Category Archives: Africa

Improving the quality of public toilet services in Kumasi

Improving the quality of public toilet services in Kumasi, 2016. Water and Sanitation for the Urban Poor.

Public toilets are the leading form of sanitation in urban Ghana: in Kumasi, 700,000 people use one each day. This Note presents the activities of Kumasi Metropolitan Assembly (KMA) to raise the standard of these services. PN027-126x188

To assist KMA in promoting greater private sector involvement, PPIAF commissioned the consultancy Ernst & Young (EY) to conduct a feasability study. The study recommended that toilets participating in the scheme be operated under a Build, Own, Operate, Transfer (BOOT) model, presented in Figure 2. Key features of the model are: 1) a Public-Private Partnership (PPP) Project Company would design, build, finance, operate and maintain the toilets for a 20-year concession period, after which the assets would be transferred back to KMA; 2) the Company would directly collect user fees and use it to cover their costs; 3) the Company would pay a monthly franchise fee to KMA, calculated as a percentage of revenue; 4) revenues 10% higher than assumptions made in the financial model would be paid to KMA; and 5) donor funding and cover to insure KMA’s termination guarantee may be sought.

There is a clear need for improved standards of public toilets in Kumasi. Progress has already been made, with training and improved monitoring impacting positively on the level of service. While rehabilitation and construction under the BOOT scheme will take time to complete, the resulting improvements should reduce waiting times for consumers, improve overall service quality and enhance financial viability.

KMA recognises that PLBs are not the long-term solution — a five-year compound sanitation strategy is being implemented in parallel, to achieve universal access to in-house sanitation in the long term — but the steps now being taken by KMA will ensure that public toilets provide the best possible service in the interim.

A tale of clean cities: Insights for planning urban sanitation from Kumasi, Ghana

A tale of clean cities: Insights for planning urban sanitation from Kumasi, Ghana, 2016. WaterAid.

Key learning points A-tale-of-clean-cities-143x203

  • Sanitation progress in Kumasi has been a long-term effort championed by a technically strong municipal Waste Management Department, supported by a wide range of development partners.
  • Despite some political consensus around the importance of sanitation, and partly due to inadequacy of monitoring systems, financial support has remained low, limiting progress.
  • Open defecation has been almost eliminated through the expansion of public toilets, prioritised at the expense of private toilets because of housing constraints.
  • Enabling policies catalysed private sector investment, improving management of public toilets and service levels across the sanitation service chain.
  • Disparities remain in terms of reach and quality of these services, which are poor in low-income areas.
  • Sanitation planning exercises helped forge a shared vision on how to advance towards sustainable service delivery.
  • The quality of these ‘learning by doing’ planning processes was more influential than were the resulting plans.

Refreshing Africa’s future: prospects for achieving universal WASH access by 2030

Refreshing Africa’s future: prospects for achieving universal WASH access by 2030, 2016. Authors: A. Markle; Z. Donnenfeld. Institute for Security Studies.

Access to water, sanitation and hygiene is indispensable to development, but what will it take for Africa to achieve universal access in 15 years? This paper uses the International Futures forecasting system to explore Sustainable Development Goal 6, which promises water, sanitation and hygiene to all by 2030.

It finds that Africa is not on track to meet this goal. In response, it uses two alternative scenarios to assess the costs and benefits associated with accelerating access. The first models an aggressive push toward universal access and the second a more moderate approach that advances access to water, sanitation and hygiene based on countries’ 2015 baselines.


High-Resolution Spatial Distribution and Estimation of Access to Improved Sanitation in Kenya

High-Resolution Spatial Distribution and Estimation of Access to Improved Sanitation in Kenya. PLoS One, July 2016. Authors: Peng Jia , John D. Anderson, Michael Leitner, Richard Rheingans

Background – Access to sanitation facilities is imperative in reducing the risk of multiple adverse health outcomes. A distinct disparity in sanitation exists among different wealth levels in many low-income countries, which may hinder the progress across each of the Millennium Development Goals.

Methods – The surveyed households in 397 clusters from 2008–2009 Kenya Demographic and Health Surveys were divided into five wealth quintiles based on their national asset scores. A series of spatial analysis methods including excess risk, local spatial autocorrelation, and spatial interpolation were applied to observe disparities in coverage of improved sanitation among different wealth categories. The total number of the population with improved sanitation was estimated by interpolating, time-adjusting, and multiplying the surveyed coverage rates by high-resolution population grids. A comparison was then made with the annual estimates from United Nations Population Division and World Health Organization /United Nations Children’s Fund Joint Monitoring Program for Water Supply and Sanitation.

Results – The Empirical Bayesian Kriging interpolation produced minimal root mean squared error for all clusters and five quintiles while predicting the raw and spatial coverage rates of improved sanitation. The coverage in southern regions was generally higher than in the north and east, and the coverage in the south decreased from Nairobi in all directions, while Nyanza and North Eastern Province had relatively poor coverage. The general clustering trend of high and low sanitation improvement among surveyed clusters was confirmed after spatial smoothing.

Conclusions – There exists an apparent disparity in sanitation among different wealth categories across Kenya and spatially smoothed coverage rates resulted in a closer estimation of the available statistics than raw coverage rates. Future intervention activities need to be tailored for both different wealth categories and nationally where there are areas of greater needs when resources are limited.


Process Evaluation of the National Sanitation Campaign of Tanzania

Process Evaluation of the National Sanitation Campaign of Tanzania, 2016. SHARE Project.

This report summarises the findings of a process evaluation of Phase 1 (2011-2015) of the Government of Tanzania’s National Sanitation Campaign (NSC) that was conducted by SHARE researchers and partners 2013-2015.

By reviewing the NSC’s mid-term achievements – at the household and school levels – and rigorously assessing its implementation, the evaluation sought to shed light on whether the NSC was likely to catalyse the changes anticipated and to identify potential steps that could increase its efficiency.


Intra-Household Access to WASH in Uganda and Zambia – Do Variations Exist?

Intra-Household Access to WASH in Uganda and Zambia – Do Variations Exist? SHARE.

This paper was produced for the 39th WEDC Conference held in Ghana in July 2016. It analyses baseline data from the SHARE-funded Undoing Inequity project to explore whether differences exist between heads of household and ‘vulnerable’ individuals’ reports on access and use of WASH at the household level.

Duncan Mara – Disease Priorities in Zambia

Disease Priorities in Zambia. Am Jnl Trop Med Hyg, July 2016.

Author: Duncan Mara. School of Civil Engineering, University of Leeds, Leeds, United Kingdom. E-mail:

An excerpt: Neonatal disorders are very important. Deaths due to neonatal sepsis and other neonatal infections have been rising steadily from 2,121 in 2000 to 2,704 in 2013. This may reflect poor WASH, the difficulty of accessing even basic-level health-care facilities in rural areas, and/or rural mothers not recognizing early symptoms of these diseases. Poor WASH should be addressed, as it is known to adversely affect maternal, infant, and child mortality. There also needs to be improved rural health care and targeted health/hygiene education for mothers and mothers-to-be.

Diarrheal diseases caused significantly fewer deaths in 2013 than in 2000. This parallels the decrease in unsafe water, unsafe sanitation, and unsafe hand hygiene, which must be sustained. The most dramatic decrease, nearly 60%, was seen in the number of human immunodeficiency virus, acquired immune deficiency syndrome, and tuberculosis deaths during 2010–2013. This truly excellent performance needs, of course, to continue.

As highlighted in this letter, an initial broad-brush approach using GBD Compare (or similar tools) is likely to produce good guidance on health priorities, especially in rural areas and periurban slums. Targeted detail can then follow.