Abstract

In low- and middle-income countries, most latrines are not accessible to young children. We explored how to modify existing pit latrines to make them child friendly. We conducted four focus group discussions with mothers to explore barriers to child latrine use. We then enrolled 20 households with a child aged 3–7 years old to test six enabling technologies developed based on the identified barriers. Two to three weeks after installing the selected enabling technologies in each household, researchers conducted 19 in-depth interviews with caregivers to explore the technologies’ acceptance and feasibility. Common barriers included the discomfort of squatting on a large pan, fear of darkness, and fear of a slippery floor. Of the potential solutions, a ring to stabilize the child while squatting in the latrine was preferred by children and was affordable and available. A wooden board with a smaller hole than the usual pan reduced fears of falling and helped eliminate discomfort but was inconvenient to handle and clean. A transparent fiberglass roof tile was affordable, available, increased visibility, and kept the latrine floor dry. In conclusion, the fiberglass roof tile and stability ring were two affordable and locally available technologies that facilitated latrine use by children aged 3–7 years.

Highlights

  • Open defecation and the unhygienic disposal of feces facilitate the transmission of diarrhea-causing enteric pathogens by contaminating the environment [1,2,3,4,5]

  • In developing the child-friendly modifications, we considered the children’s ages and ensured that the hardware added to the existing latrine was suitable for use by young children

  • These study findings demonstrate the feasibility of addressing barriers to the use of existing latrines by children and of making them more child friendly

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Summary

Introduction

Open defecation and the unhygienic disposal of feces facilitate the transmission of diarrhea-causing enteric pathogens by contaminating the environment [1,2,3,4,5]. Enteric pathogens can spread from the contaminated environment to children and adult family members and neighbors [6]. Compared to the hygienic disposal of feces in a latrine, unhygienic feces disposal in a drain, ditch, bush, or garbage heap increases the risk of diarrheal diseases [7,8]. Despite the high availability of latrines and the low prevalence of open defecation by adults, open defecation is common among children in Bangladesh [14,15]. In rural Bangladesh, open defecation occurs inside the house or in courtyards [1,16,17].

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