Urban sanitation is becoming an emerging priority in the WASH sector, partly due to the realisation that it has not been given enough attention in the past. For one thing, because the Millennium Development Goals targeted sanitation coverage (people having access to latrines) and cities are doing much better than rural areas in this respect. For another thing, because the multiple actors (communities, utilities, informal service providers, municipal governments...) and factors (population density, infrastructures, land tenure, floating population, rapid growth...) involved make a very complex issue.

I had the opportunity to attend several sessions and participate in discussions about urban sanitation during the Water and Health Conference that took place last week (13-17 October 2014) at the University of North Carolina (US). I try here to summarise the most interesting insights.

I liked the couple of research pieces that focused on the impact of lack of sanitation on women, going beyond a narrow physical perspective by including reproductive health and assessing sanitation-related psychosocial stress –more severe in urban areas. The studies highlighted four categories of challenges women face due to inadequate access to sanitation: physical-environmental (obstacles to access, discomfort, queuing), health & disease (direct impacts on health), social (lack of privacy, social restrictions and social tensions), sexual (peeping, revealing, sexual assault) and supernatural challenges (fear of ghosts, for instance). The perceived intensity of these challenges varied along the life stages considered in the research: adolescent, newly married, pregnant and adult. Menstrual hygiene management is closely related to this.

There was also a session focusing on “Tackling City Sanitation: Challenges and opportunities to foster sustained services”, convened by USAID and WSUP.
USAID shared the urban sanitation framework they are using in Indonesia, which brings into the picture the need to trigger behaviour change, to combine on-site systems, centralised systems and communal systems, and have, to plan for integrated septage management, under the coordination of a city sanitation management unit. The shift that is needed from the city authorities is the acknowledgement that sewerage covers a very small proportion of population, so Faecal Sludge Management (FSM) needs to be addressed, too.

WSUP shared their experiences of private sector engagement in four African countries. In Kibera, Kenya, pit emptiers that worked separately were brought together and engaged in a process of connecting pits. In Maputo, WSUP collaborated with a local entrepreneur to reinforce his capacity to provide viable FSM services. In Kanyama (Lusaka, Zambia), FSM was embedded in the local Water Trust, through a biodigestor and demand driven manual pit emptying services. The Clean Team in Kumasi (Ghana) is a pure private sector model, based on human centred design, customer service and branding. One lesson from these experiences is the importance of harnessing existing capacity and utilising private sector expertise. The other one is that there are generally very few incentives to scale up, due to infrastructure issues and lack of regulatory frameworks.

The World Bank shared some lessons about urban sanitation financing from Ouagadougou’s strategic sanitation plan (Burkina Faso) and Dakar’s peri-urban onsite sanitation program (Senegal). First, that sanitation needs to be part of an urban development plan that addresses issues of land tenure, drainage and solid waste. Second, that that sewerage is not the right thing to start with, an urban sanitation ladder must be followed. Finally, strong involvement of community groups and advocacy are required to make sure that services are delivered and authorities are held into account.

Andres Hueso Gonzalez is Policy Analyst for Sanitation at WaterAid, UK.