Inclusion of shared sanitation in urban sanitation coverage? Evidence from Ghana and Uganda
Adrien Mazeau, Innocent Tumwebaze, Christoph Lüthi, Kevin Sansom
This paper discusses the notions of ‘improved’ and ‘unimproved’ sanitation in the context of developing countries in urbanizing Africa and considers the role that shared facilities can play in this equation. It analyses current definitions and classifications used by the United Nations Joint Monitoring Programme (JMP) to monitor access to shared sanitation and summarizes the recent discourse on JMP's limitations. Empirical evidence from two case studies in sub-Saharan Africa (SSA) - Kampala, Uganda and Ashaiman, Ghana - is presented, showing the widespread use and limitations of the shared toilet facilities in these two cities. The empirical evidence shows that quite different types of shared sanitation facilities emerge in different cities, each influenced by the urbanization patterns, local politics and sociocultural considerations. Improving the quality of shared facilities involves the consideration of the applicability of the different types of facilities within the category ‘shared sanitation’, together with an improved understanding of the users' determinants of acceptability, such as access and cleanliness. The paper concludes with a discussion of potential indicators for shared sanitation post-2015 global monitoring, as a means of integrating shared sanitation into the overall sanitation access figures.Allen, A., Hofmann, P. and Griffiths, H. (2008) ‘Moving down the ladder: governance and sanitation that works for the urban poor’, IRC Symposium: Sanitation for the urban poor. Partnerships and Governance, Delft, The Netherlands: IRC.
Biran, A., Jenkins, M.W., Dabrase, P. and Bhagwat, I. (2011) ‘Patterns and determinants of communal latrine usage in urban poverty pockets in Bhopal, India’, Tropical Medicine and International Health 16 (7): 854-62 〈http://dx.doi.org/10.1111/j.1365-3156.2011.02764.x〉.
Black, M. and Fawcett, B. (2008) The Last Taboo: Opening the Door on the Global Sanitation Crisis, London: Earthscan Publications Ltd.
Cairncross, S. and Valdamis, V. (2006) ‘Water supply, sanitation, and hygiene promotion’, in D. Jamison, J. Breman, A. Measham, M. Claeson, D. Evans, P. Jha, A. Mils and P. Musgove (eds), Disease Control Priorities in Developing Countries, 2nd edn, New York: Oxford University Press.
Cotton, A., Franceys, R., Pickford, J. and Saywell, D. (1995) On-plot Sanitation in Low-income Urban Communities: A Review of Literature, Loughborough, UK: Water, Engineering and Development Centre (WEDC).
Günther, I., Horst, A., Lüthi, C., Mosler, H., Niwagaba, B. and Tumwebaze, K. (2012) When is Shared Sanitation Improved? The Correlation between Number of Users and Toilet Hygiene. Research for Policy 2 [online], Switzerland: ETH Zurich 〈www.nadel.ethz.ch/publikationen/policy_brief_shared_sanitation_improved_2_2012.pdf〉 [accessed 2013]. www.nadel.ethz.ch/publikationen/policy_brief_shared_sanitation_improved_2_2012.pdf
Mara, D. and Alabaster, G. (2008) ‘A new paradigm for low-cost urban water supplies and sanitation in developing countries’, Water Policy 10 (2): 119-29 〈http://dx.doi.org/10.2166/wp.2008.034〉.
Mazeau, A., Scott, R. and Tuffuor, B. (2012) ‘Sanitation, a neglected essential service in the unregulated urban expansion of Ashaiman’, Sustainable Future Conference, Kampala, Uganda.
Penchansky, R. and Thomas, J. (1981) ‘The concept of access: definition and relationship to consumer satisfaction’, Medical Care 19 (2): 127-40.
Rakodi, C. (1995) ‘Poverty lines or household strategies? A review of conceptual issues in the study of urban poverty’, Habitat International 19: 407-26 〈http://dx.doi.org/10.1016/0197-3975(95)00037-G〉.
Rakodi, C. (2005) ‘The urban challenge in Africa’, in M. Keiner, M. Koll-Schretzenmayr and W. Schid (eds), Managing Urban Futures: Sustainability and Urban Growth in Developing Countries. Hampshire, UK: Ashgate Publishing.
Schaub-Jones, D., Eales, K. and Tyers, L. (2006) Sanitation Partnerships: Harnessing their Potential for Urban On-site Sanitation, BPD sanitation series, London: Building Partnership for Development in Water and Sanitation.
Triche, T. and McIntosh, A. (2009) Improving Water Supply and Sanitation Services for the Urban Poor in India. Water and Sanitation Program Guidance Notes, New Dehli, India: Water and Sanitation Program South Asia.
Tumwebaze, I., Orach, C., Niwagaba, C., Lüthi, C. and Mosler, H. (2012) ‘Sanitation facilities in Kampala slums, Uganda: users’ satisfaction and determinant factors’, International Journal of Environmental Health Research 23 (3): 191-204 〈http://dx.doi.org/10.1080/09603123.2012.713095〉.
UBOS (2005) 2002 Uganda Population and Housing Census: Main report, Kampala, Uganda: Uganda Bureau Of Statistics.
UN-HABITAT (2006) State of the World's Cities, Report 2006/2007, Nairobi, Kenya: United Nations Human Settlements Programme.
UNICEF and WHO (2010) JMP Technical Task Force, Meeting on Sanitation and Methods for Estimating Progress, New York: UNICEF.
van der Hoek, W., Evans, B., Bjerre, J., Calopietro, J. and Konradsen, F. (2010) ‘Measuring progress in sanitation’, in DANIDA (ed.), Reaching the MDG Target for Sanitation in Africa - A Call for Realism, pp. 42-50, Denmark: Ministry of Foreign Affairs.
WHO and UNICEF (2012a) Progress on Sanitation and Drinking-water: 2012 Update. World Health Organization and United Nations Children's Fund Joint Monitoring Programme for Water Supply and Sanitation, New York: UNICEF; Geneva: WHO.
WHO and UNICEF (2012b) Report of the Second Consultation on Post-2015 Monitoring of Drinking-Water, Sanitation and Hygiene, The Hague, 3-5 December 2012. World Health Organization and United Nations Children's Fund, Joint Monitoring Programme for Water Supply and Sanitation, New York: UNICEF; Geneva: WHO.
WSUP (Water & Sanitation for the Urban Poor) (2011) When are Communal or Public Toilets an Appropriate Option? Topic brief, London: WSUP.
Allen, A., Hofmann, P. and Griffiths, H. (2008) ‘Moving down the ladder: governance and sanitation that works for the urban poor’, IRC Symposium: Sanitation for the urban poor. Partnerships and Governance, Delft, The Netherlands: IRC.
Biran, A., Jenkins, M.W., Dabrase, P. and Bhagwat, I. (2011) ‘Patterns and determinants of communal latrine usage in urban poverty pockets in Bhopal, India’, Tropical Medicine and International Health 16 (7): 854-62 〈http://dx.doi.org/10.1111/j.1365-3156.2011.02764.x〉.
Black, M. and Fawcett, B. (2008) The Last Taboo: Opening the Door on the Global Sanitation Crisis, London: Earthscan Publications Ltd.
Cairncross, S. and Valdamis, V. (2006) ‘Water supply, sanitation, and hygiene promotion’, in D. Jamison, J. Breman, A. Measham, M. Claeson, D. Evans, P. Jha, A. Mils and P. Musgove (eds), Disease Control Priorities in Developing Countries, 2nd edn, New York: Oxford University Press.
Cotton, A., Franceys, R., Pickford, J. and Saywell, D. (1995) On-plot Sanitation in Low-income Urban Communities: A Review of Literature, Loughborough, UK: Water, Engineering and Development Centre (WEDC).
Günther, I., Horst, A., Lüthi, C., Mosler, H., Niwagaba, B. and Tumwebaze, K. (2012) When is Shared Sanitation Improved? The Correlation between Number of Users and Toilet Hygiene. Research for Policy 2 [online], Switzerland: ETH Zurich 〈www.nadel.ethz.ch/publikationen/policy_brief_shared_sanitation_improved_2_2012.pdf〉 [accessed 2013]. www.nadel.ethz.ch/publikationen/policy_brief_shared_sanitation_improved_2_2012.pdf
Mara, D. and Alabaster, G. (2008) ‘A new paradigm for low-cost urban water supplies and sanitation in developing countries’, Water Policy 10 (2): 119-29 〈http://dx.doi.org/10.2166/wp.2008.034〉.
Mazeau, A., Scott, R. and Tuffuor, B. (2012) ‘Sanitation, a neglected essential service in the unregulated urban expansion of Ashaiman’, Sustainable Future Conference, Kampala, Uganda.
Penchansky, R. and Thomas, J. (1981) ‘The concept of access: definition and relationship to consumer satisfaction’, Medical Care 19 (2): 127-40.
Rakodi, C. (1995) ‘Poverty lines or household strategies? A review of conceptual issues in the study of urban poverty’, Habitat International 19: 407-26 〈http://dx.doi.org/10.1016/0197-3975(95)00037-G〉.
Rakodi, C. (2005) ‘The urban challenge in Africa’, in M. Keiner, M. Koll-Schretzenmayr and W. Schid (eds), Managing Urban Futures: Sustainability and Urban Growth in Developing Countries. Hampshire, UK: Ashgate Publishing.
Schaub-Jones, D., Eales, K. and Tyers, L. (2006) Sanitation Partnerships: Harnessing their Potential for Urban On-site Sanitation, BPD sanitation series, London: Building Partnership for Development in Water and Sanitation.
Triche, T. and McIntosh, A. (2009) Improving Water Supply and Sanitation Services for the Urban Poor in India. Water and Sanitation Program Guidance Notes, New Dehli, India: Water and Sanitation Program South Asia.
Tumwebaze, I., Orach, C., Niwagaba, C., Lüthi, C. and Mosler, H. (2012) ‘Sanitation facilities in Kampala slums, Uganda: users’ satisfaction and determinant factors’, International Journal of Environmental Health Research 23 (3): 191-204 〈http://dx.doi.org/10.1080/09603123.2012.713095〉.
UBOS (2005) 2002 Uganda Population and Housing Census: Main report, Kampala, Uganda: Uganda Bureau Of Statistics.
UN-HABITAT (2006) State of the World's Cities, Report 2006/2007, Nairobi, Kenya: United Nations Human Settlements Programme.
UNICEF and WHO (2010) JMP Technical Task Force, Meeting on Sanitation and Methods for Estimating Progress, New York: UNICEF.
van der Hoek, W., Evans, B., Bjerre, J., Calopietro, J. and Konradsen, F. (2010) ‘Measuring progress in sanitation’, in DANIDA (ed.), Reaching the MDG Target for Sanitation in Africa - A Call for Realism, pp. 42-50, Denmark: Ministry of Foreign Affairs.
WHO and UNICEF (2012a) Progress on Sanitation and Drinking-water: 2012 Update. World Health Organization and United Nations Children's Fund Joint Monitoring Programme for Water Supply and Sanitation, New York: UNICEF; Geneva: WHO.
WHO and UNICEF (2012b) Report of the Second Consultation on Post-2015 Monitoring of Drinking-Water, Sanitation and Hygiene, The Hague, 3-5 December 2012. World Health Organization and United Nations Children's Fund, Joint Monitoring Programme for Water Supply and Sanitation, New York: UNICEF; Geneva: WHO.
WSUP (Water & Sanitation for the Urban Poor) (2011) When are Communal or Public Toilets an Appropriate Option? Topic brief, London: WSUP.
Allen, A., Hofmann, P. and Griffiths, H. (2008) ‘Moving down the ladder: governance and sanitation that works for the urban poor’, IRC Symposium: Sanitation for the urban poor. Partnerships and Governance, Delft, The Netherlands: IRC.
Biran, A., Jenkins, M.W., Dabrase, P. and Bhagwat, I. (2011) ‘Patterns and determinants of communal latrine usage in urban poverty pockets in Bhopal, India’, Tropical Medicine and International Health 16 (7): 854-62 〈http://dx.doi.org/10.1111/j.1365-3156.2011.02764.x〉.
Black, M. and Fawcett, B. (2008) The Last Taboo: Opening the Door on the Global Sanitation Crisis, London: Earthscan Publications Ltd.
Cairncross, S. and Valdamis, V. (2006) ‘Water supply, sanitation, and hygiene promotion’, in D. Jamison, J. Breman, A. Measham, M. Claeson, D. Evans, P. Jha, A. Mils and P. Musgove (eds), Disease Control Priorities in Developing Countries, 2nd edn, New York: Oxford University Press.
Cotton, A., Franceys, R., Pickford, J. and Saywell, D. (1995) On-plot Sanitation in Low-income Urban Communities: A Review of Literature, Loughborough, UK: Water, Engineering and Development Centre (WEDC).
Günther, I., Horst, A., Lüthi, C., Mosler, H., Niwagaba, B. and Tumwebaze, K. (2012) When is Shared Sanitation Improved? The Correlation between Number of Users and Toilet Hygiene. Research for Policy 2 [online], Switzerland: ETH Zurich 〈www.nadel.ethz.ch/publikationen/policy_brief_shared_sanitation_improved_2_2012.pdf〉 [accessed 2013]. www.nadel.ethz.ch/publikationen/policy_brief_shared_sanitation_improved_2_2012.pdf
Mara, D. and Alabaster, G. (2008) ‘A new paradigm for low-cost urban water supplies and sanitation in developing countries’, Water Policy 10 (2): 119-29 〈http://dx.doi.org/10.2166/wp.2008.034〉.
Mazeau, A., Scott, R. and Tuffuor, B. (2012) ‘Sanitation, a neglected essential service in the unregulated urban expansion of Ashaiman’, Sustainable Future Conference, Kampala, Uganda.
Penchansky, R. and Thomas, J. (1981) ‘The concept of access: definition and relationship to consumer satisfaction’, Medical Care 19 (2): 127-40.
Rakodi, C. (1995) ‘Poverty lines or household strategies? A review of conceptual issues in the study of urban poverty’, Habitat International 19: 407-26 〈http://dx.doi.org/10.1016/0197-3975(95)00037-G〉.
Rakodi, C. (2005) ‘The urban challenge in Africa’, in M. Keiner, M. Koll-Schretzenmayr and W. Schid (eds), Managing Urban Futures: Sustainability and Urban Growth in Developing Countries. Hampshire, UK: Ashgate Publishing.
Schaub-Jones, D., Eales, K. and Tyers, L. (2006) Sanitation Partnerships: Harnessing their Potential for Urban On-site Sanitation, BPD sanitation series, London: Building Partnership for Development in Water and Sanitation.
Triche, T. and McIntosh, A. (2009) Improving Water Supply and Sanitation Services for the Urban Poor in India. Water and Sanitation Program Guidance Notes, New Dehli, India: Water and Sanitation Program South Asia.
Tumwebaze, I., Orach, C., Niwagaba, C., Lüthi, C. and Mosler, H. (2012) ‘Sanitation facilities in Kampala slums, Uganda: users’ satisfaction and determinant factors’, International Journal of Environmental Health Research 23 (3): 191-204 〈http://dx.doi.org/10.1080/09603123.2012.713095〉.
UBOS (2005) 2002 Uganda Population and Housing Census: Main report, Kampala, Uganda: Uganda Bureau Of Statistics.
UN-HABITAT (2006) State of the World's Cities, Report 2006/2007, Nairobi, Kenya: United Nations Human Settlements Programme.
UNICEF and WHO (2010) JMP Technical Task Force, Meeting on Sanitation and Methods for Estimating Progress, New York: UNICEF.
van der Hoek, W., Evans, B., Bjerre, J., Calopietro, J. and Konradsen, F. (2010) ‘Measuring progress in sanitation’, in DANIDA (ed.), Reaching the MDG Target for Sanitation in Africa - A Call for Realism, pp. 42-50, Denmark: Ministry of Foreign Affairs.
WHO and UNICEF (2012a) Progress on Sanitation and Drinking-water: 2012 Update. World Health Organization and United Nations Children's Fund Joint Monitoring Programme for Water Supply and Sanitation, New York: UNICEF; Geneva: WHO.
WHO and UNICEF (2012b) Report of the Second Consultation on Post-2015 Monitoring of Drinking-Water, Sanitation and Hygiene, The Hague, 3-5 December 2012. World Health Organization and United Nations Children's Fund, Joint Monitoring Programme for Water Supply and Sanitation, New York: UNICEF; Geneva: WHO.
WSUP (Water & Sanitation for the Urban Poor) (2011) When are Communal or Public Toilets an Appropriate Option? Topic brief, London: WSUP.
Allen, A., Hofmann, P. and Griffiths, H. (2008) ‘Moving down the ladder: governance and sanitation that works for the urban poor’, IRC Symposium: Sanitation for the urban poor. Partnerships and Governance, Delft, The Netherlands: IRC.
Biran, A., Jenkins, M.W., Dabrase, P. and Bhagwat, I. (2011) ‘Patterns and determinants of communal latrine usage in urban poverty pockets in Bhopal, India’, Tropical Medicine and International Health 16 (7): 854-62 〈http://dx.doi.org/10.1111/j.1365-3156.2011.02764.x〉.
Black, M. and Fawcett, B. (2008) The Last Taboo: Opening the Door on the Global Sanitation Crisis, London: Earthscan Publications Ltd.
Cairncross, S. and Valdamis, V. (2006) ‘Water supply, sanitation, and hygiene promotion’, in D. Jamison, J. Breman, A. Measham, M. Claeson, D. Evans, P. Jha, A. Mils and P. Musgove (eds), Disease Control Priorities in Developing Countries, 2nd edn, New York: Oxford University Press.
Cotton, A., Franceys, R., Pickford, J. and Saywell, D. (1995) On-plot Sanitation in Low-income Urban Communities: A Review of Literature, Loughborough, UK: Water, Engineering and Development Centre (WEDC).
Günther, I., Horst, A., Lüthi, C., Mosler, H., Niwagaba, B. and Tumwebaze, K. (2012) When is Shared Sanitation Improved? The Correlation between Number of Users and Toilet Hygiene. Research for Policy 2 [online], Switzerland: ETH Zurich 〈www.nadel.ethz.ch/publikationen/policy_brief_shared_sanitation_improved_2_2012.pdf〉 [accessed 2013]. www.nadel.ethz.ch/publikationen/policy_brief_shared_sanitation_improved_2_2012.pdf
Mara, D. and Alabaster, G. (2008) ‘A new paradigm for low-cost urban water supplies and sanitation in developing countries’, Water Policy 10 (2): 119-29 〈http://dx.doi.org/10.2166/wp.2008.034〉.
Mazeau, A., Scott, R. and Tuffuor, B. (2012) ‘Sanitation, a neglected essential service in the unregulated urban expansion of Ashaiman’, Sustainable Future Conference, Kampala, Uganda.
Penchansky, R. and Thomas, J. (1981) ‘The concept of access: definition and relationship to consumer satisfaction’, Medical Care 19 (2): 127-40.
Rakodi, C. (1995) ‘Poverty lines or household strategies? A review of conceptual issues in the study of urban poverty’, Habitat International 19: 407-26 〈http://dx.doi.org/10.1016/0197-3975(95)00037-G〉.
Rakodi, C. (2005) ‘The urban challenge in Africa’, in M. Keiner, M. Koll-Schretzenmayr and W. Schid (eds), Managing Urban Futures: Sustainability and Urban Growth in Developing Countries. Hampshire, UK: Ashgate Publishing.
Schaub-Jones, D., Eales, K. and Tyers, L. (2006) Sanitation Partnerships: Harnessing their Potential for Urban On-site Sanitation, BPD sanitation series, London: Building Partnership for Development in Water and Sanitation.
Triche, T. and McIntosh, A. (2009) Improving Water Supply and Sanitation Services for the Urban Poor in India. Water and Sanitation Program Guidance Notes, New Dehli, India: Water and Sanitation Program South Asia.
Tumwebaze, I., Orach, C., Niwagaba, C., Lüthi, C. and Mosler, H. (2012) ‘Sanitation facilities in Kampala slums, Uganda: users’ satisfaction and determinant factors’, International Journal of Environmental Health Research 23 (3): 191-204 〈http://dx.doi.org/10.1080/09603123.2012.713095〉.
UBOS (2005) 2002 Uganda Population and Housing Census: Main report, Kampala, Uganda: Uganda Bureau Of Statistics.
UN-HABITAT (2006) State of the World's Cities, Report 2006/2007, Nairobi, Kenya: United Nations Human Settlements Programme.
UNICEF and WHO (2010) JMP Technical Task Force, Meeting on Sanitation and Methods for Estimating Progress, New York: UNICEF.
van der Hoek, W., Evans, B., Bjerre, J., Calopietro, J. and Konradsen, F. (2010) ‘Measuring progress in sanitation’, in DANIDA (ed.), Reaching the MDG Target for Sanitation in Africa - A Call for Realism, pp. 42-50, Denmark: Ministry of Foreign Affairs.
WHO and UNICEF (2012a) Progress on Sanitation and Drinking-water: 2012 Update. World Health Organization and United Nations Children's Fund Joint Monitoring Programme for Water Supply and Sanitation, New York: UNICEF; Geneva: WHO.
WHO and UNICEF (2012b) Report of the Second Consultation on Post-2015 Monitoring of Drinking-Water, Sanitation and Hygiene, The Hague, 3-5 December 2012. World Health Organization and United Nations Children's Fund, Joint Monitoring Programme for Water Supply and Sanitation, New York: UNICEF; Geneva: WHO.
WSUP (Water & Sanitation for the Urban Poor) (2011) When are Communal or Public Toilets an Appropriate Option? Topic brief, London: WSUP.
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