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

The specific sanitation needs of children aged five to 11 years old—those too old to use small potties, but usually too young to safely and confidently use adult latrines during both the day and night, and including children in this age range with disabilities—have often been overlooked in the provision of emergency sanitation. There are multiple reasons to provide sanitation specifically for this age group. They represent a large number of beneficiaries; legal principles and the moral obligations of humanitarian actors should drive their inclusion. Failure to consider their needs results in increased risk of injuries, abuse and/or exploitation when using unsuitable locations to urinate or defecate, and negative health impacts arising from being unable to manage personal hygiene. We have critically reviewed existing guidance for the provision of emergency sanitation for children aged five to 11 and subsequently presents a new disability-inclusive framework: CHILD-SAN. CHILD-SAN is an acronym representing key factors for the water, sanitation and hygiene (WASH) sector to consider in emergency sanitation programmes: c hild participation, h eights, user-fr i endly, l ocation, d écor, s caled-down, a ccessibility, and mo n itoring and evaluation. The CHILD-SAN framework recommends (a) safe and meaningful child participation in emergency WASH preparedness planning and emergency WASH programming as a means to develop contextually-appropriate facilities, (b) specific design considerations for child-friendly toilets (that is, they meet the needs of a child), and (c) the collection of sex-, age- and disability-disaggregated data against contextually appropriate indicators to determine the prevalence of child-friendly facilities and their use. We found few examples of emergency WASH programmes adhering to elements of the CHILD-SAN framework, but the implementation of CHILD-SAN would contribute to the WASH sector’s aims of achieving universal sanitation and maximising opportunities for good health, dignity, comfort and safety for all.