Objective To establish a comprehensive evaluation index system for rural environmental sanitation.

Methods The initial framework and indicators of the rural environmental health evaluation index system were developed through theoretical analysis and literature review, and three rounds of consultation were conducted with experts in related fields. The Delphi method was used in the first two rounds to determine the index content of the evaluation index system, and the analytic hierarchy process was used in the last round to determine the index weights.

Results A total of 25 experts completed the three rounds of consultation, among whom 68.00% had senior professional titles, with 18.76±7.52 years of working on average. The expert positive coefficients were 100% for the two rounds of Delphi consultation, and the authority coefficient was 0.84 and 0.86, respectively, and the coordination degree of experts' opinions was 0.22 and 0.31, respectively (χ² = 233.57 and 207.46, P < 0.05). The consistency ratios of the judgment matrix of analytic hierarchy process ranged from 0 to 0.098, which were below 0.1. A comprehensive evaluation index system for rural environmental sanitation was finally established, containing 6 first-class indicators, 13 second-class indicators, and 31 third-class indicators, and the weights of each indicator were determined.

Conclusion The comprehensive evaluation index system for rural environmental sanitation established in this study is highly scientific and reliable, and can be used for the comprehensive evaluation of rural environmental sanitation.