User based perceptions of on-plot sanitation systems in low income urban communities in Africa and Asia

Rates of population growth in developing country cities are straining the capacity of sanitation service providers. In spite of widespread sector recognition of the need to adopt low-cost, people centred approaches, 80 per cent of investments in the water and sanitation sector continue to be allocated to high cost technologies for urban elites. Household level, on-plot sanitation systems potentially offer a solution to the sanitary needs of the urban poor. Nevertheless, commonly held assumptions amongst sector professionals that lower cost, on-plot systems are inappropriate and unacceptable in urban communities impede-their wider application. There is little empirical evidence to justify this position. The scope of this work examines the technical appropriateness and user acceptability of on-plot sanitation options. The thesis contributes to an improved understanding of the context in which on-plot systems operate, what factors constrain their application, and what issues need consideration when deciding on sanitary options in low-income communities. The research adopted a mix of methodological techniques to improve the reliability and validity of findings, with both quantitative and qualitative methods applied during fieldwork. Findings from Ghana, Mozambique and India are included in the thesis in order to permit sampling of key latrine types used internationally. The thesis concludes that user based perceptions of the performance and acceptability of on-plot systems varies markedly to those of sector professionals, particularly in relation to plot size, satisfaction levels and reasons for absence of household latrine. Furthermore, user based criteria of performance are developed for consideration practitioners when narrowing decision making on sanitary options. The implications of the study highlight the need for integration of user concerns into strategic planning for sanitation, more effective stimulation and negotiation of demand for sanitation systems and challenges for agencies in adopting a user oriented approach. The recommendations from the thesis include practitioner focused policy changes that affect project planning and support systems for user education. Potential areas of further research interest include ranking user perceptions, an holistic understanding of excreta management processes and institutional constraints affecting user-service provider consultations

Sanitation for the urban poor

Sanitation for the urban poo

Networking in the WS&S sector

Networking in the WS&S secto

The capacity gap in the water and sanitation sector

In 2006, WHO estimated that 4.3 million additional health workers are needed worldwide - 1.5 million health workers for Africa alone - to alleviate the current human resource crisis. UNESCO (2008) estimates that 18 million new teachers are needed to meet the Millennium Development Goal (MDG) of achieving universal primary education sub-Saharan Africa alone needs to increase the number of its teachers by 1.6 million or 68 per cent. It is also expected that adequate quantity and quality of service providers is one of the preconditions to making progress towards the MDG targets for safe water and basic sanitation. Yet the human resource gap in this sector is relatively unknown. This paper outlines a piece of research that is being conducted to provide reliable data on the extent of the capacity gap in the water and sanitation sector

Community initiatives in solid waste

Over recent decades one of the commonest characteristics in developing nations has been the disparity between rapid urban population growth and infrastructure provision. The product of this mismatch, described as ‘urbanisation without health’ 1 is the catalogue of overcrowding, growth in illegal settlements, uncollected household waste, and the absence of water, sanitation and other basic facilities which are typical of many urban centres in Africa, Asia and South America. As a result many millions of the urban poor live in neighbourhoods which are hazardous to health and well-being

Basic services in peri-urban areas

Provision of basic services for peri-urban areas creates various problems, and often receives less priority than similar work in rural or urban areas. This paper describes some of the characteristics of peri-urban environments and outlines some of the means available for provision of services. Various social, technical, institutional and economic problems that may be encountered when planning projects to provide basic services for peri-urban areas are then identified. Finally, some possible solutions are proposed for overcoming the various problems

Sustainability of community-led total sanitation outcomes: evidence from Ethiopia and Ghana

We conducted a study to evaluate the sustainability of community-led total sanitation (CLTS) outcomes in Ethiopia and Ghana. Plan International, with local actors, implemented four CLTS interventions from 2012 to 2014: health extension worker-facilitated CLTS and teacher-facilitated CLTS in Ethiopia, and NGO-facilitated CLTS with and without training for natural leaders in Ghana. We previously evaluated these interventions using survey data collected immediately after implementation ended, and concluded that in Ethiopia health extension workers were more effective facilitators than teachers, and that in Ghana training natural leaders improved CLTS outcomes. For this study, we resurveyed 3831 households one year after implementation ended, and analyzed latrine use and quality to assess post-intervention changes in sanitation outcomes, to determine if our original conclusions were robust. In one of four interventions evaluated (health extension worker-facilitated CLTS in Ethiopia), there was an 8 percentage point increase in open defecation in the year after implementation ended, challenging our prior conclusion on their effectiveness. For the other three interventions, the initial decreases in open defecation of 8–24 percentage points were sustained, with no significant changes occurring in the year after implementation. On average, latrines in Ethiopia were lower quality than those in Ghana. In the year following implementation, forty-five percent of households in Ethiopia repaired or rebuilt latrines that had become unusable, while only 6% did in Ghana possibly due to higher latrine quality. Across all four interventions and three survey rounds, most latrines remained unimproved. Regardless of the intervention, households in villages higher latrine use were more likely to have sustained latrine use, which together with the high latrine repair rates indicates a potential social norm. There are few studies that revisit villages after an initial evaluation to assess sustainability of sanitation outcomes. This study provides new evidence that CLTS outcomes can be sustained in the presence of training provided to local actors, and strengthens previous recommendations that CLTS is not appropriate in all settings and should be combined with efforts to address barriers households face to building higher quality latrines

On-plot sanitation in low-income urban communities: a review of the literature

More than three hundred documents were examined in this review and material relevant to on-plot urban sanitation has been summarized in sections dealing with technical, health and social, and management matters. Alternative technologies are critically reviewed, with special attention given to the relative advantages and disadvantages of each option

Sustainability criteria in sanitation planning

This article presents a list of sustainability criteria that might be of importance when assessing different sanitation solutions. The criteria presented are divided into the categories health, environment, economy, socio-culture, and technical function. We strongly recommend the use of sustainability criteria in any strategic sanitation planning and decision-making process whether on a macro or micro project level. Moreover, sanitation sustainability criteria can be used for follow-up and evaluation of sanitation systems. The list of criteria presented in this paper can be used to narrow down and focus discussions among decision-makers and also inspire to the development of context-specific sustainability criteria in the actual planning situation

The true costs of participatory sanitation: evidence from community-led total sanitation studies in Ghana and Ethiopia

Evidence on sanitation and hygiene program costs is used for many purposes. The few studies that report costs use top-down costing methods that are inaccurate and inappropriate. Community-led total sanitation (CLTS) is a participatory behavior-change approach that presents difficulties for cost analysis. We used implementation tracking and bottom-up, activity-based costing to assess the process, program costs, and local investments for four CLTS interventions in Ghana and Ethiopia. Data collection included implementation checklists, surveys, and financial records review. Financial costs and value-of-time spent on CLTS by different actors were assessed. Results are disaggregated by intervention, cost category, actor, geographic area, and project month. The average household sizewas 4.0 people in Ghana, and 5.8 people in Ethiopia. The program cost of CLTSwas $30.34–$81.56 per household targeted in Ghana, and $14.15–$19.21 in Ethiopia. Most program costs were from training for three of four interventions. Local investments ranged from $7.93–$22.36 per household targeted in Ghana, and $2.35–$3.41 in Ethiopia. This is the first study to present comprehensive, disaggregated costs of a sanitation and hygiene behavior-change intervention. The findings can be used to inform policy and finance decisions, plan program scale-up, perform cost-effectiveness and benefit studies, and compare different interventions. The costing method is applicable to other public health behavior-change programs