A mixed-methods study of women’s sanitation utilization in informal settlements in Kenya

Abstract

While access to safe sanitation is a global issue, there are large disparities in access. Women living in informal settlements, in particular, are disproportionately affected by lack of access to sanitation. Without adequate sanitation, these women may resort to unsafe strategies to manage their sanitation needs, but limited research has focused specifically on this issue. Qualitative and quantitative data were collected from women in the Mathare informal settlement in Nairobi, Kenya in 2016. A latent class analysis (LCA) using the quantitative data yielded five distinct sanitation profiles (SP) among women in Mathare. In-depth interviews and sanitation walks with women added further detail about the characteristics of and motivations underlying each profile. Women’s sanitation profiles in these settlements are complex. A majority of women in this study utilized an unsafe method of disposal at least once in a 24-hour period that increased their risk of direct exposure to waste and harmful pathogens.

Burden, Antibiotic Resistance, and Clonality of Shigella spp. Implicated in Community-Acquired Acute Diarrhoea in Lilongwe, Malawi

“…However, in the present study, most isolates were retrieved from male patients in the age group 12–45 years (30/34, 88.2% of isolates), similar to reports by another study in Iran [ 41 ]. The affected age group and gender are important for the epidemiology of shigellosis infections and appeared to be associated with the level of personal hygiene [ 42 ]. It has been suggested that females appeared to maintain better personal hygiene than males, as reported by Mayavati.…”

Environmental Correlates of Health-Related Quality of Life among Women Living in Informal Settlements in Kenya

“…As more sanitation interventions are being introduced into settlements, women’s regular access to toilets is expanding. For example, findings from this study suggest about 40% of women report having access to a toilet at all times during the night and day, up from only 26% in 2016 [18]. Even the most recent evidence, however, suggests that well over half of women do not have access to a toilet at all times.…”

“…Previous research in Mathare, carried out by the authors of this study, suggests that the majority of women living in these environments cannot, for a variety of reasons including lack of resources and/or time, fear of violence, health concerns, time of day, and building closures, access a toilet for all of their daily sanitation needs and, as a result, revert at least once in a 24 h period to using open defecation and/or plastic bags or buckets in their homes (which are then emptied into open drainages outside the home) to manage urination and/or defecation [18,33,34,35]. As more sanitation interventions are being introduced into settlements, women’s regular access to toilets is expanding.…”

“…According to estimates from the same study, only about 11% of residents had access to private in-home or in-yard piped water while the majority of the remaining residents relied on stand points or water kiosks outside the home [15]. More recent estimates from research carried out with 550 female residents of Mathare in 2016 suggest that about three-quarters of female residents of Mathare rely on shared public toilets or ‘plot’ toilets shared by clusters of 20–30 households and about three-quarters of women use plastic bags, buckets, or open defecation to manage their daily sanitation needs at least once in a 24 h period [18]. Additionally, data from the same study indicate that almost 14% of female residents have access to private in-home or in-yard taps or wells, but over half (57%) of women rely on public taps (including kiosks) or wells for their drinking water [19].…”

Mobility Patterns During COVID-19 Travel Restrictions in Nairobi Urban Informal Settlements: Who Is Leaving Home and Why

“…While transmission of COVID-19 in the country remains low [1], the potential for uncontrolled outbreaks in urban slums is still of great concern given that 60-70% of Nairobi residents reside in informal settlements [2]. To prevent COVID-19, the World Health Organization has promoted physical distancing (e.g., keeping 1-2 m apart, avoiding touching) and handwashing [1], but these strategies are harder to implement in informal settlements, areas that are densely populated, overcrowded, lack access to running water or improved sanitation, are comprised of multigenerational households, have transient household members, and experience pervasive poverty with many households having unstable or informal income [3][4][5][6][7][8].…”