Even after more toilets were built in Mathare Valley, many women in the Nairobi informal settlement still avoided them because of safety fears, poor privacy, weak cleanliness and the cost of using them. The findings, published on 21 November 2018, show that access alone has not solved the sanitation problem for women in the area.
The study said about 2.3 billion people globally lack basic toilets, contributing to poor sanitation and roughly 280,000 deaths each year. It also noted that women and girls in developing countries carry a heavier burden because sanitation gaps affect homes, schools, communities and public spaces.
Researchers said women who depend on shared toilets often struggle to manage daily toilet needs and menstruation in private and safe conditions. In unsanitary settings, they face risks including urinary tract infections, toxic shock syndrome and vaginal infections, while delaying urination or bowel movements can also cause dehydration and haemorrhoids.
The research focused on Mathare Valley informal settlement in Nairobi, Kenya, where the team examined women’s sanitation habits and the factors shaping their choices. Seven years before the article was published, Mathare had about 144 public toilet facilities, with between 17 and 232 people relying on a single toilet and more than 70 percent of residents walking over 50 metres to reach one.
Since then, non-governmental organisations and the government have expanded toilet access. Sanergy, a social venture, has launched more than 140 toilets in Mathare, while other efforts have included the Grand Challenge Canada-funded Banza toilets and a National Youth Service slum improvement project. Even so, many toilets still charge users between Sh3 and Sh10 per month, or about USD$0.03 to USD$0.10.
The study found that roughly one-third of women used a bucket, plastic bag or open defecation at least once during the day, and more than two-thirds relied on those methods at night. It also said about 40 percent used public toilets for some needs during the day, but could not depend on them exclusively. Within 24 hours, 75 percent had used plastic bags or buckets at least once and then disposed of the waste in open drains or rivers near their homes.
Researchers said the problem was not simply the number of toilets. Women reported fears of sexual assault, rape and theft, along with concerns about poor cleanliness and lack of privacy. On average, toilets in Mathare are shared by about 70 people, and some are used by hundreds, making upkeep difficult.
The study also found broken or missing doors and locks, flooded or blocked stalls, poor cleaning and toilets that were sometimes closed or had one gender section shut. Because many women do not feel safe in the settlement at night, even a short walk to a toilet can be a deterrent.
Cost was another major barrier. The article said a family fee ranges from Sh100 to Sh150, while the average household income in Mathare is about Sh8,500 and monthly spending often exceeds that amount. Some women also lack control over household spending, which limits their ability to pay for sanitation.
Researchers pointed out that many community toilets have free urinals for men, but no similar arrangement for women. When asked what would help, some participants said they wanted free urinals or one or two stalls in public toilet facilities that could be used for urination and changing menstrual pads.
The article said future policy should go beyond building more toilets and also address safety, privacy and nighttime access. Suggested measures included better lighting around public toilets and community or technological innovations that could make women feel safer when using them.
The research was carried out in two phases between 2015 and 2017. In the first phase, the team worked with 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.
The article also said about 6.5 million of Kenya’s 45.5 million people live in urban informal settlements. It added that the population in such settlements rose from 1.5 million in 1990 to more than 6.4 million in 2014, and was expected to keep growing, worsening sanitation pressures for women.
Winter is a Postdoctoral fellow, Rutgers University.
This article first appeared in The Conversation.
