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Affordability blocking the sanitation ladder in East and Southern Africa?

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It is always good to spend a week with like-minded sanitation practitioners, sharing experiences and innovations, and learning from each other. The recently completed East and Southern Africa regional sharing and learning workshop organised by the CLTS Knowledge Hub in Arusha (hosted by SNV Tanzania) enabled more than 30 government, multilateral, NGO and independent participants to dig more deeply into some of the key rural sanitation challenges in the region, and take some time to reflect on what has worked, what has not worked, and what is needed to accelerate progress towards the 2030 Sustainable Development Goal for sanitation – universal, adequate and equitable sanitation access for all, including the elimination of open defecation.

A key theme to emerge during the week was moving up the sanitation ladder – looking into what can be done to support rural households to make basic sanitation facilities more hygienic, more functional, more durable and more safely managed. Common barriers were identified, including affordability, water scarcity, lack of construction materials, and simple ‘traditional’ toilets that collapse quickly and reduce confidence in, and demand for, basic toilets.

('Traditional' direct-pit toilet in Babati, Tanzania. Photo: Andy Robinson)

In the proceeding discussion on potential solutions, sanitation marketing and other market-based approaches initially took the focus. Several participants shared experiences of developing and marketing toilet designs. As often, the presentations were positive, with optimism that new product designs and new sales approaches will reach large populations and transform project outcomes.

However, a presentation on sanitation marketing by Warren Simalgolwa from SNV Zambia was far more powerful and realistic. In Zambia, SNV started promoting two designs (corbelled latrine and SAFI latrine) in early 2015. Two masons were trained in each district, but 70 per cent of them left for other work within the first year. More masons were trained in the second year, but retention remained a problem. In the third year, SNV set up sanitation marketing committees in each ward, each comprising a group of ten religious and local leaders, business people and other sanitation stakeholders. Sales quickly accelerated from close to zero to 600 SAFI latrines sold in this single campaign. The toilet sellers diversified into the sale of improved handwashing technologies, which proved popular in the SNV Zambia SSH4A project (where handwashing with soap is heavily promoted). SNV Zambia is optimistic about the current approach, and hopes that its efforts to encourage savings and loan mechanisms will allow poorer households to buy toilets and boost sales in the future.

(Improved handwashing technologies in Zambia. Photo: Warren Simalgolwa)

The ‘fail fast’ approach used by SNZ Zambia relies on rapid feedback and adaptive programming (otherwise known as agile development), and on good information (SNV conducts annual household surveys to check progress in household sanitation and hygiene outcomes across the project area) to figure out what is working and what is not. A pertinent example for other sanitation projects, too many of which set out with one approach, and stubbornly stick to the same approach through the life of the project, even if it is not working well.

The honesty of the presentation was also refreshing – too many WASH actors are reluctant to share stories of failure. Particularly in the field of sanitation marketing, in which the most effective marketing is often of the project approach (to donors, sector actors, governments).  The reality is that few market-based sanitation approaches reach large populations, or benefit poor and disadvantaged households – those with the highest disease burden, who are the intended recipients of most public sanitation finance.

Particularly in Africa. The SNV Zambia SSH4A project is a case in point – 600 toilets have been sold after three years; however, this project covers more than 120,000 households in four districts, so the toilet sales reached just 0.5 per cent of the project population (in an area where annual population growth is around three per cent). And market-based toilets are rarely cheap – in Tanzania, the SAFI latrine retails at between 45-300 USD depending on the model – which means that very few are bought by disadvantaged or vulnerable households (The World Bank estimates that around a third of Tanzanian households live below the basic needs poverty line, earning less than one USD per day, and ten percent live below the food poverty line, unable to meet minimum nutritional requirements of 2,200 kilocalories per adult per day).

(SAFI latrine, Karato, Tanzania. Photo: Elaine Mercer)

Africa vs Asia
In 2017, the CLTS Knowledge Hub held a regional workshop in the Philippines at which regional practitioners from South and South East Asia met with global practitioners to discuss support to the poorest and most vulnerable in CLTS programmes. Some similar topics were discussed, but it was striking how different the constraints appear to be in the East and Southern Africa region.

In most regions, affordability is cited as the key constraint that prevents rural households from building more durable and hygienic toilets. But there are clearly higher affordability barriers in Africa than in South East Asia. Factor costs are lower in Asia – cement, construction materials, labour and transport all cost more in most African countries. African communities also tend to be less well connected with markets – they are further away, more expensive to reach (due to bad roads) and most small markets stock few affordable sanitation products.

Most rural households in Africa use dry direct-pit toilets (no water is used for flushing), in part because water scarcity is common in much of sub-Saharan Africa. This makes toilets easier and cheaper to build, but also means that they can be smelly, fly-infested and unpleasant to use, which dampens demand.

('Traditional' direct-pit toilet in Babati, Tanzania. Photo: Andy Robinson)

As a result, few market-based sanitation approaches have scaled in Africa. The participants at the workshop noted that specialist skills are required to design, produce, market and sell sanitation products, and that few WASH specialists have the right skills or experience. Yet several well-supported projects have failed to scale despite investing in the right skills and support - notably the World Bank Water and Sanitation Program Selling Sanitation project in Kenya, which employed top specialists to undertake human-centred design, develop and prototype consumer-oriented products, work with private sector producers to improve production, and market the sanitation products (plastic slabs and pans) … but sold less than 500 plastic slabs after five years of effort.

Once again, affordability was the key barrier – people liked the plastic slabs, but were either not willing, or could not afford, the price. Governments in Asia have seen strong economic growth in recent years, and many are now interested in investing in rural sanitation improvements (as awareness grows of the health and other benefits); but the same does not hold in Africa. Representatives of governments from six countries in East and Southern Africa confirmed that budget allocations for sanitation remain low, with limited potential for government support to help the ‘last mile’ gain access to basic or safely managed sanitation. As in Asia, African governments often prefer higher levels of sanitation service, with some national standards encouraging concrete slabs and lined pits even in remote rural areas. Given low public finance for rural sanitation, governments remain hopeful that market-based solutions will fill the gap, despite limited evidence of large-scale market-based success in Africa.

Non-market toilet improvements
So what is the solution? Several participants gave examples of non-market approaches, with most based around post-ODF processes that encourage and support households to make simple improvements to their toilet facilities.

SNV Tanzania has promoted compacted soil slabs, squat hole covers and toilet roofing, explaining that small investments in more durable and resilient toilet designs (using familiar technologies from rural Tanzanian home-building) will lengthen the life of the toilet; make it easier to clean and maintain; and reducing long-term costs.

Other examples were given of sharing catalogues of low-cost toilet designs (first utilised by VERC in Bangladesh in the early 2000s); improved pit digging techniques to make pits quicker to dig and more stable; inclusive designs that use local materials to allow people living with disability to use the same toilet as others members of the household; and promotion of affordable, easily transportable technologies such as the SaTo plastic ‘flapper’ pan, which costs only 2-5 USD in most countries.

The lesson seems to be that we should look more closely at local solutions, searching for positive deviants – the ‘village engineers’ who find ingenious solutions to local problems – and keeping affordability and accessibility uppermost in our minds when we propose approaches and solutions. Much of rural Africa remains a long way from market centres, and few market-based approaches have been successful in bringing affordable sanitation goods and services to rural communities. 

While it is important to keep searching for innovative and cost-effective ways to jump from basic toilets to the more durable, washable and hygienic facilities that we would all like to see, the evidence suggests that rural populations in sub-Saharan Africa will not gain access to affordable market products any time soon. In the interim, we should not leave them waiting. Examples were provided from across Africa of simple local improvements that made basic toilets significantly more hygienic, more pleasant to use, and more durable. Sanitation donors, programmers, practitioners, researchers need to take note, and join with governments to work with rural communities to learn how best to introduce, refine and support non-market sanitation and hygiene improvements on a community-wide basis. Only then are we likely to see the expected benefits of universal improved sanitation and hygiene!

Andy Robinson is an independent WASH Consultant.

Date: 8 June 2018