Assessment of Suitability of Slum Toilets for Use by Women and Children on Promotion of Inclusive Sanitation:

A Mixed Methods Study in Nakuru, Kenya

Abstract

Women and children encounter challenges in accessing sanitation services. Unless user-friendly designs are adopted for toilets, those living in slums could have difficult choices of excreta management. The study examined suitability of toilets for use by women and children on promotion of inclusive sanitation in a selected slum in Nakuru, Kenya. The study used convergentdesign. Quantitative data was gathered using structured questionnaires from 100 household heads sampled using proportionate simple random technique. An observation checklist was used to ascertain toilet’s status and suitability for use by women and children. The data was analyzed in descriptive and logistic regression statistics. Data gathered using focus group discussions was analyzed thematically and findings presented in narratives. The study established that use of toilets by women was compromised by inadequate maintenance, privacy, safety and hygiene provisions concerns. Chances of open defecation were 63.7% lower for women who did not fear visiting toilets at night than for those who did and 45.2% lower for women who accessed clean toilets (p<0.05). The likelihood of being comfortable with toilets was 3.664 times higher for women who accessed toilets located near households, 6.75 higher when they considered toilets as safe for use at night and 7.057 times higher with access to toilets that maintained privacy (p<0.05). Although water was apparently available as supplied by the Water and Sewerage Company, handwashing for women was minimal as the facilities mostly lacked water. Children were escorted by caregivers to toilets as they could not reach the door latches. Distance to toilets for children stood out as a significant factor that discouraged them from using toilets (p<0.05). Hand hygiene for children was minimal due to absence of handwashing facilities, or when present, positioning of the facilities at higher heights than children could reach. The study concluded that sanitation vulnerabilities in slums are amplified by provision of gender and age-non-responsive sanitation and hygiene facilities. Sanitation programming in slums should incorporate a gender and social lens to promote sanitation inclusivity for women and children. Involvement of women in planning processes of sanitation options in slums could be a worthwhile strategy of ensuring that their needs and the needs of their children are adequately addressed.