Assessment of the faecal sludge management practices in households of a sub-Saharan Africa urban area and the health risks associated

The aim of this study was to assess on-site sanitation facilities in Yaounde on the basis of the eight proposed indicators of hygienic safety, sustainability and functionality of the Millennium Development Goals (MDG) target 7 definitions of improve sanitation. Information were collected on the design of toilet facilities, management and functionality through a semi-structured interview and observations of 602 randomly selected toilets in 22 different urban settlements of Yaounde. Several methods of excreta disposal were found. Approximately 3% of households had no latrine and practiced open defecation. Households that lacked proper toilet facilities frequently suffered from orally transmitted sanitation-related diseases.

Introduction

The purpose of a sanitation system is to protect and promote human health and environmental conditions (Cheng et al., 2018). Provision of adequate sanitation facilities is a basic underlying factor for good human health, economic development and well-being (Tilley et al., 2014; Brown et al., 2015). It was estimated that in 2010, 2.6 billion individuals did not have access to improve sanitation (Peletz et al., 2020). The Sustainable Development Goals (SDGs) adopted by the UN General Assembly in 2015 aims to substantially improve water and sanitation globally, and includes two specific targets within Goal 6 for drinking water, sanitation and hygiene (WaSH): (i) the first target aims at achieving universal and equitable access to safe and affordable drinking water for all by 2030, while the second aims at achieving access to adequate, equitable sanitation and hygiene for all and end open defecation within the same period. Progress towards the Millennium Development Goals (MDGs) which preceded the SDGs was monitored globally based on the use of improved drinking water supplies and sanitation facilities. The SDGs aim at higher water and sanitation service provision and are being monitored using indicators which include elements of service quality that were not captured by the MDG indicators (Wolf et al., 2018). On-site sanitation systems for excreta collection are widespread in Yaounde, with the predominance of pit latrines. The city does not have any faecal sludge treatment plant and it was estimated by Berteigne (2012) that about 700–1,300 m³ of faecal sludge are discharged weekly into the environment of peri-urban areas. This abstract presents a detailed assessment of household excreta disposal facilities in some settlements of Yaounde, the capital city of Cameroon.

Methods

The methodology use took into account several steps as follow:

1. Assessment of the existing faecal sludge management practices at household level; 
2. Household survey (according to the methodology described by Lüthi and Parkinson (2011)); 
3. Toilet facilities observation;
4. Indicators of improved, safe and sustainable sanitation (following the methodology used by Jenkins et al., 2014);
5.  Health risks assessment related to the excreta disposal facilities ( Stenström et al., 2011);
6.  Statistical analysis.

 Results and discussion (also see in the additionnal data attached)

1. Typology of excreta disposal: The finding of this study revealed that there were differences in on-site sanitation system from one urban setting to the other within the study area with the predominance of  traditional pit latrines. Open defecation practice was also reccorded.

2. The variation of the WHO/UNICEF JMP indicators observed in the study area may be explained by the differences observed in the monthly incomes, level of education of householders as well as the willingness of householders to pay for access to an improve and sustainable sanitation system.

3. Sanitary and environmental risks associated with the current defecation practices in surveyed households: Based on the survey results, 61.30% (n=598) of the investigated population have suffered from several cases of faecal-oral transmitted diseases (amoebiasis, cholera, helminthiasis, thyphoid fever) within the past six months with the difference of prevalence between current defection practices in households.

The objective of this study was to present a detailed assessment of excreta disposal facilities in 602 randomly selected households in the city of Yaounde (Cameroon). The study aimed at proposing and applying a set of indicators to characterize and assess the hygienic safety and sustained functioning of the existing device, including locally available excreta disposal, according to JMP definitions and the assessment of the health status of latrine users. The results showed that several mods and characteristics of individual sanitation are closely related to the standard of households as well as the household incomes and the level of education. Also, the observed heterogeneity of sanitation systems is related to the standard of the surveyed households, the monthly income and the level of education. The latrine facilities were different in terms of number of users, emptying modes and frequency, as well as building material. The respondents using inadequate toilet facilities are suffering from faecal-oral transmitted diseases, with higher prevalence in rainy seasons. The finding of this study may have important implications for defining what constitutes "improved sanitation" for poor populations living in unplanned informal settlements