The poor state of New Zealand's public toilets could increase the transmission of disease, a survey has found.
The New Zealand Medical Journal has released findings showing local and central government agencies have not done enough to keep the hygiene of these facilities up to standard.
Despite the risk of increased disease transmission, nearly 15 percent of the 400 public toilets surveyed had no soap, only 28 percent had the no-touch activation.
The majority of toilet blocks - almost three-quarters - had no health-related signs.
The survey by University of Otago Department of Public Health states these results indicate an inadequate response to the Covid-19 threat.
Its authors were associate professor George Thomson and professor Nick Wilson, who said Aotearoa lagged behind other countries' emphasis on public hygiene.
"In general, when you compare New Zealand with a place like Japan, which puts a big emphasis on the quality of public toilets, we really are a long way behind," Wilson said.
"There is some concern that Covid can also be spread in various ways in this type of setting, there has been possible outbreaks associated with sewage system failures in China."
Good public hygiene was an essential defence against a pandemic, he said.
"It's very clearly demonstrated that soap and hand washing does reduce a wide range of infectious disease risks, particularly really infectious diseases like norovirus, which has sometimes caused big problems for schools and hospitals and other facilities."
A UN report cited in the survey results stated that it is essential for public hygiene facilities to maintain adequate standards of cleanliness, as a failure to do so could have "a highly detrimental impact on health and hygiene outcomes."
Wellington City councillor Fleur Fitzsimons said the results of the survey were disappointing.
"We know after Covid that we're a nation particularly committed to good hygiene, and this must extend to our public toilets all across New Zealand. Local government clearly needs to do better here in the interests of all New Zealanders."
"If any member of the public uses a toilet in Wellington that doesn't have soap or water or there are any other concerns about hygiene please contact the council, because it's not good enough and the council needs to know in order for it to be urgently fixed."
Wilson said that whilst Covid-19 was mainly spread through aerosol transmission, he wanted to see authorities cover all bases to prevent the spread of infectious diseases.