How does sanitation influence people's quality of life? Qualitative research in low-income areas of Maputo, Mozambique.

Journal: Social science & medicine (1982)

Volume: 272

Issue: 

Year of Publication: 2021

Affiliated Institutions:  Department of Global Health and Development, London School of Hygiene and Tropical Medicine, - Tavistock Place, London, WCH SH, United Kingdom; Department of Disease Control, London School of Hygiene and Tropical Medicine, Keppel Street, London, WCE HT, United Kingdom. Electronic address: ian.ross@lshtm.ac.uk. Department of Disease Control, London School of Hygiene and Tropical Medicine, Keppel Street, London, WCE HT, United Kingdom. Electronic address: oliver.cumming@lshtm.ac.uk. Department of Disease Control, London School of Hygiene and Tropical Medicine, Keppel Street, London, WCE HT, United Kingdom. Electronic address: robert.dreibelbis@lshtm.ac.uk. WE Consult, Tomás Ribeiro street , Maputo, Mozambique. Electronic address: zaida@we-consult.info. Instituto Nacional de Saúde, Distrito de Marracuene, Estrada Nacional , Maputo, Mozambique. Electronic address: rassulmn@gmail.com. Department of Global Health and Development, London School of Hygiene and Tropical Medicine, - Tavistock Place, London, WCH SH, United Kingdom. Electronic address: giulia.greco@lshtm.ac.uk.

Abstract summary 

Preventing infectious disease has often been the primary rationale for public investment in sanitation. However, broader aspects of sanitation such as privacy and safety are important to users across settings, and have been linked to mental wellbeing. The aim of this study is to investigate what people most value about sanitation in low-income areas of Maputo, Mozambique, to inform a definition and conceptual model of sanitation-related quality of life. Our approach to qualitative research was rooted in economics and applied the capability approach, bringing a focus on what people had reason to value. We undertook 19 in-depth interviews and 8 focus group discussions. After eliciting attributes of "a good life" in general, we used them to structure discussion of what was valuable about sanitation. We applied framework analysis to identify core attributes of sanitation-related quality of life, and used pile-sorting and triad exercises to triangulate findings on attributes' relative importance. The five core attributes identified were health, disgust, shame, safety, and privacy. We present a conceptual model illustrating how sanitation interventions might improve quality of life via changes in these attributes, and how changes are likely to be moderated by conversion factors (e.g. individual and environmental characteristics). The five capability-based attributes are consistent with those identified in studies of sanitation-related insecurity, stress and motives in both rural and urban areas, which is supportive of theoretical generalisability. Since two people might experience the same toilet or level of sanitation service differently, quality of life effects of interventions may be heterogeneous. Future evaluations of sanitation interventions should consider how changes in quality of life might be captured.

Authors & Co-authors:  Ross Ian I Cumming Oliver O Dreibelbis Robert R Adriano Zaida Z Nala Rassul R Greco Giulia G

Study Outcome 

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Statistics
Citations :  Agüero J.M., Bharadwaj P. Do the more educated know more about health? Evidence from schooling and HIV knowledge in Zimbabwe. Econ. Dev. Cult. Change. 2014;62:489–517. doi: 10.1086/675398.
Authors :  6
Identifiers
Doi : 113709
SSN : 1873-5347
Study Population
Male,Female
Mesh Terms
Humans
Other Terms
Capability approach;Health economics;Qualitative research;Quality of life;Sanitation;Toilets
Study Design
Study Approach
Qualitative
Country of Study
Mozambique
Publication Country
England