Sanitary Disposal of Human Feces

Sanitation bestows health benefits at two levels. There is a benefit to individual households that invest in sanitation but also a benefit to the community as a whole. The available evidence indicates that effective use of sanitary facilities to dispose of human feces reduces diarrheal disease prevalence by one-third to one-half. Reductions are highest in communities achieving a threshold of coverage, which varies, but is typically 70 percent. The communal reduction is a function of fecal contamination in the environment, which can synergistically reinforce the health impact of other hygiene interventions such as point-of-use water quality improvements.

The handling and disposal of children’s feces merits special attention. In many cultures, the feces of children are regarded as less harmful than other feces, when in fact they are more likely to contain pathogens. In addition, developing appropriate facilities for the use of children has repeatedly proven to be problematic, although recent progress on the use of potties for this purpose (with ultimate disposal in a latrine or other sanitary facility) has shown promise.

Programmatically, sustainable sanitation improvements have been difficult to achieve within public health, in both urban and rural settings. Subsidies for household-level infrastructure, such as latrine construction, have been misguided and have not insured appropriate or sustained use. Recent work focused on attitudes towards sanitation and behaviors to insure effective use of whatever sanitation solution is locally appropriate. This work has shown promise in overcoming the limitations of infrastructure-focused approaches.