Evaluating FSM and sanitation services using a Shit Flow Diagram at Iten Municipality (Kenya)

In low- and middle-income countries like Kenya, access to safe sanitation poses significant public health and economic challenges. This study aimed to evaluate human excreta management and sanitation services in Iten Municipality using the Shit Flow Diagram (SFD) to identify existing gaps. The specific objectives were to determine the main onsite sanitation technologies, assess their performance, generate SFD, and identify potential health risks associated with the current sanitation service chain. A mixed-methods approach was employed. Quantitative data was collected from 388 household heads selected using cluster random proportionate sampling. Qualitative data was gathered from key informants. Observations were also made on the existing solutions. Quantitative data were analysed using the Statistical Package for Social Sciences (SPSS) version 26 for descriptive statistics and chi-square tests, while qualitative data were manually transcribed, thematically analysed, and presented in a narrative way. Results indicated that the main onsite sanitation technologies were pit latrines (69.1%), septic tanks (22.9%), and anaerobic digesters (2.9%). The study found that 69% of waste was adequately managed, whereas 31% was not, with 3% still practicing open defecation. Common issues with the available sanitation technologies included pests (42%), odour (41.8%), and malfunctions (40%). Furthermore, 28% of the population had experienced sanitation-related health issues such as amoeba, dysentery, and diarrhoea in the past year. Additionally, 19.1% of the respondents acknowledged local water source contamination, with laboratory findings revealing high levels of E. coli and Total coliforms. The findings underscore the need for improved sanitation infrastructure, standardized maintenance protocols, and community education to enhance waste management and public health outcomes in Iten Municipality.