Physical Accessibility for Disabled People: Analysis of Toilet Facilities in Primary Health Care Units

Background: Accessibility enables the effective participation of disabled persons in public and private areas and the use of urban equipment and street furniture. Objective: This study aimed to analyze the physical accessibility of toilet facilities in urban and rural primary health care units. Methods: It was a quantitative descriptive study conducted in 157 Primary Health Care Units of 16 municipalities in the Baturité Massif region, Ceará, Brazil. The study took place from August 2014 to May 2015, with a checklist type form, designed from the Technical Standard 9050 of the Brazilian National Standards Organization, specifying the ideal access conditions established by law to allow mobility of persons with physical disabilities. Data were processed through the Statistical Package for the Social Sciences software and organized into tables. Results: Toilets designed for physically disabled people were accessible as the location and signs (59.9%), identified with symbols for males and females (57.3%);however, the doorway width was smaller than needed to accommodate a wheelchair (77.7%). Inside the bathroom, only the forward approach was possible (59.9%). Grab bars positioned on the side and rear walls were inadequate or nonexistent (67.6%);toilet seats (91.1%) and toilet paper dispensers (96.2%) were mostly in inaccessible heights;flush controls in appropriate height (59.2%) and activated by light pressure (58%). Sinks without pedestal (51%), but higher than recommended (80.3%) and without single handle faucets (95.6%). It was verified that the toilets of basic health units located in urban areas had better accessibility conditions compared to those in rural areas. Conclusion: Results showed that the analyzed units presented physical inaccessibility in some toilet facilities, making it difficult or even impossible the accessibility for the disabled. The inclusion of accessibility features in health services for this clientele provides equal opportunities and social inclusion.

Toilet Availability and Use in Public Places in Buea: Implications for Public Health

Toilet facilities in public places are a necessity and are supposed to be present in any public place where people visit. Despite the importance of toilet facilities in public places, there is limited access to toilet facilities in public places in Sub-Saharan Africa and this has been a persistent issue. Given that limited studies have been done on availability and use of toilets in public places, this study aimed to fill this research gap. To achieve the objective of the study, a cross-sectional study was used to select participants from the study site. The sample size was 400 after adjustment for non-response. Results from the study showed promising as 95% of public places had a toilet and water for hand washing. However, most of the toilet facilities lacked soap. Toilets in offices and hospitals were perceived to be cleaner and of good quality compared to those in markets and travel agencies. Results also showed that participants hardly used toilets in markets and travel agencies. Toilet facilities in offices and churches were most used, as office toilets were rated clean and of good quality by the participants. The study recommends the need for routine checks by the council to ensure the presence of toilet facilities in public places and the need to sensitise business owners on the importance of having and maintaining toilet facilities in their business establishments.

Assessing the prevalence of young children living in households prepared for COVID-19 in 56 low-and middle-income countries

Background:The COVID-19 pandemic and governments’attempts to contain it are negatively affecting young children’s health and development in ways we are only beginning to understand and measure.Responses to the pandemic are driven largely by confining children and families to their homes.This study aims to assess the levels of and associated socioeconomic disparities in household preparedness for protecting young children under the age of five from being exposed to communicable diseases,such as COVID-19,in low-and middle-income countries(LMICs).Methods:Using data from nationally representative household surveys in 56 LMICs since 2016,we estimated the percentages of young children under the age of five living in households prepared for communicable diseases(e.g.,COVID-19)and associated residential and wealth disparities at the country-and aggregate-level.Preparedness was defined on the basis of space for quarantine,adequacy of toilet facilities and hand hygiene,mass media exposure at least once a week,and phone ownership.Disparities within countries were measured as the absolute gap in two domains—household wealth and residential area-and compared across regions and country income groups.Results:The final data set included 766,313 children under age five.On average,19.4%of young children in the 56 countries lived in households prepared for COVID-19,ranging from 0.6%in Ethiopia in 2016 to 70.9%in Tunisia in 2018.In close to 90%of countries(50),fewer than 50%of young children lived in prepared households.Young children in rural areas or in the poorest households were less likely to live in prepared households than their counterparts.Conclusions:A large portion of young children under the age of five in LMICs were living in households that did not meet all preparedness guidelines for preventing COVID-19 and caring for patients at home.This study highlights the need to ensure all families in LMICs have the means to prevent the spread of the pandemic or other communicable illnesses to young children during pandemics.