79 research outputs found
Water, sanitation and the risk of chronic conditions in old age: Results from the Ghana WHO SAGE 2
No full textWater and sanitation have been related to the health of populations, yet, the effects of these factors on the occurrence of chronic conditions (CC) in later life have been least explored. This study examines the association of CC with water and sanitation among older Ghanaians and whether the associations are moderated by gender and residence. Data from the WHO-SAGE Wave 2 comprising of 4735 adults aged ≥ 50 years were analyzed in this study. The primary outcome was CC and the exposures included sources of water, sanitation facilities, and the sharing of sanitation facilities. Generalized logistic regression models estimated the effects of water and sanitation indicators on the occurrence of CC. Overall, 18.8% of the sample reported at least one CC. Compared to men and rural residents, women and urban residents respectively were more likely to report CC (p < 0.001). After full adjustments, logistic regressions showed that the use of unimproved sanitation (OR = 1.732, CI: 1.377–5.418) and sharing of sanitation facilities (OR = 1.624, CI: 1.095–1.320) were associated with higher odds of CC. However, the use of water did not reach significance (p = 0.125). We found a significant interaction effect for type of toilet × gender (OR = 3.498, CI: 1.744–16.442), source of water × residence (OR = 5.935, CI: 1.320–26.685), and type of toilet × residence (OR = 1.998, CI: 1.462–8.642). The use of unimproved sanitation facilities and the sharing of sanitation facilities are associated with the occurrence of CC among older people. Policy and public health interventions targeted at improving the health and well-being of older people should conspicuously include improving access to sanitation services
Determinants of usage of communal sanitation facilities in informal settlements of Kisumu, Kenya
No full textResidents of informal settlements in developing countries are faced with various challenges, including a lack of household sanitation facilities, which leads to use of alternative methods such as open defecation. The lack of household sanitation facilities and consequent use of improper methods necessitated the introduction of communal sanitation facilities in informal settlements as a way of increasing access to and use of sanitation facilities. However, little is known about their use and effectiveness, particularly in Africa’s informal settlements. This study used a number of quantitative and qualitative methods to assess determinants of use of communal sanitation facilities in informal settlements of Kisumu, a city in Kenya. Findings reveal that factors such as location/siting, inadequate maintenance, economic aspects, and gender issues influence the use of communal facilities, and they should therefore be included in future sanitation interventions
Socio-economic dynamics in slums and implications for sanitation sustainability in Kisumu, Kenya
No full textPreference for and characteristics of an appropriate sanitation technology for the slums of Kisumu, Kenya
No full textInvestigating quality of shared sanitation facilities in informal settlements of Kisumu, Kenya
No full textThe sanitation target was not met during the MDG period, and as the SDG period begins, the goal still remains adequacy and equity in sanitation. Due to lack of space, achieving adequacy in informal settlements is challenging, and sharing of sanitation facilities is common. One concern with shared facilities is difficulty in cleanliness, and a lacuna exists in shared sanitation quality in informal settlements. This study investigated the quality of shared sanitation in informal settlements of Kisumu city in Kenya. Data was collected by interviewing users, and by inspecting sanitation facilities for aspects of quality. The facilities were all pit latrines, most of which offered privacy, but were not hygienically clean. Cleanliness deteriorated with more households sharing, indicating that less attention was given to keeping shared facilities clean. Improvement strategies in informal settlements should not only focus on access but also target group behaviour and practices among shared sanitation users
Socio-economic dynamics of sanitation in the informal settlements of Kisumu City, Kenya
No full textThesis (PhD)--Stellenbosch University, 2016.ENGLISH SUMMARY : Countries are experiencing a surge in the number of people living in urban areas. A majority of the poor in these urban areas live in informal settlements, which face challenges such as inadequate sanitation. There thus is a need to understand why informal settlements lack sanitation facilities, as well as a need for approaches that can be used to increase access. Kisumu, the third largest city in Kenya, also hosts informal settlements that have inadequate sanitation facilities. Little is known about aspects within these settlements that influence sanitation. The goal of this study was to examine socio-economic dynamics in Kisumu’s informal settlements, and how they interact to influence access to and the management of sanitation. The main objectives were to describe living conditions in the settlements, to estimate the cost of sanitation from rental prices, to investigate determinants of shared sanitation quality, and to investigate decision-making for sanitation within the settlements. The study began with a quantitative phase, which was built on by a qualitative phase. A cross-sectional survey was conducted during the quantitative stage, while multiple case study designs and participatory research with concepts from action/transdisciplinary research were adopted in the subsequent qualitative phase. Respondents were residents of the settlements as well as stakeholders involved in sanitation. The results show that residents lack basic services such as sanitation. Residents living in compounds with absentee landlords often had poor housing, lacked basic services, and paid lower rents compared to those in compounds with live-in landlords. Sanitation facilities constituted 54% of rental prices, but willingness to pay a higher amount of rent declined when the number of households sharing sanitation facilities increased. Most sanitation facilities were shared by an average of eight households, and from inspection, 64% of these facilities were dirty. They were more likely to be dirty as the number of households sharing them increased. Reasons for dirty shared sanitation facilities were investigated using the common pool resource management principles, which showed that facilities were likely to be clean when there was a defined user group that collectively made decisions and had a defined management structure that made it easier to resolve conflicts and work together to keep sanitation facilities clean. Regarding decision making, landlords often made investment decisions, while tenants made decisions related to cleaning, often after consultations. At the community and city level, residents identified sanitation challenges within their settlements and proposed solutions to the identified challenges. The results indicate that sanitation in informal settlements is highly complex and is entrenched in residents’ daily lives. Most quantitative models lead to an understanding of measurable physical factors, but socio-economic factors such as relationships, beliefs, practices and norms equally influence access to and management of sanitation facilities. Efforts at improvement ought not to concentrate on provision only, but also on strategies to keep the provided facilities in a proper condition that enables sustained use. Stakeholders, including policy makers, should embrace working together for the common good.AFRIKAANSE OPSOMMING : Lande ervaar ’n toename in die getal mense wat in stedelike gebiede woon. ’n Meerderheid van die armes in hierdie stedelike gebiede woon in informele nedersettings, wat uitdagings ervaar soos onvoldoende sanitasie. Daar is dus ’n behoefte om te verstaan hoekom informele nedersettings ’n gebrek aan sanitasiefasiliteite het, sowel as ’n behoefte aan benaderings wat gebruik kan word om toegang te verbeter. Kisumu, die derde grootste stad in Kenia, het ook informele nedersettings wat nie voldoende sanitasiefasiliteite het nie. Min is bekend oor die aspekte binne hierdie nedersettings wat sanitasie beïnvloed. Die doelwit van hierdie studie was om ondersoek in te stel na die sosio-ekonomiese dinamika in Kisumu se informele nedersettings, en hoe hulle op mekaar inwerk om toegang tot en die bestuur van sanitasie te beïnvloed. Die vernaamste doelwitte was om die lewensomstandighede in die nedersettings te beskryf, om die koste van sanitasie op grond van huurpryse te skat, om die determinante van die kwaliteit van gedeelde sanitasie te ondersoek, en om ondersoek in te stel na besluitneming oor sanitasie binne die nedersettings. Die studie het begin met ’n kwantitatiewe fase, waarop ’n kwalitatiewe fase gebou is. ’n Deursnee opname is tydens die kwantitatiewe fase uitgevoer, terwyl veelvuldige gevallestudie-ontwerpe en deelnemende navorsing met konsepte vanuit aksie-/transdissiplinêre navorsing in die gevolglike kwalitatiewe fase opgeneem is. Die respondente was inwoners van die nedersettings sowel as belanghebbers betrokke by sanitasie. Die resultate toon dat die inwoners nie basiese dienste soos water en sanitasie gehad het nie. Inwoners wat in gebiede gewoon het met afwesige huiseienaars het in baie gevalle swak behuising en geen basiese dienste gehad nie, en het minder huur betaal as dié in gebiede waar die huiseienaars ook gewoon het. Sanitasiefasiliteite het 54% van die huurkoste uitgemaak, maar hul bereidwilligheid om meer huur te betaal het afgeneem soos die getal huise wat die sanitasiefasiliteite deel, toegeneem het. Die meeste sanitasiefasiliteite is deur ’n gemiddeld van agt huishoudings gedeel, en vanuit die inspeksie hiervan was 64% van hierdie fasiliteite vuil. Daar was ’n groter kans dat hulle vuil was hoe meer huishoudings die fasiliteite gedeel het. Die redes vir vuil gedeelde sanitasiefasiliteite is ondersoek deur gebruik te maak van die common pool resource management principles, wat aangedui het dat die fasiliteite moontlik skoon sou wees waar daar ’n gedefinieerde gebruikersgroep was wat gesamentlik besluite geneem het en wat ’n gedefinieerde bestuurstruktuur gehad het wat dit makliker gemaak het om konflik op te los en om saam te werk om die sanitasiefasiliteite skoon te hou. Met betrekking tot besluitneming, het huiseienaars gereeld beleggingsbesluite geneem, terwyl die huurders besluite oor skoonmaak geneem het, in baie gevalle ná konsultasie. Op die gemeenskaps- en stadsvlak het inwoners sanitasie-uitdagings in hulle nedersettings geïdentifiseer en oplossings vir die geïdentifiseerde uitdagings voorgestel. Die resultate toon dat sanitasie in informele nedersettings baie kompleks is en in die inwoners se daaglikse lewens verskans is. Die meeste kwantitatiewe modelle lei tot ’n begrip van meetbare fisiese faktore, maar sosio-ekonomiese faktore soos verhoudings, geloof, praktyke en norme het ’n gelyke invloed op toegang tot en bestuur van sanitasiefasiliteite. Pogings tot verbetering moet nie net op voorsiening fokus nie, maar ook op strategieë om die verskafde fasiliteite in ’n ordentlike toestand te hou wat volgehoue gebruik moontlik maak. Belanghebbers, insluitend beleidmakers, moet met genoeë saamwerk vir die algemene welsyn.Doctora
Investigating quality of shared sanitation facilities in informal settlements of Kisumu, Kenya
No full textThe sanitation target was not met during the MDG period, and as the SDG period begins, the goal still remains adequacy and equity in sanitation. Due to lack of space, achieving adequacy in informal settlements is challenging, and sharing of sanitation facilities is common. One concern with shared facilities is difficulty in cleanliness, and a lacuna exists in shared sanitation quality in informal settlements. This study investigated the quality of shared sanitation in informal settlements of Kisumu city in Kenya. Data was collected by interviewing users, and by inspecting sanitation facilities for aspects of quality. The facilities were all pit latrines, most of which offered privacy, but were not hygienically clean. Cleanliness deteriorated with more households sharing, indicating that less attention was given to keeping shared facilities clean. Improvement strategies in informal settlements should not only focus on access but also target group behaviour and practices among shared sanitation users
Enablers and barriers of handwashing with soap in low-income settlements of Mombasa, Kenya
No full textHandwashing with soap (HWWS) is an effective public health preventive measure. Review studies indicate that interventions on handwashing with soap reduce the risk of diarrhoeal diseases by approximately 30% and respiratory tract infections by up to 17% (Ross, Bick, Ayieko, et al., 2023; Wolf, Hubbard, Brauer, et al., 2022). Studies have also shown that HWWS, combined with interventions on water and sanitation, results in improved growth outcomes among children under five (Bekele et al., 2020; George, Monira, Zohura, et al., 2021; Hasan, Asif, Barua, et al., 2023).
The World Health Organisation (WHO) and the United Nations Children's Fund (UNICEF) Joint Monitoring Program (JMP) estimated that by 2022, 75% of the global population had access to basic handwashing facilities (HWFs) measured by the presence of a handwashing facility with water and soap within the premises (UNICEF and WHO, 2023a). Access to a basic HWF is an indicator for HWWS, as studies have confirmed HWWS at critical times increases as a result of the presence of a HWF (Jetha, Bisserbe, McManus, et al., 2021; Mbakaya et al., 2020; Okello, Kapiga, Grosskurth, et al., 2019; White, Thorseth, Dreibelbis, et al., 2020; Wolde, Abate, Mandefro, et al., 2022).
These JMP estimates indicate that Sub-Saharan Africa (SSA) had the lowest regional coverage of basic HWFs by 2022, with only 30% of the population having access to basic HWFs (UNICEF and WHO, 2023b). This limited coverage may indicate or lead to inadequate HWWS. In addition, significant disparities in access exist between urban and rural areas of Africa, with urban areas exhibiting higher access (32%) than rural areas (17%) (UNICEF and WHO, 2023a,b). Despite this advantage, urban areas of Africa have significant proportions of the population residing in Low Income Areas (LIAs) which are characterised by several challenges including intermittent water supply, high costs of water, lack of handwashing facilities, and a higher risk to hygiene related health outcomes (Beard & Mitlin, 2021; Corburn, Vlahov, Mberu, et al., 2020; Kisaakye et al., 2021).
Research studies examining hindrances (barriers) and enablers of HWWS in LIAs of Africa are limited. However, studies conducted in LIAs in other regions have identified financial resources, availability of water and soap, and the presence of dirt on the hands as factors that promote HWWS (Kalam, Davis, Islam, et al., 2021; Khan, Chakraborty, Brown, et al., 2021; Rahman, Nizame, Unicomb, et al., 2017).
Similar to other African countries, studies examining the enablers and barriers for HWWS in LIAs in Kenya are limited, with most of the available studies focusing on food hygiene or COVID-19 related knowledge regarding HWWS (Austrian, Pinchoff, Tidwell, et al., 2020; Davis, Cumming, Aseyo, et al., 2018; Mumma, Simiyu, Aseyo, et al., 2019; Robinson & Howland, 2022; Watson, Okumu, Wasonga, et al., 2024).
This study builds on a prior survey in LIAs of Kenyan cities that examined determinants of access to basic HWFs and of HWWS (Simiyu et al., 2025). The study indicated a lower likelihood of access to basic HWFs and of HWWS among residents of Mombasa compared to residents in low-income areas of other cities in Kenya (Simiyu et al., 2025). This study, therefore, explores the barriers and enablers of HWWS in the low-income settlements of Mombasa and identifies intervention strategies for improvement of HWWS within these areas
Determinants of quality of shared sanitation facilities in informal settlements: case study of Kisumu, Kenya.
No full textBACKGROUND: Shared facilities are not recognised as improved sanitation due to challenges of maintenance as they easily can be avenues for the spread of diseases. Thus there is need to evaluate the quality of shared facilities, especially in informal settlements, where they are commonly used. A shared facility can be equated to a common good whose management depends on the users. If users do not work collectively towards keeping the facility clean, it is likely that the quality may depreciate due to lack of maintenance. This study examined the quality of shared sanitation facilities and used the common pool resource (CPR) management principles to examine the determinants of shared sanitation quality in the informal settlements of Kisumu, Kenya. METHODS: Using a multiple case study design, the study employed both quantitative and qualitative methods. In both phases, users of shared sanitation facilities were interviewed, while shared sanitation facilities were inspected. Shared sanitation quality was a score which was the dependent variable in a regression analysis. Interviews during the qualitative stage were aimed at understanding management practices of shared sanitation users. Qualitative data was analysed thematically by following the CPR principles. RESULTS: Shared facilities, most of which were dirty, were shared by an average of eight households, and their quality decreased with an increase in the number of households sharing. The effect of numbers on quality is explained by behaviour reflected in the CPR principles, as it was easier to define boundaries of shared facilities when there were fewer users who cooperated towards improving their shared sanitation facility. Other factors, such as defined management systems, cooperation, collective decision making, and social norms, also played a role in influencing the behaviour of users towards keeping shared facilities clean and functional. CONCLUSION: Apart from hardware factors, quality of shared sanitation is largely due to group behaviour of users. The CPR principles form a crucial lens through which the dynamics of shared sanitation facilities in informal settlements can be understood. Development and policy efforts should incorporate group behaviour as they determine the quality of shared sanitation facilities
Estimating the Cost and Payment for Sanitation in the Informal Settlements of Kisumu, Kenya: A Cross Sectional Study.
No full textLack of sanitation facilities is a common occurrence in informal settlements that are common in most developing countries. One challenge with sanitation provision in these settlements is the cost and financing of sanitation. This study aimed at estimating the cost of sanitation, and investigating the social and economic dynamics within Kisumu's informal settlements that hinder provision and uptake of sanitation facilities. Primary data was collected from residents of the settlements, and using logistic and hedonic regression analysis, we identify characteristics of residents with sanitation facilities, and estimate the cost of sanitation as revealed in rental prices. Our study finds that sanitation constitutes approximately 54% of the rent paid in the settlements; and dynamics such as landlords and tenants preferences, and sharing of sanitation facilities influence provision and payment for sanitation. This study contributes to general development by estimating the cost of sanitation, and further identifies barriers and opportunities for improvement including the interplay between landlords and tenants. Provision of sanitation in informal settlements is intertwined in social and economic dynamics, and development approaches should target both landlords and tenants, while also engaging various stakeholders to work together to identify affordable and appropriate sanitation technologies
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