The study looked at factors influencing sanitation and diarrhea in a peri-urban area in Zambia. They found that having a regular income, private toilet, improved water, and handwashing facilities were linked to better toilet conditions. Surprisingly, both improved toilets and chambers were associated with higher rates of diarrhea. Women and users of unimproved toilets were more likely to use chambers. When residents owned toilets and hygiene was managed externally, chambers were more common. More users of a toilet were linked to higher rates of diarrhea. The study suggests a comprehensive approach to water, sanitation, and hygiene is needed for successful sanitation in peri-urban areas. They recommend a new sanitation ladder for high-density areas, financial support for the urban poor to access basic sanitation, and increased education on toilet models and hygiene.