Skip to main content

Table 3 CHILD-SAN: a new disability-inclusive framework for emergency sanitation for children aged five to 11

From: CHILD-SAN: a new disability-inclusive framework for emergency sanitation for children aged five to 11, based on a systematic review of existing guidance

C Child participation - Ensure (a) safe, meaningful and disability-inclusive child participation in emergency WASH preparedness planning and (b) meaningful and disability-inclusive participation in emergency WASH programming from the earliest opportunity that it is safe to do so using existing guidelines (notably O’Kane 2013a)
- See The case for CHILD-SAN facilitiessection for discussion
H Heights - Door handles (if being used) should be mounted 800 to 900 mm above the floor (UNICEF 2017a)
- Locks (if being used) should be positioned within reach of a child or wheelchair user, at a height of between 680 mm and 800 mm (Save the Children 2013; UNICEF 2017a)
- Grab rails on each side of the toilet should be located 300 to 350 mm from the centre of the toilet and between 510mm and 640 mm off the ground (UNICEF 2017a)
- Water taps should be positioned within reach of a child or wheelchair user, at a height of between 680 to 800 mm (UNICEF 2017a)
- Washbasins (with unobstructed knee clearance for wheelchair users) should be positioned at height of between 650–700 mm and 200 mm deep (UNICEF 2017a)
I user-friendly - Consider if (verbal or visual, using simple communication methods) guidance on how to use the toilet needs to be provided
- Children are often not prepared to wait, or do not have sufficient bowel or bladder control to wait, and pits may also fill-up relatively more quickly as children drop items down the hole both on purpose and accidentally (Ferron and Lloyd 2014). A ratio of 1 toilet per 20 children is recommended (Noortgate and Maes 2010)
- Allow for a spare 0.5 m of depth in the latrine pit size to avoid unpleasant sights and excreta splashing out during use. A pit with a maximum depth of 2 m (an effective depth of 1.5 m) will therefore last for about 2 years if it is used normally by 20 children (an accumulation rate of 0.04 m3/child) (Noortgate and Maes 2010)
- Consider how open the toilet should be. Children, particularly younger children, may prefer an open structure without a door, roof (this may be climate-dependent) or superstructure (Deniel 2006). Such structures alleviate fears of the dark, and younger children also like to imitate and observe others (Zomerplaag and Moojiman 2005)
- Provide enough space for two people (for example, a caregiver and child) to use the toilet to enable supervision, help and teaching (UNHCR 2018a), and that accommodates a wheelchair turning radius (1500 mm by 1500 mm) (UNICEF 2017a)
- Ensure that doors (if being used) are robust but not too heavy for children to use (Zomerplaag and Moojiman 2005). D-lever door handles are preferred rather than doorknobs (Jones and Wilbur 2014; UNICEF 2017a)
- If a toilet seat or chair is being used, grab rails should be provided on each side of the toilet. One should be moveable or foldable on one side to allow for transferring (UNICEF 2017a)
- Provide a handle bar and/or handrails to support squatting. Multiple handrails may be needed (vertical, horizontal, various heights) (Noortgate and Maes 2010; Ferron and Lloyd 2014; Jones and Wilbur 2014)
- Provide doors with locks and walls that ensure privacy; easy access to water; hooks and shelves; and discrete disposal facilities to aid the changing of soiled menstruation and incontinence products and clothing. Note that the whole collection and disposal chain of soiled items also needs to be considered (Sommer et al. 2017)
- Ensure that taps are robust but not too heavy for children to use (Zomerplaag and Moojiman 2005). Large taps with long levers are easier to operate (UNICEF 2017a)
- Locate soap for ease of use and where a child with visual or mobility disabilities can easily find/reach it (UNICEF 2017a)
L Location - Consider (distance/location) where to safely position gender-neutral and gender-segregated children’s toilets that is culturally appropriate for both the child and caregiver
D Décor - Brightly decorated walls can encourage use, and decoration with child-friendly hygiene promotion material can increase awareness at the same time (Zomerplaag and Moojiman 2005)
- Decoration can include ‘nudges’ to use handwashing facilities, for example, footsteps from the toilet to the handwashing facilities
- Involving children in decoration can encourage a sense of ownership and deter vandalism (SuSanA 2012)
-  
S Scaled-down - Drop-holes should not be so big that a child could fall-in, or be fearful of falling-in: Noortgate and Maes (2010, p.31) provide an indicative diameter of 120 mm
- Toilet-seats should be low (350 to 450 mm from floor level) (UNICEF 2017a) or a step provided for children to access the toilet-seat (Banzet 2003) although this may limit access for children with disabilities
- Squatting plate dimensions (including the distance between footrests of a squatting platform and the distance from a squatting platform to the wall) should be suitable for a child; indicative dimensions have been provided by Noortgate and Maes (2010, p.31). Smaller squatting plates can be fixed over adult ones (UNICEF 2017b)
A Accessibility - Consider accessibility for both the child and caregiver
- Position well-lit signs to show the location of the toilets at both adult and child-height, and use simple communication methods, for example, symbols (UNICEF 2017a)
- Paths should be wide enough for two people (for example, a caregiver and child) to comfortably pass (Ferron and Lloyd 2014), and ideally 1800 mm wide to allow two wheelchair users to pass (UNICEF 2017a)
- Distances and topography of paths must be appropriate for all children and caregivers to navigate
- Line paths with painted rocks and provide painted landmark posts to increase visibility (Jones and Wilbur 2014)
- Ramps are the preferred solution for access to at least some of the facilities and where used they should have a minimum width of 1000 mm with raised, painted sides (to avoid falling and to increase visibility) and painted handrails recommended for slopes steeper than 1:20 (Jones and Wilbur 2014; UNICEF 2017a)
- If there are steps, the step riser height (150 to 170 mm) and step depth (280 to 420 mm) should be suitable for a child, the step surface should be textured to prevent slippage, and a painted handrail provided for visible support (Ferron and Lloyd 2014; Jones and Wilbur 2014)
- Entrances should have a minimum width of 800 mm to allow wheelchair access with no thresholds or barriers on the ground (UNICEF 2017a)
- Doors (if being used) should open outwards (Jones and Wilbur 2014)
N monitoring and evaluation - Ensure the collection of sex-, age- and disability-disaggregated data against contextually appropriate indicators—including the WASH and Child Protection indicators of the Minimum Standards for Child Protection in Humanitarian—to indicate the prevalence of child-friendly facilities and their use
- Consider if cleaning and maintenance exploits children and/or discriminates against girls (Save the Children 2013)
SeeCHILD-SAN: a new disability-inclusive framework for emergency sanitation for children aged five to 11section for discussion