Effect of household socio-economic status on disposable diaper use and disposal in Greater Accra, Ghana and Kisumu, Kenya: a cross-sectional study

Abstract

Mismanaged disposable diaper [DD] waste is widespread in many African cities. Proposed policy responses range from free DD provision to outright bans. However, African studies examining urban DD consumption, disposal, and benefits are scarce. This cross-sectional study aimed to assess socio-economic variation in DD consumption, inappropriate DD disposal, and perceived benefits for children’s carers. A survey interviewing 440 carers of children aged 0-36 months attending health facilities in Greater Accra, Ghana and Kisumu, Kenya found that 95.0% and 94.2% used DD respectively. Median DD consumption in a child’s first 36 months of life was significantly higher in the wealthiest versus poorest households in both cities (4,099 versus 2,800 DD and 2,876 versus 1,714 DD, p=0.015 and <0.001 in Greater Accra and Kisumu respectively). In Greater Accra, 10.2% of households reported burning, burying, or dumping used DD in latrines or elsewhere, compared to 30.5% in Kisumu. Carers in all wealth quintiles consistently cited DD’s convenience and hygiene benefits. This confirms widespread DD consumption among rich and poor households. Although poor households use fewer DD, many still face DD disposal challenges because they lack waste collection services. Given DD’s likely time-saving and reported convenience benefits for children’s carers, we recommend waste management programmes that separate DDs for safe disposal instead of outright bans.

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Identifiers

ORCID for Allan G. Hill: orcid.org/0000-0002-4418-0379

ORCID for Mair L.H. Thomas-Possee: orcid.org/0000-0003-1899-2434

ORCID for Jim A. Wright: orcid.org/0000-0002-8842-2181

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