As many as 2.4 billion people lack access to improved sanitation globally. 710 million of these people live in urban areas. In India alone, 769 million people lack access to improved sanitation and as high as 597 million people defecate in the open.
Shared sanitation facilities in India
The paper titled 'Neighbour-shared versus communal latrines in urban slums: a cross sectional study in Orissa, India exploring household demographics, accessibility, privacy, use and cleanliness' published in the journal Transactions of the Royal Society of Tropical Medicine and Hygiene, informs that shared sanitation facilities, those used by two or more households, now represent a large and growing proportion of sanitation options available in low income countries such as India. In India alone, the proportion of population accessing some form of shared sanitation has increased from 5% in 1990 to 9% by 2014.
However, shared sanitation facilities have been excluded from the definition of ‘improved sanitation’ used to monitor progress toward international targets. This is because of concerns that shared facilities can be unacceptable in terms of cleanliness and accessibility. The health benefits of using shared sanitation have also been questioned, and there is evidence that shared sanitation may be a risk factor for diarrhoea in children. However, with a growing number of people living in urban India, communal or public latrines are considered to be the only realistic options available in slums.
Inclusion of shared sanitation facilities as improved sources
Due to this inevitability of shared latrines in the urban in developing countries, the Joint Monitoring Programme (JMP) by the WHO/UNICEF has been contemplating including shared latrines under improved sources by differentiating between shared latrines on the basis of user count, an idea that has been challenged by some who say that the boundaries between the different types of shared facilities are often unclear especially in dense urban settlements.
This paper presents the findings of a study that compared two different forms of shared sanitation facilities, namely shared with neighbours or the broader community. It aimed at finding out if these two varied in terms of user demographics, patterns of use, privacy, cleanliness and health risks. 295 households relying on shared sanitation in 30 slums in urban areas of Orissa, India were surveyed for the study.
Findings of the study
- There were differences among households that relied on neighbour-shared versus communal latrines, and major differences in terms of accessibility, privacy and cleanliness among these facilities.
- Households that used communal facilities were poorer, had more household members, and were less educated. Many did not have access to piped water and had atleast one household member defecating in the open.
- Communal latrines were less accessible than neighbour-shared latrines both in terms of distance, opening times and fees for use. Many did not have water or a hand washing station. They were poorly maintained and cleaned less frequently than neighbour-shared facilities, and tended to be dirty with the presence of faeces and flies.
The paper argues that these differences raise questions about the proposed policy of counting shared latrines as ‘improved’ based on the number of known users. While the policy may capture a lower risk profile, much of this may simply be due to differences in household demographics that the policy will not be able to impact directly. Rather, if the policy focused on accessibility, facilities and maintenance to establish a criteria for shared latrines to meet the definition of ‘improved sanitation’, it would encourage attention, resources and creative solutions in these areas.
The paper ends by arguing that shared sanitation seems to be inevitable but for these shared facilities to be sustainable, policy makers, programme implementers and target communities must ensure that sanitation facilities are culturally appropriate, affordable, well maintained and user friendly. For this, classification of shared sanitation in terms of ‘improved’ or ‘unimproved’ needs to focus on cultural acceptability, cleanliness, accessibility and privacy as well as technology rather than user numbers alone.
Lead image source: Sourabh Phadke in CONRADIN, K., KROPAC, M., SPUHLER, D. (Eds.) (2010): The SSWM Toolbox. Basel: seecon international gmbh. URL: http://www.sswm.info