Assessing the role of servicing in enhancing sanitation-related quality of life among container-based sanitation users

Here we evaluate the servicing of container-based sanitation (CBS)-which includes the collection, replacement and cleaning of cartridges-and its influence on sanitation-related quality of life (using the SanQoL-5 index) in informal settlements across Kenya, Peru and South Africa. We (1) compared the incidence and severity of problems associated with CBS toilets against other sanitation types, (2) assessed the quality of CBS servicing across different regions and implementations and (3) evaluated the relationship between servicing issues and sanitation-related quality of life, utilizing high-frequency longitudinal smartphone survey data collected at various intervals over 1 year. Results revealed significantly fewer and less severe issues were recorded for CBS toilets than other toilet types, such as pit latrines, sewers and open drains. CBS servicing was consistently well regarded in all countries. Participants in Kenya highlighted particular satisfaction with the frequency of container replacement, whereas, in Peru, the cleanliness of replacement containers was highly regarded. SanQoL-5 scores decreased when CBS servicing issues were recorded, particularly in Kenya. This study underscores the potential of CBS as a sustainable sanitation solution in urban informal settlements, provided that high-quality servicing is maintained.