Achieving universal sanitation in Ghana: An analysis of key drivers of toilet ownership among property owners in Urban areas

Godwin Armstrong Duku; Nana Kobea Bonso; Eugene Appiah-Effah; Yenube Clement Kunkuaboor; Emmanuel Nouwati; Barbara Gyapong-Korsah; Ebenezer Acquah; Kwabena Biritwum Nyarko

doi:10.1371/journal.pone.0307729

Peer Review History

Original SubmissionJuly 17, 2024
10 Sep 2024 Decision Letter - Elmond Bandauko, Editor PONE-D-24-27907Achieving Universal Sanitation in Ghana: An Analysis of Key Drivers of Toilet Ownership Among Property Owners in Urban Areas.PLOS ONE Dear Dr. Duku, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but may require minor revisions to meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Please submit your revised manuscript by Oct 25 2024 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. 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However, one of the reviewers said they could not review the paper because there was no introduction. Did you encounter any challenges when submitting your paper? I am therefore, giving you an opportunity to resubmit your paper following minor revisions. You will see the comments from reviewer 1. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Partly ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: N/A ****** 3. 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Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Achieving Universal Sanitation in Ghana: An Analysis of Key Drivers of Toilet Ownership Among Property Owners in Urban Areas. Comments The paper addresses an important public health issue in urban Ghana, focusing on the determinants of household toilet ownership. The manuscript is generally well-structured, with a clear flow from the introduction through to the conclusion. However, in my review I did not see the introduction section. A technical error, I guess. The introduction could benefit from a more comprehensive literature review that situates the study within the context of existing research on urban sanitation in Ghana and other similar contexts – If the authors have not adequately done so. The authors should provide more justification for the choice of the three urban districts selected for the study. Were these districts chosen because they are representative of urban areas in Ghana, or were there other reasons? It would also be beneficial to discuss any potential limitations related to the data collection process, such as response bias or the accuracy of self-reported data on household income and building characteristics. The discussion appropriately connects the results to the broader context of urban sanitation in Ghana. However, it would benefit from a more critical analysis of the findings. For instance, the paper suggests that "enforcing building regulations requiring toilet facilities in all properties is crucial." Could the authors provide more concrete examples of how such regulations could be enforced in practice? The suggestion for "innovative sanitation financing interventions" is a good one, but the paper could delve deeper into what these interventions might look like, particularly in the context of urban Ghana where financial constraints are a significant barrier. The conclusion succinctly summarizes the key findings and recommendations. However, the authors could enhance the impact of their conclusions by explicitly linking them to the Sustainable Development Goals (SDGs), particularly SDG 6 (Clean Water and Sanitation). Authors indicated that “The survey was supplemented with field notebooks and cameras to aid direct field observations.” I did not see results reflective of that, or at least images/ pictures of observations from the field. In the discussion from line 6756 provide more specific details of the studies you are engaging with……eg. For example, a study in Ghana found that…. where exactly in Ghana?… Overall Recommendation: The paper addresses a critical issue in urban sanitation and provides valuable insights into the determinants of toilet ownership among property owners in Ghana. With some revisions of suggested areas for improvement, the manuscript could make a significant contribution to the field and be a valuable resource for policymakers. I recommend minor revisions before the manuscript is considered for publication. Reviewer #2: I HAVE NOT UNDERTAKEN A REVIEW OF THIS MANUSCRIPT BECAUSE THERE IS NO INTRODUCTION SECTION IN THE ATTACHMENTS. CAN I KINDLY HAVE THE COMPLETE MANUSCRIPT, POSSIBLY IN WORD FORMAT. WOULD APPRECIATE THE CORRECT DOCUMENT BEING SHARED ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. 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Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. Attachments Attachment Submitted filename: Achieving Universal Sanitation in Ghana_Reviewers Comments.docx https://doi.org/10.1371/journal.pone.0307729.r001
Revision 1
11 Oct 2024 Author Response Achieving Universal Sanitation in Ghana: An Analysis of Key Drivers of Toilet Ownership Among Property Owners in Urban Areas. Comments The paper addresses an important public health issue in urban Ghana, focusing on the determinants of household toilet ownership. 1. The manuscript is generally well-structured, with a clear flow from the introduction through to the conclusion. However, in my review, I did not see the introduction section. A technical error, I guess. The introduction could benefit from a more comprehensive literature review that situates the study within the context of existing research on urban sanitation in Ghana and other similar contexts – If the authors have not adequately done so. Response: We sincerely appreciate your thoughtful feedback and apologize for the technical error. The introduction was indeed included in the original submission, and we have ensured that it is now properly visible in the revised manuscript. We believe we have undertaken a comprehensive literature review to situate the study within the broader context of urban sanitation in Ghana and similar contexts. We have thoroughly gone through the introduction to improve the flow and coherence of our argument as per your suggestion. 2. The authors should provide more justification for the choice of the three urban districts selected for the study. Were these districts chosen because they are representative of urban areas in Ghana, or were there other reasons? Response: Thank you for highlighting this. We selected the three districts (Kumasi Metropolitan Assembly, Ga West Municipal, and Akuapem North Municipal) using a random sampling method, and we have now included a detailed explanation of this process in the methodology section. We have also provided justification in the introduction section that these districts, though randomly chosen, represent different levels of urbanization in Ghana, thus providing a diverse urban context for the study. 3. It would also be beneficial to discuss any potential limitations related to the data collection process, such as response bias or the accuracy of self-reported data on household income and building characteristics. Response: We acknowledge the importance of discussing limitations and have now expanded the section on data limitations. Specifically, we have addressed potential response biases and the accuracy of self-reported data. 4. The discussion appropriately connects the results to the broader context of urban sanitation in Ghana. However, it would benefit from a more critical analysis of the findings. For instance, the paper suggests that "enforcing building regulations requiring toilet facilities in all properties is crucial." Could the authors provide more concrete examples of how such regulations could be enforced in practice? Response: We appreciate this insightful comment. We have expanded our discussion to provide more concrete examples of how building regulations requiring toilet facilities in all properties could be enforced in practice. For instance, we now discuss specific mechanisms such as routine building inspections, stricter penalties for non-compliance, and the potential for leveraging local government partnerships to ensure adherence. 5. The suggestion for "innovative sanitation financing interventions" is a good one, but the paper could delve deeper into what these interventions might look like, particularly in the context of urban Ghana where financial constraints are a significant barrier. Response: Thank you for this suggestion. We have expanded our discussion on potential innovative sanitation financing interventions, particularly within the context of urban Ghana. We now provide examples such as microfinance schemes for toilet construction and revolving fund to overcome financial barriers. 6. The conclusion succinctly summarizes the key findings and recommendations. However, the authors could enhance the impact of their conclusions by explicitly linking them to the Sustainable Development Goals (SDGs), particularly SDG 6 (Clean Water and Sanitation). Response: We agree with this recommendation and have revised the conclusion to explicitly link our findings to SDG 6 (Clean Water and Sanitation). 7. Authors indicated that “The survey was supplemented with field notebooks and cameras to aid direct field observations.” I did not see results reflective of that, or at least images/ pictures of observations from the field. Response: We apologize for the oversight. We have now incorporated images from our field observations into the method section. 8. In the discussion from line 6756 provide more specific details of the studies you are engaging with……eg. For example, a study in Ghana found that…. where exactly in Ghana?… Response: We have revised the discussion to include more specific details regarding the studies referenced. For example, we now explicitly mention the regions or cities in Ghana where particular studies were conducted to allow for greater clarity and contextual relevance. 9. Overall Recommendation: The paper addresses a critical issue in urban sanitation and provides valuable insights into the determinants of toilet ownership among property owners in Ghana. With some revisions of suggested areas for improvement, the manuscript could make a significant contribution to the field and be a valuable resource for policymakers. I recommend minor revisions before the manuscript is considered for publication. Response: We sincerely appreciate the positive evaluation of our manuscript. We have addressed all the points raised to the best of our ability and believe that the revisions strengthen the overall quality and clarity of the paper. Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0307729.r002
26 Nov 2024 Decision Letter - Elmond Bandauko, Editor Achieving Universal Sanitation in Ghana: An Analysis of Key Drivers of Toilet Ownership Among Property Owners in Urban Areas. PONE-D-24-27907R1 Dear Dr. Armstrong We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice will be generated when your article is formally accepted. Please note, if your institution has a publishing partnership with PLOS and your article meets the relevant criteria, all or part of your publication costs will be covered. Please make sure your user information is up-to-date by logging into Editorial Manager at Editorial Manager® and clicking the ‘Update My Information' link at the top of the page. If you have any questions relating to publication charges, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Elmond Bandauko, PhD Academic Editor PLOS ONE Additional Editor Comments (optional): Dear Dr. Armstrong Thank you for submitting your revised manuscript "Achieving Universal Sanitation in Ghana: An Analysis of Key Drivers of Toilet Ownership Among Property Owners in Urban Areas". I am pleased to inform you that your paper has been accepted for publication. Looking forward to your future submissions Reviewers' comments: https://doi.org/10.1371/journal.pone.0307729.r003
Formally Accepted
10 Dec 2024 Acceptance Letter - Elmond Bandauko, Editor PONE-D-24-27907R1 PLOS ONE Dear Dr. Duku, I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now being handed over to our production team. At this stage, our production department will prepare your paper for publication. This includes ensuring the following: * All references, tables, and figures are properly cited * All relevant supporting information is included in the manuscript submission, * There are no issues that prevent the paper from being properly typeset If revisions are needed, the production department will contact you directly to resolve them. If no revisions are needed, you will receive an email when the publication date has been set. At this time, we do not offer pre-publication proofs to authors during production of the accepted work. Please keep in mind that we are working through a large volume of accepted articles, so please give us a few weeks to review your paper and let you know the next and final steps. Lastly, if your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. If we can help with anything else, please email us at customercare@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr Elmond Bandauko Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0307729.r004

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