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  • Perspective
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Sustaining effective latrine cleaning in schools to protect child health in low-income settings

Nature Water volume 1, pages 907–914 (2023)Cite this article

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Abstract

Globally, notable emphasis is currently being placed on improving access to and acceptance of sanitation in schools as part of the drive towards achieving the United Nations Sustainable Development Goal 6. However, the importance of sustaining effective cleaning of latrines in schools remains an under-emphasized and under-researched topic, with serious negative consequences for the health of school-aged children in low-income settings. In this Perspective, we summarize the limited existing literature on the impacts of unclean latrines in schools on aspects of child health, and the methods that have been trialled to achieve sustainable school latrine cleaning programmes. We highlight research needs and propose a new approach to school-led total sanitation, with the aim of moving towards a world in which no child gets sick because of the unhygienic state of the toilets in their schools.

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Fig. 1: Illustration of unclean toilets and dysfunctional waste collection facilities at government-funded schools in Ethiopia.

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Acknowledgements

M.R.T. was supported by the Royal Academy of Engineering under the Research Chairs and Senior Research Fellowships programme. F.V.V., B.L., S.G., Z.M. and M.R.T. have collaborated in this study as members of the Consortium of Experts in Neglected Tropical Diseases (www.centd.org). We thank L Sioné for her comments on the draft paper.

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Authors and Affiliations

  1. Department of Translational Physiology, Infectiology and Public Health, Ghent University, Ghent, Belgium

    Fiona Vande Velde, Bruno Levecke & Sarah Gabriël

  2. Department of Health, Behaviour and Society, Institute of Health, Jimma University, Jimma, Ethiopia

    Zewdie Birhanu

  3. School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia

    Zeleke Mekonnen

  4. Department of Civil and Environmental Engineering, Imperial College London, London, UK

    Michael R. Templeton

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  1. Fiona Vande Velde
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Contributions

F.V.V. led the writing of all parts of the paper except the section on the ‘Evidence of negative health outcomes’. B.L. and S.G. led the writing of the section on the ‘Evidence of negative health outcomes’. Z.M. and Z.B. contributed to all parts of the paper except the section on the ‘Evidence of negative health outcomes’. M.R.T. conceived the Perspective and contributed to and provided feedback on all parts.

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Correspondence to Michael R. Templeton.

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Vande Velde, F., Levecke, B., Gabriël, S. et al. Sustaining effective latrine cleaning in schools to protect child health in low-income settings. Nat Water 1, 907–914 (2023). https://doi.org/10.1038/s44221-023-00159-5

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