Indicators for evaluating shared sanitation quality: a systematic review and recommendations for sanitation monitoring

Abstract Shared sanitation facilities have replaced open defecation in many areas, improving sanitation access. Although a broad body of literature has been published regarding the importance of shared sanitation services, it is still unclear how to assess their quality. The objective of this review was to synthesize evidence on the use of shared sanitation facilities in informal settlements and identify indicators for assessing their quality. We conducted a systematic review of relevant studies and a total of 248 studies were included in the final analysis. Findings include a proposed list of indicators for evaluating the quality of shared sanitation such as the number of people sharing facilities, cleanliness, privacy, facility location, accessibility, and safety, and a tool for distinguishing between sanitation facilities that are improved shared, basic shared and unimproved shared. We recommend incorporating the proposed indicators in primary data collection, and routine national and global sanitation monitoring.