V. Evaluation of Cross-Immunity against Type 1 Dengue Fever in Human Subjects Convalescent from Subclinical Natural Japanese Encephalitis Virus Infection and Vaccinated with 17D Strain Yellow Fever Vaccine
Sharing of sanitation is common in low-income settlements in Sub-Saharan Africa. However, shared (limited) sanitation facilities have been thought to pose health risks due to poor hygiene levels. Interventions to improve user behavior and cleanliness of shared sanitation are few, both in literature and in practice. This study details the codesign and testing of strategies to improve the cleanliness of shared sanitation facilities in low-income areas of Kisumu City in Kenya. The strategies included a cleaning plan, monitoring system, and discussions among users, and were codesigned through workshops with stakeholders and group discussions with landlords and tenants. These strategies were tested in 38 compound houses through the Trials of Improved Practices approach over a 5-month period. Field staff visited the compounds, observed the cleanliness of the shared toilets, and through discussions, encouraged users to develop a formal cleaning system and a monitoring plan. The discussions built social capital and collective action and facilitated uptake of the cleaning plan with notable improvements in cleanliness of shared toilets. The results support the acceptability of shared sanitation in low-income settlements, the importance of codesigning and coproducing solutions with users, and the need to evaluate the effects of these strategies on cleanliness of shared sanitation.
Address correspondence to Sheillah Simiyu, Urbanization and Well-Being Unit, African Population and Health Research Center, Manga Close, Off Kirawa Rd., P.O. Box 10787-00100, Nairobi, Kenya. E-mail: firstname.lastname@example.org
Financial support: Financial support was provided by the International Science Council through the Leading Integrated Research for Agenda 2030 (LIRA 2030) program, grant number LIRA2030-GR04/18.