Understanding sustained use of ecological sanitation in rural Burkina Faso.

Access to safe sanitation services is fundamental for healthy and productive lives, but in rural Burkina Faso only around 7% of the population uses improved sanitation. Ecological sanitation (ecosan) systems that allow safe agricultural reuse of nutrients in human waste have been promoted in these areas, as a way to meet sanitation needs while contributing to food security. However, little is known about the success of these interventions in terms of both sustained use of the toilet and safe excreta reuse practices. We assessed the use of ecosan systems in 44 rural communities where such interventions had taken place. Structured interviews and observations conducted at 520 randomly selected concessions (residential properties), suggested a large-scale shift from open defecation to ecosan toilet use. However, only 58% of surveyed concessions reported ever emptying the ecosan toilet vault, which is required for optimal long-term functioning. Concessions that received ecosan training programmes with a greater emphasis on agricultural reuse were more strongly associated with toilet use and emptying than those that whose training focused more on sanitation access and health benefits. The findings suggest that the safe agricultural reuse of nutrients can provide a strong motivation for long-term adoption of improved sanitation among rural smallholders.