This report examines why women in Mathare Valley, Nairobi, continue to avoid public toilets even after years of sanitation projects and new facilities.
The core problem is not simply the number of toilets. Women in the informal settlement still struggle with safety, privacy, cleanliness and the cost of using shared facilities, according to a study carried out in Mathare.
Researchers found that about 2.3 billion people worldwide still lack access to basic toilets, contributing to poor sanitation and about 280,000 deaths each year. But the burden is not shared equally: women and girls in developing countries are hit hardest when sanitation is missing in homes, schools, communities and public spaces.
In Mathare, the situation has improved only partially. Seven years before the report, there were about 144 public toilet facilities in the settlement. Even then, between 17 and 232 people depended on a single toilet, and more than 70 percent of residents had to walk more than 50 meters to reach one.
Since then, non-governmental organisations and the government have expanded access. Sanergy, a social venture, has launched more than 140 toilets in Mathare. Other efforts mentioned in the study include Grand Challenge Canada-funded Banza toilets and a National Youth Service slum improvement project.
Despite those interventions, many women still do not use the toilets consistently. The study found that about one-third of women relied on a bucket, plastic bags or open defecation at least once during the day, while more than two-thirds used those methods at night.
Within 24 hours, 75 percent of women relied on plastic bags or buckets at least once for their ablutions, then disposed of the waste in open drains or rivers near their homes. About 40 percent used public toilets for some daytime sanitation needs, but could not rely on them alone.
The researchers said the barriers go beyond access. Women feared sexual assault, rape and theft, and many also pointed to poor cleanliness and a lack of privacy. On average, toilets in Mathare are shared by 70 people, and some are used by hundreds, making upkeep difficult.
The study also found stalls with missing doors or locks, flooded or blocked toilets, and facilities that were not cleaned properly. Some public toilets had separate sections for men and women, but not all were open all the time, and some had closed one gender section entirely.
Night-time use was especially difficult. Participants said they felt unsafe leaving their homes after dark, even when toilets were close by. The women did not view the toilets as safe spaces, and many said the settlement itself felt unsafe.
Cost was another major obstacle. Most toilets in Mathare charge between Sh3 and Sh10 per month, while a family fee ranges from Sh100 to Sh150. With the average household income at about Sh8500 and monthly spending often exceeding that amount, little money is left for sanitation.
The study also noted that some women do not control household spending and therefore cannot decide to allocate more money to toilet use. In addition, many community toilets have free urinals for men, but no similar arrangement for women.
Some participants said they would benefit from free urinals or one or two stalls in a public toilet facility that could be used for urination and changing menstrual pads. The researchers said policymakers must address safety and privacy, especially at night, if sanitation gains are to last.
They recommended better lighting around public toilets and other community or technological measures that would make women feel safer when using them.
The wider context remains stark. Kenya has about 6.5 million people living in urban informal settlements. That figure rose from 1.5 million in 1990 to more than 6.4 million in 2014, and it is expected to keep growing, which will deepen sanitation pressures for women.
The data for the study was collected in two phases between 2015 and 2017. In the first phase, the researchers worked with representatives from the University of Nairobi and female residents of Mathare to conduct in-depth case studies with 55 women. In the second phase, they carried out 550 household-level surveys with women in the settlement.
