Rural Sanitation Programming in Challenging Contexts: A Desk-Based Review


  • ElaineMercer
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  • Communications and Networking Officer for the Sanitation Learning Hub, Institute of Development Studies, in the UK.
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Rural Sanitation Programming in Challenging Contexts: A Desk-Based Review

Dearfriends and colleagues,

We are pleased to announce our latest publication RuralSanitation Programming in Challenging Contexts: A Desk-Based Review. SLHLearning Paper 11.

Of the two billion people worldwide lacking access to at least basic sanitation, seven out of ten live in rural areas. Progress has been made on increasing rural sanitation and access levels are rising, but barriers remain in reaching the ‘last mile’ or some 10 to 20 per cent of the population who live in the most challenging contexts. The Sanitation Learning Hub, UNICEF, and WaterAid commissioned thisstudy to map rural sanitation approaches in challenging contexts and the guidance currently being used, drawing out emerging experiences and lessons. It involved key informant interviews (KIIs) with 44 interviewees, and consulting over 180 documented resources.

This rapid desk review written by Will Tillett (Aguaconsult) and Oliver Jones (Bluechain Consulting) collated preliminary findings across five broad ‘categories’ of challenges:
  1. Poverty and social marginalisation
  2. Entrenched attitudes and social beliefs
  3. Tough physical environments
  4. Lifestyles and livelihoods
  5. Fragile contexts
Recommendations from the review include:
  • Address key knowledge gaps identified in the study and strengthen sector learning processes.
  • Build the evidence base to identify the 'last mile' groups and understand the barriers they face. Increase access to the evidence.
  • Develop approaches, models and products that are inclusive and can address challenges at scale.
  • Build in-country capacities to effectively address challenging contexts, and build the business case and commitment of stakeholders to prioritise and include last mile groups.
  • Harmonise definitions and help governments to develop specific targets and strategies for challenging contexts. Strengthen their monitoring and review processes to track progress.

A summary of the paper’s findings is available in the related Learning Brief .

A useful document repository was created as part of the review. It contains 333 resources found, as of October 2020. Documents were identified through the researchers own files, internet searches, and those provided by the commissioning organisations and key informant interviews from the sanitation sector. It includes the author, year and title as well as the geographical scope, a hyperlink, whether the resource is publicly available, the number of pages and whether it has an executive summary or not. In addition, it categorises the resources into type, what challenging context it relates to and the sanitation approach used. Download here: Document Repository – Rural Sanitation in Challenging Contexts 2021

All three commissioning organisations aim to work with the wider sector to explore the gaps and opportunities in more detail in a second phase of this work. For more information contact

We hope you find this helpful to your work and welcome any feedback at

Many good wishes,

Elaine Mercer
Elaine Mercer
Communications and Networking Officer
The Sanitation Learning Hub
The Institute of Development Studies
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