Table 5.
External validity of the Safe San Index and its components: statistical tests of association in the expected direction with conditions for high latrine use and low open defecation behavior (71 households with functioning latrine at F1) (p-values < 0.05 in bold).
| Condition | Indicator Variable | Description | Mean [SD] or Levels (n) | LUF Association | ODR7 Association | Safe San Index Association |
|---|---|---|---|---|---|---|
| -1- | -2- | -3- | -4- | -5- | -6- | -7- |
| Spearman’s Rho (2-tailed p-value) | ||||||
| POSITIVE ATTITUDE TOWARD USING LATRINES (2 variables) |
1a. Positive attitude SD score | 9 semantic differential (SD) items (3 pt scale) summed (range 9–27) (see Suppl. Material) | 25.9 [2.2] | 0.311 | −0.211 | 0.251 |
| (p = 0.008) | (p = 0.077) | (p = 0.035) | ||||
| 1b. Positive attitude Likert score | 44 Likert scale attitudes (3 pt scale) towards using latrines & open defecation (range 0–44) (see Supplementary Material) | 37.2 [4.5] | 0.495 | −0.502 | 0.542 | |
| (p < 0.00005) | (p < 0.000005) | (p < 0.000005) | ||||
| Mean [SD] (ANOVA and Linear trend p-values) | ||||||
| SATISFACTION(2 variables) | 2a. Satisfaction with toilet | Satisfaction with toilet as place to defecate for household | V. satisfied (6) Satisfied (43) Dissatisfied (19) V. dissatisfied (3) |
83.5 [10.9] | 0 [0] | 83.5 [10.9] |
| 64.1 [20.5] | 27.5 [29.2] | 50.9 [28.4] | ||||
| 59.3 [17.4] | 29.1 [26.2] | 44.1 [23.4] | ||||
| 49.0 [32.0] | 51.9 [50.1] | 31.8 [38.8] | ||||
| (p = 0.023) | (p = 0.056) | (p = 0.012) | ||||
| (Lin. p = 0.013) | (Lin. p = 0.069) | (Lin. p = 0.012) | ||||
| 2c. Satisfaction with location | Satisfaction with toilet location | V. satisfied (7) Satisfied (60) Dissatisfied (4) V. dissatisfied (0) |
81.9 [11.0] | 0 [0] | 81.8 [11.0] | |
| 62.7 [19.7] | 28.8 [28.0] | 48.3 [27.1] | ||||
| 45.9 [28.4] | 39.6 [48.8] | 37.9 [36.2] | ||||
| - | - | - | ||||
| (p = 0.012) | (p = 0.028) | (p = 0.006) | ||||
| (Lin. p = 0.005) | (Lin. p = 0.035) | (Lin. p = 0.014) | ||||
| CONVENIENCE/ EASE OF WATER NEEDED FOR LATRINE (6 variables) |
3a. Toilet has H2O connection | Observation of facility | Yes (11) No (60) |
81.0 [9.8] | 2.3 [7.5] | 79.5 [13.0] |
| 60.4 [20.5] | 31.1 [29.5] | 45.8 [27.1] | ||||
| (p = 0.002) | (p = 0.002) | (p < 0.001) | ||||
| 3b. Location of water for toilet use | Reported (i.e., flushing, anal cleansing) | Inside toilet (12) Inside compound (38) Outside compound (21) |
81.3 [9.8] | 2.1 [7.2] | 79.9 [12.8] | |
| 62.6 [19.0] | 28.1 [24.4] | 48.2 [25.0] | ||||
| 55.2 [25.3] | 37.8 [36.7] | 39.4 [29.7] | ||||
| (p = 0.001) | (p = 0.002) | (p < 0.0005) | ||||
| (Lin. p = 0.001) | (Lin. p = 0.001) | (Lin. p < 0.0001) | ||||
| 3c. Location of water for bathing | Reported source location | In dwelling (14) In compound (18) Outside compound (39) |
74.6 [10.7] | 10.9 [17.1] | 66.9 [16.4] | |
| 70.2 [15.5] | 21.8 [17.5] | 56.9 [22.9] | ||||
| 56.6 [22.8] | 34.5 [34.1] | 42.6 [30.9] | ||||
| (p = 0.004) | (p = 0.022) | (p = 0.011) | ||||
| (Lin. p = 0.001) | (Lin. p = 0.006) | (Lin. p = 0.003) | ||||
| 3d. Bath at off-site surface source | Combining responses to reported bathing water source and location | Yes (31) No (40) |
51.6 [21.0] | 38.5 [32.7] | 36.3 [28.0] | |
| 72.9 [14.8] | 17.4 [22.4] | 62.4 [22.8] | ||||
| (p < 0.00005) | (p = 0.002) | (p < 0.00005) | ||||
| 3e. Ease of water access | Perception of ease of fetching water to use toilet | Very easy (34) Not very easy (37) |
71.6 [18.2] | 17.2 [24.4] | 62.3 [26.6] | |
| 56.3 [20.1] | 35.3 [30.7] | 40.6 [25.8] | ||||
| (p = 0.001) | (p = 0.008) | (p = 0.001) | ||||
| 3f. Men fetch own water for flushing | Reported frequency when males defecate in latrine | Always (56) Not Always (15) |
68.3 [18.1] | 22.8 [29.1] | 56.6 [27.7] | |
| 46.2 [20.5] | 40.9 [26.0] | 56.6 [27.7] | ||||
| (p < 0.0005) | (p = 0.031) | (p = 0.001) | ||||
| FACILITY FUNCTIONALITY/QUALITY (3 variables) |
4a. Fully constructed | Toilet structure considered by user to be fully constructed | Yes (26) No (45) |
77.5 [15.3] | 12.1 [19.7] | 69.7 [21.7] |
| 55.6 [19.0] | 35.0 [30.6] | 40.2 [26.0] | ||||
| (p < 0.000005) | (p = 0.001) | (p < 0.00001) | ||||
| 4b. Attached bathroom | Observation of facility | Yes (14) No (57) |
75.3 [13.6] | 19.4 [35.6] | 64.9 [30.6] | |
| 60.7 [21.1] | 28.5 [27.4] | 47.6 [26.8] | ||||
| (p = 0.017) | (p = 0.282) | (p = 0.039) | ||||
| 4c.Construction quality | Respondent’s perception of construction quality used to build facility | Excellent (3) Good (27) Fair (34) Poor (5) Very poor (2) |
86.1 [14.6] | 0 [0] | 86.1 [14.6] | |
| 64.7 [22.0] | 25.3 [31.7] | 53.8 [30.2] | ||||
| 63.4 [18.4] | 26.0 [26.0] | 49.5 [25.5] | ||||
| 61.1 [10.4] | 34.4 [25.4] | 41.8 [22.3] | ||||
| 24.1 [18.3] | 75.0 [35.4] | 9.3 [13.1] | ||||
| (p = 0.021) | (p = 0.072) | (p = 0.037) | ||||
| (Lin. p = 0.011) | (Lin. p = 0.025) | (Lin. p = 0.007) | ||||
| OWNERSHIP/VALUATION (6 variables) |
5a.Facility investment (latrine type) | Categories according to degree of household self-investment (confirmed) | GOI subsidy (5) GOI subsidy + $ (43) Self-financed (23) |
44.4 [16.5] | 45.0 [40.2] | 28.9 [25.5] |
| 58.2 [20.0] | 33.3 [27.1] | 42.5 [25.2] | ||||
| 77.9 [13.4] | 10.0 [23.5] | 71.7 [22.5] | ||||
| (p < 0.00005) | (p = 0.002) | (p < 0.00005) | ||||
| (Lin. p < 0.00001) | (Lin. p = 0.001) | (Lin. p < 0.00001) | ||||
| 5b. Chose design | Household chose design (vs. NGO, mason, gov’t) | Yes (37) No (33) * 1 md. |
72.0 [15.7] | 18.6 [27.8] | 61.3 [26.4] | |
| 53.4 [21.1] | 36.4 [28.2] | 38.3 [24.9] | ||||
| (p < 0.0001) | (p = 0.01) | (p < 0.0005) | ||||
| 5c. Subsidy was reason to build | Reported primary reason for building | Subsidy offer (40) Non-health reason (22) Avoid hookworm (4) * 5 md |
55.0 [19.8] | 34.2 [27.0] | 40.0 [23.8] | |
| 72.8 [16.6] | 20.1 [31.0] | 61.4 [28.4] | ||||
| 86.1 [7.4] | 0 [0] | 86.1 [7.4] | ||||
| (p < 0.0001) | (p = 0.024) | (p < 0.0005) | ||||
| (Lin. p < 0.00005) | (Lin. p = 0.007) | (Lin. p < 0.00005) | ||||
| OWNERSHIP/VALUATION (6 variables) |
5d. O&M emptying | Latrine has been emptied | Yes (8) No (63) |
70.0 [16.7] | 8.3 [17.8] | 66.6 [21.5] |
| 62.8 [21.0] | 28.9 [29.6] | 49.0 [28.5] | ||||
| (p = 0.355) | (p = 0.059) | (p = 0.098) | ||||
| 5e. O&M improvements | Improvements made since built | Yes (10) No (61) |
69.1 [12.6] | 24.2 [30.5] | 54.8 [23.7] | |
| 62.7 [21.6] | 27.0 [29.2] | 50.4 [29.0] | ||||
| (p = 0.37) | (p = 0.78) | (p = 0.75) | ||||
| Spearman’s Rho (2-tailed p-value) | ||||||
| 5f. Toilet age | Years toilet facility has been in operation and use | 7.2 [6.5] * 1 md |
0.335 | −0.357 | 0.389 | |
| (p = 0.005) | (p = 0.002) | (p = 0.001) | ||||
| # of Index-predictor variable associations | ||||||
| Summary | 19 predictor variables of 5 conditions | Index-predictor variable associations in the expected direction: | Not significant | 2 | 5 | 2 |
| p < 0.05, ≥0.01 | 3 | 4 | 4 | |||
| p < 0.01, ≥0.001 | 8 | 9 | 5 | |||
| p < 0.001 | 6 | 1 | 8 | |||
Note: * md: missing data.