Published November 9, 2015
In an effort to reduce open defecation in low- and middle-income countries, there has been a focus on increasing latrine coverage and, more recently, motivating people to use them.
Frequently, adults and older children use latrines, while younger children are allowed to defecate in the open. These defecation sites include ground in the yard or compound, designated fields, and dirt floors inside homes. When children defecate near the home, feces may be buried, discarded in ditches or fields, disposed in toilets or latrines, or left to decompose.
The perception is that children’s feces are less offensive and less harmful than those of adults, particularly for children that have not begun eating solid foods. Although this attitude is common in a number of countries, child feces are as much a health risk, or riskier, than adult feces due to the increased presence of pathogens. It is important, therefore, that research and interventions used to decrease open defecation include a two-pronged approach: (1) designing and constructing latrines that are accessible to children and (2) stressing the importance, among caregivers, about disposal of child feces.
Barriers that keep children from using available latrines include inconvenient latrine locations, poor cleanliness, such as the presence of flies and odor, and the perception that latrines are dangerous, e.g., the potential for children to fall into the latrines. As many of these barriers are similar to those that keep older children and adults from using latrines, addressing these issues for children may have a wider impact on latrine usage.
Physical and social interventions also need to be developed for children in the early phases of toilet training. In Peru, for example, child potties are considered ideal, but toilet training is generally inconsistent, resulting in children defecating openly. Joint efforts that focus on safe child feces disposal and accessible latrines for people with disabilities, older adults, and adolescent girls may gain added traction. As with other water, sanitation, and hygiene efforts, community participation throughout the information-gathering, design, implementation, and assessment process is key, as geographic and cultural factors have a large influence on child-rearing practices, especially toileting.