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<p>Sustainable Development Goal 6.2 measures sanitation progress by type of toilet service. Improving people’s subjective sanitation experiences is also important but rarely rigorously measured. The Sanitation-related Quality of Life index (SanQoL-5) combines answers to five simple questions (disgust, privacy, disease risk, shame and safety) into an overall score ranging from 0 to 1. Here we evaluated the validity and reliability of SanQoL-5 by interviewing 6,165 people across rural and urban areas of six countries: Ethiopia, India, Kenya, Malawi, Mozambique and Zambia. We found good evidence for construct validity, with support (<i>P</i> &lt; 0.05) for 87% of hypothesized associations between SanQoL-5 and toilet quality characteristics. In 75 intercountry comparisons, only 9% of instances showed evidence of meaningful differential item functioning, suggesting good cross-cultural comparability. SanQoL-5 conformed to expectations in item response theory models, and we found evidence of convergent, discriminant and known groups validity. SanQoL-5 can be used in impact evaluation, monitoring, needs assessment and benefit–cost analysis.</p>

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Validity and reliability of the Sanitation-related Quality of Life index (SanQoL-5) in six countries

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年4月28日

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  • Fouzia Akter,
  • Neiva Banze,
  • Igor Capitine,
  • Kondwani Chidziwisano,
  • Jenala Chipungu,
  • Catildo Cubai,
  • Oliver Cumming,
  • Robert Dreibelbis,
  • Patrick Vidzo Katana,
  • Cremildo Manhiça,
  • Mindy Panulo,
  • Priya Rampal,
  • Anjali Sharma,
  • Sheillah Simiyu,
  • Abiy Tafesse,
  • James Ben Tidwell,
  • Edna Viegas,
  • Blessings White,
  • Ian Ross

摘要

Sustainable Development Goal 6.2 measures sanitation progress by type of toilet service. Improving people’s subjective sanitation experiences is also important but rarely rigorously measured. The Sanitation-related Quality of Life index (SanQoL-5) combines answers to five simple questions (disgust, privacy, disease risk, shame and safety) into an overall score ranging from 0 to 1. Here we evaluated the validity and reliability of SanQoL-5 by interviewing 6,165 people across rural and urban areas of six countries: Ethiopia, India, Kenya, Malawi, Mozambique and Zambia. We found good evidence for construct validity, with support (P < 0.05) for 87% of hypothesized associations between SanQoL-5 and toilet quality characteristics. In 75 intercountry comparisons, only 9% of instances showed evidence of meaningful differential item functioning, suggesting good cross-cultural comparability. SanQoL-5 conformed to expectations in item response theory models, and we found evidence of convergent, discriminant and known groups validity. SanQoL-5 can be used in impact evaluation, monitoring, needs assessment and benefit–cost analysis.