ArticleDiscover water2026
Risk-based prioritization of operation and maintenance indicators for school sanitation decision support in Kampala City, Uganda.
Article in Discover 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.
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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.
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7 authors.
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Abstract
Effective operation and maintenance (O&M) of sanitation facilities are vital for ensuring consistent service delivery in schools, yet many low- and middle-income contexts continue to face challenges stemming from reactive maintenance practices and weak management systems. This study developed and applied a risk-based approach to identify and prioritize O&M processes that most threaten the continuity of sanitation services in Kampala City schools. Using a cross-sectional workshop-based design, 106 head teachers and 99 sanitation teachers from 205 schools assessed the status, likelihood, and severity of failure for 33 indicators across six O&M domains. Risk scores were computed following the adapted World Health Organization's Sanitation Safety Planning framework, and indicators were ranked using median (P50) and upper-quartile (P75) statistics to identify priority areas. The results showed that 46% of the indicators were rated as low risk, 24% as medium risk, and 30% as high risk, with no indicator classified as very high-risk. Material supply and use management, toilet cleanliness, preventive maintenance schedules, menstrual hygiene material provision, and sanitation budget-line implementation were identified as the most critical areas requiring attention. Although several monitoring and evaluation indicators ranked as lower risk, this reflects their strong current performance rather than a reduced importance in sustaining sanitation services. The findings highlight that the main threats to sanitation service reliability arise from weak O&M practices and resource management processes rather than infrastructure deficits. Targeting preventive maintenance, supply management, and budget execution provides a practical pathway for strengthening the functionality, reliability, and continuity of sanitation services within resource-limited school environments. Graphical abstract: Supplementary Information: The online version contains supplementary material available at 10.1007/s43832-026-00412-4.
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