Evidence map›Paper›PMID 41853472›Full record

ArticleACS ES&T water2026

What Makes Household Sanitation Systems Resilient to Floods? Evidence from Ethiopia, Uganda, and Nepal.

Jeremy Kohlitz, Abraham Geremew, Kenan Okurut, Prativa Poudel, Anish Ghimire, Anisha Nijhawan, Alejandro Valenzuela, Jay Falletta, Anjali Manandhar-Sherpa, Juliet Willetts and 1 more

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Article in ACS ES&T water, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Jeremy KohlitzInstitute of Sustainable Futures, University of Technology Sydney, 235 Jones Street, Sydney, New South Wales 2007, Australia.
Abraham GeremewDepartment of Environmental Health, College of Health and Medical Sciences, Haramaya University, P.O. Box 138, Dire 138, Dawa, Ethiopia.
Kenan OkurutKyambogo University, P.O. Box 1, Kyambogo, Kampala, Uganda.
Prativa PoudelDepartment of Environmental Science and Engineering, Kathmandu University, Dhulikhel, 45200, Nepal.
Anish GhimireDepartment of Environmental Science and Engineering, Kathmandu University, Dhulikhel, 45200, Nepal.
Anisha NijhawanSchool of Civil, Aerospace and Design Engineering and Cabot Institute for the Environment, University of Bristol, Bristol BS8 1TR, U.K.ORCID https://orcid.org/0000-0003-0317-7306
Alejandro ValenzuelaInstitute of Sustainable Futures, University of Technology Sydney, 235 Jones Street, Sydney, New South Wales 2007, Australia.
Jay FallettaInstitute of Sustainable Futures, University of Technology Sydney, 235 Jones Street, Sydney, New South Wales 2007, Australia.
Anjali Manandhar-SherpaSchool of Civil, Aerospace and Design Engineering and Cabot Institute for the Environment, University of Bristol, Bristol BS8 1TR, U.K.
Juliet WillettsInstitute of Sustainable Futures, University of Technology Sydney, 235 Jones Street, Sydney, New South Wales 2007, Australia.ORCID https://orcid.org/0000-0002-3975-9642
Guy HowardSchool of Civil, Aerospace and Design Engineering and Cabot Institute for the Environment, University of Bristol, Bristol BS8 1TR, U.K.ORCID https://orcid.org/0000-0002-1848-9807

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Climate change is influencing precipitation events and patterns, leading to more frequent and severe flooding in many regions worldwide. In low- and middle-income countries, concerns about worsening floods disrupting access to safe sanitation for households are driving discussions about how to make sanitation systems more resilient. Much of this discourse relies on context-specific experiences or theory. This study surveyed 1,429 households in Nepal, Ethiopia, and Uganda to identify attributes linked to poor sanitation outcomes due to flooding to better inform sanitation planning and policy. Logistic regression was used to examine correlations between household and sanitation-system characteristics and (1) sanitation system failures and (2) adoption of open defecation following floods. The findings suggest that exposure to flooding significantly increases household sanitation system failures and that the quality of the construction and maintenance of sanitation facilities is correlated with these failures. Living in rural areas, using poor-quality latrine slabs, and discomfort in using a neighbor's toilet were correlated with open defecation following flood damage to household sanitation systems. These findings support a policy focus on well-built, well-maintained sanitation in flood-prone areas and the provision of alternatives when facilities fail. Other commonly recommended measures, such as raising latrines, were not found to correlate with outcomes and require further investigation.

Indexed as

AfricaAsiaclimate changefloodingLMICstoilets: latrinesvulnerability

Identifiers

PMID41853472
PMCPMC12993853

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.