Category Archives: Progress on Sanitation

Testing CLTS Approaches for Scalability: Nepal Learning Brief

Nepal UNC

Pour Flush Toilet in Nepal. Photo Credit: Vidya Venkataramanan

Plan International supports Community-led Total Sanitation (CLTS) implementation in a number of districts in Nepal. In this learning brief, we review Plan International Nepal’s CLTS activities. We found government targets and definitions to be ambitious while decentralized planning allowed a focus on community-led processes. Plan International and other sanitation practitioners can support CLTS outcomes by providing post-triggering training and technical support to community volunteers, focusing on achieving gradual, yet sustained outcomes in program areas, and continuing to work with local governments to ensure that financing mechanisms for the poor are locally developed and equitable.

Link to learning brief:

Citation: Community-led Total Sanitation in Nepal: Findings from an Implementation Case Study. Venkataramanan, Vidya, Alexandra Shannon, and Jennifer Bogle. 2015. Chapel Hill, USA: The Water Institute at UNC.

New Video Offers Five Lessons for Sanitation Policy and Practice

A new video from Plan International and the Water Institute at UNC offers a preview of five exciting lessons on sanitation policy and practice, based on findings from operational research on community-led total sanitation (CLTS). These lessons relate to CLTS planning at the national and local levels, its place in national sanitation systems, and the importance of involving local actors. In particular, government officials, teachers, and natural leaders can play important roles in improving access to basic sanitation, and their involvement can ensure sustainable outcomes over time.

New week NEW BRIEF! Finance Brief N. 8: “A few cents on your water bill: Tana’s (Anatanarivo) surcharge system” By Sylvie Ramanantsoa, Julie Ranaivo and Guy Norman

Tana 001    In Madagascar’s capital Antananarivo (Tana), water bills include various surcharges designed to help finance water and sanitation. In recent years, Water & Sanitation for the Urban Poor (WSUP) has been working with local government and with the utility JIRAMA to optimise the use of these revenues to support water supply improvements in low-income communities. This brief describes how this interesting system works, and considers how it might be further developed.

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WASHplus Weekly: Lessons Learned in Sanitation

Issue 211 | Oct. 23, 2015 | Lessons Learned in Sanitation

This issue includes studies and resources on lessons learned and innovative approaches in sanitation. Included are a UNICEF learning series, recent studies from USAID, and studies on fecal sludge management, urban sanitation, hygiene, and behavior change.


UNICEF East and Southern Africa Region Sanitation and Hygiene Learning SeriesLink
This series is designed to improve knowledge of best practice and lessons learned in sanitation and hygiene programming across the region. The series has been funded in part by the Bill and Melinda Gates Foundation in support of improved knowledge management in the sanitation sector.  Field notes, technical briefs, and journal articles are written by practitioners for practitioners and should encourage adoption of innovative or new approaches and technologies within the region and contribute to scaling up access to sanitation and hygiene for the most under-served.

Documents included in the series are:


USAID/West Africa Sanitation Service Delivery – Making Kumasi a Cleaner City.PSIIMPACT, Sept 2015. D Ward. Link
Dana Ward, PSI country representative in Ghana and chief of party for Sanitation Service Delivery (SSD) Project in Ghana, Benin, and Cote d’Ivoire interviewed Anthony Mensah, director, Waste Management Department Kumasi Metropolitan Authority, about the city’s strategy to make Kumasi among the five cleanest cities in Africa. WASHPlus_HTMLbanner_weekly_600x159

Water and Sanitation Assistance: USAID Has Increased Strategic Focus but Should Improve Monitoring, 2015. GAO. Link
The U.S. Government Accountability Office recommends that USAID take steps to improve monitoring and reporting of WASH activities by identifying and addressing reasons for Missions’ inconsistent adherence with Agency guidance. USAID generally concurred with the recommendations and, in particular, outlined steps it is taking to address the report’s second recommendation.


Innovative Tools for Sanitation Capacity Mapping and Planning in Kenya, 2015. Water and Sanitation Program. Link
Lack of capacity is a major bottleneck that hinders progress in achieving access to sanitation. The Water and Sanitation Program has developed and tested a set of practical tools designed to support clients at the local level as they plan, build, and sustain sanitation capacity.

Continue reading

Plan International – Testing CLTS Approaches for Scalability: Indonesia Learning Brief

Testing CLTS Approaches for Scalability: Indonesia Learning Brief, 2015. Plan International.

Sanitation Marketing Project in Grobogan District, Indonesia. photo credit to Jonny Crocker

Sanitation Marketing Project in Grobogan District, Indonesia. photo credit to Jonny Crocker

Plan International supports Community-led Total Sanitation (CLTS) implementation in a number of sub-districts in Indonesia.

In this learning brief, we review the roles of local actors in Plan International Indonesia’s program activities and highlight considerations for scalability, planning, implmentation, and evaluation.

Plan International and other sanitation practitioners can support the national government and local actors by placing more responsibility on sub-district staff to lead triggering, enlisting the added support of village facilitators to lead post-triggering, and scaling up village-based financing mechanisms to sustain CLTS outcomes.

Link to project website:

The Consequences of Deteriorating Sanitation in Nigeria

The Consequences of Deteriorating Sanitation in Nigeria | Source: Council on Foreign Relations Blog, July 23, 2015 |

This is a guest post by Anna Bezruki, an intern for the Council on Foreign Relations Global Health Program. She studies biology at Bryn Mawr College.

According to the final report on Millennium Development Goals (MDGs) released earlier this month, more than a third of the world population (2.4 billion) is still without improved sanitation.

Children play at a slum in Ijegun Egba, a suburb of Nigeria's commercial capital of Lagos, July 2, 2008. (Courtesy Reuters/George Esiri)

Children play at a slum in Ijegun Egba, a suburb of Nigeria’s commercial capital of Lagos, July 2, 2008. (Courtesy Reuters/George Esiri)

The target to halve the global population without adequate toilets by 2015 has not been reached. Consequently, sanitation has been pushed on to the post-2015 sustainable development goals (SDGs).

Although India is perhaps the most widely cited failure, accounting for roughly half of open defecation worldwide, it is at least making progress toward the SDG target. The same cannot be said for Nigeria. Lacking the political infrastructure to reform sanitation and faced with security and political concerns that overshadow development goals, Nigeria is struggling to reverse the trend.

Unlike in India, where the percentage of people with access to a toilet shared by only one family increased by eighteen points between 1990 and 2012, that percentage declined in Nigeria from 37 to 28 percent.

This incongruity is best illustrated by the fact that there are more than three times as many cell phones in Nigeria as people who have access to adequate toilets. This means thirty-nine million defecate outside, sixteen million more today than in 1990.

Poor sanitation contributes to diarrheal diseases and malnutrition through fecal contamination of food and water. One gram of feces can contain one hundred parasite eggs, one million bacteria, and ten million viruses.

Diarrheal diseases kill approximately 121,800 Nigerians, including 87,100 children under the age of five each year. Eighty-eight percent of those deaths are attributed to poor sanitation. Poor sanitation is thought to strain the immune system to the point that permanent stunting and other manifestations of malnutrition can result.

More than 40 percent of Nigerian children under the age of five are stunted, and malnutrition is the underlying cause of death in more than 50 percent of the approximately 804,000 deaths annually in the same age range.

The impact of inadequate toilets goes beyond hazardous exposure to feces. A survey conducted by WaterAid, a nonprofit organization focusing on providing safe water and sanitation access, in a Lagos slum revealed that the 69 percent of women and girls without access to toilets are at higher risk of verbal and physical harassment when they relieve themselves.

The effects of poor sanitation are also costing Nigeria economically. The Nigerian Water and Sanitation Program estimates that poor sanitation costs the country at least three billion U.S. dollars each year in lost productivity and health care expenditures.

While estimates vary, in 2011, Nigeria invested approximately $550 million, less than 0.1 percent of GDP, on sanitation, a number which has likely decreased since then. This is less than a quarter of the approximately $2.3 billion annually that would have been necessary to meet the MDG target.

It will take more than money and infrastructure to fix Nigeria’s sanitation. Even if investments were to sufficiently rise, the lack of a single government entity with complete responsibility for sanitation within the government, as well as widespread corruption and a lack of community support, would likely hamper efforts.

Providing latrines without first creating demand within the community has failed repeatedly, including in India, where latrines have been repurposed for extra storage. There are also other problems, like a treasury emptied by corruption and the war on Boko Haram, that top President Buhari’s agenda.

While these are immediate threats that require intense focus, sanitation is an essential long-term investment that will help Nigeria grow.  

UNICEF/WHO: Progress on Sanitation and Drinking Water – 2015 update and MDG assessment.

Progress on Sanitation and Drinking Water – 2015 update and MDG assessment. UNICEF/WHO.

NEW YORK/GENEVA, 30 June 2015 – Lack of progress on sanitation threatens to undermine the child survival and health benefits from gains in access to safe drinking water, warn WHO and UNICEF in a report tracking access to drinking water and sanitation against the Millennium Development Goals. JMP-Update-report-2015_English

The Joint Monitoring Programme report, Progress on Sanitation and Drinking Water: 2015 Update and MDG Assessment, says worldwide, 1 in 3 people, or 2.4 billion, are still without sanitation facilities – including 946 million people who defecate in the open. “What the data really show is the need to focus on inequalities as the only way to achieve sustainable progress,” said Sanjay Wijesekera, head of UNICEF’s global water, sanitation and hygiene programmes.

“The global model so far has been that the wealthiest move ahead first, and only when they have access do the poorest start catching up. If we are to reach universal access to sanitation by 2030, we need to ensure the poorest start making progress right away.”

Access to improved drinking water sources has been a major achievement for countries and the international community. With some 2.6 billion people having gained access since 1990, 91 per cent of the global population now have improved drinking water – and the number is still growing. In sub-Saharan Africa, for example, 427 million people have gained access – an average of 47,000 people per day every day for 25 years. The child survival gains have been substantial. Today, fewer than 1,000 children under five die each day from diarrhoea caused by inadequate water, sanitation and hygiene, compared to over 2,000 15 years ago.

On the other hand, the progress on sanitation has been hampered by inadequate investments in behaviour change campaigns, lack of affordable products for the poor, and social norms which accept or even encourage open defecation. Although some 2.1 billion people have gained access to improved sanitation since 1990, the world has missed the MDG target by nearly 700 million people. Today, only 68 per cent of the world’s population uses an improved sanitation facility – 9 percentage points below the MDG target of 77 per cent.