitat for Humanity International, 1202 Aspen Meadows Dr NE, Rio Rancho, NM, 87144, USA.
  11. Musa Manga: Department of Environmental Sciences and Engineering, The University of North Carolina at Chapel Hill, 4114 McGavran Greenberg Hall, Campus Box # 7431, NC, 27599, Chapel Hill, NC, USA; Department of Construction Economics and Management, College of Engineering, Design, Art and Technology (CEDAT), Makerere University, P.O. Box 7062, Kampala, Uganda. Electronic address: mmanga@email.unc.edu.
PMID: 38788338 DOI: 10.1016/j.ijheh.2024.114392

Abstract

Shared sanitation facilities are not considered a type of basic sanitation by the WHO/UNICEF Joint Monitoring Programme (JMP), though they may be the only alternative to open defecation in urban informal settlements. Additionally, JMP indicators for sanitation do not cover aspects related to the quality of shared sanitation, such as those outlined in the Human Right to Water and Sanitation (HRTWS) framework. Data on the prevalence of shared sanitation within informal settlement areas is limited, and there is a need to understand user preferences, experiences, and barriers to the use of shared sanitation to inform effective policy and practice. This systematic review aims to summarize the prevalence and number of households sharing sanitation in informal settlements globally, as well as user experiences and barriers to successful implementation of shared sanitation. We included studies available in English and published after January 1, 2000. We retrieved 4741 articles from seven databases and included a total of 167 relevant publications. Among included studies, 54 reported the prevalence of shared sanitation in informal settlements, and 138 studies reported on user perceptions and experiences related to shared sanitation quality. A meta-analysis of studies reporting the prevalence of shared sanitation in informal settlements globally revealed an estimated overall prevalence of 67% [95% CI: 61%-73%]. Commonly reported user preferences included cleanliness to promote continued use of shared facilities, privacy with a lockable door, facilities for menstrual hygiene management, safety and protection against violence, 24/7 access, proper lighting, and shared responsibility for facility management - which align with the HRTWS framework and represent barriers to shared sanitation use. Based on the findings of this review, we recommend including the number of households or people sharing a sanitation facility in monitoring of shared sanitation quality, locating sanitation facilities within compounds, where applicable, and promoting safety, dignity, and privacy of all users in the development of shared sanitation quality indicators.

Keywords

Human right to water and sanitation (HRTWS) Informal settlements Joint monitoring programme (JMP) Shared sanitation User perspectives

MeSH Term

Humans
Prevalence
Sanitation
Journal Article Meta-Analysis Systematic Review

Word Cloud

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