Benefits and barriers to safe use of ecological sanitation in El Alto, Bolivia – a need for improved hygiene education?

This briefing summarizes a mixed-methods study on an ecological sanitation (ecosan) pilot project in El Alto, Bolivia. The project, implemented by Fundación Sumaj Huasi with technical support from the Stockholm Environment Institute and funding from Sida, installed 897 sanitation units—including urine-diverting dry toilets (UDDTs) and handwashing basins—benefitting approximately 4,489 people in District 7. The study evaluated the project's impact on health and identified barriers to the sustained use of these systems.

• The installation of ecosan units, specifically UDDTs and handwashing stations, led to a statistically significant reduction in the incidence of diarrhoeal disease. However, this health improvement was significantly smaller for households with lower socioeconomic status, which the study attributes to factors such as the use of unimproved water sources and a lack of soap for handwashing.
• Age-related sociocultural differences acted as a barrier to adoption; while younger users generally adopted the toilets and handwashing, some older residents continued to practice open defecation. Older users cited the inconvenience of cleaning the toilets and removing waste, as well as the perceived ease of open defecation, as primary reasons.
• Irregular waste collection services undermined the system's safety and sustainability. When waste built up due to inconsistent collection, households resorted to open defecation or the unsafe disposal of waste, including dumping it in drainage ditches or vacant lots and applying untreated human waste to household vegetable gardens.
• There is a critical gap in hygiene education regarding the link between sanitation practices and health. While participants accepted the toilets and valued cleanliness (particularly in the kitchen), they lacked knowledge about the risks of pathogen exposure and the specific health benefits of hygiene practices in preventing diarrhoea.

APA

Murad, S., & Dickin, S. (2016). Benefits and barriers to safe use of ecological sanitation in El Alto, Bolivia – a need for improved hygiene education? Stockholm Environment Institute. https://www.sei.org/mediamanager/documents/Publications/SEI-2016-DB-Dickin-Murad-ElAlto.pdf

Chicago

Murad, Sofia, and Sarah Dickin. Benefits and barriers to safe use of ecological sanitation in El Alto, Bolivia – a need for improved hygiene education? Stockholm Environment Institute, 2016. https://www.sei.org/mediamanager/documents/Publications/SEI-2016-DB-Dickin-Murad-ElAlto.pdf.

Wikipedia

{{cite report |last1=Murad |first1=Sofia |last2=Dickin |first2=Sarah |title=Benefits and barriers to safe use of ecological sanitation in El Alto, Bolivia – a need for improved hygiene education? |publisher=Stockholm Environment Institute |date=2016 |url=https://www.sei.org/mediamanager/documents/Publications/SEI-2016-DB-Dickin-Murad-ElAlto.pdf |access-date=17 August 2026 |via=Climate Insights Directory}}

BibTeX

@techreport{murad2016benefits, author = {Murad, Sofia and Dickin, Sarah}, title = {{Benefits and barriers to safe use of ecological sanitation in El Alto, Bolivia – a need for improved hygiene education?}}, institution = {Stockholm Environment Institute}, year = {2016}, url = {https://www.sei.org/mediamanager/documents/Publications/SEI-2016-DB-Dickin-Murad-ElAlto.pdf}, urldate = {2026-08-17}, note = {Indexed by Climate Insights Directory} }