Objective To examine the coverage of harmless sanitary toilets and barriers for toilet retrofitting in rural areas of Yunnan province for providing references to develop relevant improvement measures.

Methods Information on type of toilets and manure treatment in household settings, public places, schools, medical and health institutions in rural areas across Yunnan province were collected by trained interviewers between May and December 2018; then the implementation of toilet retrofitting was analyzed.

Results In the whole rural area of the province, the coverage of harmless sanitary toilet was 34.93% (3 443 880/9 860 782) for all rural households and 22.48% (386 562/1 719 755) for poverty stricken households; the harmless sanitary toilets accounted for 45.69% (31 573/69 106) of all public toilets and 56.28% (11 155/19 822) of toilets in medical institutions were harmless sanitary toilets, with 0.75 harmless sanitary toilet per medical institution on average; the coverage of harmless sanitary toilet for all the nine-year compulsory primary and secondary schools was 63.58% (24 105/37 910) .

Conclusion In rural areas of Yunnan province, the overall coverage of harmless sanitary toilets is lower than the goal of " toilet revolution” and the implementation of toilet retrofitting is unbalanced among various settings, with harmless sanitary toilet construction in household settings being a difficult part for rural toilet retrofitting.