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Pit latrines are one of the most common human excreta disposal systems in low-income countries, and their use is on the rise as countries aim to meet the sanitation-related target of the Millennium Development Goals. There is concern, however, that discharges of chemical and microbial contaminants from pit latrines to groundwater may negatively affect human health. Our goals were to a) calculate global pit latrine coverage, b) systematically review empirical studies of the impacts of pit latrines on groundwater quality, c) evaluate latrine siting standards, and d) identify knowledge gaps regarding the potential for and consequences of groundwater contamination by latrines. We used existing survey and population data to calculate global pit latrine coverage. We reviewed the scientific literature on the occurrence of contaminants originating from pit latrines and considered the factors affecting transport of these contaminants. Data were extracted from peer-reviewed articles, books, and reports identified using Web of ScienceSM, PubMed, Google, and document reference lists. We estimated that approximately 1.77 billion people use pit latrines as their primary means of sanitation. Studies of pit latrines and groundwater are limited and have generally focused on only a few indicator contaminants. Although groundwater contamination is frequently observed downstream of latrines, contaminant transport distances, recommendations based on empirical studies, and siting guidelines are variable and not well aligned with one another. In order to improve environmental and human health, future research should examine a larger set of contextual variables, improve measurement approaches, and develop better criteria for siting pit latrines.

In Fiji, 90% of the population has access to basic sanitation; however, there are still persistent health risks from endemic faecal-oral diseases such as typhoid fever. There is a need to assess the contribution of existing sanitation facilities in the faecal pathogen transmission pathway. This study was conducted as part of a larger planetary health study across 29 rural communities within five river catchments. This specific research aimed to characterise latrine front-ends, both infrastructure and usage behaviour, and to assess the faecal contamination levels on various frequently contacted latrine surfaces in rural Fiji. A sanitation survey, along with observation and latrine swab sampling, was conducted in households over three phases: baseline ( n  = 311) (Aug–Dec 2019), endline ( n  = 262) (Jun–Sep 2022) and an in-depth front-end study ( n  = 12) (Oct–Nov 2022). Of 311 households, almost all had pedestal-type latrines, predominately cistern-flush (83%), followed by pour-flush (13%), and then hole-type (pit) latrines (4%). Washable latrine floors had significantly higher E. coli densities (6.7 × 10 2  CFU/25 cm 2 ) compared to non-washable floors (1.3 × 10 2  CFU/25 cm 2 ) ( p  = 0.05), despite washable floors indicating improved latrines. The in-depth front-end analysis found that moist latrine surfaces had significantly elevated E. coli densities (1.2 × 10 3  CFU/25 cm 2 ) compared to the dry ones (14.3 CFU/25 cm 2 ) ( p  < 0.001), highlighting the importance of maintaining dry latrine surfaces. Latrine floors and mid-walls were the most frequently contaminated surfaces, emphasising the need to clean and disinfect these surfaces. Only 46% of the households reported always using soap for handwashing after defecation, exacerbating the risk of transmitting faecal pathogens. This study highlights that latrine cleanliness and hygiene are as crucial as latrine infrastructures for the effective disruption of faecal pathogens transmission during latrine use.

Ethiopia recorded the world's fastest increase in latrine coverage over the past two decades, but it was largely achieved by the adoption of latrines that do not meet basic hygienic standards. Therefore, this study aims to examine the quality of latrines and their upgrading at household level through a case study from the Loka Abaya district, South Ethiopia. Of the initially sampled 549 households, 422 (77%) had private latrines, and a survey was administered among them. The data were characterized descriptively, and correlates of the latrine quality and willingness to improve were analysed. The average latrine quality score in the sample was only 2.8 of the maximum six quality dimensions. Despite the low quality of latrines, 63% of respondents were satisfied with their sanitation situation. Both past improvements and plans to improve latrines were frequently reported. However, these reported changes mostly involved regular maintenance or reconstructions of collapsed latrines. No substantial upgrading of the functionality was identified. We identified inadequate awareness about the means of hygienic sanitation, implying the importance of community education. Demand for as well as supply of hygienic sanitation products are further constrained by the low purchasing power of households implying a need for sanitation subsidies.

Background Despite evidence showing that access to and use of improved sanitation is associated with healthier households and communities, barriers influencing the adoption and sustainablity of sanitation facilities remain unclear. We conducted a qualitative case study to explore barriers influencing the adoption, sustainablity and consistent use of sanitation facilities in rural Ethiopia. Methods A qualitative study was conducted in the rural district of Becho, in central Ethiopia, from June to August 2016. A socio-ecological model and Integrated Behavioural Model (IBM) for a Water Hygiene and Sanitation (WASH) framework were employed to design the study and analyse data. A total of 10 in-depth interviews (IDI) were conducted with latrine adopters ( n  = 3), latrine non-adopters (n = 3), health extension workers (n = 3) and the district WASH coordinator ( n  = 1). Eight Focus Group Discussions (FGD) were undertaken with 75 participants, of which 31 were women. The FGDs and IDIs were tape-recorded, transcribed verbatim and translated into English. The analysis was supported using Nvivo version 10 software. Results Barriers to sustained adoption and use of sanitation facilities were categorized into 1) individual level factors (e.g., past latrine experience, lack of demand and perceived high cost to improved latrines), 2) household level factors (e.g., unaffordability, lack of space and absence of a physically strong family member), 3) community level factors (e.g., lack of access to public latrines, lack of shared rules against open defecation, lack of financial access for the poor), and 4) societal level factors (e.g., lack of strong local leadership, flooding, soil conditions, lack of appropriate sanitation technology, lack of promotion and demand creation for improved latrines). Conclusion The use of the socio-ecological model and IBM-WASH framework helped to achieve a better understanding of multi-level and multi-dimensional barriers to sustained latrine adoption. The results indicate that there is a need to consider interventions that address multi-level factors concurrently.

The ventilated improved pit (VIP) latrine is a cheaper and convenient alternative to water-borne sanitation for many households in developing countries. To mimic the water closet toilet, some users have introduced prefabricated ceramic seats with covers, which are known to disrupt the odour control mechanism of the latrine. The objective of this study was to quantitatively establish the extent to which the use of seats with covers affects the ventilation rate in the VIP latrine and to explore whether an innovative seat with a partially-screened cover could significantly minimise the effect of seat covering. The ventilation rates in experimental latrines with various modifications of superstructure and user interface designs were monitored with an air flow meter. The study revealed that seat covering could lead to >87% reduction in the ventilation rate and allow the generation of <50% of the minimum ventilation rate required to achieve odour-free conditions in an otherwise standard VIP latrine. The study also established that lining part of the seat cover with an insect screen could increase the ventilation rate by more than three times and could attain the minimum ventilation rate when combined with the conventionally recommended superstructure design.

Background Within the past two decades, Ethiopia has achieved one of the fastest reductions of open defecation worldwide. This change can be attributed to the implementation of a national sanitation strategy that focused on facilitating community demand for latrine adoption and use of basic self-constructed latrines but less on other preconditions of hygienic sanitation. Recognition of sanitation by policymakers also catalyzed primary research in this area. As such, the synthesis of the available evidence is both warranted and possible. In this article, we thus decided to assess available primary evidence on the household-level sanitation in Ethiopia and its influencing factors. Methods We searched primary studies that present findings on the role of factors influencing household-level sanitation outcomes in Ethiopia. We typologically classified sanitation outcomes analyzed in identified literature and computed pooled estimates for the most prevalent ones (measures of latrine availability and use). We characterized thematic types (themes and sub-themes) of influential sanitation drivers and used network analysis to examine the relational patterns between sanitation outcomes and their influencing factors. Findings We identified 37 studies that met our inclusion criteria—all but one published after 2009. The general latrine coverage pooled across 23 studies was 70% (95% CI: 62–77%), the share of improved latrines pooled across 15 studies was 55% (95% CI: 41–68%), and latrine use pooled across 22 studies was 72% (95% CI: 64–79%). Between-study heterogeneity was high, and no time trends were identified. The identified sanitation outcomes were classified into eight types and factors reported to influence these outcomes were classified into 11 broader themes and 43 more specific sub-themes. Factors around the quality of latrines represented the most frequent sub-theme of consequential drivers. We found that the available research focused predominantly on outcomes concerning the initial adoption and use of basic latrines, emulating the main focus of national sanitation strategy. By contrast, research on drivers of the sustainability of sanitation change and, in particular, on the upgrading of latrines, has been rare despite its urgency. There is a high need to redirect the focus of sanitation research in Ethiopia towards understanding these factors on both the demand and supply side.

Background A pit latrine is the most basic form of improved sanitation which is currently used by a number of people around the globe. In spite of the wide spread use, known successes and advantages associated with pit latrines, they have received little attention in form of research and development. This review focuses on the usage and performance (filling, smell and insect nuisance) of pit latrines in urban areas of sub-Saharan Africa (SSA) and proposes approaches for their improvements and sustainability. Methods Current pit latrine usage within urban SSA was calculated from Joint Monitoring Programme (JMP) water and sanitation country-files. We conducted a literature search and review of documents on pit latrine usage, filling, smell and insect nuisances in urban areas of SSA. Findings of the review are presented and discussed in this paper. Results and Discussion Pit latrines are in use by more than half the urban population in SSA and especially among low income earners. An additional 36 million people in urban areas of SSA have adopted the pit latrine since 2007. However, their performance is unsatisfactory. Available literature shows that contributions have been made to address shortfalls related to pit latrine use in terms of science and technological innovations. However, further research is still needed. Conclusion Any technology and process management innovations to pit latrines should involve scientifically guided approaches. In addition, development, dissemination and enforcement of minimum pit latrine design standards are important while the importance of hygienic latrines should also be emphasized.

The primary objective of this research was to identify the factors that influence sanitation behaviors toward the adoption and use of latrines in Babille woreda, Fafan zone, Somali region, eastern Ethiopia. A cross-sectional community-based study design was used. Household survey was used to collect quantitative data. Qualitative data were also gathered through focus group discussions and key informant interviews. A total of 383 respondents were included in the study. Descriptive statistics and logistic regression were used to analyze the quantitative data. Adjusted odds ratio and 95% confidence intervals were calculated using a logistic regression model. Focus group discussions and key informant interviews were analyzed through thematic analysis. In the study area, 228 (59.5%) households had adopted latrines. However, only about one-third of them (111, 29.0%) consistently used the latrine. Sex, occupation, income, being aware of latrine construction, use and maintenance, and sources of information were significantly associated with household latrine adoption. Interventions to increase latrine adoption and utilization should account for differences in latrine adoption disparities by sex of the household head, occupation, and household income.

Latrine ownership and utilization is an integral part of the Community-Led Total Sanitation concept. This study assessed ownership and utilization of latrines in selected Open Defecation and Open Defecation-Free communities within the Bole district. A cross-sectional survey design and quantitative approach were employed in this study. Simple random sampling was used to select 166 households from 15 Open Defecation and 5 Open Defecation-Free communities. Data collection was done using a structured questionnaire. Data was analyzed using descriptive statistics, chi-square, and binary logistic regression. The proportion of latrine ownership and utilization were 22.3% and 6.6% respectively. Educational qualification, tertiary education (aOR: 6.1; 95% CI: 1.05–35.56), household subjective norms (OR: 0.19; 95% CI: 0.04–1.01), and awareness of Community-Led Total Sanitation (aOR: 13.3; 95% CI: 2.95–60.24) were determinants of latrine ownership and or utilisation. In conclusion, latrine ownership and use were generally low with education, awareness of community-led total sanitation, residential status, and household subjective norms as factors associated with ownership and or utilization. Education or sensitization should target cultural norms impeding latrine construction and usage. Again, implementable by-laws/community regulations must be implemented to propel latrine ownership and utilization.

In vitro methods were used to assess the full potential for decomposition (measured as biogas formation) from pit latrine samples taken from the top layer of 15 Tanzanian latrines. We found considerable variability in the decomposition rate and extent. This was compared with decomposition in the same latrines, measured by comparing top layer composition with fresh stools and deeper (older) layers, to assess whether this potential was realised in situ. Results showed a close match between the extent of organic material breakdown in situ and in vitro, indicating that anaerobic digestion is the dominant pathway in latrines. The average potential decrease in chemical oxygen demand (COD) (determined as methane production in vitro within 60 days) and actual measured decrease in situ are 68.9% ± 11.3 and 69.7% ± 19.4, respectively. However in the in vitro tests, where samples were diluted in water, full decomposition was achieved in 2 months, whereas in situ it can take years; this suggests that water addition may offer a simple route to improving latrine performance. The results also allowed us to estimate, for the first time to our knowledge using experimental data, the contribution that latrines make to greenhouse gas emissions globally. This amounts to ∼2% of annual US emissions.