User Perceptions of Shared Sanitation among Rural Households in Indonesia and Bangladesh
Open accessAbstract
BACKGROUND: The practice of sharing sanitation facilities does not meet the current World Health Organization/UNICEF definition for what is considered improved sanitation. Recommendations have been made to categorize shared sanitation as improved sanitation if security, user access, and other conditions can be assured, yet limited data exist on user preferences with respect to shared facilities. OBJECTIVE: This study analyzed user perceptions of shared sanitation facilities in rural households in East Java, Indonesia, and Bangladesh. METHODS: Cross-sectional studies of 2,087 households in East Java and 3,000 households in Bangladesh were conducted using questionnaires and observational methods. Relative risks were calculated to analyze associations between sanitation access and user perceptions of satisfaction, cleanliness, and safety. RESULTS: In East Java, 82.4% of households with private improved sanitation facilities reported feeling satisfied with their place of defecation compared to 68.3% of households with shared improved facilities [RR 1.19, 95% CI 1.09, 1.31]. In Bangladesh, 87.7% of households with private improved facilities reported feeling satisfied compared to 74.5% of households with shared improved facilities [RR 1.15, 95% CI 1.10, 1.20]. In East Java, 79.5% of households who reported a clean latrine also reported feeling satisfied with their place of defecation; only 38.9% of households who reported a dirty latrine also reported feeling satisfied [RR 1.74, 95% CI 1.45, 2.08]. CONCLUSION: Simple distinctions between improved and unimproved sanitation facilities tend to misrepresent the variability observed among households sharing sanitation facilities. Our results suggest that private improved sanitation is consistently preferred over any other sanitation option. An increased number of users appeared to negatively affect toilet cleanliness, and lower levels of cleanliness were associated with lower levels of satisfaction. However, when sanitation facilities were clean and shared by a limited number of households, users of shared facilities often reported feeling both satisfied and safe.
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By WHO standards, even an improved facility that is shared by more than one household is considered unimproved.
“By WHO standards, even an improved facility that is shared by more than one household is considered unimproved [4, 5].”
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- Authors
- Nelson, K. B., Karver, J., Kullman, C., & Graham, J. P.
- Affiliations
- George Washington University (US)
- Corresponding author
- Graham, Jay P.
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2014-08-04
- Volume
- 9
- Issue
- 8
- Pages
- e103886
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4121202
- OpenAlex
- W2094237502
- Cited by
- 48
- References
- 13
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 3 · 2023: 1 · 2022: 4 · 2021: 7 · 2020: 5 · 2019: 3 · 2018: 10 · 2017: 7 · 2016: 2 · 2015: 3
- FWCI
- 3.73
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by)
- Figshare (submittedVersion, cc-by)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Social Sciences › Gender Studies › Gender Studies and Social Issues
- Physical Sciences › Environmental Science › Pollution › Energy and Environment Impacts
- Keywords
- shared sanitation, user perception, rural households, improved sanitation, user satisfaction, East Java, Bangladesh
- MeSH terms
- Adult, Bangladesh, Family Characteristics, Female, Humans, Hygiene, Indonesia, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Risk Factors, Rural Population, Sanitation, Toilet Facilities
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