Survey of Disposable Diaper Use Among Children’s Carers Attending Health Facilities in Greater Accra, Ghana and Kisumu, Kenya, 2023

Amponsah, Mavis and Wanza, Peggy and Thomas-Possee, Mair and Asamoah, Moses and Boafor, Emefa and Hornuvo, Ruby and Amoah, Josephine and Dzodzomenyo, Mawuli and Hill, Allan and Okotto-Okotto, Joseph and Okotto, Lorna-Grace and Oigo, James and Wright, Jim (2024). Survey of Disposable Diaper Use Among Children’s Carers Attending Health Facilities in Greater Accra, Ghana and Kisumu, Kenya, 2023. [Data Collection]. Colchester, Essex: UK Data Service. 10.5255/UKDA-SN-856911

According to WHO/UNICEF, whilst 91.8% of urban households in Sub-Saharan Africa (SSA) had access to piped or protected groundwater sources in 2015, only 46.2% had safely managed water available when needed. Vendors provide a key role in supplying urban off-grid populations, with consumption of bottled or bagged water (sachets, water sold in 500ml plastic bags) growing in SSA. Whilst several studies show bottles and bags are usually free from faecal contamination, given that many off-grid urban populations lack solid waste disposal services, when people drink such water, there can be problems disposing of the plastic bags and bottles afterwards.
This project aims to deliver evidence on the different ways that people sell water to off-grid populations and what this means for plastic waste management. We plan to do this in Ghana, where most urban household now drink bagged water, and by way of contrast, Kenya, where the government has banned plastic bags. In this way, we want to widen access to safe water and waste management services among urban off-grid populations, by supporting water-sellers and waste collectors to fill the gaps in municipal services.
Both countries (and many others elsewhere) already have nationwide household surveys that collect data on the food and goods people consume and the services they have. However, as yet, these surveys have not been connected to the problem of waste management. We plan to visit marketplaces, buying foods and then recording packaging and organic waste. By combining this information with the household survey data, we can work out how much domestic waste like plastics gets collected and how much is discarded or burned, ultimately entering the atmosphere or oceans.
In Ghana, we will also survey informal waste collectors in urban Greater Accra. We want to find out how much these small businesses support waste collection and recycling across this urban region (particularly plastic from bagged water), so we can help government identify gaps in waste collection coverage. We also believe highlighting the important role of small waste collectors could lead to greater business support for such collectors. We will also evaluate whether community education campaigns to encourage domestic waste recycling reduce the amount of waste and plastic observed in the local environment. Such campaigns are currently pursued by several local charities with support from the Plastic Waste Management Project.
In Kenya, where water is usually sold in jerrycans rather than bagged, the jerrycan water often gets contaminated. We plan to find out whether this jerrycan water is safer under an arrangement known as delegated management. This involves a water utility passing on management of the piped network to a local business in slum areas, so as to reduce vandalism of pipes and bring water closer to slum-dwellers. We will compare water quality in areas with and without this arrangement to see if it makes the water sold safer. We also plan to bring water-sellers and consumers together to find and test ways of reducing contamination of water between a jerry-can being filled and water being drunk at home. Rather than imposing a solution, we want to work together with vendors and consumers on this issue, but there are for example containers designed to keep water cleaner that we could explore.
Through these activities, we thus plan to develop evidence on different strategies for water-sellers to deliver safer water to people lacking piped connections, whilst managing plastic waste at the same time. In Ghana, this involves trying to increase recycling and waste collection for bagged water, which is relatively safe. In Kenya, this involves trying to reduce contamination of water sold in reusable jerrycans. Alongside our household survey evidence on how domestic waste is managed in slums, this should help governments plan waste and water services in poorer areas of Africa's expanding cities.

Data description (abstract)

This data set comprises the responses to a cross-sectional questionnaire survey of children's carers attending child health clinics at health facilities in Greater Accra, Ghana and Kisumu, Kenya. The study was designed to identify differences in disposable diaper use by socio-economic status and entailed interviews with 200 children's carers attending four purposively selected health facilities in each city. Parents or carers of children aged up to 36 months attending clinics were first asked about their age, level of education and socio-economic characteristics, enabling patterns of nappy use to be explored across different population groups. The questionnaire also covered the gender and month of birth of children to facilitate assessment of the age of toilet training. The interviewer then asked about the age of the child, the way that the child's stools are disposed of, frequency of diaper use, brands used, and diaper disposal for the specific child attending the clinic.

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