Impact Evaluation of a Large-Scale Rural Sanitation Project in Indonesia

Total Sanitation and Sanitation Marketing (TSSM) is the Indonesian component of World Bank Water and Sanitation Program's Scaling Up Rural Sanitation initiative. The approach consists of raising awareness of the problems of open defecation; marketing sanitation products; and supporting policies, financing, training, and regulations that are conducive to these efforts. Therefore, desired outcomes of the program include changes in perception of the consequences of poor sanitation, toilet construction and access to improved sanitation, reduction in open defecation, and child health outcomes. This impact evaluation assesses these results using a randomized controlled trial (RCT), and unlike many RCTs that are carried out on pilot programs, it looks at an intervention that has been implemented at scale and led by the government under real-world conditions, providing more reliable estimates. TSSM is associated with sanitation improvements overall, particularly among wealthier households that had no sanitation prior to the intervention

Rural Water Supply and Sanitation Challenges in Latin America for the Next Decade

A decade after a 1999 World Bank-sponsored meeting of Latin American water and sanitation experts, there has been progress in rural sanitation in that region. Nonetheless, the Millennium Development Goals for improved sanitation services may be out of reach. Looking toward the next ten years, important challenges for rural water and sanitation will include: ensuring long-term sustainability of sanitation services and monitoring systems, improving the contribution of municipal government, and establishing appropriate legal and financial policies

Building Towards a Future in Which Urban Sanitation Leaves No One Behind

Plans to improve access to sanitation in towns and cities of the global South are hampered by multiple challenges. One is a lack of reliable information. In particular, global and national-level data often diverge from data on particular settlements, collected by inhabitants of those settlements themselves. Local data highlight the inadequacy of living conditions -- and in so doing evidence the difficulties in securing improvements. Another challenge lies in the setting of standards around acceptable sanitation. At a global level, for instance, shared sanitation is not considered part of "improved" sanitation. Yet the reality for many low-income urban populations is that communal sanitation can be hygienic, cost-effective and locally acceptable.The difficulties in reaching a consensus around data and standards point to the importance of diverse approaches to increasing and improving sanitation, including considering both on-site and off-site solutions. They also highlight how crucial it is for the planning and implementation of all such solutions to be inclusive of those often missing from global debates, such as the low-income urban groups that cannot afford substantial sanitation spending. Financial and political commitments, drawing on the circumstances and approaches articulated by low-income groups themselves, will be key to securing a future in which everyone has access to the sanitation they need

Rethinking Sanitation: Lessons and Innovation for Sustainability and Success in the New Millennium

This report highlights some of the key lessons learned from the past about sustainable sanitation solutions, new thinking emerging from consolidated learning and innovative experimentation on-the-ground, and some of the conditions necessary for success if real improvements in sanitation are to be achieved and sustained in rural and urban areas. Special attention is placed on the shift from supply-led sanitation projects to demand-led and market-oriented projects. The report concludes that with much deeper attention and broadened interest in sanitation, a more realistic view of the complexity, time, resources and effort needed to meet the challenge of large-scale sustainable changes in sanitation at the household level

Sanitation Now: What is Good Practice and What is Poor Practice?

To meet the 2015 Millennium Development Goals sanitation target or the 2025 universal sanitation coverage target it is essential that it is properly understood where the available sanitation options are applicable. In high-density low-income urban areas conventional sewerage and ecological sanitation systems are inapplicable solely on grounds of cost. In these areas the options are simplified sewerage, low-cost combined sewerage and community-managed sanitation blocks. In medium-density urban areas on-site systems are also applicable (alternating twin-pit VIP latrines and pour-flush toilets, urine-diverting alternating twin-vault ventilated improved vault latrines, biogas toilets and ecological sanitation systems, all with greywater disposal or use). In medium- to low-density rural areas the options are the same as those in medium-density urban areas, with single-pit VIP latrines and pour-flush toilets, rather than alternating twin-pit systems. The level of water supply service (public or community-managed standpipes, yard taps, multiple-tap in-house supplies) also influences the choice of sanitation option

Sanitation as a Business: Unclogging the Blockages

The first Unclogging the Blockages conference took place in Kampala, Uganda in February 2014 with the aim of putting on the table some of the major challenges facing the scale up of sustainable sanitation as well as collaborating towards innovaive soluions. This report summarizes the discussions and takeaway messages from the conference, including concrete action plans developed around a number of thematic areas. [KEY FINDINGS]Market based approaches are key to addressing some of the main barriers for scaling sustainable sanitation solutions. Participants came away with a much richer understanding of the principles and key tenets of sanitation as a business. A push for greater integration in sanitation programming between the housing, energy, business, health, and education sectors will allow for sustainable city and district-wide sanitation services.Unlocking finance for businesses and households and embedding monitoring within all work is critical. One interesting outcome of the group work was a suggestion to form a Global Sanitation Financing Alliance.Supporting sanitation businesses to be successful in the realities of the market requires on-the-ground, real time, market-focused technology development and R&D. A variety of these technologies were on display at the meeting

Sanitation and Externalities: Evidence from Early Childhood Health in Rural India

This paper estimates two sources of benefits, one direct and the other external, related to sanitation infrastructure access on early childhood health: a direct benefit a household receives when moving from open to fixed-point defecation or from unimproved sanitation to improved sanitation, and an external benefit (externality) produced by the neighborhood's access to sanitation infrastructure. Using a sample of children under 48 months in rural areas of India, it finds evidence of positive and significant direct and concave positive external effects

School Sanitation in Underserved Urban Areas in India

This paper discusses how GIZ is supporting the Ministry of Urban Development in improving the sanitation situation for the urban poor. It selected 47 schools in five Indian cities to significantly improve the sanitation conditions, aiming to build awareness and capacity. All schools showed measurable improvements on school sanitation at the end of the project

The Political Economy Of Sanitation: How Can We Increase Investment and Improve Service For The Poor?

This report presents the results of a Global Economic and Sector Work (ESW) Study on the Political Economy of Sanitation in Brazil, India, Indonesia, and Senegal that was conducted by the Water and Sanitation Program (WSP) and the World Bank. Its purpose is to help WSP and the World Bank -- through a better understanding of the political economy of sanitation -- in their efforts to support partner countries and development practitioners in the design, implementation, and effectiveness of operations that aim to provide pro-poor sanitation investments and services to improve health and hygiene outcomes

What Influences Open Defecation and Latrine Ownership in Rural Households?: Findings from a Global Review

In this review, the Water and Sanitation Program of the World Bank identifies commonalities and differences across sanitation market research studies it has conducted in eight countries since 2006 to determine factors that affect sanitation behaviors. Three specific behaviors -- open defecation, acquisition of toilets, and improvement of latrines -- are covered