Is our approach to instituting sanitation programs broken? How efficient have the NGOs been so far?

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Is our approach to instituting sanitation programs broken? How efficient have the NGOs been so far?

Dear all,

I am starting this new thread for a broad discussion based on a suggestion by Chuck Henry here .

Chuck put forward the following questions for discussion:

There appears to be a move towards a market-based approach from the donor one of the past. How efficient have the NGOs been so far? Does this help bring in the private industry? Protection of technologies from copying has always been a pertinent issue – both from simple recovery of investment and also from assurance that copied products are of similar quality and not give a bad name to the original.

1. What has the industry accomplished and at what cost?
- what funding level for how many toilets?
- have patents (or other product protection) been the problem?

2. The move towards a market-based approach
- does this help private industry?
- does this suggest the NGO/donor approach isn't working

3. Do you find it unethical for companies to make a profit when they're serving the poor?


Diane Kellogg also sent me some of her thoughts by e-mail which are providing additional food for thought:

Some business owners are criticized for "making money off selling toilets to the poor," but I don't see any evidence of that. I can't name a toilet company that sells "off-grid toilets" to the poor that is profitable enough to be sustainable and scalable. NGOs, however, are making enough money to stay in business through serial grant funding. I notice that some of the big funders (USAID, DfID) have turned to private enterprise. Is this threatening to NGOs? or will they welcome the participation of private enterprise?


We have also existing threads which have touched on this, see here:
I am looking forward to a lively discussion on this topic from a multitude of different angles.
This would actually be a great topic for a time-bound structred "thematic discussion", we'd just have find a couple of experts who'd be willing to run and moderate such a thematic discussion (any suggestions or volunteers?).

Regards,
Elisabeth

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Re: Is our approach to instituting sanitation programs broken? How efficient have the NGOs been so far?

Some food for thought from my side:

On the developmental side there are the "old fashioned" programs that support local/national government in setting up regulatory structures, build sewerage/septage treatment plants etc. There is nothing inherently wrong with those, but they suffer from all the same issue any programs that work with often mostly defunct governments do. I think some smarter selection which governments to work with, and which not (i.e. less politically motivated funding by state donors) would help, but in the end it is an inherently slow process with few easily tangible outcomes.

Than there are the "sexy" market driven / demand creation programs. In theory those are great and you have some nice pilots that show good results, but rarely scale.
What I think people/donors need to realize is that such programs need a certain socio-economic base-level of the country to work. In some countries you can run 10 years of a great market creation program, and be easily still 10 years away from any self driven scale-up. Not because the program isn't working, but because the situation just isn't there (yet). However, those places that would greatly benefit from such programs are often excluded from donor funding because of middle-income country status or other self-defeating reasons like pro-poor strategies etc.

So NGOs end up doing serial grants in countries that are not well suited for such programs, simply because this is where the money is. Trying to change this by inviting the private sector into the same situation will either result in the private sector doing more or less the same not very efficient stuff as NGOs do, or them simply refusing to start/continue such an endeavor as they realize this will not become profitable/sustainable any time soon.

P.S.: Regarding patents... nothing inherently wrong about them and I agree that they are probably the least of a problem when it comes to sanitation. But their purpose it to protect investments into R&D, so if the research was in fact funded by an external donor I see no reason why they should allow a patent on the outcome; And in the long run it will probably prevent duplication by local producers, which is not what the external donor would want to happen.

Krischan Makowka
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  • Marijn Zandee
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Re: Is our approach to instituting sanitation programs broken? How efficient have the NGOs been so far?

Dear all,

In response to Elizabeth's questions:

1.What has the sector achieved?

-Since we are far from universal coverage, the answer is probably: too little. Kris has summed up some of the problems in his post already.
-I have no yet come across any patent issues in this field. Considering the facts that toilets need to be robust and simple, and the fact that treatment processes usually relies on natural processes, I am not very worried that this will become a large issue (sorry for those holding toilet-patents).

2. The move toward a market based approach

Are we talking about empowering local entrepreneurs to deliver sanitation? That seems good to me. Especially for toilets and local treatment systems. For (semi) centralized treatment systems maybe utilities would be better?

- I am not sure I have seen many "big funders" come up with pro-private sector approaches that work and seem scale-able. But in theory, yes it should help the private sector.

- I think we have to be realistic and think about the limitations of a NGO driven approach. 2.6 billion toilets are needed, assume about $300 per toilet and you are talking about 780 billion US dollar for toilets alone (not counting conveyance and treatment).
I think NGOs can help to motivate populations, manage local savings funds, train skilled manpower, etc. But the NGO sector cannot build everyone a toilet, let alone take responsibility for conveyance and treatment.

3. No, it is not unethical to make money of the poor for sanitation. However, it is unethical for companies not to deliver good value products, for governments not too support those who can really not afford a toilet, for governments not to have, and implement, a strategy for safe excreta management, or to charge very high interest on sanitation loans.

Regarding the older post Elizabeth mentions. Behind the scenes, Dorothee Spuhler and I are trying to work on a document, which should become a mix between a syntheses of the earlier threads and our own opinions. I hope we can put a draft in the forum soon... :dry: :whistle:

Regards

Marijn

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  • I support sanitation projects that result in sustainable toilets for households and schools. Currently, my largest project is a grant funded by the Dutch government titled, "Private and Social Toilets" (PRISTO). I am also working on the SuSanA grant from the BMGF, to improve collaboration and knowledge sharing in the sanitation sector.
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Re: Is our approach to instituting sanitation programs broken? How efficient have the NGOs been so far?

The math on the cost of paying for billions of toilets is persuasive and should be pointing everyone--donors and sanitation specialists included--toward building a sustainable toilet industry, made up of profit-making enterprises. Hopefully ones that employ the poor, so that any money spent on toilets stays within the community and builds the local economy.

We can agree that if all the donor money in the world just bought toilets (with no money at all going to NGOs)....there's still not enough to buy enough toilets.

Even if all things point toward private enterprise, we are still left with the problem that the poor can't afford to buy their own toilets, no matter how inexpensive. The BMGF goal of $300 is still way, way out of reach. If I had to choose between food, medical care and a toilet ? I wouldn't buy a toilet either.

I once subscribed to the belief that Ghanaians who were paying for the daily use of public toilets could instead use that money to pay off a toilet loan on a private toilet. That math was persuasive, too. With apologies to anyone who saw that presentation at SuSanA in Senegal, the lights came on when soon thereafter a poor woman I've known for years reminded me that "flying toilets are free." That was her delicate way of saying "Diane, do you REALLY think I'm walking 20 minutes every morning and night and paying for a public toilet, when every time I go to the market they put my purchases in small black plastic bags that they don't charge me for?" Free toilets.

I do think it's "progress" to see big funders spending money on market development for private sector products. But is "demand creation" what's needed? The demand for dignity and privacy is a pre-existing condition. The ability to pay for dignity and privacy? That's what the poor can't afford. Spending money on market education programs to tell people about their options for off-grid toilets? Instead, spend that money on starting a toilet business that will employ the poor.

My thinking does keep evolving, so I will be following what others have to say here. But for now only two scenarios make any sense to me. (1) Employ the poor, and encourage them to buy locally. Eventually, maybe, within poor communities there will be enough disposable income. The second scenario? (2) Continue the pressure on governments to invest in off-grid toilets for the poor. The middle class gets the use of sewer pipes and sewage treatment facilities, why not use tax revenue for household toilets with on-site processing capability for those living off that grid?

Diane M. Kellogg
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  • I support sanitation projects that result in sustainable toilets for households and schools. Currently, my largest project is a grant funded by the Dutch government titled, "Private and Social Toilets" (PRISTO). I am also working on the SuSanA grant from the BMGF, to improve collaboration and knowledge sharing in the sanitation sector.
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Re: Is our approach to instituting sanitation programs broken? How efficient have the NGOs been so far?

The math on the cost of paying for billions of toilets is persuasive and should be pointing everyone--donors and sanitation specialists included--toward building a sustainable toilet industry, made up of profit-making enterprises. Hopefully ones that employ the poor, so that any money spent on toilets stays within the community and builds the local economy.

We can agree that if all the donor money in the world just bought toilets (with no money at all going to NGOs)....there's still not enough to buy enough toilets.

Even if all things point toward private enterprise, we are still left with the problem that the poor can't afford to buy their own toilets, no matter how inexpensive. The BMGF goal of $300 is still way, way out of reach. If I had to choose between food, medical care and a toilet ? I wouldn't buy a toilet either.

I once subscribed to the belief that Ghanaians who were paying for the daily use of public toilets could instead use that money to pay off a toilet loan on a private toilet. That math was persuasive, too. With apologies to anyone who saw that presentation at SuSanA in Senegal, the lights came on when soon thereafter a poor woman I've known for years reminded me that "flying toilets are free." That was her delicate way of saying "Diane, do you REALLY think I'm walking 20 minutes every morning and night and paying for a public toilet, when every time I go to the market they put my purchases in small black plastic bags that they don't charge me for?" Free toilets.

I do think it's "progress" to see big funders spending money on market development for private sector products. But is "demand creation" what's needed? The demand for dignity and privacy is a pre-existing condition. The ability to pay for dignity and privacy? That's what the poor can't afford. Spending money on market education programs to tell people about their options for off-grid toilets? Instead, spend that money on starting a toilet business that will employ the poor.

My thinking does keep evolving, so I will be following what others have to say here. But for now only two scenarios make any sense to me. (1) Employ the poor, and encourage them to buy locally. Eventually, maybe, within poor communities there will be enough disposable income for some to afford toilets. The second scenario? (2) Continue the pressure on governments to invest in off-grid toilets for the poor. The middle class gets the use of sewer pipes and sewage treatment facilities, why not use tax revenue for household toilets with on-site processing capability for those living off that grid?

Diane M. Kellogg
Bentley University Management Department
Partner, Kellogg Consultants
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Re: Is our approach to instituting sanitation programs broken? How efficient have the NGOs been so far?

Hello Diane,

Hmmm, thought provoking and I just really wish that the problem is as simple as you have suggested, yes it is not rocket science either :-)!

I do agree absolutely with your point for market development for private sector products and I think part of that market development which NGOs seem to do well is working with people like the poor Ghanaian woman to understand that the free plastic bags she gets and converts to toilet is not exactly cheap. It's reuse as a toilet does come with implications and costs that may just be perpetuating her poverty status, costs that may well be above the costs for investment in a Toilet- which she cant afford now?

The big question your post has raised for me is the chicken and egg question, which one comes first; build businesses employ people so they can afford toilets and good life or work with people to access toilets by all means and their lives are improved ( because they have toilets now) and they can build businesses and live happily ever after.

Let the thinking continue to evolve... Like you I have taken some positions before that I must apologise for.

Kind regards,
Ada
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Re: Is our approach to instituting sanitation programs broken? How efficient have the NGOs been so far?

Thanks for your response, Ada. We are wasting time and money until we unravel this and can see the best actions to take. I like SuSanA's "systems thinking" theme for Kampala: let’s get in the helicopter and figure out what’s happening on the ground before we design more ineffective projects.

I find working to unravel causes and effects (chickens and eggs) valuable for the sake of finding a starting point. A first step. Something I can actually do, not just talk about doing. It’s the practical orientation I learned growing up on a chicken farm, with 40,000 of them laying free-range eggs. (No roosters allowed.) My father always shook his head at the absurdity of the question, though. "Chicken," he said over and over again. It takes a chicken to get an egg. End of story. There were no chickens inside our eggs.

I may not be able to make a dent in the problem, but I employ people inside the urban poor community as research assistants. That’s something. I admire anyone who is trying to do anything to make their own dent. Educating people about the real cost of flying toilets sounds worthwhile. Sometimes those programs can be so condescending, though--depending on who’s in charge. It won’t be me, as I’m in learning mode when it comes to urban sanitation. I’m learning as I go from the people who live closest to the problem, and getting more humble all the time about what I don’t know.

Diane M. Kellogg
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Re: Is our approach to instituting sanitation programs broken? How efficient have the NGOs been so far?

The Global Sustainable Aid Project (GSAP) has been training local artisans on the proper fabrication of the GSAP Microflush toilet. There are now hundreds of MAKERs in 17 countries around the world. They earn $100 on the toilet, which is odor-free and fly-free, off grid and virtually closed. Diane is aware of our work. One of the things that gets in the way of this local empowerment model are the grants that come to town and give away some toilets to needy households. The "why should I buy one when, if I wait, someone will give me one" problem!

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Re: Is our approach to instituting sanitation programs broken? How efficient have the NGOs been so far?

Dear Steven,

I had a quick look at your work and it seems quite interesting. As you seem to research and document very well, I would like to ask you some follow-up questions.

1) When you say that:

The "why should I buy one when, if I wait, someone will give me one" problem!

do you have any research to back this claim up? I think this kind of problem may well exist, but I have never come across any solid data to pin it down.

2) Do you have a good theory, or even better some evidence, as to what drives demand for your Makers and Lenders? Why do people want to buy these toilets, what income groups do they represent and have your Makers and Lenders "created" their own market in your view?

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Marijn Zandee

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Re: [SuSanA forum] Is our approach to instituting sanitation programs broken? How efficient have the NGOs been so far? (Market development in action)

Marijin,

The two biggest obstacles some of our MAKERs have is the give away phenomenon. Why buy one when, if I wait, I may be given one. It is an understandable reaction. We encourage our donors as follows: instead of donating $1500 to give toilets to 5 households, use these funds in a LENDER program and it will build toilets in the community forever.

We focus on households in the lowest quintile of the household income spectrum and while it is tempting to give a GSAP Microflush toilet, it is far better to empower the household to acquire it through in-kind effort to the MAKER and a loan for the balance.

The second impediment to toilet purchase is the fact that many households are occupied by tenants, who are reluctant to invest in the landlord's property. When the landlord can be identified, we encourage a purchase (and loan if necessary), which they can help repay through a slight increase in rent.

Thanks for your interest.

..Steve

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Re: Is our approach to instituting sanitation programs broken? How efficient have the NGOs been so far?

Dear Steve,

Thanks for your answer. I think the "why buy one, if I can probably get it free at some point" is narrative plausible. In Nepal, for example, this has prompted the government to ban subsidies on toilets. I am still not sure that a zero-tolerance policy on toilet subsidies is the way forward, but I get the logic.

Maybe, I will broaden the question to everyone who is reading.

We make a lot of assumptions about what drives people and entrepreneurs when investing in sanitation. Are there any methodologically sound surveys out there to support some of these ideas?

Regards

Marijn

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Re: Is our approach to instituting sanitation programs broken? How efficient have the NGOs been so far?

Hi everyone,

Thanks for this topic, there is plenty to say about sanitation marketing. I work for the Gret, a French NGO, and we started to run sanitation marketing project about 6 years ago, first in Cambodia, then in Madagascar, Mauritania and recently in Burkina Faso. Our approach is to assist local entrepreneur in expending their activity in sanitation. Their trained to produce and sell hygienic toilet, as well a manage the business.
We found out 4 benefits to a sanitation marketing approach:

- Hygienic toilets are built (as opposed to the traditional toilets resulting of CLTS approach alone).

- People use their toilet as intended, not as a storage or who know what: because they invested in it, they use it and maintain it. In Madagascar, 98% of the customers of the sanimarkets use the toilets as such.

- Sanitation marketing doesn’t mean that you don’t need subsidy: as efficient is your strategy marketing, if your toilet price is higher than the population’s capacity to pay, nothing will happen. But you can use subsidies (in a discreet way, and based on result) to reduce the price, as a promotion. For example in Cambodia, people can pay 60$ for a toilet, and the pricate operator sells a toilet with shelter for 62$, so there is no need for subsidy. In Madagascar, people can pay 12,5€ but the minimal cost for a toilet is 28€ : subsidy is necessary. But sanitation marketing is increasing the efficiency of the subsidy. In Mauritania, sanitation marketing subsidy was 4 time more efficient than in classic sanitation project. Moreover, it’s not uncommon to subsidy sanitation services provided by private sector, even in developed countries.

- For the poorest, sanitation marketing is not enough, an entire social reinforcement is necessary, as sanitation is definitively not the priority for them.

- Sanitation reinforce the local sanitation offer instead of destroying it with an unbeatable competition of free toilets. Nobody is going to pay for something he can get for free, let’s be honest. We had the case in Mauritania, where people withdraw their commands when a project arrived and offered free latrine, consequently the sanimarket closed. Regarding the ethics problem to make money from the poor, as sanitation marketing is a social business, (at least when it’s implemented by NGOs), so the margin as not extraordinary. We can exactly say that business make money of selling toilets to the poor when the margin are around 5% on a product costing less than 50$.

Of course sanitation marketing is not a miracle solution, there is plenty of challenges in low income countries. The main is to ensure the durability of the approach. It takes time to reach a structured and durable local sanitation market, and even more time (around 10 years) to reach the level of social business. There is project objectives to achieve, and it’s not always compatible with the rhythm of selling. And there is the constraint people being used to free toilet because of the pas projects. It takes time and a lot of communication so that people are willing to pay for something they were given free. We are testing a bunch of solutions to reach the durability of sanitation marketing, but I’m not going to present it just yet, I think this post is long enough as it is.

In conclusion, just a few figures from Madagascar, our more advanced experience in low income coutry: In 6 years, over 6 000 hygienic toilets have been sold, by 31 sanimarkets managed by 19 private entrepreneurs. Since 2012, the sanimarkets implemented by the Gret are responsible of at least 25% of the new hygienic toilets build in Madagascar, according to the Water Minister.
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