Descending the sanitation ladder in urban Uganda: evidence from Kampala Slums
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BACKGROUND: While the sanitation ladder is useful in analysing progressive improvements in sanitation, studies in Uganda have not indicated the sanitation barriers faced by the urban poor. There are various challenges in shared latrine use, cleaning and maintenance. Results from Kampala city indicate that, failure to clean and maintain sanitation infrastructure can lead to a reversal of the potential benefits that come with various sanitation facilities. METHODS: A cross sectional qualitative study was conducted between March and May 2013. Data were collected through 18 focus group discussions (FGDs) held separately; one with women, men and youth respectively. We also used pictorial methods; in addition, 16 key informant interviews were conducted. Data were analysed using content thematic approach. Relevant quotations per thematic area were identified and have been used in the presentation of the results. RESULTS: Whether a shared sanitation facility was improved or not, it was abandoned once it was not properly used and cleaned. The problem of using shared latrines began with the lack of proper latrine training when people do not know how to squat on the latrine hole. The constrained access and security concerns, obscure paths that were filthy especially at night, lack of light in the latrine cubicle, raised latrines sometimes up to two metres above the ground, coupled with lack of cleaning and emptying the shared facilities only made a bad situation worse. In this way, open defecation gradually substituted use of the available sanitation facilities. This paper argues that, filthy latrines have the same net effect as crude open defection. CONCLUSION: Whereas most sanitation campaigns are geared towards provision of improved sanitation infrastructure, these findings show that mere provision of infrastructure (improved or not) without adequate emphasis on proper use, cleaning and maintenance triggers an involuntary descent off the sanitation ladder. Understanding this reversal movement is critical in sustainable sanitation services and should be a concern for all actors.
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Bad smell discourages use of shared toilets and subsequent use of polyethylene bags.
“More recently, bad smell has been frequently mentioned as a reason for dissatisfaction with shared toilets [40, 49], discouraging their use and subsequent use of polyethylene bags [37].”
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 [37]
Sanitation facilities were commonly cited to not be safe, clean, and accessible.
“Sanitation facilities were commonly cited to not be safe, clean, and accessible (Kwiringira et al., 2014;Sato et al., 2016;Khan et al., 2017;Aluko et al., 2018;Angoua et al., 2018;Dendup et al., 2018;Desalegn et al., 2018;Njuguna, 2019;Winter et al., 2019).”
From A Systematic Review of Water and Gender Interlinkages: Assessing the Intersection With Health (2020) · cites this paper as Kwiringira et al., 2014
The absence of safe, secure, and private latrines forces women and girls to avoid practicing sustainable sanitation, hygiene, and MHM due to fear of violence or stigmatization.
“The absence of such facilities forces women and girls to avoid practicing sustainable sanitation, hygiene, and MHM due to a fear of violence, or as a result of stigmatization (Kwiringira et al., 2014;Khan et al., 2017;Budhathoki et al., 2018;Davis et al., 2018;Winter et al., 2019).”
From A Systematic Review of Water and Gender Interlinkages: Assessing the Intersection With Health (2020) · cites this paper as Kwiringira et al., 2014
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- Authors
- Kwiringira, J., Atekyereza, P., Niwagaba, C., & Günther, I.
- Affiliations
- Kyambogo University (UG)
- Makerere University (UG)
- ETH Zurich (CH)
- Corresponding author
- Kwiringira, Japheth
- Venue
- BMC Public Health
- Published
- 2014-06-19
- Volume
- 14
- Issue
- 1
- Pages
- 624-624
- ISSN
- 1471-2458 (ISSN-L)
- PMC
- PMC4071028
- OpenAlex
- W2087253709
- Cited by
- 96
- References
- 47
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 6 · 2023: 4 · 2022: 7 · 2021: 16 · 2020: 16 · 2019: 8 · 2018: 8 · 2017: 6 · 2016: 8 · 2015: 6 · 2014: 1
- FWCI
- 6.52
- 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)
- Repository for Publications and Research Data (ETH Zurich) (submittedVersion, cc-by)
- ETH Zürich Research Collection (cc-by)
- Funders
- University of South Dakota
- Branco Weiss Fellowship – Society in Science
- College of Humanities and Social Sciences, United Arab Emirates University
- Eidgenössische Anstalt für Wasserversorgung Abwasserreinigung und Gewässerschutz
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Social Sciences › Urban Studies › Urban and Rural Development Challenges
- Social Sciences › Gender Studies › Gender Studies and Social Issues
- Keywords
- open defecation, urban slums, Kampala, urban poverty, sanitation facilities
- MeSH terms
- Adolescent, Adult, City Planning, Cross-Sectional Studies, Drainage, Sanitary, Female, Humans, Male, Poverty Areas, Toilet Facilities, Uganda, Urban Population, Focus Groups, Qualitative Research
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