Vouchers for Improving Sanitation: A Step toward Stopping Open Defecation.

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Author: Wendee Nicole
Date: July 2022
From: Environmental Health Perspectives(Vol. 130, Issue 7)
Publisher: National Institute of Environmental Health Sciences
Document Type: Report
Length: 1,180 words
Lexile Measure: 1630L

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Eliminating open defecation by 2030 is one of the United Nations' Sustainable Development Goals. (1) As of 2020, more than 494 million people worldwide routinely defecated outdoors instead of using a toilet. (2) This represents a sharp decrease from the 1990 estimate of 1.3 billion people, (3) but it is not clear whether further sanitation improvements can be achieved or sustained, especially by poor and vulnerable households. (4) A new study reported in Environmental Health Perspectives (4) investigated how providing durable toilets to vulnerable Ghanaian households would affect communities' "open defecation-free" (ODF) status.

ODF status is achieved when a community has no evidence of open defecation and 80-100% of households--depending on the country--own and use toilets. (2) A strategy called community-led total sanitation (CLTS) is used to help attain ODF status. (5) This method involves triggering feelings of shame and disgust about a community's level of visible defecation in order to motivate people to build and use toilet facilities. (5) Although there is evidence that CLTS prompts people to discontinue open defecation initially, its long-term effectiveness for maintaining sanitation is less certain. (5) One reason is that toilets are expensive to construct and maintain. People with limited income typically build latrines with unlined pits, mud walls, and squatting platforms. (5) If these structures collapse, residents often return to open defecation. (6)

The new study included more than 5,000 households in 109 randomly selected communities in the Tatale and Kpandai Districts of Northern Ghana. Prior to the study, these communities had achieved ODF status through implementation of CLTS, although not all had maintained that status. Fifty communities were assigned as controls. The remaining 59 were assigned to the subsidy group, where vulnerable households received vouchers to purchase a latrine substructure. Personnel from the District Assemblies (planning...

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Gale Document Number: GALE|A712308614