Yes, I was also mainly thinking of public facilities, but the same applies also to households sharing a toilet.

Attached a good policy brief on the issue from u-act research project (with findings from Kampala).

Christoph discussed an included very interesting diagram on perception of cleanliness Vs. number of users here : forum.susana.org/forum/categories/106-us...-kampala-uganda#6567.

Aside from increased health risks that may be associated with shared sanitation versus an individual household latrine, shared sanitation often suffers in other dimensions as well: Harassment of women using the facilities after dark, poor accessibility for people living with disabilities and pay-per-use fees that could lead poor people to pay more for sanitation in the long-run than richer people (such as is often the case with water) come to mind. I guess I'm thinking more of an urban, public facility run by the government or entrepreneur though.

While Elisabeth has a point, when she says: "Shared sanitation is usually not as good as household-level sanitation but shared sanitation can be better than nothing (or better than open defecation)." Examining strictly in the context of this region, I have seen shared sanitation facilities that are simply dirty, unhygienic and pathetic. This could be due to the fact that, in shared facilities, no one is responsible for maintenance. May be, there could be a different case in developed countries.

I would, therefore, support the authors' views - shared sanitation facilities should not be counted as improved sanitation.

F H Mughal

The Ugandan government figure that includes shared sanitation is something like 70% coverage, while the MDG figure is something like 30%. Even though I agree that shared sanitation is better than nothing in most cases (and is definitely needed in urban settings) it is mainly an additional service to household level sanitation and can't replace it. Thus counting it towards sanitation coverage (with usually hugely inflated user numbers) will just result in a neat excuse for governments to continue with their business as usual.

It depends what you compare it to: Shared sanitation is usually not as good as household-level sanitation but shared sanitation can be better than nothing (or better than open defecation).

Just think of the acclaimed Sanergy model with shared (public) sanitation... (forum.susana.org/forum/categories/52-mob...ry-loo-user-and-kiva)

So I do think that "shared sanitation" should have some sort of impact on the MDG counting for sanitation.

This has been discussed at length by the working groups that have been discussing possible MDGs after the year 2015. See here in this thread from 2012:
forum.susana.org/forum/categories/80-glo...anitation-monitoring

In fact, recently I received the attached document by Eddy Perez entitled "WASH POST-2015: proposed targets and indicators for drinking-water, sanitation and hygiene" (April 2014). In there you find the following statement which sounds reasonable to me:

Each of the following sanitation facility types is
considered as basic sanitation for monitoring
progress toward the household sanitation
targets, if the facility is shared among no more
than 5 families or 30 persons, whichever is
fewer, and if the users know each other.

It's a nice compromise: "shared" would be counted but only if not shared with too many people, and not shared with strangers.

Actually I am not up to scratch where this process with the future MDGs or SDGs is at right now (see here on Sustainable Development Goals, SDGs: forum.susana.org/forum/categories/80-glo...velopment-goals-sdgs)

If anyone can enlighten us (Jonathan? Madelein? Chris Z.?), that would be appreciated.

Regards,
Elisabeth

Thanks Krischan - can you tell me some of the non-technical and non-health related reasons why you think they should not count towards the policy goal (or maybe that is not your opinion but the one held in Uganda, I'm not clear from your post).

This is a constant topic here in Uganda as the government is counting shared facilities towards their sanitation coverage goal.

I think that due to mostly non-technical and non-health related reasons they should not count towards a policy goal (which the MDG "improved sanitation" category is).

Hello friends,

I've just noticed this interesting review article in PlOS ONE: www.plosone.org/article/info%3Adoi%2F10....journal.pone.0093300

The authors say that shared facilities are not counted as improved sanitation (for example for MDG target), but that maybe they should be.

Interested to hear thoughts.

Edit:

On closer examination, it does seem to suggest that a change might not be a good idea:

In general, the evidence suggests that those relying on shared sanitation facilities compared to IHLs are at increased risk of adverse health outcomes, including diarrhoeal disease, helminth infection, poliomyelitis, as well as prematurity, antepartum fetal death and perinatal death. The evidence on diarrhoeal disease and on helminth infection reflects a consistent pattern across most studies and study sites, while the evidence on poliomyelitis and adverse birth outcomes was generated from single studies. On the other hand, research found no increased risk of trachoma associated with reliance on shared sanitation.

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Shared Sanitation versus Individual Household Latrines: A Systematic Review of Health Outcomes
Marieke Heijnen, Oliver Cumming, Rachel Peletz, Gabrielle Ka-Seen Chan, Joe Brown, Kelly Baker, Thomas Clasen