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

IF 4.5 2区 医学 Q1 INFECTIOUS DISEASES International journal of hygiene and environmental health Pub Date : 2024-05-23 DOI:10.1016/j.ijheh.2024.114392
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
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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.

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非正规住区的共用卫生设施:关于普及率、偏好和质量的系统回顾和荟萃分析
世卫组织/儿童基金会联合监测方案(JMP)并不认为共用卫生设施是一种基本卫生设施,尽管在城市非正规住区,共用卫生设施可能是露天排便的唯一替代方式。此外,联合监测方案的卫生设施指标不包括与共用卫生设施质量有关的方面,如享有饮用水和卫生设施的人权(HRTWS)框架中概述的方面。有关非正规居住区共用卫生设施普及率的数据十分有限,因此有必要了解用户的偏好、经验以及使用共用卫生设施的障碍,以便为有效的政策和实践提供依据。本系统性综述旨在总结全球范围内非正规居住区共用卫生设施的普及率和家庭数量,以及用户的使用经验和成功实施共用卫生设施的障碍。我们纳入了 2000 年 1 月 1 日之后发表的英文研究。我们从 7 个数据库中检索到 4741 篇文章,共纳入 167 篇相关出版物。在纳入的研究中,54 项研究报告了非正规居住区共用卫生设施的普及率,138 项研究报告了用户对共用卫生设施质量的看法和体验。对报告全球非正规居住区共用卫生设施普及率的研究进行荟萃分析后发现,估计总体普及率为 67% [95% CI:61%-73%]。报告中常见的用户偏好包括:清洁以促进共享设施的持续使用、可上锁的隐私门、经期卫生管理设施、安全和防止暴力、全天候使用、适当的照明以及共同承担设施管理责任--这些都符合 HRTWS 框架,也是共享卫生设施使用的障碍。根据本次审查的结果,我们建议在监测共用卫生设施的质量时纳入共用卫生设施的家庭或人数,酌情将卫生设施设在院落内,并在制定共用卫生设施质量指标时促进所有使用者的安全、尊严和隐私。
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来源期刊
CiteScore
11.50
自引率
5.00%
发文量
151
审稿时长
22 days
期刊介绍: The International Journal of Hygiene and Environmental Health serves as a multidisciplinary forum for original reports on exposure assessment and the reactions to and consequences of human exposure to the biological, chemical, and physical environment. Research reports, short communications, reviews, scientific comments, technical notes, and editorials will be peer-reviewed before acceptance for publication. Priority will be given to articles on epidemiological aspects of environmental toxicology, health risk assessments, susceptible (sub) populations, sanitation and clean water, human biomonitoring, environmental medicine, and public health aspects of exposure-related outcomes.
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