Acceptability of urine diversion dry toilets in Dollo Ado refugee camp, Ethiopia
Dan Campbell
From: Patrick, Molly (CDC/DDID/NCEZID/DHQP) <ve...@cdc.gov>
Date: Mon, Apr 5, 2021 at 10:34 AM
We have a new publication summarizing our findings from a large acceptability study on urine-diversion dry toilets at a refugee camp in Ethiopia – it is available for free download until May 20th.
https://authors.elsevier.com/a/1cqEK574Px292Q
Acceptability of urine diversion dry toilets in Dollo Ado refugee camp, Ethiopia. International Journal of Hygiene and Environmental Health, Volume 234, May 2021.
Given the increasing frequency and duration of humanitarian emergencies worldwide, there is a need to identify a greater range of effective and contextually appropriate water, sanitation and hygiene (WASH) interventions. Typical sanitation systems may be poorly suited for some of the conditions in which humanitarian emergencies can occur, such as in drought-prone regions.
Urine-diversion dry toilets (UDDTs) are one potential alternative sanitation option which can be used in these conditions. Between 2014 and 2016, the U.S. Centers for Disease Control and Prevention (CDC) partnered with local agencies to evaluate the acceptability of UDDTs in a refugee camp in Ethiopia. The overall goals were to provide evidence regarding the level of adoption and satisfaction with UDDTs in this emergency context and the factors associated with satisfaction.
Two cross-sectional surveys were conducted 18-months apart, using a stratified design to sample UDDT and latrine users for comparison. The proportion who reported to use their UDDT consistently was 88.8% (95% CI 85.1–92.5) in the first survey and 93.4% (95% CI 90.6–96.2) in the second survey.
Reported satisfaction levels were significantly higher among respondents in the second survey (p < 0.0001), where 97.0% (95% CI 95.1–98.9) of respondents stated either that they were mostly or very satisfied with their UDDT. There was no significant difference detected in satisfaction between UDDT and latrine users (p = 0.28).
Using a multivariable logistic regression model, we identified several factors associated with a higher level of satisfaction with UDDTs. Those who had previously (before coming to the camp) used a pit latrine (AOR = 4.2; 95% CI 1.4–12.7) or had no sanitation system (AOR = 2.4; 95% CI 1.3–4.4) relative to a pour-flush toilet, had a clean UDDT (AOR = 2.8; 95% CI 1.7–4.6), had been in the camp for a longer time period (AOR = 2.3; 95% CI 1.7–3.0), did not share their UDDT (AOR = 1.8; 95% CI 1.0–3.0) and had used their UDDT for a longer time period (AOR = 1.7; 95% CI 1.2–2.4) had higher odds of satisfaction.
The findings demonstrate that UDDTs have been effectively introduced and utilized in this context and this may have implications for other humanitarian settings where they can be similarly managed.
Best,
Molly
Dan Campbell
Knowledge Creation/WASH Specialist, ECODIT│www.ecodit.com
USAID Water Communications and Knowledge Management (CKM) Project
Implemented by a Consortium led by ECODIT
Email: dcam...@waterckm.com
Phone: 571-777-8485, ext. 107
Skype: dan.campbell49
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