Sanitation: Thinking Again
Sanitation may be one of the most urgent and difficult development challenges of the coming decade. While the
need for action is well-recognised (for example in MDG Target 10, and as reinforced in Chapter 3 of the 2006 Human Development
Report) there is little concensus on what actions should be taken. The root of the problem lies in the fact that sanitation
is not a recognisable 'sector' in the same way that water, education or health are. Sanitation itself is a term which
means many things to different people but fundamentally the 'idea' of sanitation combines elements of infrastructure (eg.
latrines or toilets, water supplies, wastewater treatment, stormater drainage), elements of services (eg. solid waste management,
sludge management, wastewater management) and elements of behaviour change (eg. using a latrine, washing hands after
In any given context the appropriate balance of interventions across these
three 'elements' of sanitation is heavily dependent on the current situation, and in particular on:
- current practices and beliefs within households and society;
- current levels of provision;
- personal/ household priorities;
- public sector development priorities;
- density of settlement;
- potential for individual and communal action; and
- availability of public service and facilities.
This diversity can best be understood
when considering the differing nature of the sanitation challenge for example in a dispersed rural area in war-ravaged
DRC, and in a heavily congested urban community in downtown Dhaka. When both are compared with the situation in
a well-established sanitation environment (such as the UK for example, where incremental issues of environmental management
and utility tariffs dominate the debate) it becomes clearer that there is no such thing as a universal 'sanitation sector'
simply a range of different environments within which sanitation interventions need to be designed and implemented.
The fact that sanitation is almost invariable 'lumped' with water supply becomes particularly unhelpful except in those situations
when utility-provision of networked water and sanitation services is the most appropriate option; a rare situation indeed.
Rather it seems that sanitation needs to become embedded in health, education, rural development and urban poverty thinking
so that the delivery of all its parts becomes a part of development in general; it is time for sanitation to come into the
mainstream of development thinking.
Barbara has worked on a number of interesting sanitation
projects in rural and urban areas and has done much thinking on the subject. Some of her recent published papers
which may be of interest are listed above and described briefly below:
Based on some early thinking
on the institutional economics of urban sanitation provision the community incentives paper provides some
ideas on an analytical framework for assessing the balance between community and utility service provision in urban areas.
A more nuanced debate has subsequently begun to develop; the International Water Association has done useful work pulling
together some of the thinking which links technical issues with the political economy of the city and has developed a framework
for planners which is summarised in Sanitation 21. Some practical guidance on national and regional programming
can be found in the WSSCC document on Sanitation Programming. Finally a useful summary of the economic
case for investing in sanitation, along with a more generalised institutional analysis is provided in Making the Case
Other useful links include:
IWA Sanitation 21: http://www.iwahq.org/templates/ld_templates/layout_633184.aspx?ObjectId=639578
Connection (a web portal to a wide range of sanitation resources): http://www.sanicon.net/
The Global Public-Private Partnership for Handwashing with Soap: http://www.globalhandwashing.org/
School Sanitation Toolkit: http://www.schoolsanitation.org/
Joint Monitoring Program: http://www.wssinfo.org/en/welcome.html
WEDC/ WELL Resource Centre: http://www.lboro.ac.uk/well/
Stockholm International Water Institute: http://www.siwi.org/
Hygiene Central (London School of Hygiene and Tropical Medicine): http://www.hygienecentral.org.uk/
Some useful recent publications:
The 2006 HDR: http://hdr.undp.org/hdr2006/
WHO data on costs and benefits: http://www.who.int/water_sanitation_health/wsh0404/en/index.html
BPDWS paper on sanitation
The WELL briefing note on Total Sanitation Campaigns, Sanitation marketing and Community-managed toilets in
Smart Sanitation Solutions from the Netherlands Water Partnership: http://www.irc.nl/page/28448