~~On-siteLINDP-World BankWater andSanitation Sa n i ttiProgram -South Asia An International Review

Of World Bank Experience

21292July 1999

Andrew FangJuly 1999

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A study carriedout by the 2n,East AsiaEnvironmentand SocialDevelopment*

Uni of the S Ef

World Bank 7. 77

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Photography (Front Cover)

Hjalte Tin/Still Pictures- Government-funded latrines in Likolaneng Village, Maseru

Province, Lesotho.

Mark Edwards/Still PicturesSlum in Ghana.

Guy StubbsCommunity contributions for sanitation, Ahmedabad, India.

U Paul Harrison/Still PicturesSanitary latrine in Western Kenya.

July 1999This document is published by the UNDP-World Bank Water and Sanitation Program-South Asia. Copies are availablefrom the Program, 55 Lodi Estate, New Delhi -110 003. Tel: 011 469 0488, 469 0489. Fax: 011 462 8250.

The World Bank does not accept responsibility for the views expressed herein, which are those of the authors and shouldnot be attributed to the World Bank or its affiliated organizations. The findings, interpretations, and conclusions are theresult of research supported by the Bank. The designations employed and the presentation of the material are solely forthe convenience of the reader and do not imply the expression of any legal opinion whatsoever on the part of the WorldBank or its affiliates concerning the legal status of any country, territory, city, area, or of its authorities, or concerning thedelimitations of its boundaries or national affiliation.

On-site Sanitation:An International Review of

World Bank Experience

Andrew Fang

July 1 999

Acknowledgements

ACKNOWLEDGEMENTS

The original report on which this paper is based was prepared by Andrew Fang during June-July 1998 working as World Bank summer intern attached to the then Environment Sector Unit ofthe East Asia and Pacific Islands region of the World Bank (EASEN). The impetus for undertakingthis review came from the perception that many Bank-financed projects in Asia included on-sitesanitation components, but that no comprehensive review of their success or failure had beendone. The original concerns were mostly related to the suitability of the technologies employedand their environmental sustainability. But during the review, institutional and social aspects werefound to be of great concern as well.

The work was undertaken under the general guidance of the unit manager, KristalinaGeorgieva (EASES), and with encouragement from Robert Goodland (ENV). Hakon Kryvi andHeinz Unger (EASES) provided the terms of reference and then directed and oversaw Mr Fang'swork on a day-to-day basis. Many Bank colleagues cooperated by contributing ideas andinformation. Comments on the draft report were given by Daniel Hoornweg (EASUR), KirstenHommann (SASIN), Mary Judd (EASES), and Jennifer Sara (AFTU2). Stephen Latham (School ofPublic Affairs, University of Maryland) and Kevin Tayler (GHK - Research and Training, UK), carriedout detailed reviews of the draft report and provided extensive comments. Kirsten Fehrenkamp(EASES) performed a check on the sources quoted and did some initial editing.

Publication of this report was funded by the UNDP-World Bank Water and SanitationProgram-South Asia.

Heinrich K. UngerSenior Environmental Specialist

East Asia Environment and Social Development Unit, World Bank

*M. -U

ABBREVIATIONS ANDACRONYMS

CIDA Canadian International Development AgencyCBO ComYmunity Based OrganizationsCWSSP Community Water Supply and Sanitation ProjectDCC Dhaka City CorporationFW4SP First Water Supply, Sewerage and Sanitation Sector ProjectFY Fiscal YearIBRD International Bank for Reconstruction and DevelopmentICR Implementation Completion ReportIDA International Development AssociationIDRC International Development Research CenterIER Impact Evaluation ReportKfW Kreditanstalt fur WiederaufbauNGO Non-governmental OrganizationODA Overseas Development AdministrationPCR Project Completion ReportPPAR Project Performance Audit ReportRWSA Rural Water and Sanitation AssociationSAR Staff Appraisal ReportSSA Strategic Sanitation ApproachTOR Terms of ReferenceUN United NationsUNICEF United Nations Children's FundUNDP United Nations Development ProgramUNDP/TAG United Nations Development Program/Technology Advisory Group*UNDP/WB United Nations Development Program/World Bank*US United StatesUSIT Urban Sanitation Improvement TeamVIP Ventilated Improved Pit

*UNDP/TAG ond UNDP/WB were forerunners of the Water and Sanitotion Program (WSP).

Contents

CONTENTS

Abbreviations and Acronyms

Foreword .1

I. Executive Summary ........................................................................ 3

II. Introduction. 6Background ........................................................................ 6Objectives ........................................................................ 6Study Methodology ........................................................................ 6Projects Reviewed ........................................................................ 7

111. Findings ....................................................................... 9Low-Cost On-Site Sanitation Technology ........................................................................9Pit Size, Single and Double Pits ....................................................................... 1 1Other Important Considerations ....................................................................... 12Issues and Problems of Bank-supported On-site Sanitation Projects ................................ 14The Community Involvement Approach ....................................................................... 19Experience of Other Organizations ....................................................................... 21The Strategic Sanitation Approach ....................................................................... 21

IV. Conclusions..23

Bibliography ....................................................................... 25

Attachment 1: List of Bank Projects Reviewed in this Study ............................................................. 29

Attachment 2: Technical Options of On-site Sanitation .............................................................. 30

Fore-word

FOREWORD

Sanitation has long been neglected in water supply and sanitation projects and programs.While there has been widespread acknowledgement that improved sanitary behavior is necessaryto realize the potential health benefits of improvements in water supply, adequate emphasis is yetto be placed on sanitation components of most projects, in terms of funding (relative toinvestments in water supply), attention to innovations in project design and in supervision. Manysanitation investments fail to result in improved health and environment for target communities,and indeed in the worst cases, a positive deterioration in the living environment can be the endresult (a non-functioning latrine, for instance, serving to concentrate potential contamination andinfection closer to the house, can be worse than no latrine at all).

Over the past 20 years much progress has been made in developing innovative andappropriate sanitation technologies which can serve the specific needs of low income andinformal communities. One major area has been in the development of so called 'on-site'technologies; technologies which enable a household to own a self-contained sanitary latrinewhich is not dependent on the functioning of an expensive and technically complex seweragenetwork for safe disposal of human excreta. These latrines have brought relief to homes aroundthe globe and have been widely adopted in major investment programs of both governments anddonors. Nonetheless the adoption of new technologies in projects has not, in itself, necessarilyimproved the effectiveness of investment. To understand why, it is necessary to unravel thecomplex institutional and financial issues associated with past investments to find out why thingswent wrong. This is a major task but one which is permanently ongoing, with donors,governments, independent bodies and NGOs providing a range of good quality review materialwhich looks at past project experience.

This study aims to add to this body of work by carrying out a brief review of a specific set ofproject experiences; those associated with World Bank investment projects around the world. Thestudy has deliberately limited its scope to older, large scale World Bank investment projectsutilizing on-site technology. This does not imply a lack of merit in other approaches, merely aneed to focus the analysis on a discreet set of experiences (experiences in the use of off-sitetechnology and the significant achievements and lessons from the informal sector are alsosignificant as we move forward to new project approaches). The study looks at the design ofprojects, both technical and institutional, and evaluates, to the extent possible, the outcomes ofinvestments over the longer term. The value of the approach is that it is possible to draw usefullessons from these projects relating to the long term effectiveness of the investments undertaken.

As all major actors in the sector, including the World Bank, move towards a more openacknowledgement of the institutional and financial challenges inherent in successful sanitationinvestments, it is hoped that this retrospective study can provide some useful indicators of how toimplement more successful projects and programs in the future.

Barbara EvansRegional Urban Specialist

Water and Sanitation Program -South Asia

1

Ghana: In many slums, the street is the only place available for washing, bathing and defecation.

2

I

EXECUTIVE SUMMARY

O ver 50 infections can be transferred * Task managers and mission team membersfrom a diseased person to a healthy one by of some projects were identified and

various direct or indirect rout es involving interviewed whenever possible; and

excreta. The primary objective of sanitation * A literature review of on-site sanitation was

programs is the improvement of public health. conducted to follow the latest developments in

This primary health objective can often be fully technology and management aspects of low-

achieved by on-site sanitation technologies cost on-site sanitation in developing countries.

which are much simpler and cheaper than The review covers on-site sanitation work in

conventional sewerage. 24 water supply and sanitation projects over

The Work Bank has supported low-cost on- the past 20 years. Because some projects

site sanitation projects in developing countries involved a series of investments that took plcce

for many years. The purpose of this review is to within the same target areas and had similar

identify successes, issues, and problems of objectives, they were grouped together and

World Bank-supported low-cost on-site analyzed as a single project. This reduced the

sanitation projects and explore technology sample size to 16 projects, with five in East

options of low-cost on-site sanitation. New Asia, eight in South Asia, two in Africa, and

strategies for sustainable on-site sanitation are one in South America.

also presented in the report. Sanitation projects Many different latrine designs have provided

implemented in East Asia, South Asia and effective low-cost on-site sanitation. Innovative

Africa over the past 10-20 years were the focus technology is needed for low-cost sanitation in

of the review. low-income urban areas with high population

Three major approaches were used in this density. It is difficult to determine and measure

study: groundwater contamination by pit latrines,

* Bank reports, such as Staff Appraisal Reports especially in saturated zones. Although many

(SARs), Implementation Completion Reports Bank projects do have some sort of water

(ICRs), Project Performance Audit Report source monitoring program for bacteria, no

(PPARs), and Impact Evaluation Reports (IERs), efforts have seemingly been made to relate

were consulted to obtain information on the any found problems with the locations of

design, preparation, implementation and latrine pits and the possibility of groundwater

social and environmental impacts of a pollution by these pits.

specific project; Getting communities involved in the

3

selection process is the key to finding an where households have been exposed toeconomically and culturally acceptable design. health education. When promoting andHowever, frequently, the most popular marketing sanitation, therefore, projecttechnology was chosen and there was no implementers should focus on the socialevidence showing that any modifications were benefits that a latrine can bring as well as themade to accommodate requirements from hygiene benefits.communities with special economic and Most of the projects reviewed in this studycultural backgrounds. employed a cost-sharing scheme of grant and

It has commonly been found that project loan or grant and user contribution. Thebeneficiaries, sometimes even project success of loan programs depended heavily onmanagers, do not understand the importance the willingness of the households to apply forof sanitation in fully realizing the health credit. A low sense of ownership, highbenefits that water supply programs are subsidies, and the perception of being mereintended to bring. Sanitation rarely receives recipients of assistance rendered cost recoveryadequate political support, and low public difficult in some of the projects.awareness often results in difficulties for Many of the projects reviewed in this studysanitation programs. Rarely does a Bank report failed to result in sustained improvementsgive the reasons for the failure or success of through sanitation. This is often the result of athe sanitation part of a project. Other low sense of ownership by the users, or a lowinformation related to sanitation, such as level of users' awareness of operation andlatrine design, cost sharing and recovery, and maintenance procedures.facility operation and maintenance, are usually Many strategies have been developed by theabsent in Bank reports as well. The Bank Bank and other development organizations toneeds to focus more on all aspects of develop sustainable sanitation programs. Thesanitation programs if they are included in principles implied in these strategies includeprojects, that is, to give it a higher profile, developing demand-driven programs, focusingmore attention, and more preparation and on promotion, expanding communitysupervision resources. participation, user-oriented financial

Most latrine users considered latrines to be management, and making proper institutionalsome kind of a status symbol. The motivating arrangements. Engaging NGOs to undertakefactors for many households to build a latrine some of the work can also enhance efficiencyare not hygienic but primarily social: comfort, and effectiveness of sanitation projects.convenience and privacy. This is true even

4

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INTRODUCTION

Backgrou=nd Obj'ect;vesA convenient supply of safe water and the The purpose of this review is to identify

sanitary disposal of human wastes are essential lessons from World Bank-supported low-cost

ingredients of a healthy, productive life. Over on-site sanitation projects. East Asia, South

50 infections can be transferred from a Asia and Africa were the focus of the review.

diseased person to a healthy one by various The objectives of the study were to:

direct or indirect routes involving excreta. * examine low-cost on-site sanitation

Coupled with malnutrition, these excreta- technologies, their advantages and

related diseases take a dreadful toll in disadvantages; and

developing countries, particularly on the poor * review Bank-supported on-site sanitation

who suffer the most from absence of access to projects to identify the problems and issues

safe water and sanitation. UN statistics indicate related to technology selection, project

that, in 1 990, approximately 380 million people implementation, and the sustainability of

were still without adequate sanitation in urban improvements.

areas worldwide (United Nations, 1990). One

of the fundamental problems in improving the Study Methodlokgy

situation in developing countries is the high Three major approaches were used. First,

cost of conventional sanitation services. In Bank reports, such as SARs (Staff Appraisal

industrialized countries, the standard solution Reports), ICRs (Implementation Completion

for the sanitary disposal of human excreta is Reports), PPARs (Project Performance Audit

waterborne sewerage. In addition to its Reports), and IERs (Impact Evaluation Reports),

technical complexity, this solution is beyond the were consulted. Second, task managers and

bounds of affordability for many low-income mission team members of some projects were

communities in developing countries. identified and interviewed whenever possible,

The primary objective of sanitation programs generating valuable first hand information of

in developing countries must be the individual projects. Unfortunately, because of

improvement of public health. This primary the time constraints and the departure of staff

health objective can often be fully achieved involved in projects completed many years

by on-site sanitation technologies which ago, only a few projects could be analyzed with

are much simpler and cheaper than the help of interviews.

conventional sewerage. Third, a selective literature review of on-site

6

Introduction

sanitation was also conducted. The purpose of together and analyzed as a single project. Thisthe literature review was to follow the latest reduced the sample size to 16 projects, withdevelopments in technology and the five in East Asia, eight in South Asia, two inmanagement aspects of low-cost on-site Africa, and one in South America. In addition,sanitation in developing countries. information from a project in Burkina Faso was

provided by one of the mission leaders. ThisPro'ects Reviewed project is included in the discussion because it

The review covers on-site sanitation work in offers a good example of a successful demand-24 water supply and sanitation projects over driven on-site sanitation project.the past 20 years. The projects studied are None of the 24 projects was a stand-alonelisted in Attachment 1. These projects were on-site sanitation investment. Withoutreviewed to learn overall lessons of experience, exception, sanitation was just one componentnot to critique them individually. Because some within a larger water supply or sewerageprojects involved a series of investments that project. Often, sanitation was allocated only atook place within the same target areas and small portion of the project resources andhad similar objectives, they were grouped staff time.

7

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8

III

FINDINGS

Low-cost On-s'$te Sanitatien allow liquids to soak away. A squat hole in the

Technology slab or a seat is provided so that the excretaOn-site sanitation usually involves the use of falls directly into the pit. Insects (flies and

some form of pit. In pit latrines excreta and mosquitoes) and odor nuisance are major

anal cleansing materials are deposited in a disadvantages of this type of latrine. The

hole in the ground where they undergo addition of a lid that fits tightly into the hole incomplex chemical and biological reactions and the slab has been reported to help reduce flydecompose, producing innocuous humus-like numbers significantly. In places where the

solids, water and gases. Water and gases 'open-air' approach is acceptable or evendissipate into the ground or air, leaving a solid preferred, the odor problem can be reduced byresidue in the pit. According to the sociological building a latrine without any superstructure,and cultural preferences of users, various types except for a privacy screen. This design canof superstructures - ranging from a privacy also reduce costs. A floating layer ofscreen with no roof, to high quality enclosures polystyrene beads, through which female

- can be added above the pit. mosquitoes cannot lay eggs and larvae cannotMuch work has been done on the technical breathe, can be used to control mosquitoes.

aspects of pit latrines (Cotton and others, The beads have been found to remain in

1995; Franceys and others, 1992; Mara, place for as long as four years (Cotton and1 982). Technical options, their advantages and others, 1 995).disadvantages, and their application criteriaare well documented. The following Venfiatrd improvedpit(VIP)Iufrmneparagraphs give a brief description of various Insect and odor nuisance may be furtheron-site sanitation systems. Attachment 2 gives reduced if the pit is ventilated by a pipe

a summary of cost, water requirements (if any), extending above the latrine roof, with fly-proofand the advantages and disadvantages of netting across the top. Such latrines are knowneach system. as Ventilated Improved Pit (VIP) latrines. Field

work in Botswana and Zimbabwe indicates that

Simple pith laine the incidence of wind blowing across the top ofA simple pit latrine consists of a slab over the vent and into the latrine shelter is the most

a pit, which may be 2 meters or more in depth. important factor in reducing insect and odorThe pit walls and floors are permeable and nuisance. An earlier notion suggested that the

9

6 *,,,3

pipe should be on the sunny side of the Compost ladrnebuilding and should be painted black (Cotton In this latrine, excreta fall into a watertightand others, 1995). In urban areas, where other tank to which ash or biodegradable organicbuildings allow neither wind nor sunshine to matter is added. If the moisture content andreach the vent pipe, the effectiveness of chemical balance are controlled, the mixtureventilation pipes becomes questionable. will decompose to form a good soil conditioner

in about four months. Pathogens are killed inPour-RushpiHlfrine the dry alkaline compost, which can be

The pour-flush latrine incorporates a toilet removed for application as a fertilizer. Compostbowl in the slab. The toilet bowl has a trap that latrines allow a natural resource to beprovides a water seal. The toilet is cleared of recycled. Most compost latrines are not easy tofaeces by pouring in small quantities of water operate. They require a considerable amount(1 -2 liters) to wash the solids into the pit and of conscientious user care and maintenance inreplenish the water seal. A water seal prevents that the correct amount of ash orflies, mosquitoes and odor from reaching the biodegradable organic matter must be addedlatrine from the pit. The pit may be offset from at the correct time to control the moisturethe latrine by providing a short length of pipe content and the carbon to nitrogen ratio. Evenor covered channel from the bowl to the pit. It if such material is available throughout thecan be upgraded by connection to a sewer year - and it is unlikely to be so in dense urbanwhen sewerage becomes available. The major areas - it is doubtful that the users will bedisadvantage is the requirement of a reliable sufficiently motivated to produce a goodwater supply, which makes it unsuitable in dry quality humus which they may not have a useareas. It is also unsuitable where solid anal for or be able to sell (Mara, 1982). In addition,cleaning material is used. the lack of an adequate composting period can

result in high levels of worm infection (CottonCombinafion of VIP and pour-flush pH latrine and others, 1995). As a result, compost latrine

It seems that some Bank-supported projects use is restricted to those nations where theapplied a design that is a sort of hybrid of the practice is customary and the discipline ofVIP and the pour-flush latrine. For instance, in operation is observed by well educated users.the India Uttar Pradesh Urban Development Nonetheless, Kalbermatten (1 976) reportedProject (World Bank, 1987), the SAR report compost latrines had widespread applicationrefers its latrine design as "ventilated improved and acceptance in Vietnam. The reader ispit latrine with pour flush". However, no referred to the literature for furthertechnical details were given in the report. The information.SAR report also mentioned that the UNDP/TAGhad conducted feasibility studies in the 26 Sep& tanktowns where the low-cost sanitation programs A septic tank is an underground watertightwere carried out. Further study on this design settling chamber into which raw sewage ismay be conducted by consulting corresponding delivered through a pipe from plumbingUNDP/TAG documents (see the SAR report- fixtures inside the house or another building.Credit/Loan No.: 1780-IN (IDA)/2797- The sewage is partially treated in the tank byIN (IBRD)). separation of solids to form sludge and scum.

10

Findings

Septic tanks are expensive, require piped hazard low enough for the latrines to be

water, and need to be emptied regularly. considered as satisfactory. Bucket latrines have

Effluent from the tank infiltrates into the a bucket or another container for the retention

ground through drains or a soakpit. Some of faeces, which is periodically removed for

design modifications can make it possible to treatment or disposal. Excreta removed in this

use septic tanks at higher housing densities, way are sometimes termed nightsoil. Poor

provided that soil is suitable for on-site operation or inconsistent and infrequent

disposal. Mara (1 982) suggested a modified collection make bucket latrines malodorous

design with three compartments. The first and they can induce an insect problem.

compartment receives only the cistern-flush Nightsoil collection everywhere results in

toilet wastewater which after settlement passes health hazards to collectors. Millions of bucket

to the second compartment for further latrines still exist in developing countries as

settlement and then into a third compartment they provide reasonable privacy and

that also receives directly all the household convenience to the users. However, they can

sullage. The net result of having three never be promoted as a sanitary option

compartments and initially separating the toilet because of the associated health risks.

wastewater and the sullage is that the effluent

can be expected to have a long-term infiltration Vaults and cesspts

rate, some two-three times greater than the In some areas, watertight tanks called

effluent of a conventionally designed septic vaults are built under or close to latrines to

tank with one or two compartments, so that store excreta until they are removed by hand

the drain field can be two-three times smaller. or vacuum tanker. Similarly, household

sewage may be stored in larger tanks called

Aqua-pnvy cesspits, which are usually emptied by vacuum

An aqua-privy has a watertight tank tankers. They have high construction and

immediately under the latrine floor. Excreta collection cost.

drop directly into the tank through a pipe. The

bottom of the pipe is submerged in the liquid A

in the tank, forming a water seal. Effluent is Experience in East Africa (Cotton and others,

discharged to a soakpit. Aqua privies have a 1 995) suggests that if soakage pits are deeper

reputation for poor operation and are seldom than 4 meters, they never fill up. Pit latrines

constructed now, except as communal latrines. may have double pits with each pit being used

The need for large quantities of water for alternately. When one pit is full, it is 'rested' for

cleaning the drop pipe and maintaining a two years while the other one is in operation.

water seal has been given as a major This is long enough for all pathogens,

disadvantage of aqua-privies. including roundworm, to die. At the end of this

period, the accumulated solids can be safely

Ove*fungluhlineandhtwueflafrkne removed. While the possibility of using the

Overhung latrines are built over water into decomposed contents as a fertilizer or soil

which faeces fall. Only when the water has conditioner is frequently stated, it is not always

sufficient flow to carry excreta away and is not an option for households in urban areas. In

used by people downstream is the health fact, disposal of the contents often presents

I 1

problems. In addition, some households fail to minimum lateral spacing between a wateruse twin pits properly. Frequently, both pits are supply and an on-site sanitation unit inused together and fresh solids are removed saturated soil because of the complexity offrom both pits simultaneously with all the factors such as permeability and hydraulicattendant health hazards. The routine of gradients that control saturated flow rate.alternating pits may be neither acceptable nor Nonetheless, it is obvious that in areas whereconvenient to users in some areas. soil is sandy and groundwater table is high,

There is always a trade-off between a large building a latrine within a few meters of a wellsingle pit and two shallow pits. The former is is not acceptable. Bank projects in Indonesiaconstructed and emptied with a higher cost and the Philippines report a minimum requiredand provides only limited treatment of the distance of 1 5-20 meters. However, there is nowaste, but requires minimum maintenance in evidence to show whether this distance is 'safe'terms of the frequency of emptying. The latter as groundwater surveys for every project areaare easier to construct and empty but require are both financially and technically unrealistic.more frequent maintenance in terms of both Although many Bank projects do have someemptying and operating. It seems that many sort of water source monitoring program forBank projects promote the use of twin pit bacteria, no efforts have seemingly been madelatrines because of their low construction cost, to relate any problems with the location ofhealth benefits and the fact that once built, the latrine pits. This is either because water supplypits are more or less permanent. and sanitation components of a project are

Technical options for on-site sanitation are rarely coordinated, or because the beneficiariessummarized in Attachment 2. The use of and the project implementators do notoverhung latrines, bucket latrines, vaults and understand the link between water sourcecesspits is not recommended. contamination and inappropriately positioned

latrine pits.-R j

Small plots and high-density populationGroundwaterpollution Critics of pit latrines often claim that they

Soakage pits pose a risk to health where are unsuitable for small plots in urban areas.there is an inadequate separation between the In Indonesia, regulations state that areas withpit and the groundwater table.' In these over 250 persons per hectare shall becircumstances, pathogens may contaminate classified as densely populated and shall notground water leading to contamination of use on-site excreta disposal. The smallest plotwater supplies in the vicinity. However, where size recommended for twin-pit pour-flushthe pit is well above the groundwater table, latrines in India is 26 square meters. However,water may be safely abstracted from a well or Cotton and others (1 995) pointed out thatborehole a few meters away from a latrine. In none of the criteria used appears to be basedthe saturated zone (below the groundwater on reasoned argument or evidence oftable), bacteria and viruses have been performance. A survey conducted in Bihar,observed to travel several hundred meters with India, indicated that among 3,246 householdsthe groundwater (Lewis and others, 1982). As that had failed to convert to pour-flush pitssuch, it is very difficult to establish a safe from dry latrines when funds were available,1. According to Lewis and others (1982), the risk of faecal groundwater pollution is minimal when the thickness of relatively fine (<1mm), continuous unsaturatedsoil beneath the base ofa latrine is greater than 2 m, provided that hydraulic loading does not exceed 50mm/day. Here, the hydraulic loading is defined as theprobable range of daily effluent volume divided by the basal excavation area of the latrine concerned (values at 25 15 mm/d for VIP latrines to 90 t30 mm/d forpour-flush latrines).

only 0.9 per cent of respondents gave 'lack of water or maintain the toilets. Examples of suchspace' as the reason for not taking advantage failure can be found in the Indonesia Jakartaof the scheme. Sewerage and Sanitation Project (1983) and in

the India First, Second, and Third MumbaiUsersWperceptionsofdifferenton-site Water Supply and Sewerage Project (Worldtedunologies Bank, 1978, 1986a, 1990d, 1996d, 1997c).

Cotton and Saywell (1 998) conducted In many communities, sharing a toilet withresearch on users' perceptions of different on- strangers is just unacceptable. In addition,site technologies in Ghana, Mozambique and public facilities are inconvenient and usersIndia. They employed several different often return to their previous habits. Successfulmethodological tools simultaneously: stories of public facilities in low-income high-household surveys, semi-structured interviews, density areas are often associated withquantitative testing, postal surveys, and privatized ownership and a 'pay and use'literature review. Results show that both lid- model. For instance, in the Philippines Firstcovered simple pit latrines and septic tanks Water Supply, Sewerage and Sanitation Sectorenjoy a more than 90 per cent level of overall Project (World Bank, 1990a), the mostuser satisfaction, while both VIP latrines and successful public toilet facilities appeared to bepour-flush latrines have a satisfaction level of located in areas served by a private entity such83 per cent. Bucket latrines receive a low 33 as a church or a market association. Suchper cent overall user satisfaction, a result of the facilities were able to collect fees for use, whichfrequency and cost of emptying and associated were then used to purchase water andodor and insect nuisance. The study by Cotton maintenance services. In some instances, theseand Saywell also indicates that the motivating facilities returned substantial profits whichfactors for households to build a latrine are could then be reinvested.primarily social: comfort, convenience andprivacy. This is true even for households that Condominialseweragehave received health education. A recent innovative development in solving

the sanitation problem in crowded low-incomeTechnolgy for low-income, high density urban areas uses intermediate-cost sewers forcomnwni.ies carrying away the effluent from pour-flush

Because of regulations in many developing toilets or septic tanks (Wright, 1 997). Simplifiedcountries, densely populated low-income sewerage systems are less expensive thanurban communities often do not adopt on-site conventional systems but have the samesanitation solutions. Public latrines or public benefits. Since the technology carries thesewered toilets are often adopted instead. effluent away from the house it reduces theHowever, these often fall apart quickly due to land requirements of household latrines. Thepoor operation and maintenance practices. condominial system is a good example of anThis problem is particularly grim for public intermediate cost system. Developed by thefacilities built with Bank project funds. The Brazilian engineer Jose Carlos de Melo, thecommunities or the public organizations condominial system saves on both householdassigned to do the operation and maintenance and trunk sewer costs. It replaces therarely honor contracts or pledges to provide conventional deep main sewers with shallow

13

I feeder sewers running through the backyards nation's sanitation conditions.

of neighborhoods.2 Because the feeder sewers Sanitation investments are often

are shallow and there is only one main sewer unsuccessful because sanitation and hygiene

connection per block, the main sewers can also interventions are:

be much shallower, saving on costs. These * often not seen to be as important as water

systems usually enjoy fairly good operations by either project managers or communities;

and maintenance; if one household drain * more difficult as they rely on a change in

blocks, neighbors quickly bring it to the behavior of targeted individuals, families and

attention of the user and the blockage is communities;

quickly cleared. Condominial systems have * inadequately coordinated with water

proven to be highly successful in north east investments, leading to conflicting messages

I Brazil and are being replicated on a large scale being directed to communities; and

(Wright, 1997). * not based on the priorities, cultural practices

and needs of communities.3

-W. i et a To make matters worse, it is often difficult to,a= jaa -00 A i dj n-j,1t ,a a°stg; jtj;ta f a Vprove direct cause-effect relationships between

1_1 wi et taE specific sanitation interventions and

Almost every Bank-supported water supply improvements in health. As a survey taken in

project has a sanitation or sewerage five Nepalese urban centers revealed, low

component. Linking sanitation to water supply income families are rarely convinced of the

investments makes sense to secure improved benefits of sanitation by health statistics. Only

health benefits. Low-cost on-site sanitation is 28 per cent of the people surveyed gave health

often, although not always, the natural choice as a reason for building latrines outside the

for low-income rural and peri-urban government subsidized program; 43 per cent

communities, because of the high cost and gave prestige, comfort, privacy or a

technical constraints of a conventional combination of these as the primary reason

sewerage system. But many of the projects (Cotton and others, 1 995). With this perception

studied experienced problems. of sanitation benefits in mind, it is not difficult

to understand that in areas where poverty and

Lowpriority for sanifation indebtedness prevail, when money is available,

Despite its importance, sanitation always it may well be prioritized for other essential

received a small proportion of the project items.

resources and staff time. Within the 11 projects The limited attention that sanitation

that have records of cost or budget for programs receive from project managers and

sanitation, eight show investment in sanitation beneficiaries can be illustrated by the following

as being less than 1 0 per cent of the total cost. two cases. In the case of Bangladesh Third

The two projects that took place in the Dhaka Water Supply and Sanitation Project

Philippines are exceptions, with spending on (World Bank, 1 986b), funds were initially

sanitation components being 43 per cent and included for the Dhaka City Corporation

26 per cent, respectively. This could be a result (DCC), the entity responsible for municipal

of the Philippine Government's understanding services including sanitation, to develop a low-

and strong commitment to improving the cost sanitation program that involved an

2. Variations in the Brazilian design are possible, for instance, where access is not possible behind plots, shallow sewers can be laid in the street or under thepavement provided traffic loading is low.3. Excerpted from Rural Water Supply and Sanitation in.Malawi: Sustainability Through Community-Based Management (Second Draft), Government of Malawiwith support of the United Nations, (May 1995).

Findings

assessment of the sanitation in Dhaka and reports and project files and is oftenimplementation of a pilot program providing unfocused.4,000 latrines covering about 88,000 people. Bank reports, such as SARs, ICRs, andHowever, due to lack of commitment by the PPARs, rarely provide details of latrine designsDCC and insufficient interest by potential or other technical considerations. Among thebeneficiaries in the project, it took five years 24 projects encountered in this review, onlyfor the DCC to approve the terms of reference one SAR has a diagram of the latrine proposedand finalize the bidding procedures. The short- to be constructed in the project. More often,list of consultants was submitted to the bank but not always, only the name of theonly nine months prior to the Credit closing technology employed is mentioned.date, when it was no longer possible for the Justification for the technology selection,DCC to implement the program. As a result, design modifications and measures to limitthe low-cost sanitation program was groundwater pollution are rarely found in'eventually eliminated' (World Bank, 1 996c). In these reports. Project files, maintained asthe Somalia Second Mogadishu Water Supply archives, may be a better source for suchProject (World Bank, 1 982d), although the information but these are hard to access.project was originally designed as a water Interviews with task managers show thatsupply stand-alone project, it was felt during sanitation programs often only adopt thepreparation that a linkage between water and most popular on-site sanitation technology insewerage had to be established. However, the the project country or the region and use itGovernment did not push for a component in for all project areas. In East Asia and Souththe project beyond earmarking US$ 0.3 million Asia for instance, the twin-pit pour-flush latrinefor sanitation studies. Nonetheless, a low-cost is the most popular on-site technology, whilesanitation component consisting mainly of for projects in Africa, the VIP latrine dominates.demonstration latrines and related technical Other options may be more appropriateassistance was prepared and the Bank assisted in some of these cases but choice isin looking for financing. Although the cost was often restricted.modest (US$ 0.6 million), no foreign grantfunding could be mobilized. The Government Designsekcti.nanddemnndgenerafionindicated before the effectiveness of the Credit Considering the tight links between thethat it would finance it, but the commitment income level, cost, cultural preferences andbecame less clear afterwards. In the end, the technology choice, it is not difficult toProject Completion Report (World Bank, 1 990b) understand the importance of selecting andid not mention the low-cost sanitation appropriate latrine design for a specific projectcomponent at all. Apparently, funding was not area. Some Bank projects have tested anrealized and the sanitation program was never approach to let the project beneficiaries decideimplemented. on the latrine designs they want. With this

Considering the low level of attention that approach, more than one type ofsanitation projects have received from clients demonstration latrine will be built with full orand Bank staff, it is not difficult to understand partial subsidies in selected communities.the fact that information about sanitation Information about the cost of each design iscomponents is often scattered through Bank made available to potential users. The

15

-3!3~~~~

operation and maintenance of the latrines, and According to the Implementation Completion

the benefits from using them are illustrated Report (ICR), 70 percent of the toilet bowls were

with the usage of the latrines. The purpose of installed, with virtually all of the remainder

this approach is two-fold: to identify a suitable being completed after the loan was closed.

latrine design and to generate demand for on- However, in many instances the latrines were

site sanitation. However, in two projects this not installed according to project specifications.

approach failed for two reasons. In the The most frequently reported problems were

Indonesia Water Supply and Sanitation for Low the lack of a vent pipe (about 40 percent) andIncome Communities Project (World Bank, substandard quality of superstructure (about

1 993a) and the Philippines First Water Supply, 32 percent). In some instances, the p-trap that

Sewerage and Sanitation Project (World Bank, came with the bowl was not installed because

1 990a), contractors hired to construct beneficiaries or builders did not understand the

demonstration latrines often gave poor importance of having a water seal. The on-

performance which resulted in faulty latrines going Indonesia Water Supply and Sanitation

that quickly became unusable. Moreover, for Low Income Communities Project (1 993a)

sometimes only public latrines were built. Both employs a more comprehensive stimulant

these factors contributed to defeating the strategy. One hundred packets of materialsoriginal purpose of the approach. In the China (two sacks of cement, one plastic or ceramic

Rural Water Supply and Sanitation Project toilet pan, and a small section of ventilation

(World Bank, 1992a), although villagers in pipe), necessary to build as many family

project areas appreciated and enjoyed the latrines, were provided to each community

benefits that a model latrine could bring to where water supply facilities were constructed.

them, they simply were not able to afford to Training in latrine construction methods was

build one on their own. Apparently, supposed to be provided by the civil workaffordability had not been accurately contractors of the Ministry of Public Works.

considered during the project design process. However, according to the primary contractor

Of all the projects reviewed - the successful of the overall implementation of the project, a

ones or the failed ones - none enabled the field review in 120 target villages indicated that

eventual users to make effective choices only half of these have constructed more than

about technology. 30 percent of the latrines for which the

Other than constructing demonstration materials were provided. There are two likely

latrines, some projects employed a stimulating reasons for the low turnout of the stimulant

method to generate demand, by providing strategy. Firstly, communities seldom received

communities part or all the materials needed any training during the construction of the

for constructing a latrine free of charge. In the demonstration facilities. Secondly, the amount

Philippines First Water Supply, Sewerage and of material (cement, toilet pans, vent pipes)

Sanitation Project (World Bank, 1 990a), the received by communities typically fell short from

pour-flush toilet bowls were issued at no cost what was allocated in the budget, meaning

to beneficiaries who had expressed interests in that either the material or the money thatbuilding a family pour-flush latrine. The should have been used to buy them

beneficiaries provided labor and materials for was diverted.

pit digging and superstructure construction. A successful case of the demand-driven

16

Findings

method comes from an on-site sanitation to cover the balance. Loans were usually paidprogram in Ouagadougou, Burkina Faso, in monthly instalments with or without an(Ouayoro, 1998). This program is not a loan or interest payment. For instance, the India Tamilcredit program from the Bank. Instead, the Nadu Water Supply and Sanitation ProjectUNDP/WB Water Supply and Sanitation (World Bank, 1984) recommended that theProgram provided advice and assistance while loan element provided to households bethe local water and sanitation utility is recovered at an interest rate of 9.5 per centfinancially self-reliant and covers program cost over 25 years (the estimated lifetime of aand cost recovery. The utility provides free slabs latrine) in monthly instalments beginning fromfor pits and soakaways, which cover about 25 the month following the completion of thepercent of the total cost of a twin pit VIP latrine. latrine installation.4 In Malawi First and SecondA distinguishing feature of this program is that, Lilongwe Water Supply Engineering Projectin order to take the advantage of the free slab, (World Bank, 1982a, 1986c), however, nohouseholders must show evidence that they interest payment was added to the threehave sufficient resources to complete the monthly instalments for the cost of rawlatrine. Apparently, a strong demand for the materials. Often, householders who wanted tosanitation facilities is the basis to the success of build a latrine contributed their share of thethe program. The utility runs TV and radio cost in the form of labor, such as pit digging,promotion programs and hires personnel to do and using locally available materials, such asfield education and demonstrations. Since wood for superstructures.1993, 14,000 units have been built. Starting The success of the loan programs dependsfrom 1 999, 7,000 more units are to be built heavily on the willingness of the households toeach year until 2005. Latrines built are of good apply for such credits. In the Indonesia Jakartaquality and are well maintained because of the Sewerage and Sanitation Project (1 983), manyclear ownership and the relative ease of households perceived the cost of a twin-pitoperation and maintenance of the twin pit latrine (US $200 equivalent) to beVIP system. unaffordable. It was subsequently found that

only 1 6 per cent of the household sites in needCostsharing of sanitation were finally considered for an on-

Most of the projects reviewed in this study site facility. Had a more affordable design beenemployed a cost sharing system of grant and chosen, there might have been greater interestloan or grant and user contribution. Grants in the program.were given out in the form of either Another approach towards cost sharing isconstruction materials or latrine parts, as in the the 'revolving fund'. In the Indonesia Waterstimulant schemes, or cash credits, as in the Supply and Sanitation for Low IncomeKerala Water Supply and Sanitation Project Communities Project (World Bank, 1993a),(World Bank, 1985). The grant amount ranged 1 million Rupiah (US $500) was provided tofrom 20 percent to 1 00 percent of the total various communities for establishing acost, depending upon the project design, which revolving fund. Households which built latrinesin turn was usually determined by income level financed by the fund, would subsequentlyin the project areas. Where necessary deposit a certain amount of money back intobeneficiaries were expected to apply for loans the fund to enable the community to build

4 Since latrines are relatively inexpensive, monthly instalments would have been almost negligible, suggesting that the design of the loan regime was not wellthought out.

-~~~~ S

more latrines. In the Sri Lanka Community commercial banks. Clearly, loan repaymentsWater Supply and Sanitation Project (World will not be a problem in this program.Bank, 1 992b), the Community-basedOrganizations (CBOs) managed a revolving Projectsustlinabilityfund on behalf of the communities. The CBOs Lack of sustainability is a problem frequentlyprovided interest-free loans to those cited in the appraisal reports for the sanitationindividuals in the community who wanted to projects reviewed in this study. Many lessonsconstruct or upgrade their sanitation services, can be learned from unsuccessful experiences.and who were capable of repaying their loans Lack of a sense of ownership andwithin two years. The maximum projected loan inappropriate operation and maintenanceamount for a new latrine represented about services appear to be the major reasons whytwo-thirds of the cost. investments in sanitation fail in the long run.

In the Philippines First Water Supply,Costrecovery Sewerage and Sanitation Project (World Bank,

Cost recovery is always a problem that 1 990a), the Project Management Office of theBank-supported sanitation projects have to Department of Health was responsible forface. In the India Kerala Water Supply and overall supervision of the sanitation programSanitation Project (World Bank, 1 985), it was and providing nationwide planning,reported that cost recovery was generally poor. programming, management, monitoring,Many areas reported that hardly anyone was reporting, and logistic support to its districtbothering to make loan payments on their offices, which were responsible for the actuallatrine, although it went better in some other implementation of the project activities. Thisareas. Enforcement on the loan repayments top-down project implementation schemewas rare. Frequently, the beneficiaries or the resulted in beneficiaries' low sense of projectproject implementation units of Bank- ownership. Because some of the facilities weresupported projects perceived them as grant-in- inappropriate to the actual needs of theaid projects for which funding would be communities, some beneficiaries refused toprovided by the national government. organize themselves for the operation andGenerally, there was a low level of acceptance maintenance of the facilities. Althoughfor the concept of cost sharing. In some household latrines built in the project wereprojects with a water supply component, generally maintained in good conditionbeneficiaries were charged a water fee because there was a clear sense of ownership,intended to cover the costs of sanitation the sustainability of some of them isfacilities as well as the water supply costs. questionable because of sub-standardHowever, no specific information could be construction. Public toilets assigned to privatefound relating to the effectiveness of cost organizations for operation and maintenancerecovery for sanitation facilities in the projects remained in good condition but those operatedreviewed in this study. In the Ghana Kumasi and maintained by public organizations, suchOn-site Sanitation Program (Ouayoro, 1998), as schools, fell into disuse shortly afterhowever, people who wanted to build a latrine construction. In the Malawi First and Secondhad to finance the balance (after 40 percent Lilongwe Water Supply Engineering Projectsgovernment subsidy) with loans from local (World Bank, 1 982a, 1 986c), the sustainability

18

Findings

of household latrines was threatened because sense of ownership to the sustainability of

emptying services were not easily available. sanitation facilities.When the audit was conducted, there were

only four vacuum tanks in operating condition, Eavironenfalsinabilikythree of which were owned by private Information on the environmental

contractors. The rates for pit emptying were sustainability of the projects was rarely

also reported to be high (as much as the included in Bank documentation. Apparently,

average monthly family income of about 50 per not much attention has been paid to this issue

cent of Lilongwe's population). Although no in Bank-supported sanitation projects which is

project design details are available, the not surprising considering the low priority that

unsustainability of this project is apparently sanitation investments have generally received.

the result of an inappropriate latrine design Groundwater pollution was the only related

that required frequent emptying service issue addressed by a few references, but no

and inadequate consideration of post- overall conclusions could be drawn from the

project services.5 information available.

Some successful examples of sustainable

sanitation programs come from India. In the

India Kerala Water Supply and Sanitation

Project (World Bank, 1 985), latrines constructed In the early 1 980s, the Bank realized that to

were reported to be properly maintained ensure success in a sanitation project, users'

because: participation should extend from the initial

* ownership of the latrine was clearly defined collection of baseline data and identification of

with a household; preferences, through design and construction,

* the users appeared satisfied with the to the continued operation and maintenance of

functioning of the latrines; and facilities. The reasons for this are both practical

* the users were aware of the operation and and psychological. Sanitation facilities that are

maintenance procedures including the socially unacceptable will not be used by their

switching of pits, as this had already been intended owners. For instance, the household

demonstrated with the help of local masons. of the first demonstration unit constructed in

In the India Gujarat Water Supply and Kumasi, Ghana, refused to use the latrine

Sewerage Project (World Bank, 1 982b), it was because he was a Moslem and the latrine

reported that those who had a latrine were faced in the direction of Mecca (Cotton and

highly satisfied and in cities owners even kept others, 1995). It is, therefore, clearly worth the

the facilities locked to prevent stray animals effort involved to determine the preferences of

from spoiling them. In villages, people took the intended users. This way users will not only

pride in keeping units sparkling clean. Most accept the design but also feel involved; the

people considered toilets to be some kind of a system becomes essentially theirs and will not

status symbol. Interestingly, the concept of be perceived as having been imposed upon

communal latrines was abandoned as them by a remote government agency. The

unworkable in this project because the sense of being the partner of a project and the

facilities could not be maintained. The two owner of the system will promote cost sharing

cases again show the importance of a clear and ensure sustainability. User involvement

5. Long term arangements for emptying of on-site latrines and disposal of ihe contents isa recurring problem. In urban areas, in particular, it is often difficult forlocal authorities to manage and finance such services effectively. Use of private operators may help, but this issue indicates that use of on-site technologies does notdo away with the need for good overall management planning at city level.

MIT,

also makes it much easier for a local authority was formed to engage in all phases of theto train users to operate and maintain project activities, from negotiation on financinghousehold systems properly, and also to mount and repayment schedules, to design,successful health education programs. construction, operation, and maintenance of

There is a large body of literature dealing facilities. The project completion report statedwith approaches to community participation in however, that there were problems in creatingsanitation and water projects. See for instance RWSAs and this very important component ofKalbermatten and others (I 980), Mara (1 982) the project's institutional development wasetc. Most of the literature agrees that, to be unsuccessful. The reason for this failure wassuccessful, participation of users must extend that the Rural Waterworks Developmentfrom preliminary planning right through to Corporation, which was established by theimplementation and operation and project to be responsible for coordination of allmaintenance. Such planning is often rural water supply and sanitation activitiesjeopardized by demands to speed up projects including the RWSA program, never receivedand reduce spending on non-hardware the necessary political support from theinvestments. government. In the Philippines First Water

It must be pointed out however, that the Supply, Sewerage and Sanitation Project (Worlddegree of community participation and users' Bank, 1 990a), some of the Barangay (Village)willingness to pay for improved service levels Waterworks and Sanitation Associationsby contribution of money, labor or materials, (BWSAs), did not function well because theydepends fundamentally upon household felt they were not treated as project partnersincome levels and perceived needs. Whether a but mere recipients of assistance. Top-downproject properly meets the demands of the aspects of the project design also resulted,community depends upon the accuracy, at times, in a low sense of project ownership,completeness and timeliness of information with some facilities being inappropriateexchanged between residents and project to the actual needs of the community,implementors at the planning stage. and some beneficiaries refusing to

Community-centred approaches can be organize themselves.time-consuming, labor-intensive, and costly. Engaging non-governmental organizationsNonetheless, it is clear that in all the projects to undertake some of the work can sometimesreviewed in this study the community greatly enhance the efficiency andinvolvement approach has been more or less effectiveness of sanitation projects. Foraccepted and utilized by project developers, instance, in the Indian Gujarat Water Supplyboth from the Bank and the governments. and Sewerage Project (1983), initially theEfforts have been made in each of the projects Gujarat Water Supply and Sewerage Boardto establish community-based organizations or undertook implementation through its ownengage existing organizations. However, in staff and progress was extremely slow. After sixmany cases, the approach did not give the years of frustration, in 1 989, the Environmentalexpected results. In the Philippines Rural Water Sanitation Institute, a reputed local non-Supply and Sanitation Project (World Bank, governmental organization with considerable1 982c), a local community organization - the experience throughout India in low-costRural Water and Sanitation Association (RWSA) sanitation, began participating in the project.

20

The positive impact of this engagement was conditions in Lesotho. For instance, consumer

very impressive: by the credit closing date, preferences dictated that squatting slabs in VIlPs

29,946 latrines had been installed, an increase were totally unacceptable and a seat must be

of 12 per cent over the original objective. incorporated into the design.

* Don't subsidize: Whenever possible, the

St As r48 VI -16i users should finance their latrines themselves,

Ir-rv.sX .0-,3,f,2t4 or through a credit mechanism. The users

Besides the World Bank, many other should directly employ private sector local

international and national development builders, who are trained in latrine

organizations, such as UNICEF, UNDP, construction.

Canadian International Development Agency + Focus on promotion: To attract the users,

(CIDA), and Kreditanstalt fur Wiederaufbau and to make them pay for the latrines, the

(KfW), Germany, have financed low-cost issues of health and status should be

sanitation programs in developing countries. addressed through various media. Promotional

The experiences and lessons learned from materials need not be professionally produced,

these programs are valuable sources for the but must be thoroughly tested. USIT has been

further development of effective low-cost very successful in advertising the VIP latrines.

sanitation programs. Two primary approaches were used, separately

The successful low-cost urban sanitation and together. The first was to publicize the

program started in Lesotho in 1 980 provides health, hygiene and cleanliness benefits of

many widely applicable lessons (Blackett, improved sanitation, and the second approach

1994). The program was started on a pilot heightened the status of a VIP latrine as a new,

basis as part of an IDA funded urban desirable, modern, and convenient product.

development project. The Urban Sanitation The promotion program was so successful that

Improvement Team (USIT) was established it is becoming increasingly embarrassing in

within the framework of the IDA project. Over urban areas of Lesotho to be unable to offer

the years, USIT has received funding and house guests the use of a latrine.

assistance from many development Ensure proper institutional arrangements:

organizations, especially KfW, Overseas Work within government structures if possible.

Development Administration (ODA), UK, CIDA, Encourage collaboration with related

and the International Development Research programs, and keep running costs appropriateCenter (IDRC). USIT later became a to government budgets, so that the local

department in the Lesotho government. government can afford to take over the costs

Four key lessons emerged from this once donor financing is phased out. Select staffsanitation program: carefully, and create a team spirit. Hire a few

Get the design right: Ensure that the system expatriates who demonstrate a long-term

is technically adequate, affordable for most commitment to the program, but localize the

people and acceptable to the users; then staff over time.

standardize it for economy and simplicity. It

was concluded that the VIP latrine was the fIse Strae'c Stin'ttatnlmost suitable design. However, the detailed Approach

designs had to be modified for the particular The range of project and other experience

21

-~~~~~~ *

has led many groups both inside and outside addition, the SSA looks at sanitation servicesthe Bank to accept that effective sanitation for the city as a whole and not as stand alonerequires not only appropriate technological projects for specific communities or specificand social strategies, but also improvement in services. It also stresses the importance ofinstitutional design (policies and organizations) viable financial policies and careful attention toand overall sound financial management. This incentives of various actors towards long termhas led to the development of a number of sustainability of service.'frameworks' within which sanitation In a UNICEF report titled A Handbook forinvestments can be developed. Improving Sanitation Programs (1995), some

Conceptualized by the World Bank/UNDP guiding principles of sanitation improvementWater and Sanitation Program, the Strategic were proposed. The table below is a summarySanitation Approach (SSA) is a set of ideas to of these principles divided into five categories.help improve investment effectiveness in urban These principles resemble the SSA and echoareas. The approach is built upon the idea that lessons from USIT in Lesotho.provision of sustainable sanitation to urban All these typologies suggest a need to shiftareas is only possible by a demand-oriented from independent project interventions towardsservice delivery system, or in other words, a more 'programmatic' approach which aimswhen public agencies are able to deliver to change the way government institutions doservices that the people want and are willing to business. It seems to be increasingly clear thatpay for. This means a system that has the this approach is needed to address theflexibility and space to offer alternative systematic problems which have previouslytechnological options and corresponding dogged sanitation investments all overinstitutional arrangements of delivery. In the world.

Guiding Principles forBetter Sanitation and Hygiene Programs

Be people-centred CeIaledeain i Use local Establish clear Be flexible andinstitutions rules adaptive

Use enabling Fiitt loa Scale-up and Clarify responsibilities Take the communityapproaches ownership multiply results and commitments perspective from

oatthe start the start

Rely on local Be Be realisticpeople mta

Use local Ce t Develop simple, Clarify the time Learn fromknowledge and cot - standard frame at the start experiencepractices management

systems

22

IV

CONCLUSIONS

Tle following broad conclusions can be communities' needs and levels of affordability.drawn from both the review of Bank-supportedprojects and the available literature. iti4-4 tt's i(4

tik svfS7Lt-'4-t>t#'-X' It is commonly true that target communities,

Many latrine designs have proved effective sometimes even project managers, do notfor low-cost on-site sanitation. Care must be understand the importance of sanitation totaken to select appropriate and acceptable fully realize the health benefits that waterdesigns in every situation. Innovative supply programs are intended to bring. Limitedtechnology is needed for low-cost sanitation in political support and low public awarenesslow-income urban areas with high population often jeopardize sanitation programs. Thedensity. Latrine pit emptying and disposal of Bank and all donors need to focus on allwaste remains a serious challenge in many aspects of sanitation programs to givecases. It is difficult to determine and measure sanitation a higher profile, improve projectgroundwater contamination by pit latrines, preparation and supervision and to buildespecially in saturated zones. More work is understanding and commitment among clients.required to provide information on the

pollution risks associated with on-site latrines. A'i_&' Z, j1 .

Most latrine users consider latrines to be

.A.,.t Tt't;'t'}+9 some kind of a status symbol. The motivatingThe importance of selecting an appropriate factors for many households to build a latrine

latrine design for a specific project area cannot are not hygienic but primarily social: comfort,be overemphasized. Getting communities convenience and privacy. This is true eveninvolved in the selection process is the key to where households have been exposed tofinding an economically and culturally health education. When promoting andacceptable design. Demonstration latrines can marketing sanitation, therefore, projectbe used to explore technological options and implementers should focus on the socialto generate demand, but they must be well benefits that a latrine can bring as well as theconstructed and suitable for target hygiene benefits.

23

S

Cot Shang ad Recover decisions. It also requires that usable systemsMost of the projects reviewed in this study for operation and maintenance be identified

employed a cost sharing scheme of grant and and established as an integral part of all

loan or grant and user contribution. The projects or programs. Such arrangements

success of loan programs depended heavily on should be self-financing and suitable to the

the willingness of the households to apply for needs of the users.

credit. A low sense of ownership, high

subsidies, and the perception of being mere Straegt Aproachesrecipients of assistance, rendered cost recovery Many strategies have been developed by the

difficult in some of the projects. Effective cost Bank and other development organizations to

sharing and cost recovery policies are essential develop sustainable sanitation programs. The

to build user-ownership of sanitation facilities. principles implied in these strategies include

developing demand-driven programs, focusingq<;g s nb.g@Sty on promotion, expanding community

Many of the projects reviewed in this study participation, user-oriented financial

failed to result in sustained improvements management, and making proper institutional

through sanitation. This is often the result of a arrangements. Engaging NGOs to undertake

low sense of ownership by the users, or a low some of the work can also enhance efficiency

level of users' awareness of operation and and effectiveness of sanitation projects. When

maintenance procedures. Sustainable preparing a sanitation project, the Bank should

investment in household sanitation require look outward to identify successful approaches,

explicit approaches which involve users and including up-to-date, sustainable, and tested

give them a degree of control over investment technologies and institutional approaches.

24

Bibliography

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World Bank, Report No. P-3274-MAI. Division, South Asia Projects Department,

Washington, D.C. Report No. 5964-BD. Washington, D.C.

17. . 1982b. Staff Appraisal Report: India: 25. . 1 986c. Staff Appraisal Report:

Gujarat Water Supply and Sewerage Project. Malawi: Second Lilongwe Water Supply

Regional Projects Department, South Asia Engineering Project. Water Supply and Urban

Projects, Report No. 3667b-IN. Washington, Development Division, Eastern and Southern

D.C. Africa Projects Department, Report No. 6212-

18. .1982c. Staff Appraisal Report: MAI. Washington, D.C.

Philippines: First Rural Water Supply and 26. . 1987. Staff Appraisal Report: India:

Sanitation Project. Urban and Water Supply Uttar Pradesh Urban Development Project.

Division, East Asia and Pacific Projects Urban and Water Supply Division, South Asia

Department, Report No. 3866-PH. Washington, Projects Department, Report No. 6458-IN.

D.C. Washington, D.C.

19. . 1982d. Staff Appraisal Report: 27. .1 990a. Staff Appraisal Report:

Somalia: Second Mogadishu Water Supply Philippines: First Water Supply, Sewerage and

Project. Energy & Water Supply Division, Sanitation. Infrastructure Operations Division,

Eastern Africa Regional Office, Report No. Country Department II, Asia Regional Office,

3252-SO. Washington, D.C. Report No. 8143-PH. Washington, D.C.

20. . 1983. Staff Appraisal Report: 28. _ . 1990b. Project Completion Report:

Indonesia: Jakarta Sewerage and Sanitation Somalia: Mogadishu Second Water Supply

Project. Projects Department, Urban and Water Project. Infrastructure Operations Division,

Supply Division, East Asia and Pacific Regional Eastern Africa Department, Africa Regional

Office, Report No. 4158-IND. Washington, Office. Report No. 8454. Washington, D.C.

D.C. 29. . 1990c. Project Completion Report:

21. . 1984. Staff Appraisal Report: India: Malawi: First Lilongwe Water Supply

Tamil Nadu Water Supply and Sanitation Engineering Project. Infrastructure Operations

Project. Urban and Water Supply Division, Division, Southern Africa Department, Africa

South Asia Projects Department, Report No. Regional Office, Report No. 8642.

26

Washington, D.C. 37. _.1993c. Project Completion Report:30. . 1 990d. Project Performance Audit India: Gujarat Water Supply and SewerageReport: India: The Second Bombay Water Supply Project. Infrastructure Operation Division,and Sewerage Project. Operations Evaluation Countr,y Department II, South Asia RegionalDepartment, Report No. 9265. Washington, Office, Report No. 12349, Washington, D.C.D.C. 38. . 1994a. Project Completion Report:31. .1 991 a. Project Performance Audit Indonesia: Jakarta Sewerage and SanitationReport: Somalia: Mogadishu Second Water Project. Operations Evaluation Division, ReportSupply Project. Operations Evaluation No. 13285. Washington, D.C.Department, Report No. 9727. Washington, 39. . 1994b. Project Completion Report:D.C Malawi: Second Lilongwe Water Supply

32. .1991 b. Project Completion Report: Engineering Project. Infrastructure OperationsPhilippines: Rural Water Supply and Sanitation Division, Southern Africa Department, AfricaProject. Infrastructure Operations Division, Region, Report No. 13744. Washington, D.C.Country Department II, Asia Regional Office, 40. _. 1995. Implementation CompletionReport No. 10225. Washington, D.C. Report: India: Kerala Water Supply and33. . 1 992a. Staff Appraisal Report: Sanitation Project. Agriculture and WaterChina: Rural Water Supply and Sanitation Operations Division, Country Department II,Project, Environment, Human Resources and South Asia Regional Office, Report No. 14783.Urban Development Operations Division, Washington, D.C.Country Department II, East Asia Regional 41. . 1996a. Implementation CompletionOffice, Report No. 10028-CHA. Washington, Report: India: Tamil Nadu Water Supply andD.C. Sanitation Project. Agriculture and Water34. _.1992b. Staff Appraisal Report: Sri Operations Division, Country Department II,Lanka: Community Water Supply and Sanitation South Asia Regional Office, Report No. 15475.Project. Energy and Infrastructure Operations Washington, D.C.Division, Country Department IlIl, South Asia 42. . 1996b. Performance Audit Report:Regional Office, Report No. 10571 -CE. India: Gujarat Water Supply and SewerageWashington, D.C. Project. Operations Evaluation Department,35. . 1993a. Staff Appraisal Report: Report No. 15715. Washington, D.C.Indonesia: Water Supply and Sanitation for Low 43. _. 1996c. Performance Audit Report:Income Communities Project. Population and Bangladesh: Second and Third Dhaka WaterHuman Resources Operations Division, Supply and Sanitation Project and SecondCountry Department Ill, East Asia and Pacific Chittagong Water Supply Project. OperationsRegional Office, Report No. 11 777-iND. Evaluations Division, Report No.] 5848.Washington, D.C. Washington, D.C.36. . 1993b. Project Completion Report: 44. . 1996d. Impact Evaluation Report:Indonesia: Jakarta Sewerage and Sanitation India: Water Supply and Wastewater Services inProject. Infrastructure Operations Division, Bombay. Operation Evaluation Department,Country Department ll, East Asia and Pacific Report No. 15849. Washington, D.C.Regional Office. Report No. 12150. 45. _ . 1996e. Project Completion Report:Washington, D.C. Bangladesh: Third Dhaka Water Supply and

27

Sanitation Project. Infrastructure Operations Department, Report No. 17923. Washington,

Division, Country Department I, South Asia D.C.

Regional Office, Report No.16205. 51. . 1998c. Implementation Completion

Washington, D.C. Report: Philippines: First Water Supply,

46. . 1997a. Performance Audit Report: Sewerage and Sanitation Sector Project. Rural

Malawi: First and Second Lilongwe Water Development and Natural Resources Unit, East

Supply Engineering Project. Operations Asia and Pacific Region, Report No. 18004.

Evaluation Department, Report No. 16430. Washington, D.C.

Washington, D.C. 52. . 1998d. Impact Evaluation Report: Sri

47. . 1997b. Implementation Completion Lanka: Community Water Supply and Sanitation

Report: India: Uttar Pradesh Urban Project. Operations Evaluation Department,

Development Project. Energy and Infrastructure Report No. 18113. Washington, D.C.

Operations Division, Country Department II, 53. . 1998e. Impact Evaluation Report:

South Asia Regional Office, Report No. 16579- India: Comparative Review of Rural Water

IN. Washington, D.C. Systems Experience. Operations Evaluation

48. . 1997c. Implementation Completion Department, Report No. 18114. Washington,

Report: India: Third Bombay Water Supply and D.C.

Sewerage Project. Agriculture and Water 54. Whittington, Dale, Donald Lauria, Albert

Operations Division, Country Department II, Wright, Kyeongae Choe, Jeffrey Hughes, and

South Asia Regional Office, Report No. 26650. Venkateswarlu Swarna. 1992. Household

Washington, D.C. Demand for Improved Sanitation Services: A

49. . 1 998a. Performance Audit Report: Case Study of Kumasi, Ghana. UNDP-World

India: Kerala Water Supply and Sanitation Bank, Water and Sanitation Program.

Project. Operations Evaluation Department, Washington, D.C.

Report No. 17922. Washington, D.C. 55. Wright, Albert Morgan. 1997. Toward a

50. . 1998b. Impact Evaluation Report: Strategic Sanitation Approach: Improving the

Paraguay: Community-based Rural Water Sustainability of Urban Sanitation in Developing

Systems and the Development of Village Countries. UNDP-World Bank, Water and

Committees. Operations Evaluation Sanitation Program. Washington D.C.

28

Attachment 1

Aftachment 1List of Bank Projects Reviewed in This Study

Country FY Title L/C num. Status WB Loan Total cost/ AvailableAmount San. Reports(US$ (US$million) million)

Indonesia 1993 WS & S for Low Income SAR SupervisionCommunities A 800 123.3/16.0 Missin Rep.

Sri Lanka 1993 CommunityWS & S Project C-2442 A 24.3 32.3/1.4 SAR, ConsultantReport, IER

China 1992 Rural WS&SProject A 110.0 189.1/5.9 SM

Philippines 1990 First WS, Sewerage &Sanitation Sector P L-3242 C 85.0 132.8/17.5 SAR, ICR

India 1988 Uttar Pradesh Urban C-1780Development Project U2791 C 150O.0 237.8/5.2 SAR, ICR

Malawi 1982 (1) First Lilongwe WS Engr.Project C-1272 (I} C 24 4.0 (1), PR (1), SAR (11),

PCR (1,11),1986 (1I) Second Lilongwe WS Engr.

Project C-1742(11) 77.7(11)/0.15 PAR

India 1985 KeralaWS&SProject C-1622 C 28.98 56.11/3 SAR

India 1984 Tamil Nadu WS & S Project C-1452 C 48.1 (IDA) 171.0/2.88 SAR, ICRSF 12 48.8 (SF 12)

India 1983 GujaratWS & SewerageProject C-1280 C 54.5 78.1/2.5 SAR, PCR, PAR

Indonesia 1983 Jakarta Sewerage and SAR, PCR,Sanitation Project L-2236 C 21.6 32.8/2.1 PAR, IER

Philippines 1983 Rural WS&S Project L2206 C 35.5 58.4/25.0 SAR, PCR

India 1980 Rajasthan Water Supplyand Sewerage C-1046 C 80.0 ICR

1991 Maharashtra Rural WS &Environ. Sanit. C-2234 C 109.9

1993 Kamataka Rural WS &Environ. Sanit. C-2483 A 92.0

Paroguay 1978 (1) Rural Water Supply (I-IV) L-1502 (1) C (1) 6.0 (1) ICR1981 (11) L-2014 (11) C(lI) 11.8(11)1993 (111) L-42222 (I C (111) 23.0 (111)1998(I11) A (IV) 40.0 (IV)

India 1978 (11) Second, andThird BombayWaterSupply C-390(1) C L-2769/ SAR (11, 111),

1986 (111) & Sewerage Project C-842 (11) C-1750 (111) 185 (111) PAR (pl), ICR (111)

L-2769/ 3.4.3 (111) IER (1,11,111)C-1 750 (11)

Bangladesh 1988 Third Dhaka WS & S Project C-1 734 C 29.6 47.22/ SAR, PCR, PAR

Somalia 1983 Second MogadishuWater Supply Project C-1236 C 7.5 40.2/ SAR,PCR,PAR

29

Attachment 2Technical Options of On-site Sanitation

Simple pit Low None *Can be built by *Insect and smelllatrine household. nuisance.

VIP latrine Low None *Can be built by *Does not controlhousehold; mosquitoes;*Control of flies; *Extra cost of vent pipe.Control of smell.

Water seal pour- Low Standpipe *Control of flies and eNeeds reliable waterflush latrine mosquitoes; supply;

*Control of smell; *Unsuitable where solid*Contentof pit not anal cleaning material isvisible; used.* Gives users the conve-nience of a watercloset;*Can be upgraded;*Latrine and pit can belocated separately.

Compost latrine Medium None *Avaluable humus is *Requires carefulproduced. operation;

=Additives must beadded regularly;* Urine has to be collectedseparately.

Septic tank High In-housetap *Gives the users the *High cost;connections convenience of a water *Requires reliable and

closet, ample piped water;*Only suitable for low-density housing;*Regular desludgingrequired;*Permeable soil required.

Aqua-privy Medium Yard taps *No need for piped *Water must be availablewater; nearby;*Less expensive than a * Not easy to maintain aseptic tank. seal;

*Regular desludgingrequired;*Permeable soil required.

30

UNDP-World BankWater and Sanitation Program-South Asia

55 Lodi Estate, New Delhi - 110 003.Tel: 011 4690488, 469 0489. Fax: 011 462 8250. E-mail: bevansl@worldbank.org