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ABSTRACT: Background
Health improvements realized through sanitation are likely achieved through high levels of facilities utilization by all household members. However, measurements of sanitation often rely on either the presence of latrines, which does not guarantee use, or respondent-reported utilization of sanitation facilities, which is prone to response bias. Overstatement of sanitation metrics limits the accuracy of program outcome measures, and has implications for the interpretation of related health impact data.Methods
We conducted a cross-sectional study of 213 households in 14 village water, sanitation and hygiene committee clusters throughout rural Bangladesh and used a combined data- and relationship-scale approach to assess agreement between respondent-reported latrine utilization and sensor-recorded measurement.Results
Four-day household-level respondent-reported defecation averaged 28 events (inter-quartile range [IQR] 20-40), while sensor-recorded defecation averaged 17 events (IQR 11-29). Comparative analyses suggest moderately high accuracy (bias correction factor=0.84), but imprecision in the data (broad scatter of data, Pearson's r=0.35) and thus only weak concordance between measures (?c=0.29 [95% BCa CI 0.15 to 0.43]).Conclusions
Respondent-reported latrine utilization data should be interpreted with caution, as evidence suggests use is exaggerated. Coupling reported utilization data with objective measures of use may aid in the estimation of latrine use.
SUBMITTER: Delea MG
PROVIDER: S-EPMC5914303 | biostudies-literature | 2017 Jul
REPOSITORIES: biostudies-literature
Delea Maryann G MG Nagel Corey L CL Thomas Evan A EA Halder Amal K AK Amin Nuhu N Shoab Abul K AK Freeman Matthew C MC Unicomb Leanne L Clasen Thomas F TF
Transactions of the Royal Society of Tropical Medicine and Hygiene 20170701 7
<h4>Background</h4>Health improvements realized through sanitation are likely achieved through high levels of facilities utilization by all household members. However, measurements of sanitation often rely on either the presence of latrines, which does not guarantee use, or respondent-reported utilization of sanitation facilities, which is prone to response bias. Overstatement of sanitation metrics limits the accuracy of program outcome measures, and has implications for the interpretation of re ...[more]