Thanks for sharing this interested report. I am copying below the methodology and the recommendations. I think a few of us will be surprised at recommendation Number 8 ("Keep excreta in the ground") but keep in mind that this report looked at rural areas, i.e. with ample space.

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Methodology and process

Rapid desk reviews were conducted on 11 GSF-supported programmes in sub-Saharan Africa
and Asia, assessing relevant documentation, evaluations and progress data, supplemented by
remote key informant interviews.
GSF outcome surveys were available for five of the GSFsupported programmes.
An online survey was implemented by the GSF global learning team
and four country visits were made in mid-2019 to collect detailed information on the Cambodia,
Madagascar, Tanzania and Uganda programmes.

Recommendations:
1. Improve monitoring the use of safely managed sanitation services.
Investments should be made in developing, testing, improving and scaling up reliable SMSS
monitoring systems.

2. Collaborate with sector for national SMSS assessments.
Advocate for and support efforts to produce reliable national assessments of SMSS through
coordination, finance, and capacity and monitoring systems development.

3. Analyse SMSS challenges at national (or programme) level.
Use SMSS data to prepare Shit Flow Diagrams (including child excreta flows) and use these SFDs
to identify critical unsafe excreta flows and inform national policy.

4. Address unsafe excreta return before containment.
Prioritise interventions to address unsafe excreta return (including unsafe child excreta disposal)
before excreta enters containment.

5. Use non-market technical support to upgrade unimproved toilets.
Non-market technical support is recommended to encourage both new and upgraded toilets with
safe containment, provision for safe management when containment systems are full and—where
necessary—more durable and easily cleaned toilet slabs.

6. Undertake groundwater vulnerability mapping.
Conduct macro-assessments to map groundwater (and water supply) vulnerability to contamination
from on-site sanitation.

7. Conduct formative research in critical areas.
Where solutions are not apparent, formative research to identify and design interventions to
improve access to SMSS should be conducted.

8. Keep excreta in the ground.
Where space and groundwater conditions allow, excreta should be stored and left in the ground
to encourage pathogen die-off and limit the risk of faecal exposure.

9. Bury fresh faecal sludge.
Where faecal sludge containing fresh excreta (or any excreta stored for les/s than two years)
has to be emptied, and suitable land is available, encourage burying of faecal sludge in pits or
trenches (as close to the emptying site as possible).

10. Test communal emptying and disposal processes.
Test and promote collective emptying and disposal processes (with the support and involvement
of private service providers wherever possible).

11. Raise household awareness of SMSS costs and requirements.
Programmes should make households aware of SMSS costs and requirements before investment
in new or upgraded sanitation facilities.

12. Determine strategies for challenging environments.
Work to develop specific strategies and approaches for SMSS in challenging environments and
ensure that SMSS progress in these areas is carefully monitored (including progress among key
disadvantaged groups in these areas).

13. Raise awareness of the risks of agricultural use of faecal sludge.
Raise awareness of the risks of direct application of faecal sludge to fields.

14. Don’t forget handwashing with soap.
Handwashing with soap at critical times blocks faecal exposure routes that are not addressed
by other safely managed sanitation services. However, the GSF outcome surveys confirmed that
handwashing outcomes were considerably lower than sanitation outcomes. More rigorous and
more frequent monitoring of handwashing should be encouraged (to provide regular feedback
to policy and programming on what works) and more attention paid to find and develop more
effective approaches to behaviour change for the sustained practice of handwashing with soap
at critical times.

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Regards,
Elisabeth

SustainableDevelopment Goal 6 for water and sanitation calls for the realization of safely managed services (SMSS) for everyone by 2030. While there has been significant research and implementation to improve the sanitation service chain in urban settings, little guidance is available on how to achieve and sustain SMSS in rural contexts. 

In 2019, WSSCC commissioned this study conducted by Andy Robinson and Andy Peal to examine to what extent Global Sanitation Fund (GSF)-supported programmes enabled SMSS in rural areas with collective behaviour change approaches like CLTS.

This study includes:     

• A summary of SMSS concepts and issues in rural areas·        
• SMSS findings from GSF-supported programmes in sub-Saharan Africa and Asia·        
• Good practices for monitoring SMSS in rural areas·       
•  Recommendations for rural programming

Download the report