Assessment of the Acceptability and Feasibility of Child Potties for Safe Child Feces Disposal in Rural Bangladesh.

Faruqe Hussain,Audrey J Buckland,Tania Naushin,Elli Leontsini,Peter J Winch,Leanne Unicomb,Stephen P Luby

doi:10.4269/ajtmh.15-0932

Abstract

.Indiscriminate defecation among young children and the unsafe disposal of their feces increases fecal contamination in the household environment and the risk of diarrheal disease transmission. Improved sanitary technology for children too young to use a latrine may facilitate safe feces disposal and reduce fecal contamination in the household environment. We assessed the acceptability and feasibility of child potties in rural Bangladesh in 2010. Our team introduced child potties into 26 households for 30 days, and conducted semistructured interviews, group discussions, and observations to assess the acceptability and feasibility of their use for parents and children. Residents of this rural Bangladeshi community accepted the child potties and caregivers found them to be a feasible means of managing child feces. The color, shape, design, and size of the potty influenced its acceptability and use. These residents reported that regular use of the potty improved the household’s physical environment and caregiver and child personal hygiene. Regular potty use also reduced caregivers’ work load by making feces collection and disposal easier. Primary caregivers viewed 4–6 months as the appropriate age to initiate potty training. Sanitation interventions should integrate and emphasize potties for children’s feces management to reduce household environmental contamination.

Highlights

IntroductionDiarrheal illness is a leading cause of childhood morbidity and mortality.[1,2] Open defecation and unsafe disposal of feces increases the risk of disease transmission.[3,4,5,6] An improved sanitary environment may reduce childhood diarrheal incidence substantially by interrupting fecal–oral transmission.[7,8,9,10] Safe disposal of children’s feces was associated with reduction in helminth infestation in children under 2 years of age in rural Bangladesh.[11]
Our team introduced child potties into 26 households for 30 days, and conducted semistructured interviews, group discussions, and observations to assess the acceptability and feasibility of their use for parents and children. Residents of this rural Bangladeshi community accepted the child potties and caregivers found them to be a feasible means of managing child feces
We report on formative research that used a small-scale household trial of improved practices (TIP) to assess the feasibility and acceptability of child potties among caregivers of children < 3 years of age in rural Bangladesh

Summary

Introduction

Diarrheal illness is a leading cause of childhood morbidity and mortality.[1,2] Open defecation and unsafe disposal of feces increases the risk of disease transmission.[3,4,5,6] An improved sanitary environment may reduce childhood diarrheal incidence substantially by interrupting fecal–oral transmission.[7,8,9,10] Safe disposal of children’s feces was associated with reduction in helminth infestation in children under 2 years of age in rural Bangladesh.[11]. The safe disposal of child feces is an important component of child health because feces present in a child’s environment can expose them to diarrheal pathogens and parasites.[12] Young children in rural Bangladesh do not usually wear diapers,[13] and few use potties (a bowl/pot/container used by small children as a toilet). Open defecation is the norm among young children in Bangladesh, as reported in the Philippines,[7] Indonesia,[14] Sri Lanka,[15] Burkina Faso,[16] and Peru.[17]

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Results

Discussion

Conclusion