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Defecation practices of young children in a Peruvian shanty town
B A Yeager1, S R Huttly, R Bartolini
1Instituto de Investigación Nutricional, Lima, Peru. byeager@iin.sld.pe
Insights
Promoting hygienic feces disposal for young children is crucial for controlling diarrheal diseases. Research in Lima found that potty use is feasible and acceptable, offering a viable intervention strategy.
Area of Science:
- Public Health
- Environmental Health
- Child Development
Background:
- Feces disposal practices of young children are poorly understood, hindering diarrheal disease control.
- Limited water and sanitation infrastructure in densely populated areas pose challenges.
- Formative research is essential for developing effective interventions.
Purpose of the Study:
- To investigate feces disposal practices and their determinants among young children in a Lima shanty town.
- To develop and test an intervention promoting sanitary feces disposal for children.
- To understand barriers and facilitators to adopting hygienic defecation practices.
Main Methods:
- In-depth interviews with mothers, husbands, and community leaders.
- Focus group discussions with mothers to validate findings and explore intervention acceptability.
- A micro-trial to assess the feasibility and acceptability of promoting potty use.
Main Results:
- Key defecation sites included diapers, potties, the ground, and latrines.
- Determinants of practice included child age, effort, perceived cleanliness, and resource availability.
- Potties were perceived as acceptable and hygienic for children aged 1-3, despite challenges in potty training.
Conclusions:
- Existing sanitation projects focusing solely on latrines neglect the needs of young children.
- Interventions promoting hygienic defecation and stool clearance practices for infants and young children are necessary.
- Promoting potty use is a feasible and acceptable strategy for improving child feces disposal.
Abstract:
Little is known about feces disposal practices, their determinants and feasibility for change, despite their importance in the control of diarrheal diseases. We report here the results of formative research for the development of an intervention to promote sanitary disposal of feces of young children. The study was conducted in a densely populated shanty town area of Lima, where water and sanitation systems are scarce. In-depth interviews were undertaken with mothers, husbands and community leaders. Group discussions were held with mothers in order to validate findings from the interviews, investigate particular topics further and explore reactions to possible intervention strategies. The principal defecation sites for young children were diapers, potties, the ground in or near the home, the hill, latrines and flush toilets. The main determinants found were the age of the child, the effort required by the method, perceptions of dirtiness and the availability of resources. Almost all children under one year of age use diapers but the high resource cost of diaper washing is a strong motivation for mothers to move their children on as early as possible. Potties were considered the most socially acceptable and 'hygienic' defecation method for children between one and three years of age. Nevertheless, defecation directly onto the ground is common at this age. Potty training is deemed to be quite difficult and the long term achievements are determined by the initial training success. In most cases, the training process is authoritative and inconsistent. The use of latrines and flush toilets is not considered appropriate for children until they are three to four years old. Based on these initial findings, a micro-trial was conducted to assess the feasibility and acceptability of promoting greater use of potties and associated practices. The results of the trial were very encouraging and provided valuable information for the design of a community-wide intervention. Our findings help explain why the emphasis given in most sanitation projects, where efforts have been concentrated on the promotion of latrines, has failed to induce their utilization by small children. Sanitation projects should incorporate interventions that will promote hygienic defecation and stool clearance practices for infants and small children.