![]() ![]() Unfortunately, studies focusing on such interventions are few, thereby limiting the available options to learn from in developing relevant interventions. ![]() Conversely, it is acknowledged that ‘high quality’ shared sanitation facilities may be the best interim solution in low-income settlements, and thus, interventions to improve the cleanliness of these sanitation facilities are needed. Unfortunately, since shared sanitation facilities are often the only option available for most residents in low-income areas, it is feared that users may revert to open defecation practices if the facilities are inaccessible or unclean. Studies have confirmed that the number of users, the relationship among users, and lack of cooperation contribute to the low levels of cleanliness of shared sanitation facilities. This classification also implies that any improvements to shared facilities may not count towards meeting global sustainable development goals, which may result in investments and improvements not being directed towards users of the shared facilities. This classification is mainly due to increased health risks of exposure to faecal matter, and human rights concerns relating to dignity and safety. Sanitation facilities that are shared by two or more households are classified as ‘limited’ sanitation service by the Joint Monitoring Program (JMP) of the World Health Organisation (WHO) and the United Nations Children’s Fund (UNICEF). Due to these inadequacies, most households share sanitation facilities with other households, facilitating access to sanitation for residents who would otherwise lack these services. These settlements are faced with challenges such as inadequate water and sanitation services. In Africa, approximately 62–70% of the urban population lives in low-income settlements. Since the 1960s, the urban population worldwide has risen steadily, leading to the urbanisation of poverty, inequality, and the expansion of low-income settlements. This study provides further evidence on approaches for improved management of shared sanitation facilities in line with the World Health Organization’s (WHO) Joint Monitoring Program’s (JMP) recommendation for high quality shared facilities. Through a social approach, shared sanitation facilities can be managed appropriately to provide the millions of low-income residents in Kenya an opportunity to access sanitation. The results highlight the need to focus on social aspects for improvement of cleanliness in shared sanitation facilities in low-income settlements. These approaches could form the basis for designing intervention strategies for improving the cleanliness of shared sanitation facilities. Available opportunities for improvement included instituting clear cleaning plans, improving communication among users, and enhanced problem-solving mechanisms between landlords and tenants. Participants singled out behavioural (poor use of the shared toilets) and social (lack of cooperation in cleaning) challenges that led to unclean shared toilets. Sanitation facilities were mainly pit latrines, typically shared among landlords and tenants. Analysis followed a thematic approach to define the problem, specify the target behaviour and identify the changes needed. Thirty-nine in-depth interviews and 11 focus group discussions were held with residents – mainly tenants and landlords – of a low-income settlement in Kisumu. This study sought to investigate barriers and opportunities for improved cleanliness of shared sanitation facilities in low-income settlements of Kisumu city, Kenya. These shared facilities are often the only option available for most residents in low-income settlements, and improving their cleanliness and overall management is key to reducing open defecation and risk of disease. However, shared sanitation is currently categorized as a limited sanitation service, and may therefore not count towards meeting the global goals. ![]() The sharing of sanitation facilities is a common practice in low-income areas in sub-Saharan Africa.
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