The residents of the coastal town of Malindi, popular for its beautiful beaches, largely depend on on-site sanitation. There is no waste treatment plant and only 25% of the waste is safely managed. As a result, 90% of hand dug wells are contaminated causing serious health risks in the communities.

Leaders in Kilifi County Government and the water and sanitation utility, Malindi Water and Sewerage Company (MAWASCO) have recognised the urgent need to improve the sanitation and solid waste challenges in the city and have created an ambitious plan to tackle this problem.

This summary report shares the vision for city-wide inclusive sanitation (CWIS) and the developed action and investment plans.

Shared sanitation has immensely contributed to sanitation access in urban areas, but is at best considered a “limited” solution due to the lack of quality standards within Sustainable Development Goal 6.

This policy brief presents the main results of the QUISS project (Quality Indicators of Shared Sanitation), a three-country comparative mixed-methods study that identified the key criteria of what constitutes “acceptable quality” shared toilets in urban low-income contexts and provides recommendations for strengthening the acceptability, functionality and sustainability of shared sanitation facilities.

Click the button below for overall results.

Country specific policy briefs:

QUISS Policy Brief: Bangladesh

QUISS Policy Brief: Ghana

QUISS Policy Brief: Kenya

Marginalised urban communities are often characterised by three things: complexity, interdependence of challenges, and constant evolution.

The sheer numbers of people living close together in poorly planned communities can make improving the quality of life extremely difficult. The rapid rate of urbanisation – by 2050, the number of people living in African cities will double to 1.5 billion – means that there is no such thing as the status quo. Every month, every year, unplanned urban settlements get larger, and more complex.

In urban environments, issues such as water access, drainage, health, street design and solid waste management are all inextricably linked. Poor drainage leads to flooding, causing damage to flimsy sanitation facilities. Rubbish collected in drainage canals can exacerbate the issue and lead to stagnant water which becomes a breeding ground for disease. Sanitation facilities cannot be safely emptied if poor road access makes it impossible for emptying services to operate.

Tackling these issues in an integrated manner makes intuitive sense – but too often it just doesn’t happen, due to significant barriers such as cost, complexity, and the siloed nature of the development sector.

This report by Water & Sanitation for the Urban Poor (WSUP) and Arquitectura sin Fronteras (also known as ASF-España, referred to in the report as ASF-E), examines how to overcome this immense challenge, from the perspective of water and sanitation services.

The report demonstrates why water and sanitation improvements can be more effective when combined with other areas of urban development, and analyses how, in practice, this integration can occur.

Drawing on evidence from cities such as Maputo, Accra, Nairobi and Antananarivo, the report finds that integrating WASH with wider slum development can improve the overall impact, and the ease of delivery, of WASH services.

For urban sanitation systems to function safely, at scale, over time, and inclusively, they must be organized to support three functions: responsibilityaccountability, and resource planning and management.

This short publication looks at the function of resource planning and management, drawing on a desk review of over 40 urban sanitation investments in twenty-eight countries across Africa, Asia and Latin America.

For urban sanitation systems to function safely, at scale, over time, and inclusively, they must be organized to support three functions: responsibilityaccountability, and resource planning and management.

In this paper, we explore the accountability mechanisms that can be applied to the different service provision mandate structures identified in our parallel paper on responsibilities.

For urban sanitation systems to function safely, at scale, over time, and inclusively, they must be organized to support three functions: responsibilityaccountability, and resource planning and management.

This short publication looks at the function of responsibility: the extent to which sanitation authorities are clearly mandated.

What does ‘quality’ sanitation mean in low-income urban areas?

By Sam Drabble, Head of Evaluation, Research & Learning Broadly speaking, when we advocate for investment in sanitation, it is because we are trying to achieve two critically important aims: improve human health, and improve wellbeing or quality of life. But to what extent are sanitation interventions actually achieving these aims? In many cases, the […]


This discussion paper explores how high-quality sanitation can be achieved in low-income urban areas in developing contexts. It is based on findings from four research projects conducted under, or in association with, WSUP’s Urban Sanitation Research Initiative 2016–2020 (USRI), funded by DFID.

The four research projects considered here are:

  1. The Faecal Pathogen Flows study in Dhaka, Bangladesh — aiming to track and model how faecal pathogens move through urban low-income communities (LICs), as a tool to support sanitation intervention planning in developing contexts.
  2. The MapSan study carried out in Maputo, Mozambique — one of the largest and most rigorous studies ever conducted of the health impacts of an urban sanitation intervention.
  3. The QUISS study — based on large-scale surveys in Bangladesh, Ghana and Kenya, aiming to identify minimum standards for high-quality shared sanitation in urban contexts, and workable indicators of shared sanitation quality.
  4. The Clean Team evaluation — assessing customer experience among customers of Clean Team Ghana, a container-based sanitation enterprise.
Illegal water connections Biafra, Nairobi

Citywide access to water and sanitation services in Kenya

Clean, piped water brings dignity to people, reduces living costs, frees up time – and crucially, given the situation right now, is a critical defence against infectious diseases. With the support of The Coca-Cola Foundation’s Replenish Africa Initiative (RAIN), Water & Sanitation for the Urban Poor (WSUP) has been working with Kenyan city authorities to […]


Dirty water_ John Laing

Stronger regulators crucial to improving sanitation services for the poorest, report finds

A new report published by Water & Sanitation for the Urban Poor (WSUP) and the Eastern and Southern Africa Water and Sanitation (ESAWAS) Regulators Association identifies how stronger regulators can play an important role in improving sanitation for under-served urban residents. The report, entitled Referee! Responsibilities, regulations and regulating for urban sanitation, has four key […]