headline facts

what to do and when to do it

the total sanitation campaign

urban sanitation marketing

community managed toilet blocks

lessons learned

key references

pdf file

If the world is serious about addressing the Millennium Development Goal (MDG) target of halving the current 2.6 billion people without access to basic sanitation services by 2015, sanitation programmes must move beyond successful, yet isolated, projects - the "islands of success" - towards ensuring equitable coverage at scale.

Here, three different but innovative approaches are identified, all of which appear to have potential for tackling the sanitation problem at the scale required in the rural and urban contexts. A cautionary note is that whilst these approaches have all worked in more than one locality, the evidence on scale-up remains slight.

The aim of this briefing note is to use three case studies where governments work in partnership with small scale private sector and civil society groups in successful innovative approaches to sanitation.

WELL BRIEFING NOTE 18                              Go Back

Achieving sanitation at scale

Innovative approaches to rural and urban sanitation

This Briefing Note outlines three innovative approaches for sanitation provision at the scale required in urban and rural contexts.

Compiled by: Julie Fisher of  WEDC

Briefing Note Source Material: Rebecca Scott, Andrew Cotton and Kevin Sansom, WEDC

Headline facts

• Diarrhoeal disease kills 5,000 children a day - almost 2 million a year.  Best estimates suggest that sanitation improvements could prevent 600,000 of these deaths.

• There is little evidence of sanitation programmes that have successfully delivered sustainable improvements at the scale required to achieve national targets in line with the MDG sanitation target.

• The nature of partnerships is critical to success.  Countries that are on track to achieve the water target have activities that are clearly owned and driven by government

• The Total Sanitation Campaign is Bangladesh has achieved 100% sanitation coverage in over 400 villages, with no household subsidy for infrastructure.

• Marketing sanitation has been successfully applied in a low income settlement in Dar es Salaam.

• An urban sanitation programme in Mumbai, India is successfully constructing and operating good quality community toilet blocks for use by slum dwellers.

What to Do and When to Do It

The political agenda

Growing awareness of the impact of sanitation and hygiene practice is moving the issue onto the political agenda as demonstrated by the African Ministerial Initiative for Water, Sanitation and Hygiene (AMIWASH). Such commitment helps promote an enabling environment to implement country action plans.

Allocating adequate resources

National sanitation budgets account  for about 20% of sector investment. As the political focus on sanitation grows, increased resources are needed to satisfy demand. Policies on subsidies for sanitation vary but they should be coherent across programmes and only cover that for which nobody else will pay. E.g. household latrine construction is not subsidised, but sanitation promotion and capacity building for service suppliers is.

Matching supply and demand

Limited government capacity is a major constraint to achieving sanitation targets. Operating in partnership enables the private sector, non-government agencies and civil society to provide technical, educational and human resources which government may lack in-house.

Involving government in sanitation partnerships

Although current thinking sees government’s role changing from implementation to enablement, in fact, it has rarely had an implementing role on the scale required. What is actually needed is to identify the role of government in a partnership with those who have long been facilitating access to sanitation. Countries on track to meet the MDG water supply target are doing so through activities owned and driven by government.

The Total Sanitation Campaign (TSC) Bangladesh

The approach

TSC is based on the principle that rural communities can address their own sanitation problems, with external support from NGOs. Central to this approach is the no open defecation rule. Motivational tools involve the whole community, such as calculating the volume of faeces and urine (‘goo’) dumped through open defecation, considering its effects on collective health, and how the situation can be improved.

Political support

Sanitation provision has attracted high level support in Bangladesh, with government commitment to a National Sanitation Strategy to achieve full coverage by 2010. This is supported by a multi-sectoral strategy involving CBOs, NGOs and private entrepreneurs.

Resources

20% of the Annual Development Programme (ADP) funds are now committed to improving sanitation for the poorest. From 2005, 25% of rural sanitation funding is allocated to promotional activities. The remainder is for hardware, with subsidy only for the most vulnerable ‘hardcore poor’. The range of user-safe, hygienic latrines provides affordable options for almost everyone in the community.

Matching supply and demand

Low cost latrine components are easily available at local shops and rural sanitation marts. The growing market provides income generating opportunities in the community.

Partnerships

The TSC is a working partnership between small scale entrepreneurs and community groups, supported by national and local governments and national and international NGOs. Community involvement is key to the success of this approach.

Table 1. Addressing key constraints to achieving sanitation at scale: an overview (pdf file)

Urban Sanitation Marketing, Tanzania

The approach

The sanitation marketing approach sees users as consumers with the right to buy the toilets they want. Market research revealed strong social factors and user preferences for the improvement of sanitation facilities. Consequently, marketing assumes that households want to be independent, which is reflected in the brand name choo chetu, ‘our toilet’. Key elements of this approach are to provide suitable technology, plus effective delivery mechanisms and tried and tested marketing strategies.

Political support

Sanitation marketing is recognised and supported by municipal governments, wishing to adopt it for the Dar es Salaam Community Infrastructure Upgrading programme (CIUP). Temeke Municipal Council intends to scale-up the approach to other settlements. 

Resources

Building on initial funding by DFID, scaling up is now possible through the World Bank CIUP. There are no household subsidies, but there is investment in key software aspects such as promotion, education and builder training to ensure sustainability.

Matching supply and demand

Achieving a balance between supply and demand is vital as successful marketing requires responsive supply mechanisms. Part of this is to strengthen the capacity of toilet builders to supply affordable, quality products at a sustainable profit margin.

Partnerships

Sanitation marketing in Dar es Salaam has brought together trained masons and the  public, in partnership with marketing agencies, NGOs, government and financial institutions in a customer-centred approach to providing latrines. Women also play an important role in manufacturing and selling components at toilet centres. Effective communication and marketing is achieved via schools, using children to take home messages about improved toilet services.

Community Managed Toilet Block, India

The approach

The legacy of contractor-built public toilet blocks in Mumbai’s slums is unhygienic and unstable structures, 80% of which are malfunctioning. The number does not meet demand, they lack water supply, electricity and privacy for women, and have a typical life span of two to three years. The SSP was initiated with World Bank assistance, as part of the Mumbai Sewage Disposal Project, as a collaborative effort between the Municipal Corporation of Mumbai (MCGM), the private sector, local CBOs and NGOs. The MCGM let the contracts for work by private contractors and NGOs. There are Memorandums of Understanding with CBOs, who collect community contributions and manage completed toilet blocks. Design decisions are made in consultation with users, and construction is to high specifications. This results in high usage levels and revenues leading to sustainable management.

Political support

Although the MCGM retains ownership of the toilet blocks, a flexible approach is applied to contractual aspects so that the contractor/ NGO partnership can respond to local demand. Combining both technical and community development elements allows faster implementation and a more holistic and sustainable approach.

Resources

The MCGM pays construction costs and connection charges for water and electricity supplies. Users cover operation and maintenance costs. Joining the CBO entitles users to a low monthly flat rate. Pay as you go charges can be ten times as much.

Matching supply and demand

Community involvement ensures that user needs are met and that capacity keeps up with demand. The MCGM will now prioritise more slum areas for development; this is  easier for those built on municipal rather than private land.

Partnerships

The SSP is a tripartite partnership between local government, civil society and the private sector. They define sanitation as a package of both hardware and software, including management by CBOs, providing information to users, construction and the supply of utility services. This is a radical departure from traditional, centrally provided services. It works best if the municipality contracting out the services, focuses on the outputs of the contract rather than the details of implementation, allowing those party to the contract to work towards the parameters agreed. It is also important that the partners promote the toilet blocks to nearby unserved communities.

Lessons Learned

• There is no single 'off the shelf' model that will deliver scaled-up sanitation coverage.  The nature of the partnership and the roles and responsibilities need to reflect the local context.

• Key to partnerships is that government owns the problem and an enabling environment is created, and sufficient resources provided.

• Access by users to information about what is available and what they need to do is as important as access to the hardware and software. 

• Although capacity to deliver services can be problematic as demand grows, partnership approaches offer solutions to this at district and municipality level.

  Key References

1. ERM (2005). Meeting the Water and Sanitation Millennium Development Goal, Main Report, May 2005, Environmental Resources Management, London. Report prepared for DFID.

2. Kar, K. (2003). Subsidy or self-respect? Participatory total community sanitation in Bangladesh, IDS Working Paper 184, September 2004, Institute if Development Studies, Brighton, UK.

3. Nitti, R. and Sarkar, S., (2003). Reaching the Poor through Sustainable Partnerships: The Slum Sanitation Programme in Mumbai, India.  Thematic Group on Services to the Urban Poor, Urban Notes, Number 7, Jan 2003. The World Bank, Washington D.C.

4. WELL (2005). Supporting the Achievement of the MDG Sanitation Target; Potential actions, WELL Briefing Note for CSD-13, http://www.lboro.ac.uk/well/resources/publications/ 

Background Report containing full details of all the materials used in support of this Briefing Note

For further information contact:

WELL

Water, Engineering and Development Centre (WEDC)

Loughborough University

Leicestershire LE11 3TU  UK

Email: well@lboro.ac.uk 

Phone:  +44 (0)1509 228304

Fax: +44 (0)1509 223970

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