Typhoon impacts on sanitation access and service reliability in rural Philippines

Abstract

The Philippines, one of the most typhoon-prone countries worldwide, faces serious risks to rural sanitation systems. However, limited empirical evidence exists on how typhoons impact household sanitation access. This study examined the effects of typhoons on household sanitation infrastructure and access in three rural municipalities. We carried out a cross-sectional study involving 994 households, in collaboration with community partners. One barangay (village) from each rural district was purposively chosen, and all households were invited to participate. We used bivariate and multivariate logistic regression to identify factors linked to typhoon damage (p < 0.05), and Cox proportional hazards model to assess facility downtime. Before the typhoon event, 29% of households reported using basic sanitation, 42% limited, 22% unimproved, and 7% practiced open defecation. Post-typhoon, basic sanitation coverage dropped to 16%, while unimproved sanitation and open defecation increased to 30% and 15%, respectively. Nearly half of the households using basic sanitation shifted to unimproved services. Typhoon-affected households were more likely to practice open defecation (aOR = 1.60, 95% CI: 1.11–2.29, p = 0.012) and more than twice as likely to report diarrheal disease (aOR = 2.24, 95% CI: 1.22–4.11, p = 0.009). Facilities located further from dwelling areas were more vulnerable to damage (aOR = 3.32, 95% CI: 2.27–4.86). Conversely, facilities with dedicated cleaning staff (aOR = 0.23, 95% CI: 0.15–0.36), repair and maintenance staff (aOR = 0.19, 95% CI: 0.12–0.30), or climate-adaptive measures (aOR = 0.08, 95% CI: 0.05–0.13) showed greater resilience. Median downtime for damaged facilities was two days, though recovery was slower among lower-income households and those with older facilities. These findings demonstrate how typhoons can undo sanitation gains, forcing households to fall back to lower service levels and worsening inequalities. Post-disaster responses should aim to prevent slipping from basic to unsafe sanitation practices. Long-term strategies must incorporate climate-resilient technologies, strengthen community capacity for repairs, and target vulnerable households with support. While current data on the role of community groups in resilience is limited, this study underscores the need for further research into how social support systems can improve sanitation outcomes.