Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2016 Nov 30;13(12):1189.
doi: 10.3390/ijerph13121189.

Comparing Sanitation Delivery Modalities in Urban Informal Settlement Schools: A Randomized Trial in Nairobi, Kenya

Kate Bohnert  1 , Anna N Chard  2 , Alex Mwaki  3 , Amy E Kirby  4 , Richard Muga  5 , Corey L Nagel  6 , Evan A Thomas  7 , Matthew C Freeman  8
Affiliations
Randomized Controlled Trial

Comparing Sanitation Delivery Modalities in Urban Informal Settlement Schools: A Randomized Trial in Nairobi, Kenya

Kate Bohnert et al. Int J Environ Res Public Health. .

Abstract

The provision of safely managed sanitation in informal settlements is a challenge, especially in schools that require durable, clean, sex-segregated facilities for a large number of children. In informal settlements in Nairobi, school sanitation facilities demand considerable capital costs, yet are prone to breakage and often unhygienic. The private sector may be able to provide quality facilities and services to schools at lower costs as an alternative to the sanitation that is traditionally provided by the government. We conducted a randomized trial comparing private sector service delivery (PSSD) of urine-diverting dry latrines with routine waste collection and maintenance and government standard delivery (GSD) of cistern-flush toilets or ventilated improved pit latrines. The primary outcomes were facility maintenance, use, exposure to fecal contamination, and cost. Schools were followed for one school year. There were few differences in maintenance and pathogen exposure between PSSD and GSD toilets. Use of the PSSD toilets was 128% higher than GSD toilets, as measured with electronic motion detectors. The initial cost of private sector service delivery was USD 2053 (KES 210,000) per school, which was lower than the average cost of rehabilitating the government standard flush-type toilets (USD 9306 (KES 922,638)) and constructing new facilities (USD 114,889 (KES 1,169,668)). The private sector delivery of dry sanitation provided a feasible alternative to the delivery of sewage sanitation in Nairobi informal settlements and might elsewhere in sub-Saharan Africa.

Keywords: informal settlements; private sector provision; sanitation; sanitation service delivery; school.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Timeline of study components.
Figure 2
Figure 2
Geometric mean of samples collected throughout the day from toilets in both arms in Term 3.
See this image and copyright information in PMC

References

    1. UN-Habitat Streets as Public Spaces and Drivers of Urban Prosperity. [(accessed on 30 November 2015)]. Available online: http://unhabitat.org/books/streets-as-public-spaces-and-drivers-of-urban...
    1. World Health Organization (WHO) Meeting the MDG Drinking Water and Sanitation Target: The Urban and Rural Challenge of the Decade. [(accessed on 30 November 2015)]. Available online: http://www.who.int/water_sanitation_health/monitoring/jmpfinal.pdf.
    1. Paterson C., Mara D., Curtis T. Pro-poor sanitation technologies. Geoforum. 2007;38:901–907. doi: 10.1016/j.geoforum.2006.08.006. - DOI
    1. Mara D. Low-Cost Urban Sanitation. Wiley; Chichester, UK: 1996.
    1. Mara D. Sanitation: What’s the real problem? IDS Bull. 2012;43:86–92. doi: 10.1111/j.1759-5436.2012.00311.x. - DOI

Publication types

LinkOut - more resources