Objective To investigate the use of household toilets and toilet demands among rural residents in three areas planning to improve toilets.

Methods Twenty percent of rural residents each from four administrative villages (with a penetration rate of sanitary toilets below 30%) were randomly selected from each of three counties with toilet improvement plans (county A, county B, and county C) from three provinces. A household survey was conducted among participants, involving the types and sanitary conditions of household toilets and the disposal of excreta.

Results ① Among 1 004 rural households surveyed, 98.8% (992/1 004) had toilets, with sanitary toilets accounting for 12.6% (127/1 004). Simple dry toilets accounted for 94.5% (495/524), 86.1% (93/108), and 48.4% (180/372) in counties A, B, and C, respectively; and 25.5% (95/372) households used unsanitary flush toilets in county C. ② Among households having toilets, 32.0% (317/992) reported that their toilets were inconvenient to use, with accounting for 43.6% (225/516), 32.7% (34/104), and 15.6% (58/372) in counties A, B, and C, respectively. Clean toilets accounted for 44.3% (439/992), and dirty toilets accounted for 24.6% (244/992), with 59.6% (62/104) of household toilets had a relatively large number of flies in county B. ③ Excreta were directly taken for farmland fertilization in 81.1% (805/992) of household toilets. Among households with unsanitary toilets, 81.4% (410/504), 88.8% (87/98), and 53.5% (147/275) of households, in counties A, B, and C, respectively, wanted to build sanitary toilets but did not meet the conditions. ④ The knowledge rates on sanitary toilets, which had positive correlations between the knowledge rates and the level of education, were 18.1% (182/1 004), 20.0% (201/1 004) and 23.1% (232/1 004) in country A, B and C, respectively (P < 0.05).

Conclusion In counties A, B, and C, the proportion of sanitary toilets is relatively low, and the proportion of simple dry toilets is relatively high. The sanitary conditions of household toilets are generally good, but there are flies in some toilets. For most of the household toilets, harmless treatment of excreta after cleaning is needed. The demand for toilet improvemen in the three counties is relatively high.