ArticleBMC public health2014
Descending the sanitation ladder in urban Uganda: evidence from Kampala Slums.
Article in BMC public health, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
43 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Open defecation-free slippage and its associated factors in Ethiopia: a systematic review.Systematic reviews · 2020Pooled it
- Performance of Pit Latrines and Their Herd Protection Against Diarrhea: A Longitudinal Cohort Study in Rural Ethiopia.Global health, science and practice · 2024Trial
- Shared Sanitation Management and the Role of Social Capital: Findings from an Urban Sanitation Intervention in Maputo, Mozambique.International journal of environmental research and public health · 2018Trial
- Long-term usage, condition, and cultural acceptability of the BALatrine project: findings from a subsidised sanitation improvement intervention in rural Central Java, Indonesia.Infectious diseases of poverty · 2026Article
- An exploratory study on shared sanitation and equity in peri-urban India.Scientific reports · 2026Article
- Behavioral patterns in latrine use and handwashing in rural western Kenya: Age, time of day, and the role of perceived safety.PloS one · 2026Article
- Risk-based prioritization of operation and maintenance indicators for school sanitation decision support in Kampala City, Uganda.Discover water · 2026Article
- Factors enhancing operation and maintenance of sanitation facilities for improved service levels in Kampala Schools.BMC public health · 2025Article
- Sanitation-related withholding and suppression among women in urban Uganda and India.Nature water · 2025Article
- Article
- ATP-based assessments of recent cleaning and disinfection for high-touch surfaces in low-resource shared toilets.NPJ clean water · 2024Article
- Challenges of sanitation in developing counties - Evidenced from a study of fourteen towns, Ethiopia.Heliyon · 2023Article
- Shared but Clean Household Toilets: What Makes This Possible? Evidence from Ghana and Kenya.International journal of environmental research and public health · 2022Article
- Stakeholders' Knowledge, Attitude, and Perceptions on the Control ofFrontiers in veterinary science · 2022Article
- Formative Research to Design a Child-Friendly Latrine in Bangladesh.International journal of environmental research and public health · 2021Article
- Using path analysis to test theory of change: a quantitative process evaluation of the MapSan trial.BMC public health · 2021Article
- Diarrhoea among Children Aged under Five Years and Risk Factors in Informal Settlements: A Cross-Sectional Study in Cape Town, South Africa.International journal of environmental research and public health · 2021Article
- Re-conceptualizing sustainable urban sanitation in Uganda: why the roots of 'Slumification' must be dealt with.BMC public health · 2021Article
- Using system dynamics to assess the complexity of rural toilet retrofitting: Case study in eastern China.Journal of environmental management · 2021Article
- Characteristics of sanitation and hygiene facilities in a slum community in Kampala, Uganda.International health · 2021Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWhile 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.
methodsA 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.
resultsWhether 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.
conclusionWhereas 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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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.