{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T23:17:03Z","timestamp":1774480623235,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2017,7,25]],"date-time":"2017-07-25T00:00:00Z","timestamp":1500940800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Water and Sanitation for the Urban Poor (WSUP)","award":["1123\/PERL\/DFID04\/"],"award-info":[{"award-number":["1123\/PERL\/DFID04\/"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Provision of toilets is necessary but not sufficient to impact health as poor maintenance may impair toilet function and discourage their consistent use. Water in urban slums is both scarce and a prerequisite for toilet maintenance behaviours. We describe the development of behaviour change communications and selection of low\u2010cost water storage hardware to facilitate adequate flushing among users of shared toilets.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted nine focus group discussions and six ranking exercises with adult users of shared toilets (50 females, 35 males), then designed and implemented three pilot interventions to facilitate regular flushing and improve hygienic conditions of shared toilets. We conducted follow\u2010up assessments 1 and 2 months post\u2010pilot including nine in\u2010depth interviews and three focus group discussions with adult residents (23 females, 15 males) and three landlords in the pilot communities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Periodic water scarcity was common in the study communities. Residents felt embarrassed to carry water for flushing. Reserving water adjacent to the shared toilet enabled slum residents to flush regularly. Signs depicting rules for toilet use empowered residents and landlords to communicate these expectations for flushing to transient tenants. Residents in the pilot reported improvements in cleanliness and reduced odour inside toilet cubicles.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our pilot demonstrates the potential efficacy of low\u2010cost water storage and behaviour change communications to improve maintenance of and user satisfaction with shared toilets in urban slum settings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.12914","type":"journal-article","created":{"date-parts":[[2017,6,28]],"date-time":"2017-06-28T01:33:19Z","timestamp":1498613599000},"page":"1099-1111","source":"Crossref","is-referenced-by-count":18,"title":["If I do not have enough water, then how could I bring additional water for toilet cleaning?! Addressing water scarcity to promote hygienic use of shared toilets in Dhaka, Bangladesh"],"prefix":"10.1111","volume":"22","author":[{"given":"Ronald E.","family":"Saxton","sequence":"first","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farzana","family":"Yeasmin","sequence":"additional","affiliation":[{"name":"Environmental Intervention Unit Enteric and Respiratory Disease Program International Centre for Diarrhoeal Disease Research Dhaka Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahbub\u2010Ul","family":"Alam","sequence":"additional","affiliation":[{"name":"Environmental Intervention Unit Enteric and Respiratory Disease Program International Centre for Diarrhoeal Disease Research Dhaka Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdullah","family":"Al\u2010Masud","sequence":"additional","affiliation":[{"name":"Environmental Intervention Unit Enteric and Respiratory Disease Program International Centre for Diarrhoeal Disease Research Dhaka Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Notan Chandra","family":"Dutta","sequence":"additional","affiliation":[{"name":"Environmental Intervention Unit Enteric and Respiratory Disease Program International Centre for Diarrhoeal Disease Research Dhaka Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dalia","family":"Yeasmin","sequence":"additional","affiliation":[{"name":"Environmental Intervention Unit Enteric and Respiratory Disease Program International Centre for Diarrhoeal Disease Research Dhaka Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen P.","family":"Luby","sequence":"additional","affiliation":[{"name":"Stanford University Stanford CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leanne","family":"Unicomb","sequence":"additional","affiliation":[{"name":"Environmental Intervention Unit Enteric and Respiratory Disease Program International Centre for Diarrhoeal Disease Research Dhaka Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter J.","family":"Winch","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,7,25]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2015.06.031"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60950-8"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2011.10.042"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(14)70307-9"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/1756-0500-7-486"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(14)70326-2"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3156.2011.02764.x"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/anti.12117"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.3362\/1756-3488.2008.023"},{"key":"e_1_2_7_11_1","unstructured":"G\u00fcntherI NiwagabaBC L\u00fcthiC HorstI MoslerHJ TumwebazeIK.When is shared sanitation improved sanitation? 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