Influence of gender in toilet access, use and maintenance on the performance of shared sanitation facilities in the Nanyuki Slums (Nairobi)

The need for safe sanitation alongside equality is a well-recognized agenda yet sanitation in slums is still a global challenge with noticeable gender disparities in access to and choices of safe sanitation facilities which present non-proportional difficult gender-related sanitation choices in slums. The study examined the influence of gender in toilet access, use and maintenance on performance of shared sanitation facilities in Nanyuki slums. A convergent design and mixed methods approach was used and a sample of 98 participants targeted. Quantitative data was collected using structured questionnaires from household heads selected using cluster and simple random sampling techniques. The data was analysed using the Statistical Package for Social Sciences (SPSS) version 26 in descriptive statistics and in inferential statistics to unveil relationship between variables. Qualitative data was collected using focus group discussion guides and was analysed using the MAXQDA software in themes and presented in a narrative way. Findings revealed that females were the most users of toilets compared to men (Adjusted OR=1.14, 95% CI: 0.05-1.92, P=0.009<0.05) because they were left at their households due to commitments of carrying out household chores when men could use toilets in their places of work. Toilets were 0.76 times less acceptable and 0.75 less preferable for females than for males. Toilet location far from households, access to toilets with gapped super structures, unsafe and contaminated toilets significantly reduced the odds of toilet use (P<0.05). Adequacy of toilets (adjusted OR 4.95, 95% CI: 0.98-4.40, p= 0.032<0.05), and ability to meet user needs (adjusted OR 5.73, 95% CI: 0.70-4.15, p= <0.001) increased the chances of use of shared toilets. The odds for preference of toilets significantly increased by 4.95 and 2.09 when toilets adequately addressed user needs and when they were separated by gender respectively (p<0.05). In toilets where women took cleaning roles, the chances of hygiene increased by 1.83 compared to when men took the roles. Unavailability of toilet cleaning materials seemed to have a negative impact on the hygiene of shared toilets (adjusted OR 0.53, 95% CI: 0.10-2.96, p= 0.003<0.05). The study concluded that sanitation was among the critical issues that affected slum dwellers and its impact was disproportional to gender. The gender-based sanitation needs in slums suggested the essence of accommodating uniqueness of gender beyond just provision of toilets. The study recommended the need for strengthening the role of women in leadership, the need for advocacy, community cohesion and gender mainstreaming in sanitation policies to promote gender-responsive sanitation facilities in slums.