Effect of household socioeconomic status on disposable diaper use and disposal in Greater Accra, Ghana and Kisumu, Kenya: a cross-sectional study

ABSTRACT Mismanaged disposable diaper (DD) waste is widespread in many urban African cities. Proposed policy responses range from free DD provision to outright bans. However, African studies examining DD consumption, disposal, and benefits are scarce. This cross-sectional study aimed to assess socio-economic variation in DD consumption, inappropriate DD disposal, and perceived benefits for children's carers. A survey interviewing 440 carers of children aged 0–36 months attending health facilities in Greater Accra, Ghana and Kisumu, Kenya found 95.0 and 94.2% used DD, respectively. Median DD consumption in a child's first 36 months was significantly higher in the wealthiest households, respectively, compared to the poorest households (4,099 versus 2,800 DD and 2,876 versus 1,714 DD, p ¼ 0.015 and 0.001 in Greater Accra and Kisumu, respectively). In Greater Accra, 10.2% of households reported burning, burying, or dumping used DD in latrines or elsewhere, compared to 30.5% in Kisumu. Carers in all wealth quintiles consistently cited DD's convenience and hygiene benefits. This confirms widespread DD consumption among rich and poor households, posing disposal challenges for those lacking waste collection services. Given DD's likely time-saving and reported convenience benefits for children's carers, we recommend waste management programmes that separate DDs for safe disposal as opposed to outright bans.