Author: Celia Zeilberger
Affiliated organizations: USAID Water Team
Type of publication : Article
Date of publication : May 4, 2018
Challenge
One of the greatest health threats facing West Africa is lack of sanitation. In Benin, Côte d’Ivoire, and Ghana, the rates are particularly low, with just 14.30, and 14 percent having access to basic sanitation, respectively. While urban areas have higher rates than rural areas overall, sanitation access among the urban poor is extremely low.
The UNICEF/WHO Joint Monitoring Programme estimates that basic sanitation rates among the urban poor in all three countries are below 14 percent.
Efforts by national governments, development banks, and donors to improve urban sanitation have mostly focused on large infrastructure projects. However, many of these projects have yet to serve the poor and vulnerable.
Moreover, the vast majority of the urban population with sanitation in these countries — especially the poor — use on-site sanitation, most of which is shared among multiple families. And fecal sludge collection services — a necessity for on-site sanitation — are often prohibitively expensive.
Many of the urban poor in these countries live in crowded, informal settlements where a family will reside in a single room in a compound house. These compounds usually lack sanitation services entirely. People living in these densely populated areas are especially vulnerable to disease.
Approach
The USAID West Africa Sanitation Service Delivery Project (SSD) is working to create a more effective, efficient, and inclusive sanitation market for the urban poor in Benin, Côte d’Ivoire, and Ghana by partnering with the private sector, governments and municipalities, and consumers. It aims for at least 25 percent of those gaining access to sanitation to be from the lowest poverty quartile.
Building the capacity of the private sector is an important first step to improving the quality of service. SSD is supporting target enterprises via a four-step capacity building process.
Efforts by national governments, development banks, and donors to improve urban sanitation have mostly focused on large infrastructure projects. However, many of these projects have yet to serve the poor and vulnerable
First, project staff reaches out to federations of toilet entrepreneurs and vacuum truck operators to establish trust and learn more about each industry in each country. SSD then offers training to help these entrepreneurs improve their craft, professionalize operations, increase the transparency of pricing, and reduce operational costs. Once the entrepreneurs complete their training, the project gives them key equipment such as starter kits and SSD certification. Lists of “certified” entrepreneurs are provided to municipalities and end users to promote their services.
In addition to its training and certification program, SSD partners with the private sector to make sanitation more accessible. The project also partners with microfinance institutions (MFIs) to offer loans to poor customers who could not otherwise afford a latrine, including those in the bottom 40 percent of wealth distribution in each country.
SSD partners with governments to facilitate an improved enabling environment for sanitation, with a focus on building their capacity to institute and enforce sanitation laws that address sanitation challenges in each country.
SSD collaborates with both the private sector and government to conduct sanitation marketing initiatives using a variety of approaches — flyers, brochures, radio spots, cultural shows, community demonstrations, and private home visits. Special attention is given to ensure marketing approaches are culturally appropriate and reach the poor — in Benin, for example, community leaders play traditional gongs in neighborhoods to capture the attention of community members, and relay messages about sanitation.
Results
Getting SSD activities fully off the ground took about two years due to its ambitious scope and large number of stakeholders. Now in its fourth year of implementation, SSD has begun to successfully identify and address factors inhibiting the growth of urban sanitation markets in the region.
As of the end of 2017, the project had helped more than 1,000 people gain access to basic sanitation; more than 900 to gain access to limited sanitation; more than 2,000 to gain access to sanitation shared by fewer people; and more than 400 people to gain access to safe FSM services.
Government officials in all three countries have found study tours and other capacity-building exercises helpful, and are beginning to take a larger role in implementing and enforcing sanitation laws.
However, willingness to pay for sanitation products and services in all three countries is still low, despite lower prices, improved products and services, increased transparency, and credit options. While a latent demand exists for sanitation products and services, many of the urban poor have multiple competing priorities that inhibit them from investing in sanitation.
A chief obstacle is financial, with many of the urban poor reporting that the cost of purchasing and maintaining a toilet is too high. Landlords say that a number of their tenants default on rent, which makes paying for sanitation — especially regular FSM payments — prohibitive.
MFIs have been able to play a role in alleviating these concerns. Helping consumers finance sanitation, whether through loans or through mobile installment payment plans, has been a major factor in convincing them to invest in sanitation. MFIs have made sanitation options that would otherwise be out of reach to consumers accessible.
But financial issues are not the only impediment to the urban poor obtaining sanitation. SSD found that land issues also play a major role. Because land is scarce, especially in slum areas, there is often not enough room for a latrine. Furthermore, land rights in these areas are often insecure, which can mean that landlords are reluctant to invest in a toilet for their compound. SSD is now experimenting with shared latrines and portable latrines to overcome these obstacles.
As of the end of 2017, the project had helped more than 1,000 people gain access to basic sanitation; more than 900 to gain access to limited sanitation; more than 2,000 to gain access to sanitation shared by fewer people; and more than 400 people to gain access to safe FSM services
Lessons Learned
- Getting the input of the poor is critical to ensuring sanitation options introduced are attainable for them and meet their needs.
- While the “lean start-up approach” is an effective way to learn about the challenges facing various stakeholders, it is very time-consuming. It is important to plan sufficient time for research when piloting a new approach.
- Because the poor have limited funds and multiple competing priorities, SBCC that educates them on the links between sanitation and health is necessary to increase demand for sanitation. SBCC campaigns should employ communication media the poor have access to, such as radio and in-person demonstrations.
- Land tenure issues often impede the urban poor, especially those in slums, from investing in sanitation. Shared and subscription latrines are viable alternatives for areas with insecure land rights.
- Prohibitive prices for FSM services stop many landlords and poor households from investing in sanitation. To build a market for toilets, it is important to ensure that FSM services are affordable, professional, and accessible. Mobile container toilets in which subscription prices include FSM services are another way to accommodate the urban poor.
- Costs for most toilets are still prohibitive for the urban poor. Microfinance and mobile money are effective ways to enable these populations to afford a toilet.
Targets for urban sanitation projects need to be realistic, given the financial and land constraints facing the urban poor. For these populations, private improved household sanitation can be out of reach. A pro-poor urban sanitation plan should also integrate solutions such as composting toilets and shared latrines.
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