Lead author: IMC Worldwide.

The overall aim of the project is to respond to the Government of Ghana’s interest to establish a National Sanitation Authority (NSA) to prioritise sanitation service delivery and achieve Ghana’s commitment to SDG Goal 6. The Ministry of Sanitation & Water Resources (MSWR) has requested the Urban Sanitation Research Initiative in Ghana to undertake a policy research project to assist in decision-making around the setup of the proposed NSA. The specific objective of the assignment is to provide technical support to the MSWR and other key stakeholders to help decide upon the role/function and structure of the proposed NSA, and its relationship with other institutions.

The decision-making process about the roles and responsibilities of the NSA and the institutional structure is informed by an international review and assessment of the institutional arrangements for the sanitation sector in the following fifteen countries. The aim is to assess how effective these institutional models are and consider their viability and appropriateness within the context for the expectations from existing Ghanaian authorities, utilities, NGOs and civil society.

Africa: Burkina Faso, Kenya, Mozambique, Nigeria, Rwanda, Senegal, South Africa, Tanzania, Uganda, Zambia.
South America and Asia: Brazil, India, Indonesia, Nepal, Vietnam.

This report presents the findings from these assessments on the assumption that one, or a combination of these examples, is likely to provide the basis for the model to be adopted in Ghana.

This Policy Brief reports a research project that identified ways of improving enforcement of by-laws requiring urban landlords to provide acceptable sanitation facilities for their tenants. In Ga West, as in other Ghanaian municipalities, by-laws requiring landlords to provide adequate sanitation exist: but they are rarely enforced.

Nearly half of landlords are unaware of the existence of such by-laws. Most tenants (93%) who are aware of the by-law have not lodged any complaint with the relevant authority (the Environmental Health & Sanitation Department), for fear of eviction.

The key barriers to the construction of household and compound toilets in Ghana are lack of capital, limited land space, and the wide availability of public toilets. Ga West Municipal Authority (the regulator) reports a number of critical bottlenecks to enforcement, including a lack of financial resources and incentives.

Evaluating the willingness of Kenyan water utility customers to pay a little bit extra on their water bill to support slum sanitation.

This Policy Brief explores the main factors that influence willingness to pay (WTP) among utility customers to pay a hypothetical sanitation surcharge. These factors included: trust that the money would be spent correctly; perceived own-benefit from slum sanitation improvement; feelings of solidarity with slumdwellers; and satisfaction with water and sanitation services.

Median WTP was 100 Kenya shillings (Ksh) per month, around $1. If applied across all of Kenya’s 91 utilities, this could potentially raise up to 1.6 billion Ksh annually, around $16 million.

This research was conducted by Aquaya with support from University of California Berkeley.

Full findings can be found in “Cross-subsidies for improved sanitation in low income settlements: assessing the willingness to pay of water utility customers in Kenyan cities”, World Development (March 2019), Vol.115, pp.160-177. https://doi.org/10.1016/j.worlddev.2018.11.006

How can city officials plan (and pay) for sanitation improvements in their municipality?

This Policy Brief summarises a literature review that explored the costs of various sanitation technologies.

The review indicates that conventional sewer systems are the most expensive urban sanitation solution, followed by systems based on septic tanks, ventilated improved pits (VIP), urine-diverting dry toilets (UDDT), then pour-flush pit latrines. Simplified sewer systems may cost less than both conventional sewer systems and septic tank-based systems.

Cost reporting methodologies are inconsistent, and few studies provide data on lifecycle costs for the full urban sanitation chain.

Building sanitation cost databases at country or city level could be useful for investment planning.

This literature review was completed by Loïc Daudey. See open access: Daudey, L. 2017 ‘The cost of urban sanitation solutions: a literature review’, Journal of Water, Sanitation and Hygiene for Development http://washdev.iwaponline.com/content/early/2017/10/19/washdev.2017.058

Creating a methodology so city-level sanitation investment decisions can be supported by a better understanding of pathogen flows

This Policy Brief summarises an initial research study which developed a conceptual model of faecal pathogen pathways in urban environments.

The proposed model uses a “source-pathway-receptor” approach: it considers release of pathogens into the environment, transport in the environment, and eventual human exposure.

The model can potentially provide a framework for comparing the relative impacts of different sanitation options on health; the next step should be to test the approach in a real city.

This research was led by the University of Technology Sydney (UTS). See open access: Mills, F., Willetts, J., Petterson, S., Mitchell, C. and Norman, G. 2018 ‘Faecal pathogen flows and their public health risks in urban environments: A proposed approach to inform sanitation planning’  International Journal of Environmental Research and Public Health http://www.mdpi.com/journal/ijerph/  

Findings from the Maputo Sanitation (‘MapSan’) project in Mozambique

This Policy Brief summarises the findings of a qualitative research study which looked at causes and levels of psychosocial stress among users of traditional shared latrines and high-quality shared toilets in Maputo (Mozambique). The findings suggest that high-quality shared toilets can substantially reduce feelings of stress associated with fear of robbery, physical assault or sexual assault when using the toilet.

However, fear of violence was not totally eliminated, reflecting high crime levels in these communities, and suggesting that additional measures (such as improved compound fencing) may be necessary.

This research was led by Tess Shiras and Robert Dreibelbis of the London School of Hygiene & Tropical Medicine, and was funded under a grant to the MapSan project by the Bill & Melinda Gates Foundation.