Shared toilet users’ collective cleaning and determinant factors in Kampala slums, Uganda
Open accessAbstract
BACKGROUND: Dirty shared toilets are a health risk to users in urban slum settlements. For health and non-health benefits among users of shared toilets to be guaranteed, their cleanliness is important. The objective of this study was to investigate the cleanliness situation of shared toilets in Kampala's slums and the psychological and social dilemma factors influencing users' cleaning behaviour and commitment by using the risks, attitudes, norms, ability and self-regulation (RANAS) model and factors derived from the social dilemma theory. METHODS: We conducted a cross-sectional study in three slums of Kampala between December 2012 and January 2013. Data were collected from 424 household respondents that were primarily using shared toilets. Semi-structured questionnaires administered through face-to-face interviews were used in data collection. Linear regression was done for the multivariate analysis to test for the association between respondent cleaning behaviour and a combination of RANAS and social dilemma predictors. RESULTS: Out of 424 respondents interviewed, 44.3% reported cleaning the shared toilet daily, 34.4% cleaned once or several times a week, 1.4% cleaned every second week, 5.4% cleaned once or several times a month and 14.4% did not participate in cleaning. The main RANAS factors significantly associated with respondents' cleaning behaviour were: attitudinal affective belief associated with cleaning a shared toilet (β = -0.13, P = 0.00) and self-regulating factors, such as coping planning (β = 0.42, P = 0.00), commitment (β = 0.24, P = 0.00), and remembering (β = 0.10, P = 0.01). For social dilemma factors, only the social motive factor was statistically significant (β = 0.15, P = 0.00). The R square for the linear model on factors influencing cleaning behaviour was 0.77 and R square for factors influencing cleaning commitment was 0.70. CONCLUSION: The RANAS factors provide a more robust understanding of shared toilet users' cleaning behaviour than social dilemma factors. Self-regulating factors and changing the negative affective cleaning feelings are shown to be very important for interventions to increase shared toilet users' collective participation in their cleaning. In addition to RANAS, social dilemma factors have an important influence on slum residents' commitment to clean their shared toilets.
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In a survey by Tumwebaze and Mosler, respondents considered clean latrines as those free from smell and insects.
“For example, in a survey by IK Tumwebaze and H-J Mosler [51], respondents considered clean latrines as those free from smell and insects.”
From Are pit latrines in urban areas of Sub-Saharan Africa performing? A review of usage, filling, insects and odour nuisances (2015) · cites this paper as [51]
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Ikiring, B. O., Okia, D., Okolimong, C., Alunyo, J. P., Katuramu, R., Khainza, A. T., Mukunya, D., Matovu, J. K. B., Musoke, D., Olupot‐Olupot, P., et al. (2025) · Scientific Reports · doi:10.1038/s41598-025-20430-x · Cited by 1 · see citing works
“Items were adapted from validated instruments used in previous studies in East Africa 7,8 and were reviewed by two independent experts in environmental health and behavioral science to assess content validity.”
Nalugya, A., Ssempebwa, J. C., Muleme, J., Wafula, S. T., Tamale, B. N., Tigaiza, A., Nakalembe, D., Kansiime, W. K., Isunju, J. B., Ssekamatte, T., et al. (2024) · BMC Public Health · doi:10.1186/s12889-024-19525-3 · Cited by 1 · see citing works
“The findings concur with those reported in previous studies which have shown peer influences to be significant drivers of household WASH behaviours [62, 63].”
ResultIdentification of vulnerable urban areas in Accra, Ghana using census and remote sensing data
MacTavish, R. (2021) · eScholarship@McGill (McGill) · doi:10.82308/18365 · Cited by 2 · see citing works
Müller, K., Cornel, P., & Nashilongo, A. (2016) · Journal of Water Sanitation and Hygiene for Development · doi:10.2166/washdev.2016.176
Socio-economic dynamics of sanitation in the informal settlements of Kisumu City, Kenya
Simiyu, S. N. (2016) · SUNScholar (Stellenbosch University)
Public Health in Rural India: Exploring Sanitation Outcomes and the Role of Community Health Workers
Jain, A. (2019) · eScholarship (California Digital Library)
Kikuchi, M., & Azad-uz-zaman, Q. (2024) · Journal of Water Sanitation and Hygiene for Development · doi:10.2166/washdev.2024.148
Bick, S., Buxton, H., Chase, R. P., Ross, I., Adriano, Z., Capone, D., Knee, J., Brown, J., Nalá, R., Cumming, O., et al. (2021) · Figshare · doi:10.6084/m9.figshare.14998962
Bick, S., Buxton, H., Chase, R. P., Ross, I., Adriano, Z., Capone, D., Knee, J., Brown, J., Nalá, R., Cumming, O., et al. (2021) · Figshare · doi:10.6084/m9.figshare.14998977
Bick, S., Buxton, H., Chase, R. P., Ross, I., Adriano, Z., Capone, D., Knee, J., Brown, J., Nalá, R., Cumming, O., et al. (2021) · Figshare · doi:10.6084/m9.figshare.14998971
Bick, S., Buxton, H., Chase, R. P., Ross, I., Adriano, Z., Capone, D., Knee, J., Brown, J., Nalá, R., Cumming, O., et al. (2021) · Figshare · doi:10.6084/m9.figshare.14998965
Bick, S., Buxton, H., Chase, R. P., Ross, I., Adriano, Z., Capone, D., Knee, J., Brown, J., Nalá, R., Cumming, O., et al. (2021) · Figshare · doi:10.6084/m9.figshare.14998980
Bick, S., Buxton, H., Chase, R. P., Ross, I., Adriano, Z., Capone, D., Knee, J., Brown, J., Nalá, R., Cumming, O., et al. (2021) · Figshare · doi:10.6084/m9.figshare.14998974
Nalugya, A., Ssempebwa, J. C., Muleme, J., Wafula, S. T., Tamale, B. N., Tigaiza, A., Nakalembe, D., Kansiime, W. K., Isunju, J. B., Ssekamatte, T., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26409891
Mbogo, H. N., Home, P. G., Raude, J. M., & Mwangi, W. R. (2026) · Journal of Water Sanitation and Hygiene for Development · doi:10.2166/washdev.2026.165
- Authors
- Tumwebaze, I. K., & Mosler, H.-J.
- Affiliations
- University of Zurich (CH)
- Swiss Federal Institute of Aquatic Science and Technology (CH)
- Corresponding author
- Tumwebaze, Innocent K
- Venue
- BMC Public Health
- Published
- 2014-12
- Volume
- 14
- Issue
- 1
- Pages
- 1260-1260
- ISSN
- 1471-2458 (ISSN-L)
- PMC
- PMC4295474
- OpenAlex
- W2072316997
- Cited by
- 58
- References
- 52
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 5 · 2022: 6 · 2021: 12 · 2020: 7 · 2019: 3 · 2018: 9 · 2017: 4 · 2016: 6 · 2015: 3
- FWCI
- 4.04
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Public Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DORA Eawag (Swiss Federal Institute of Aquatic Science and Technology (Eawag)) (submittedVersion, cc-by)
- Funders
- National Science Foundation
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
- Direktion für Entwicklung und Zusammenarbeit
- Eidgenössische Anstalt für Wasserversorgung Abwasserreinigung und Gewässerschutz
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Social Sciences › Gender Studies › Gender Studies and Social Issues
- Social Sciences › Urban Studies › Urban and Rural Development Challenges
- Keywords
- shared toilets, toilet cleanliness, slum sanitation, self-regulation, coping planning, social norms, attitudes, commitment, social motives
- MeSH terms
- Adolescent, Adult, Aged, Attitude, Cooperative Behavior, Cross-Sectional Studies, Female, Group Processes, Humans, Male, Middle Aged, Poverty Areas, Surveys and Questionnaires, Social Control, Informal, Toilet Facilities, Uganda, Linear Models, Young Adult, Social Norms
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