Some first thoughts.

1. Dimensions covered in the post-2015 targets: Sanitation dimensions have largely focused on health. However, sanitation has (i) the potential to achieve other SDG targets as well and (ii) choice of sanitation technology can impact choice of technologies in other SDG sectors. For instance, sanitation can have significant and measurable impact on agriculture, energy (either by directly producing energy or by saving energy used to produce chemical fertilizers which is also huge considering the quantum of naptha required for urea fertilizer as well as energy required to operate the fertilizer plants) and climate change. It also links with Goal 11.1 (by 2030, ensure access for all to adequate, safe and affordable housing and basic services, and upgrade slums) given that non-sewer based systems can help reduce dependence on capital-intensive sanitation projects before increasing housing supply. Therefore, if the choice of sanitation technologies do not result in realizing the benefits in other sectors, the other sectors have to necessarily choose technologies that are necessarily sub-optimal. How can we cover these aspects in the post-2015 targets?

2. With regard to reflecting human rights in sanitation targets and indicators, (i) are there communities for whom sanitation access should be prioritized (based on demographic, socio-economic or other factors such as proximity of dwelling units to rivers etc)? (ii) if yes, what criteria can be used to define such population? (iii) how can we have a special focus on identifying the most vulnerable and at-risk population and prioritizing reach of interventions to these population first? (iv) how do we ensure the sanitation technologies integrate with the lifestyles of special categories of population, particularly, nomadic tribes who need highly mobile/portable/carryable toilets but may not have any access to cleaning supplies, O&M, etc? (These tribes do not carry luggage like trekking backpacks, so even the design of the toilet has to be specially adapted.) What does sanitation access mean for nomadic tribes?

3. Progressive realization of rights: Rights relating to sanitation has the dimensions of (i) sanitation features which are covered by the first 2 rungs of the sanitation ladder provided disabled-friendly access and child excreta get covered under “facility is adapted to needs of the users of the facility”, (ii) economics – cost borne by the household, financing available and at what cost, realized net increase in income and cash flow, % of HH income required to access a said sanitation facility, purchase decisions, external funding for superstructure when the intent is to transition to a more environment friendly technology, (iii) enabling environment – access to information for decision making and ensuring proper maintenance, ease of completing requisite procedures and (iv) equity viz., access, quantity, quality and affordability.

4. Lifespan of the different technologies – what is the minimum lifespan for a sanitation technology to be considered? Supposing we complete total sanitation (at least basic access) by 2030, would we want to consider another round of development goals relating to sanitation? What is the status of the sanitation facilities covered under the MDGs? Would they require high maintenance expenditure or overhaul during or towards the end of the SDG period?

5. Integrating inequalities in the sanitation ladder: Progressive realization of rights includes the dimensions of economics, enabling environment and equity. Equity (defined to comprise these 3 dimensions) could be added to rungs 1 & 2 viz., excreta containment and safe access and availability.

6. How to measure equity (or the lack thereof): Inequity could be caused by several factors (gender, income, features of geographical location such as remoteness or desert area, caste/community, special situations like those in conflict situations and those who are affected by natural calamities every year, etc). Further, a population group might have two or more features that result in inequity (for instance, women in remote area affected by floods every year). Therefore, one measure is inadequate. While a Lorenz curve or Gini coefficient is the standard statistical measure of equity, equity measurement would require analysis along these aspects (viz., each factor and when multiple factors are present). Sanitation access relates to rungs 1 & 2 the information for which is collected from large population surveys and national censuses. Therefore, disaggregated analysis is required along with ensuring that the survey forms have questions that help collect data (risk factors that result in inequity) to conduct equity analysis.

7. Schools and health centres – adequacy of sanitation ladder to monitor the important dimensions of sanitation access: Schools and health centres are similar to households in the sense of being an entity in which individuals interact for some stated purpose. Be it a community hall, shopping mall, schools or health centres, the underlying concept is the same. Therefore, the concepts defining adequate sanitation access (viz., cleanliness, safety, privacy, 24-hour access, etc.,) covered by rungs 1 & 2 of the sanitation ladder apply to schools and health centers as well. The difference lies in the definition (number of persons using the toilet and/or the users knowing each other) – we need to explore how this affects realization of sanitation goals. For instance, waiting time (ie., queue time), geographical distance (how far from the classroom given the timespan of breaks), risk of infectious diseases spread, “comforting” (do women and girls feel comfortable with the location and superstructure design, water access, do upper caste and lower caste individuals use the same toilet), “facility is adapted to needs of the users of the facility” viz., indicator 2.3 of the sanitation ladder requires special focus as this can include disabled-friendly access, persons with mental health issues, samples for lab testing in case of inpatient/outpatient facilities, patients who have had ambulatory care surgeries in resource scarce settings, etc. Similarly, rungs 3 & 4 are important particularly for health centres (pathogen destruction as well as safe treatment and disposal of excreta and greywater, presence of pharmaceutical drugs in the excreta and greywater). The information is collected from institutional surveys and the incremental cost of collecting additional data might not be high.

8. Schools and health centres – is a separate sanitation ladder necessary: As per JMP definitions, basic sanitation includes shared facilities between not more than 5 households or 30 persons, whichever is lesser. A separate sanitation ladder is necessary only if the above dimensions (eg., waiting time, geographical distance, etc.,) are significantly different from the dimensions required to be considered for shared facilities for households. While reporting might have to be separate (separately for households, schools and health centres), a common integrated sanitation ladder is more appropriate. A common sanitation ladder framework is also useful for explaining the concepts to various stakeholders, harmonization of terms while conducting analysis such as sanitation access across households and schools and health centers in specific locations – disaggregated analysis – or comparative analysis between communities and/or locations.

Warm regards,

Sowmya

Dear all,

After one first week of debate, the aim during this second week is to move the discussion forward and focus on the post-2015 agenda and emerging monitoring challenges in the sanitation sector. In last week, some key ideas were raised in relation to SDGs, so it is now time to deeply discuss about them …

Just as short introduction, it is important to recall that the Open Working Group on Sustainable Development Goals has proposed two different targets specifically related to sanitation (sustainabledevelopment.un.org/sdgsproposal):

- 6.1 by 2030, achieve universal and equitable access to safe and affordable drinking water for all
- 6.2 by 2030, achieve access to adequate and equitable sanitation and hygiene for all, and end open defecation, paying special attention to the needs of women and girls and those in vulnerable situations

Based on these two targets, the JMP has coordinated a consultative process to define more specific WASH post-2015 targets and indicators (www.wssinfo.org/post-2015-monitoring/).

- By 2030, eliminate open defecation;
- By 2030, achieve universal access to basic drinking water, sanitation and hygiene for households, schools and health facilities;
- By 2030, halve the proportion of the population without access at home to safely managed drinking water and sanitation services; and progressively eliminate inequalities in access

It is important to recall that in the process of defining new indicators, an appropriate balance between ambition, achievability and measurability should be maintained. And more specifically, the following were identified as important considerations in formulating targets:

- Including hygiene: Post-2015 targets should adopt an integrated approach to drinking water, sanitation and hygiene (WASH) in order to maximize positive impacts on the health, welfare and productivity of populations.
- Eliminating inequalities: Future targets should aim to progressively eliminate inequalities between population sub-groups.
- Improving service levels: Future targets should promote progressive improvements in the quality of services based on the normative criteria of the human right to water and sanitation i.e. accessibility, quantity, quality and affordability.
- Going beyond the household: Future targets should prioritize settings beyond the household, where lack of access to WASH significantly impacts on the health, welfare and productivity of populations.
- Addressing sustainability of services: Future targets should address the challenge of sustaining services to ensure lasting benefits.

Against this background, following thought provoking questions are suggested as starting point for debate:

- Post-2015 targets are beyond the debate whether technology-based approaches are adequate to monitor the sector … However, are all important dimensions of sanitation included in the proposed post-2015 targets?
- It is clear that the targets aim to reflect the human rights to water and sanitation … Is a ladder best monitoring approach to monitor access to basic services from a rights perspective?
- Another important background issue in the post-2015 agenda is the concept of progressive realization of the rights … Is the sanitation ladder metaphor able to deal with such concept?
- As regards the challenge of monitoring inequalities … Which is best way to integrate inequalities and gaps in service delivery in the sanitation ladder? How such inequalities should be measured?
- When moving beyond the household, it seems that schools and health centres are settings where lack of access to WASH has significant impact. Do we need a specific ladder for each setting? Does it make sense to integrate into one single ladder different settings?

We would be delighted to hear from you and we look forward to your comments, either on the previous questions or on any other issue related to SDGs – sanitation – post-2015 agenda …

With best wishes,


Some key JMP definitions (additional information):

Basic sanitation: Basic sanitation facilities are those that effectively separate excreta from human contact, and ensure that excreta do not re-enter the immediate household environment. Each of the following sanitation facility types is considered as basic sanitation for monitoring progress toward the household sanitation targets, if the facility is shared among no more than 5 families or 30 persons, whichever is fewer, and if the users know each other:

• A pit latrine with a superstructure, and a platform or squatting slab constructed of durable material. A variety of latrine types can fall under this category, including composting latrines, pour-flush latrines, and ventilation improved pit latrines (VIPs).
• A flush toilet connected to a septic tank or a sewer (small bore or conventional).
Household access to basic sanitation facilities alone is not sufficient for safe management of excreta. Each of the above is only considered to be safely managed where excreta is safely transported to a designated disposal/treatment site, or treated in situ before being re-used or returned to the environment.

Basic handwashing facilities: are those where handwashing facilities, with soap and water, are available in or near sanitation facilities and where food is prepared or consumed.

Safely managed sanitation services include the regular use of a basic sanitation facility at the household level, as well as the safe management of faecal sludge in the household, neighbourhood, community and city level through the proper sludge emptying of on-site cess pits or septic tanks, transport of the sludge to a designated disposal/treatment site, and/or re-use of excreta as needed and as appropriate to the local context. The percentage of population with safely managed sanitation services is defined as the fraction of households using a basic sanitation service whose excreta:

• Are carried through a sewer network to a designated location (e.g. treatment facility);
• Are hygienically collected from septic tanks or latrine pits by a suction truck (or similar equipment that limits human contact) and transported to a designated location (e.g. treatment facility or solid waste collection site); or
• Are stored on site (e.g. in a sealed latrine pit) until they are safe to handle and re-use (e.g. as an agricultural input).

The proposed indicator for global monitoring of access to safely managed sanitation services is: the percentage of people who (1) use a basic sanitation facility and (2) whose excreta is safely transported to a designated disposal/treatment site, or treated in situ before being re-used or returned to the environment.

Global monitoring of access to safely managed sanitation services must engage both at the household and community level. Households can provide information on the types of sanitation facilities they use, as well as any treatment and re-use of excreta they undertake. In communities where excreta are transported away from households, information is required from service providers and/or regulatory institutions regarding the transport, treatment, and discharge of wastes into the environment.