What Makes Household Sanitation Systems Resilient to Floods? Evidence from Ethiopia, Uganda, and Nepal

Climate change is influencing precipitation events and patterns, leading to more frequent and severe flooding in many regions worldwide. In low- and middle-income countries, concerns about worsening floods disrupting access to safe sanitation for households are driving discussions about how to make sanitation systems more resilient. Much of this discourse relies on context-specific experiences or theory. This study surveyed 1,429 households in Nepal, Ethiopia, and Uganda to identify attributes linked to poor sanitation outcomes due to flooding to better inform sanitation planning and policy. Logistic regression was used to examine correlations between household and sanitation-system characteristics and (1) sanitation system failures and (2) adoption of open defecation following floods. The findings suggest that exposure to flooding significantly increases household sanitation system failures and that the quality of the construction and maintenance of sanitation facilities is correlated with these failures. Living in rural areas, using poor-quality latrine slabs, and discomfort in using a neighbor's toilet were correlated with open defecation following flood damage to household sanitation systems. These findings support a policy focus on well-built, well-maintained sanitation in flood-prone areas and the provision of alternatives when facilities fail. Other commonly recommended measures, such as raising latrines, were not found to correlate with outcomes and require further investigation.