Evaluation of user experiences for the Clean Team Ghana container-based sanitation service in Kumasi, Ghana

There are few affordable and acceptable sanitation solutions for dense, low-income urban settlements. Though container-based toilets are a safely managed sanitation solution, little is known about user experiences to inform how such a solution should be viewed by governments. We conducted a before and after enrolment study of objective and subjective measures of sanitation quality due to the Clean Team Ghana (CTG) container-based toilet service in Kumasi, Ghana from June to December 2019. We collected data immediately prior to installation and 10 weeks afterwards for 292 customers. Most of them initially used public toilets with good structural quality, but sometimes these toilets had poor hygiene, lacked handwashing facilities, requiring a 14.3-min mean time to use. We found that CTG delivered a high-quality service that positively impacted the quality of life of customers, saved them money, reduced gender gaps in the quality of life, and addressed the needs of those with physical disabilities. Problems with the CTG service, such as leaking, filling, smelling, or not being replaced as scheduled, were reported by fewer than 10% of customers. This evaluation supports the growing body of evidence that container-based sanitation provides a service valued by users in dense urban settlements.