Table 2 Capability, opportunity and motivation enablers (+) and barriers (−) and possible intervention strategies for cleaning of shared sanitation facilities in low income settlements of Kisumu, Kenya

Capabilities

(Individual’s psychological and physical capacities)

• An awareness that toilets need to be cleaned (+)

• Awareness that toilets should be cleaned after being soiled by children (+)

• Need to increase awareness on use and cleanliness of shared toilets.

Physical and social opportunities and barriers

(Factors in the physical and social environment that enable or hinder behaviour)

• Availability of cleaning aids e.g. water, detergents, disinfectant, and broom/brush (+)

• Availability of individuals who clean, e.g. caretakers and youth groups (+)

• Non-compound members who use and soil the toilets (−)

• A stern/strict/firm resident landlord ensured cleaning is done (+)

• A cleaning schedule in some compounds enhanced cleaning (+)

• Cleaning rules that were adhered to by all users (+)

• Landlords and tenants reminded other users to clean (+)

• Responsibilities were shared among landlords and tenants (+)

• Lack of or poor communication between tenants and landlords (−)

• Poor structural quality of the toilets discouraged cleaning (−)

• Children in the compound soiled toilets (−)

• Provision of cleaning aids

• A barrier e.g. fence/gate to the compound.

• Locking of toilets.

• Defined and agreed upon cleaning schedule between landlords and tenants, or among tenants

• Sharing responsibilities between men and women.

• Improving relationships among compound members

• Involving all users in cleaning

• Communication and problem solving mechanisms among tenants, and between tenants and landlords

• Improving on structural qualities of the shared toilets, e.g. emptying, and improving the superstructure

Motivations

(Automatic and reflective brain processes that energize and direct behaviour)

• Users desire to be comfortable when using toilets (+)

• Users clean toilets because it is the right thing to do (+)

• Users are demotivated to clean dirty toilets (−)

• Users clean shared toilets because of living next to the toilet (to avoid the smell) (+)

• Users are demotivated to clean when cooperation was lacking (−)

• Demotivation because of poor quality toilets (−)

• Women feared contracting diseases (+)

• Women feared their children contracting diseases (+)

• Enhance the motivation to clean shared toilets

• Discourage poor use of toilets

• Enhance the benefits of clean toilets and the disadvantages of dirty toilets