A tale of two communities: Comparing user perceptions of condominial and conventional sewer systems in Salvador, Brazil

Abstract

Problems of access and quality of sanitary sewage disproportionately impact the health of populations in urban peripheries of low-and middle-income countries. The condominial sewer system is a practical, low-cost, effective, and simplified engineering approach compared to conventional sewer systems. In support of meeting the sanitation needs in highly populated urban settings, there is a need to understand the residents’ perceptions regarding the advantages and disadvantages of this sanitation model compared to conventional sewer systems. We conducted a cross-sectional study from September to December 2021 in two urban communities of Salvador, Bahia, Brazil, where condominial and conventional sewer systems had been implemented in the last five years. Of the 203 residents we interviewed, 50.7% lived in a site served by a condominial sewer system. Residents in the condominial sewer site reported not connecting to public sewage network (23.7% vs. 11.2%; p = 0.022) more often than in the conventional site. They reported more collective action to solve urban sanitation problems (69.9% vs. 54.0%; p = 0.020), such as manhole cleaning and unclogging efforts to fix plumbing. Despite these challenges, these residents expressed that the current service quality is better than it was in the previous two years. Our results suggest that even within urban periphery communities of a large Brazilian city, disparities exist in access to and quality of sanitation services that may be linked to sewage system implementation. Implementing simplified sewer systems is important to meet the growing sanitation demands of urban areas. However, these systems should also play a role in reducing sanitation disparities and the adoption of participatory approaches to meet the needs of populations in the most disadvantaged conditions. Despite challenging conditions, there is the potential for community engagement and active participation in sanitation-related matters, which could enhance the implementation and long-term sustainability of these systems.