Household ownership of latrines does not ensure use: a scoping review

This study aimed to conduct a scoping review of the factors associated with latrine utilisation by households.

We performed a scoping review to determine the factors associated with household latrine utilisation.

We conducted a bibliographic search using PubMed, Google Scholar, ScienceDirect, Epistemonikos and Semantic Scholar until April 2023.

The papers we included met the following criteria: the study population included members of households equipped with latrines, regardless of their status, excluding children under five; the study followed an observational design; the study design was quantitative; the manuscript was in either French or English; the study focused on factors associated with latrine utilisation; the study employed multivariate methods and the study manuscript was published in a peer-reviewed journal.

We conducted a narrative synthesis of key results.

This review selected 31 articles. The percentage of latrine utilisation spanned from 36.00% to 94.30%. Elderly individuals and those with lower educational attainment showed reduced latrine utilisation compared with younger and more educated people, respectively. Households without school-going children, those of larger size and those with lower economic status had less latrine utilisation than those with school-going children, smaller size and a higher wealth index. Some latrine attributes (age, level of household member involvement in construction, hand hygiene facilities, geographical accessibility, functionality, maintenance, cleanliness, type, superstructure, condition, etc) influenced latrine utilisation. Exposure to sanitation communication initiatives heightened the likelihood of latrine utilisation by individuals.

The study stresses the importance of improving children's education and implementing poverty reduction initiatives to enable households to afford adequate sanitation facilities. It also suggests empowering communities to build suitable latrines, promoting community-based sanitation models and emphasising the need to raise awareness of the adverse effects of open defecation through educational campaigns.