On-street toilets for sanitation access in urban public spaces: A systematic review

Highlights

• On-street toilets allow citizens to circulate in cities and enjoy public spaces.

• Literature review shows that provision is the leading in the public-toilets research area.

• Women, transgender people, homeless, elderly and people with disabilities are vulnerable users.

• Gender and accessibility are neglected by current policy solutions.

• More focused discussion on the right to sanitation in public spaces is necessary.

Abstract

This review aims to raise awareness of the role of on-street public toilets in urban sanitation and to identify gaps in understanding and guiding future research. Although the literature shows a diversity of viewpoints with regard to solutions, sanitation in public spaces was shown as indispensable for providing universal access to safe, accessible, and inclusive public spaces, particularly for women, transgender people, children, elderly, and people with disabilities. The provision of sanitation services in public spaces can be guided by further research, inclusive engagement, and the elements of the normative policy framework provided by the United Nations.

Introduction

Sanitation in public places is essential for hygiene and public health. Nonetheless, providing sanitation infrastructure in public sites can be challenging, mainly due to management. It may also bring benefits from an urban perspective by fostering the local economy, enabling the use of public transport and even strengthening tourism (Greed, 1995, 2004). Generally, sanitation in public spaces is constituted by public toilets, which could be on or off-street toilets. Public toilets should be addressed as a vital component of modern, livable cities and as a subject of municipal policy planning. Implementing public infrastructures should take into account all different social groups and their different demands in relation to the same problem (Greed, 2003; House of Commons London, 2008).

The lack of on-street toilets encourages open urination and defecation, raising public health and nuisance concerns (Norén, 2010; Stanwell-Smith, 2010). Aiming to solve this issue, it is common for some cities to impose sanctions on citizens that use the streets as toilets (Norén, 2010; Cozens et al., 2019). However, this masks the real problem by neglecting the right to access public toilets as a citizen right. For instance, gender and disability-rights groups have been struggling to access public toilets as an approach to embrace inclusive civil rights (Serlin, 2010).

As mentioned, the claim of on-street toilets as a citizen right has been decentralized, either by gender or by disability rights groups. However, the United Nations General Assembly (UNGA) recently published a report (A/HRC/42/47) on the human right to drinking water and sanitation (HRWS) in all spheres of life beyond households (UNGA, 2019). Sanitation services enhance public spaces and should be guaranteed, especially to street workers, homeless people, people with disabilities, transgender people, and women and girls (UNGA, 2019). In 2015, the United Nations released the 2030 Agenda with the Sustainable Development Goals (SDGs), which established goals to be achieved by the year 2030, including universal access to water and sanitation (Goal 6.2) and universal provision of accessible, safe, and inclusive public spaces, especially for women, girls, the elderly and people with disabilities (Goal 11.7) (UN, 2015). Public space, according to the New Urban Agenda, ideally provide multifunctional areas for social interaction and inclusion, human health, and well-being (UN, 2016).

It is assumed that public toilets are an infrastructure that must be provided to guarantee people's rights to sanitation when they are away from their households. Nonetheless, even in cities where public toilets are provided in sufficient number, there is still dissatisfaction with the currently adopted solutions related to safety and violence factors, hygiene, bathroom design, level of supply, location, and accessibility (Greed, 2003). A previous study raised several questions concerning practicality when using a public toilet. For instance: (1) How far is the toilet? (2) Does it have free access or is payment required? (3) Can we sit in the toilet or should we squat? (4) Is toilet paper or a bidet available? (5) Is there protective paper for the toilet board, or will it be necessary to hover over the toilet? (Molotoch, 2010). According to the author, the answers to these questions vary, depending on local specificities and different needs, as regarding gender, age, physical mobility, and socioeconomic status (Molotoch, 2010; UNGA, 2019).

In light of those questions, we can consider the elements of the normative content of human rights to water and sanitation in public spaces (HRWS-PS) exposed by UNGA for understanding the effectiveness of on-street toilets (UNGA, 2019). The first demand is related to availability, the first element of HRWS-PS. In this matter, sanitation infrastructure in public spaces must be provided in quantity to attend the number of people circulating the area, while the number of facilities should consider the reason for attendance and the time spent in the place (UNGA, 2019). Thus, if the distance to a nearer public toilet is considered far by the user, it is assumed that the planning did not consider availability in the first place.

The second element of HRWS-PS is accessibility, which concerns the physical access of the toilet and potential barriers, such as stairs and narrow spaces or a long distance to reach the facility. Moreover, it may also consider the physical infrastructure, regarding solutions adapted to children, elderly, and wheelchair users, or even associated to its opening hours, since many public toilets close during the night, affecting many people who rely on them (UNGA, 2019). The facility's opening hours are also associated with toilet availability, and thus service provision.

The third element of HRWS-PS is affordability, which indicates that users can pay for the service. However, in reality, many people that rely on public toilets for their physiological needs do not have the resources to pay the fee, while many municipalities charge the use of public toilets in return for maintenance and operation (UNGA, 2019).

Acceptability is the fourth element of HRWS-PS, which considers insurance of privacy and dignity when using the toilet. The questions discussed by Molotoch (2010), when raising the question of sitting or squatting in the toilet, also relates to cultural habits and acceptability. For instance, in western countries, it is usual to have a sitting toilet, while in many eastern countries, it is more common to use squatting toilets (Braverman, 2010). Regarding this aspect, sanitation planning for public spaces must consider habits and cultural needs and, consequently, user acceptance. Within the acceptability element, UNGA combined privacy and dignity. The privacy element should also be considered for vulnerable and marginalized groups, as an example for women and transgender people (UNGA, 2019).

The fifth and last element regards safety and quality. These issues may be related to the questions considering toilet paper provision, showerhead, and protective paper on toilet sets, among other needs. Failure to provide a safe public toilet of good quality will negatively affect health and hygiene (UNGA, 2019).

Even though the elements of HRWS-PS are only recently being discussed, they were implicit in discussions about public toilets in scientific publications for a longer time, either by demonstrating the importance of providing toilets for access to other goods in the city or by the right related to gender or physical mobility, for instance (Greed, 1995, 2003; Nóren, 2010; Serlin, 2010; Molotoch, 2010).

The framework and elements of HRWS-PS have brought to light critical perspectives on the provision of sanitation services in public spaces that are crucial for urban and utility planning and policymaking. It is possible to understand the other sectors that shall be involved concerning public toilets beyond sanitation, such as urban planning and public health. Urban planning involves public space planning, management, and decision-making regarding the provision, accessibility, and gender/sex segregation. Public health is important when discussing hygiene and health issues related to public toilets. Moreover, although not the primary focus of this study, human rights might also be addressed regarding its principles, i.e., non-discrimination, equity, social participation, accountability, access to information and transparency, progressive realization, and non-retrogression (Brown et al., 2016). In this manner, those aspects are also crucial for implementing public toilets in urban spheres.

Public toilets were considered a requirement to care for the welfare of people away from their homes, and as a civil right that states must provide. According to the UN report, few countries have effective legislation on providing these services, and regulated countries do not yet offer services under the lens of human rights (UNGA, 2019). Thus, this work aims to conduct a systematic review on urban public toilets, inspired by HRWS-PS elements, public health, and urban planning issues to identify gaps in understanding and guide future research.