Objectives: To examine characteristics of household heads in two districts of Northern Ghana who had or had not participated in latrine promotion programmes; to inspect latrines; and to explore perceptions of latrine ownership.
Methods: One hundred and twenty latrine owners and 120 non-owners were randomly selected from all trachoma-endemic villages and interviewed. Structured questionnaires assessed demographics, household data, wealth indicators, and perceptions of latrine ownership. Latrines were inspected.
Results: Latrine owners and non-owners were similar demographically, but owners were more likely to report any education or wealth indicators: any education OR = 2.0, (95% CI 1.2-3.4); large family size OR = 4.6 (2.6-8.2); children in school OR = 3.8 (1.3-10.5); and metal roof OR = 9.1 (2.0-40.0). All 120 latrine owners were participating in promotion programmes; no latrines had been self-built without programme support. Inspection showed 73/120 (60.1%) latrines were completed and used. Of the uncompleted latrines 41/47 (87.2%) were more than a year old. Programme participants (regardless of whether they had a completed latrine) had contributed cash (mean 16.74 dollars S.D.18.09) and 117/120 had provided labour and/or construction materials. The most frequently reported advantages of latrine ownership were convenience, cleanliness and health benefits; reported disadvantages were the need for maintenance and cleaning and bad odour.
Conclusions: Current latrine promotion programmes do not reach all households equally. Joining a latrine programme was expensive and did not guarantee latrine ownership; this may cause people to lose trust in such programmes. Latrines were perceived to be useful, suggesting unmet demand. Reliable and inclusive programmes that provide low cost latrines may receive community support.