A cross-sectional survey to assess household sanitation practices associated with uptake of "Clean Team" serviced home toilets in Kumasi, Ghana

Clean Team provides serviced, free-standing toilets as a sanitation option in low-income areas of Kumasi, Ghana. A cross-sectional survey was carried out to assess sanitation and hygiene practices in 199 Clean Team households and 201 neighbouring, non-Clean Team households. Adults in non-Clean Team households were no more likely to report unsafe defecation (faeces not contained in a latrine) than their Clean Team neighbours, although their reliance on public toilets may lead to occasional unsafe practices. Children in Clean Team households used the household toilet from a younger age than those in non-Clean Team households, and their faeces were thus more often disposed of safely. Soap and water were more frequently found at the latrine in Clean Team households than in latrine-owning non-Clean Team households. Use of Clean Team toilets is likely to reduce faecal contamination of the environment through safer child defecation and stool disposal practices, and may increase the opportunity for post-defecation handwashing with soap.