Category Archives: East Asia & Pacific

Using microfinance to facilitate household investment in sanitation in rural Cambodia

Using microfinance to facilitate household investment in sanitation in rural Cambodia. Health Policy and Planning, November 2016.

Authors: Kimberley H Geissler-1, Jeffrey Goldberg-2 and Sheila Leatherman-3. Author affiliations: 1 – University of Massachusetts School of Public Health and Health Sciences, Amherst, MA 01003, USA. 2 – Office of Water, Bureau for Economic Growth, Education, and Environment, US Agency for International Development, Washington, DC, USA. 3 – Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA

Improved sanitation access is extremely low in rural Cambodia. Non-governmental organizations have helped build local supply side latrine markets to promote household latrine purchase and use, but households cite inability to pay as a key barrier to purchase.

To examine the extent to which microfinance can be used to facilitate household investment in sanitation, we applied a two-pronged assessment: (1) to address the gap between interest in and use of microfinance, we conducted a pilot study to assess microfinance demand and feasibility of integration with a sanitation marketing program and (2) using a household survey (n = 935) at latrine sales events in two rural provinces, we assessed attitudes about microfinance and financing for sanitation.

We found substantial stated intent to use a microfinance institution (MFI) loan to purchase a latrine (27%). Five percent of current owners used an MFI loan for latrine purchase.

Credit officers attended 159 events, with 4761 individuals attending. Actual loan applications were low, with 4% of sales events attendees applying for a loan immediately following the event (mean = 1.7 loans per event).

Ongoing coordination was challenging, requiring management commitment from the sanitation marketing program and commitment to social responsibility from the MFI.

Given the importance of improving sanitation coverage and concomitant health impacts, linking functional sanitation markets to already operational finance markets has the potential to give individuals and households more financial flexibility.

Further product research and better integration of private vendors and financing modalities are necessary to create a scalable microfinance option for sanitation markets.

Fed up with no sewers, Pakistan’s slum residents go DIY

Fed up with no sewers, Pakistan’s slum residents go DIY | Source: Reuters, Oct 13 2016 |

In Orangi Town, home to an estimated 2.4 million people, residents have given up waiting for the government to install public services – and built them by hand

KARACHI, Pakistan, Oct 13 (Thomson Reuters Foundation) – For Sultana Javed, one of dozens of residents living without proper sanitation on her street in the Orangi Town slum, the final straw came when her toddler daughter fell into the soak pit where the family disposed of their waste.


An aerial view of informal settlements in Orangi Town, Karachi on October 4, 2016. Thomson Reuters Foundation/Aamir Saeed

Since moving to the Gulshan-e-Zia area of the slum in Karachi nine years earlier, Javed had poured waste into the soak pit, a porous chamber that lets sewage soak into the ground and is often used by communities that lack toilets.

Javed, whose son caught dengue fever from mosquitoes near the pit outside their home, began mobilising others among 22 families on her street to install their own sewerage system.

“We are fed up with stench of wastewater and frequent mosquito-borne diseases like malaria and dengue fever. So, we have decided to lay a sewerage pipeline in our street on a self-help basis,” Javed, 45, told the Thomson Reuters Foundation.

Read the complete article.

Better Nutrition Alone Won’t Stop Stunting, Study Says

Better Nutrition Alone Won’t Stop Stunting, Study Says | Source: The Cambodia Daily, Sept 27 2016 |

Despite steady gains over the past two decades, about a third of Cambodia’s children are still stunted—leaving them smaller, prone to illness and cognitively impaired—according to new research that suggests a more flexible approach is needed to continue progress.

Increased education among parents, better maternal care, improved sanitation and higher incomes were credited as the key drivers in reducing stunting from 51 percent of children in 2000 to 34 percent in 2014, according to a study released last week.

The researchers from the U.K. said that there seemed to be divergent causes for the drop in rural and urban areas.

The study, titled “What Explains Cambodia’s Success in Reducing Child Stunting: 2000-2014?,” also finds that programs focused exclusively on improving child nutrition had not shown sure signs of success.

Read the complete article.

SNV publications on urban sanitation

SNV’s Urban Sanitation & Hygiene for Health and Development (USHHD) programme works with municipal governments to develop safe, sustainable city-wide services. The programme integrates insights in WASH governance, investment and finance, behavioural change communication and management of the sanitation service chain. We engage private sector, civil society organisations, users and local authorities to improve public health and development opportunities in their city.

As part of our USHHD programme, we have a long term partnership with the Institute for Sustainable Futures, University of Technology Sydney focused on knowledge and learning to improve practice and contribute to the WASH sector knowledge and evidence. Our recent collaborative efforts have resulted in the following papers:

Are we doing the right thing? Critical questioning for city sanitation planning (2016)
Cities are clear examples of complex and rapidly changing systems, particularly in countries where urban population growth and economic development continue apace, and where the socio-political context strongly influences the directions taken. The concept of double-loop learning can be usefully applied to city sanitation planning. This paper prompts practitioners, policy-makers and development agencies to reflect on their approaches to city sanitation planning and the assumptions that underlie them.
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Exploring legal and policy aspects of urban sanitation and hygiene (2016)
During 2012-2014, SNV did four country reviews of legal arrangements for urban sanitation and hygiene in Nepal, Bhutan, Bangladesh and Indonesia. Based on these experiences, this guide was developed to provide support and guidance for WASH practitioners undertaking a scan of legal arrangements to inform the design (use of frameworks and tools) and delivery (advocacy for improvements) of urban sanitation and hygiene programs.
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A guide to septage transfer stations (2016)
Septage transfer stations have the potential to significantly reduce the amount of faecal sludge entering the environment by providing a local solution for septage disposal. Localised transfer stations shorten the time required for local operators to collect and transport septage, and they will be able to use smaller vacuum tanks that can navigate the densely populated residential areas. This guide provides information on the salient aspects of selecting, designing, building, operating and maintaining a septage transfer station.
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Financing sanitation for cities and towns (2014)
Planning and financing for sanitation in cities and towns in developing countries is often ad hoc and piecemeal. Stronger capacity to plan financing for sanitation infrastructure (and services) for the long term will lead to better outcomes. Planning for adequate long-term services requires consideration of the complete sanitation service chain over the lifecycle of the associated service infrastructure. This paper focuses on access to the upfront finance and other lumpy finance needs for initial investment and for rehabilitation and/or replacement as physical systems approach their end of life.
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For further information about these papers or the organisations, please contact:
Antoinette Kome (SNV) –
Juliet Willetts (ISF) on

Poor sanitation cost global economy US$ 223 billion in 2015

True cost poor sanitation cover

Lack of access to sanitation cost the global economy US$222.9 billion in 2015, up from US$182.5 billion in 2010, a rise of 22% in just five years, according to a new report released on 25 August 2016 by LIXIL Group Corporation (“LIXIL Group”), a global leader in housing and building materials, products and services.

The true cost of poor sanitation, published in collaboration with WaterAid and Oxford Economics, which conducted economic modeling to develop up-to-date estimations of the global cost of poor sanitation, brings to light the high economic burden in low-income and lower-middle income countries.

More than half (55%) of all costs of poor sanitation are a consequence of premature deaths, rising to 75% in Africa. A further quarter are due to treating related diseases, and other costs are related to lower productivity as a result of illnesses and time lost due to lack of access to a private toilet.

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iDE Shares Lessons Learned in Building Markets for Sanitation

iDE is proud to announce a new microsite: This site outlines the evolution of iDE’s sanitation program in Cambodia, from preliminary market studies to the largest program of its kind in the world.

We made this site because we hope that our experiences will inform the design, implementation, and cost-effectiveness of future sanitation marketing projects.

Here are a few featured posts on the site:

Are We Moving the Needle on Latrine Coverage? Sanitation coverage increased from 29% to 45%in the seven project provinces, a jump of 16% in just over just 2.5 years.

Latrine Sales Exceed “Excellent” Target The project surpassed the topline “excellent” target of latrines sold through project-connected businesses. Update in May 2016: 228,151 latrines have been sold through project-connected business, with average monthly sales at around 5,000.

Reaching the Poor with Sanitation Overall, there has been a doubling (12% increase) in sanitation coverage among the poor since the baseline in early 2012.

Professionalized Sales Drive Latrine Uptake Achieving the public health goal of rapid latrine uptake necessitated an active role by the project in managing latrine sales activities. Professionalization of sales is a crucial investment for sanitation market development efforts to ensure that the critical activity of selling is deliberate and based on industry best practices. With the support of Whitten & Roy Partnership, the project developed a sales training approach that included systematic sales training and sales management processes and a package of supporting tools, which were developed in collaboration with 17 Triggers.

Driving Latrine Affordability With Access to Finance In partnership with IDinsight, we learned that under certain conditions, financing has the potential to increase latrine uptake fourfold at a $50 market price and decrease operating costs by 70%.

To contact iDE about a potential partnership, send an email to:

PMA2020 WASH Brief on Indonesia

Performance Monitoring and Accountability (PMA2020) uses innovative mobile technology to support low-cost, rapid-turnaround surveys to monitor key indicators for family planning and WASH. indonesia-pma-4

The project is implemented by local university and research organizations in 10 countries, deploying a cadre of female resident enumerators trained in mobile-assisted data collection at 6-month and 12-month intervals.

PMA2020 WASH briefs provide a two-page snapshot of key WASH indicators including number of household water sources, use of unimproved water sources and sanitation facilities, as well as percent of population using open defecation as a main or regular practice.

Our latest WASH brief from Indonesia is based off of a nationally representative survey conducted between June and August 2015.

For more information on PMA2020 WASH please visit, or contact Alec Shannon at