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. 2014 Aug 15;11(8):8319–8346. doi: 10.3390/ijerph110808319

Table 1.

Safe San Index items, scoring, and computation.

Q # Item # Survey Question Response Options
(Score Value)
1 -na- How often do you (respondent) personally use the toilet to defecate? Never (1)
Sometimes/Occasionally (2) Usually/Mostly (3)
Always (4)
2 LUF 1 How often do the elders (over 60 years of age) in your household use the toilet to defecate? No members/ others besides respondent (0)
Never (1)
Sometimes/Occasionally (2) Usually/Mostly (3)
Always (4)
3 LUF 2 How often do the (other) married women who are not elders, use the toilet to defecate? (same)
4 LUF 3 How often do the (other) unmarried women (over 15 years old) who are not elders, use the toilet to defecate? (same)
5 LUF 4 How often do the married men who are not elder use the toilet to defecate? (same)
6 LUF 5 How often do the unmarried men (over 15 years old) who are not elder use the toilet to defecate? (same)
7 LUF 6 When school age children in your household are at home, how often do they use the toilet to defecate? (same)
8 LUF 7 For young children who are too young to be able to use the toilet, after they defecate on the ground in your courtyard or in your house, how often do you put their feces in the toilet? (same)
9 LUF 8 If a member of your household becomes critically ill * and must defecate in the dwelling or courtyard, do you throw their feces in the toilet? Never (1) Sometimes/Occasionally (2)
Usually/Mostly (3)
Always (4)
10 LUF 9 When adult females (such as yourself) in your household have a need to defecate during mid-day, would they use the latrine? (same)
11 LUF 10 When adult males in your household have a need to defecate during mid-day, would they use the latrine? (same)
12 LUF 11 When any member of your household, whether adult or child, needs to defecate in the night, how often do they use the latrine? (same)
13 -na- On how many of the mornings of the last 7 days did you defecate in the open (e.g., field, bush, roadside, side of canal, back of house, etc.)? No days (1)
Some days (2)
Most days (3)
Every day (4)
14 -na- On how many of the evenings of the last 7 days did you defecate in the open? (same)
15 -na- On how many of the last 7 days did you defecate in the open at noon time, or at night? (same)
16 ODR7 1 Considering the routines of the other adults (over 15) in your household over the past week, on how many of the last 7 days did ANY other women in your household defecate in the open? No (other) adult women (0)
No days (1)
Some days (2)
Most days (3)
Every day (4)
17 ODR7 2 On how many of the last 7 days did ANY men in your household defecate in the open? No (other) adult men (0)
No days (1)
Some days (2)
Most days (3)
Every day (4)
18 ODR7 3 Considering the routines of children (15 and under) in your household during the past week, on how many of the last 7 days did school age children in your household defecate in the open? No school age children (0)
No days (1)
Some days (2)
Most days (3)
Every day (4)
19 ODR7 4 On how many of the last 7 days did any pre-school age child in your household defecate in the open? No pre-school children (0)
No days (1)
Some days (2)
Most days (3)
Every day (4)
  Computation Steps
LUF Index component

  1. If respondent’s response (Q1) is lower than the LUF response for their specific demographic (i.e., LUF item 1, 2, 3, 4 or 5), replace the demographic response value with the Q1 response value.

  2. Sum LUF items 1to 11 to compute a raw LUF total score (possible raw range 5–44).

  3. Count #of LUF items with non-zero score value (possible range 5–11).

  4. Standardize the raw LUF total score using the ratio of non-zero to total (11) items (possible standardized range 11–44).

  5. Convert the standardized LUF total to an equivalent 0–100 scale LUF Index score.
ODR7 Index component

  1. Determine respondent’s overall score as maximum of Q13, Q14, and Q15.

  2. If respondent’s overall score is higher than the ODR7 response for their demographic (i.e., ODR7 item 1 or 2), replace the demographic response score with the respondent’s score.

  3. Sum ODR7 items 1to 4 to compute a raw ODR7 total score (possible raw range 1–16).

  4. Count #of ODR7 items with non-zero score (possible range 1–4).

  5. Standardize the raw ODR7 total score using the ratio of non-zero to total (4) items (possible standardized range 4–16).

  6. Convert the standardized ODR7 total to an equivalent 0–100 scale ODR7 Index score.
Safe San Index

  1. Calculate the ‘No-ODR7’ Index score as 100 minus the ODR7 Index score.

  2. Multiply the LUF Index score by the No-ODR7 Index score and divide by 100 to compute the Safe San Index score.

Note: * The notion is “so ill”, that is bed-ridden or in a state of weakness that the person is unable to walk to the latrine or to an open defecation area away from the house.