Dear Mughal,

In support of the comments submitted by Florian.

Recent developments are that the sanitation ladder should NO longer be viewed in the context of technology, i.e. the ladder being technology prescriptive but rather be based on meeting particular criterion. This will at least make it easy for measuring progress (on sanitation provision) using a standard criteria irrespective of the technology employed in diffferent countries/regions compared.

Find the attached paper for sanitation ladder as currently defined.

Regards,

Charles Mpho Makgatha
Sanitary Engineering Professional
South Africa

Very nice summary!

I like the idea of country specific ladders. This might be a nice way to overcome the complexitiy of more complete concepts like the function based ladder, by limiting the range of options to the ones known or common in the countries.

I attach two slides, which are taken from a discussion we had in our projects in Moldova and the Ukraine about the strategy and objectives in rural sanitation. The first one takes up the idea of the function based ladder, I added the addtional element regarding status and comfort, which is what often matters most to the users. I then tried to place all existing and potentially applicable options in a 2-dimensional graph. I quite like this representation, though I'm not entierely happy with it. Still too complicated and oversimplifying at the same time...

To be clear, this is not an officially used sanitation ladder of Moldova or similar, it is just part of our on-going thinking process...

The Sanitation Ladder

It was as early as 1998, when UK’s DFID (Department for International Development) developed a sort of sanitation ladder, listing a hierarchy of sanitation technologies from deficient facilities to appropriate facilities, which DFID called as Levels of Service (Guidance Manual on Water Supply and Sanitation Programmes, London School of Hygiene & Tropical Medicine (LSHTM) and the Water, Engineering and Development Centre (WEDC), Loughborough University, UK). Four levels of service were proposed. These are (I have picked sanitation sector only; levels of service for water supply and sullage disposal are also given):


Typical levels of service providing access to and sanitation in rural and urban areas (pp 35)

Deficient (Open defecation OR dirty communal latrine)

Minimum Simple pit latrine on householder’s plot

Intermediate Improved pit latrine or pour-flush toilet on householder’s plot

High Flush toilet with septic tank OR sewerage (if water supply is sufficient)

These levels of service apply to both urban and rural areas. Major urban centers are connected with sewerage system (piped sewer system), as such, the proposed levels would apply more to peri-urban areas rather than the urban centers themselves.

The proposed levels of service are sensible and rational. The key aspect here is that, if I were to apply the proposed levels in rural areas of Pakistan, I would easily and readily get the picture, where a particular rural town stands, in terms of the sanitation level. For local government officials, the proposed levels of service provide guidance on the town’s sanitation-related status.

JMP’s Sanitation Ladder

In 2008, JPM proposed sanitation ladder (Progress on Drinking Water and Sanitation – Special Focus on Sanitation, UNICEF/WHO, pp 6). Various rungs of sanitation ladder, from unimproved to improved sanitation, are:

Open defecation
Open defecation: Defecation in fields, forests, bushes, bodies of water or other open spaces, or disposal of human faeces with solid waste

Unimproved
Unimproved sanitation facilities: Facilities that do not ensure hygienic separation of human excreta from human contact. Unimproved facilities include pit latrines without a slab or platform, hanging latrines and bucket latrines.

Shared
Shared sanitation facilities: Sanitation facilities of an otherwise acceptable type shared between two or more households. Shared facilities include public toilets.

Improved
Improved sanitation facilities: Facilities that ensure hygienic separation of human excreta from human contact. They include:
• Flush or pour-flush toilet/latrine to:
- piped sewer system
- septic tank
- pit latrine
• Ventilated improved pit (VIP) latrine
• Pit latrine with slab
• Composting toilet.

JPM sanitation ladder's approach is pertinent, in that, sanitation technologies are given for each rung. Based on this ladder, local government officials will be able to easily classify sanitation status of a town. However, it must be mentioned here that the main thrust of JPM is on meeting the Millennium Development Goal (MDG) target, for monitoring sanitation target. In addition, JPM data is largely based on data furnished by the governments, which in some cases, may be highly inflated. For rural areas of Pakistan, JPM data show 90 per cent for sanitation coverage, whereas, in practice, it is hardly 10 per cent.

JPM sanitation ladder is, surprisingly, in reverse order, meaning that when one climbs the ladder (from bottom to top), it is from improved rung to open defecation rung!!

Kvarnström, et al. (2011) have corrected the order, which is given below:
[Kvarnström, E, McConville, J, Bracken, P, Johansson, M and Fogde, M (2011), The sanitation ladder – a need for a revamp? Journal of Water, Sanitation and Hygiene for Development]


Rung Description of what counts towards achievement of rung

Improved

Facilities that ensure hygienic separation of human excreta from human contact. They
include:
• Flush or pour-flush toilet/latrine to:
– piped sewer system
– septic tank
– pit latrine
• Ventilated improved pit (VIP) latrine
• Pit latrine with slab
• Composting toilet

Shared


Sanitation facilities of an otherwise acceptable type shared between two or more
households. Shared facilities include public toilets

Unimproved

Facilities that do not ensure hygienic separation of human excreta from human
contact. Unimproved facilities include pit latrines without a slab or platform, hanging
latrines and bucket latrines

Open defecation

Defecation in fields, forests, bushes, bodies of water or other open spaces, or
disposal of human faeces with solid waste


Kvarnström, et al. (2011), however, are of the view that the JPM’s sanitation ladder can be made more useful if it can be refined to use a function approach rather than a technology approach for each rung. They have presented a seven-step sanitation ladder where the seven steps are divided into health functions and environmental functions. Their suggested function-based sanitation ladder is shown below:

(Sorry, the image could not be copied here. It is on pp 8 of the paper)


While the function-based sanitation ladder is interesting, it is somewhat complicated, and perhaps, can be useful in areas where level of technical knowledge is relatively high. For a developing country like Pakistan, where expertise in sanitation is low (female literacy rate in rural Sindh is only 17 per cent. In rural areas, household water and sanitation is the responsibility of females), the function-based sanitation ladder would prove too complicated. This would also apply to the local government department functionaries. It is prudent to keep the sanitation ladder simple, so as to achieve its implementation.

In Africa, simplified form of the sanitation ladder, based on sanitation technologies, is used (Africa’s Infrastructure - A Time for Transformation, Eds. Vivien Foster and Cecilia Briceño-Garmendia, 2010, The World Bank).

WASHCost Sanitation Ladder

Sanitation ladder proposed by WASHCost is simple and can be used with relative ease in developing countries. The sanitation ladder is:
(Assessing sanitation service levels, Alana Potter with Amah Klutse, Mekala Snehalatha, Charles Batchelor, André Uandela, Arjen Naafs, Catarina Fonseca and Patrick Moriarty, IRC International Water and Sanitation Centre, Second Edition, July 2011, Working Paper 3)


Improved
All households members have easy access to and use at least one convenient, safe, clean
facility, regular or routine O&M, and there is non-problematic environmental impact and safe
re-use or disposal of sludge.

Basic
All household members have reasonable access to and use a safe, clean facility, weak maintenance provisions, and non problematic environmental impact or safe disposal of sludge.

Limited
A platform separates the user from faeces, there is little or no evidence of cleaning of the latrine,
and there is significant environmental pollution increasing with population density

No service
There is no separation between the user and faeces, e.g. open defecation, and there is
significant environmental pollution increasing with population density.


The Lao PDR Sanitation Ladder

The Lao PDR sanitation ladder is simple and is technology-based. The components of the ladder are shown below:

(Consumers Choice…… The Sanitation Ladder: Rural Sanitation Options in Lao PDR, National Water Supply and Environmental Health Programme, Ministry of Health, Lao People’s Democratic Republic, Vientiane, Lao PDR, May 2001)

Option 6: Septic Tank System

Option 5: Single Pit Pour Flush latrine

Option 4: Ventilated Improved Pit Latrine

Option 3: Lid/ Cover Latrine

Option 2: Conventional Dry Latrine

Option 1: Improved Traditional Practice

I would appreciate, if the friends here highlight sanitation ladder used in their respective countries

F H Mughal