An example of hanging latrin

As Uganda joins the rest of the world to celebrate World Toilet Day which falls on November 19 every year, and take action to ensure that everyone has a safe toilet by 2030, a report published by the World Health Organization and UNICEF in 2015, estimated that about 2.4 billion people or roughly one –third of the world’s population lack access to proper toilets.

Inadequate sanitation is said to be the cause 280 000 diarrhoeal deaths annually and is a major factor in several neglected tropical diseases, including intestinal worms, schistosomiasis, and trachoma. Poor sanitation also contributes to malnutrition and diarrhea.

Relatedly in Uganda, according to Sauti za Wananchi data on Ugandan citizens’ experiences of education, health and water services and access on affordable access to clean and safe water, it was established that citizens suffer the same consequences of poor sanitation.

Sauti za Wananchi is a nationally-representative, high-frequency mobile phone panel survey is an initiative designed to regularly collect views and perceptions on issues of public interest from a broad cross-section of Ugandan citizens.

For instance the study established that one out of four urban households in urban areas use “hanging latrines” situated above water, either a stream or lake, or piped directly into drains or streams. This arrangement can be very bad for public hygiene, encouraging the spread of water-borne diseases such as typhoid and cholera.

It was established that 5 per cent of urban households use flush toilets and one in five use a ventilated pit latrine. In rural areas, four in ten use ventilated pit latrines.

Meanwhile the survey found out that seven out of ten citizens use an improved source of drinking water in the dry season, rising to eight out of ten in the wet season

Household access to improved water supplies is slightly higher in the wet season compared to the dry season. Eight in ten households (80 per cent) access water from an improved source during the rainy season, up from seven in ten (73 per cent) in the dry season.

At all times of the year, households in urban areas have better access to clean and safe water than their rural counterparts. Similarly, wealthier households are more likely than the poor to access drinking water from an improved source.

The survey further found out that health services are citizens’ top problem for the country as well as the cost of living for households. 59 per cent cite poor health services as one of the top three problems facing Uganda today, more than for any other issue. Inflation and the high cost of living is cited by four in ten (38 per cent) and a lack of jobs by one in three (33 per cent).

Also cited by substantial numbers are poor transport services (30 per cent), hunger/drought (30 per cent), corruption (26 per cent), poor quality of education (24 per cent) and poor access to clean water (24 per cent).

Just one in a hundred people cite terrorism as among the top three problems in the country.

Use of government health facilities

According to survey findings, when seeking treatment for illness or injury, half the population (51 per cent) turn first to government health facilities. “A further one out of four (24 per cent) turn first to private or NGO health facilities, and others go to the pharmacy (12 per cent),” the survey states.

Nationally insufficient water points is the main challenge mentioned by four out of eight citizens. The three main challenges cited by citizens in accessing clean drinking water are linked: a shortage of water points (43 per cent) distance to water points (39 per cent) and dirty water (28 per cent). In urban areas, the cost of water (36 per cent) and irregular supply (29 per cent) are mentioned the most.

Citizens are most engaged with the management of education

Over half of all Ugandans (54 per cent) say they have attended an education committee meeting in the past 12 months, compared to four in ten (39 per cent) who have done the same on water services and just over three out of ten (34 per cent) on health services.

Similarly, public engagement in other forms – raising issues at community meetings, speaking to authorities about an issue, and discussing in a community group – is higher in the education sector than on health or water issues.

And poor sanitation is linked to transmission of diseases and yet the most commonly encountered problems at government health facilities are long waiting times or queues (30 per cent) and a lack of medicines or other supplies (29 per cent).