The WHO/UNICEF joint monitoring programme defines improved sanitation as access to individual household toilets. This ultimate goal advocates for every family to access and maintain their own latrine - providing the dignity, safety and convenience of not having to share. However, in many urban areas issues of land ownership, space and a lack of infrastructure make this an impossible aim. Although CLTS has been very successful in creating the demand for sanitation, we must look further to viable and sustainable solutions in urban settings which can respond to these challenges. How can we assist people shifting from open defecation if household toilets are not an option? Can public toilets play a part in this solution? If so, how can we support clean, affordable and safe public toilets to meet this challenge? These were some of the discussions raised within the CLTS sharing and learning workshop, the presentation sessions and which continued throughout the week-long WEDC conference in Kumasi.

The use of shared and public toilets is a very relevant subject in Ghana where up to 60% of the population rely on them as their main source of sanitation. In the workshop, we heard some of the challenges preventing families from building their own toilets. One significant issue is that landlords do not see the provision of sanitation as a priority; toilets are not usually part of a rental package, and in some cases landlords are demolishing facilities to make way for extra rooms to rent. Subsequently many families are crammed into one compound without any access to sanitation and no mandate to build upon the land. These issues are similar to the ones I've encountered in Madagascar, where even if adequate space is available, landlords refuse to build or allow latrines, fearing a lack of cleaning and maintenance which may result in problems further down the line. Several workshop participants suggested that there is a need to focus on triggering landlords as part of CLTS activities to help shift mind-sets and support the demand from triggered tenants. When discussing the most effective way to do this, it was suggested that triggering should focus on the added financial benefits landlords could receive from providing sanitation facilities in addition to the associated health benefits for them and their tenants. However, it was acknowledged that there is little evidence to show that landlords can make significant financial gain from this strategy; especially in areas where space is at a premium.

A further point discussed was the creation and enforcement of laws which ensure landlords provide sanitation for tenants. However it seems for many urban areas, weak institutions and a lack of political will currently prevents this from being a reality on the ground. For example in Ghana, although bylaws insist that landlords must provide toilets, there is no evidence of real enforcement and little confidence that this would change anytime soon.

It is clear therefore, that public latrines will continue to be heavily relied upon in many areas, especially where CLTS programmes have created demand for sanitation. As a result, we must look towards best practice for successful business models and ensuring customers access clean and well maintained toilets, reducing the risk of reversion to open defecation. In Ghana and Kenya we learnt of the importance of accessing affordable, well managed and safe shared facilities. It was argued that this must be implemented alongside regular monitoring and maintenance of facilities as well as meaningful involvement of stakeholders, especially at the municipal level, to ensure sustainability. If this cannot be provided and household toilets remain inaccessible, the momentum created by CLTS activities is at risk of slowing or even coming to a halt.

Although it may not be the perfect solution, examples from our discussions indicate that maintaining good standards and affordability can help to turn public facilities into a viable interim solution for over-crowded and under-resourced urban environments, enabling such facilities to act as a bridge between open defecation and improved sanitation. At the same time, CLTS programmes must look towards triggering landlords to ensure household toilets are built where space is available; ensuring sanitation is provided as standard as part of a tenancy arrangement.

Bethany Lomas is an Urban Sanitation and Hygiene Specialist for SEED Madagascar.