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TDS: Week 1 Theme - Evolution and Further Development of the Sanitation Ladder

  • bracken
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TDS: Week 1 Theme - Evolution and Further Development of the Sanitation Ladder

Dear all,
As Roslyn indicated above, we have an initial proposal for the structure of the planned three week discussion here on the Forum. Given that this is the first discussion of this kind here, we will be adopting a fairly flexible aporach to this proposed programme and will be willing to "go with the flow" to a certain extent should discussions be taken us all in an interesting direction.

To start this first week off, I would like to begin by looking at the idea of the function-based sanitation ladder, and particularly the seven-step ladder sanitation ladder as presented in the 2011 paper “The Sanitation Ladder: A need for a revamp?” (Kvarnström et al, 2011 - see attached) (Had we been writing it today we no doubt would have said “reboot”).

The idea behind the “reboot” is that the outcome and impact of a functioning sanitation system should be the focus of sanitation monitoring, rather than the number of a particular type of sanitation infrastructure. The proposed reboot was presented simply as a relatively generic outline in the paper, with the functions as technically neutral as possible. The first step on the ladder focused on excreta containment, the lower rungs were primarily concerned with health protection, and the higher rungs progressively added issues of environmental protection and the integrated resource management of the different flow streams in sanitation systems.

It was expected that the costs of the systems would increase as one moves up the functional ladder, as do the needs for management and logistical and institutional capacity. Additionally, a shift in responsibility can be presumed from the user to a more communal model as the broader environmental functions come into play on moving up the ladder. In general, this would correspond to a shift in operation and management (O&M) needs as well, often with the responsibility moving from household-centered to off-site treatment and management, demanding appropriate institutional set-ups to deal with the shift in responsibility.

The paper explicitly stated that the adoption of a function approach would demand a significant shift in current monitoring processes and that the indicators of the rungs to measure MDG achievement would have to be qualitative.

The paper was broadly welcomed. However, the operationalization of the function-based ladder is still something that would require further precision. Below are a few examples of how the approach has been adopted and adapted by different organisations in order to make it operational.

The German NGO, Welthungerhilfe (which may be known to some as German Agro Action) addressed this in Chapter 6 of their “Orientation Framework for Water, Sanitation and Hygiene” (which can be downloaded here: www.welthungerhilfe.de/en/about-us/media...-framework-wash.html ). Their function-based sanitation ladder framework specifically considered WHH’s project environments, with the very bottom of the ladder being the situation where there are no sanitation facilities and no demand for them. The first rung then represented an improvement upon this situation in a community where there is a basic knowledge, awareness and demand for improved sanitation and hygiene. In all, they use a six rung ladder (the top rung being safe use of treated excreta / productive sanitation systems) to monitor progress in the sanitation and hygiene status of partner communities. Rungs two to 6 of the WHH ladder correspond to rungs one to five in the paper from Kvarnström paper.

A slightly different approach was adopted by the researchers engaged in IRC’s WASHCost Project, which ran from 2008 to 2013, who were initially approaching the topic from a costing perspective for different sanitation and hygiene service levels, in their working paper “Assessing sanitation service levels” (downloadable here: www.ircwash.org/resources/assessing-sanitation-service-levels ). For all intents and purposes, different rungs on the ladder can be translated to different service levels.
The paper used Kvarnström’s concept of functional areas across the sanitation service delivery chain and proposed parameters and indicators for sustainable sanitation services across each functional area. It is suggested that this approach is not only useful for the WASHCost research, but could also be considered more broadly by those involved in planning and monitoring sanitation service delivery.
Similar to the revamp paper, the authors proposed a set of globally comparable service levels comprising key service indicators, rather than sanitation technology options. They defined four levels of service, ranging from “no or unacceptable service” over “limited” then “basic services” to “improved services”. The improved services included the containment, collection, treatment, disposal and / or reuse of excreta and solid and liquid waste. Basic services contained and collected the waste, whilst limited services served simply to contain it.
The service levels were then described by four key indicators: accessibility, use, reliability and environmental protection.

Another step towards “functionalizing” sanitation and hygiene service levels was presented briefly in a discussion here on the SuSanA Forum by Florian Klingel from SKAT. The two slides supplied by Florian (which I attach again here) demonstrate nicely an attempt at developing a country specific approach to a pragmatic use of functionality. As Florian noted at the time of posting, the different service levels can be described in terms of health protection, environmental protection, comfort / status, fulfilment of human rights and cost and management complexity, as shown on the first slide. The second slide then shows a plotting of existing technologies in Moldova / Ukraine against these functional indicators. I know that Florian himself said at the time he was not completely happy with this representation, but it does present a good start I think at perhaps pragmatically reconciling the technocentric approach and functionality at country level.

I’d be interested to hear any thoughts on these examples, or of any other similar attempts and if or how they are being used in real world situations.

Regards,
Patrick

Water and Sanitation Specialist
AHT GROUP AG
Management & Engineering
D-45128 Essen, Huyssenallee 66-68
Germany
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  • JKMakowka
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Re: TDS: Week 1 Theme - Evolution and Further Development of the Sanitation Ladder

Thanks for starting this initiative!

A function based assessment and monitoring of services levels is definitely the way forward.

However for a reboot of the "sanitation ladder" I think we should also give the metaphor of the ladder itself a critical look.

Like already written in the 2011 paper it source is community awareness rising and for offering a very simplified technology based outlook to personal life improvements.
I guess the original idea of such a limited linear(!) concept was to appeal to the desires of villagers to move up the "social ladder", which might be an appropriate metaphor for that use but falls short for more advanced matters such as monitoring national progress. Last but not least the entire concept of "climbing up" to improve one's condition is culturally quite euro-centristic and might not always so intuitive to other cultures.

However my doubts mainly come from the fact that a ladder implies a linear system (even if functional based) that probably does not allows for sufficient flexibly to be used for more advanced matters.

Thus I would rather suggest a "score card" like semiquantitative monitoring system with only a generic service level scoring at the end.

A score based system would also encourage stakeholders to optimise the systems in an "low hanging apples first" way according to the specific circumstances instead of being stuck at one step of the ladder and thus not even considering to improve factors attributing to higher up steps.

I will probably outline this score card based system later today when I have more time, but maybe someone already knows of a similar system used for sanitation?

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  • joeturner
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Re: TDS: Week 1 Theme - Evolution and Further Development of the Sanitation Ladder



I am quite interested to discuss this image, which you used in the presentation, from the 2011 paper, Patrick.

A question I am still struggling to understand is how the proposed sdgs on sanitation fit into this disussion - as far as I can tell, the most recent proposals will be measured against something approaching tier number 6 on this table, whereas the MDG target (which we all know failed to be hit by a wide margin) was more like step 2 or 3. Ultimately we still seem to be expecting many communities to join at the 'bottom' of the ladder, which is actually well below the minimum standards expected in the high level sustainable development agenda discussions.

I also wonder the extent to which the existence of a 'ladder mentality' amongst those involved in sanitation policy has an impact on delivery and perceptions of users. I have heard stories of communities who refuse to join at a 'lower' rung because (sometimes quite correctly) they believe that having some sanitation will mean that they miss out when agencies come around offering something 'better'. I am not sure that portraying the ladder functionally rather than as particular engineering solutions really changes that.

Third, I wonder whether some might perceive a change away from some version of a 'flush' toilet as the ideal 'top rung' as being a rather demeaning way to tell people to 'make do' with a low functioning dry toilet. Of course, I understand the arguments about dry toilets and why they are not necessarily inferior, but there must be some resistance from communities who have always previously been led to believe that this is what they should aspire to own.
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  • bracken
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Re: TDS: Week 1 Theme - Evolution and Further Development of the Sanitation Ladder

Good morning JKM - did you manage to get the chance to flesh out that score card idea at all? I'd like to see it

I can understand where you are coming regarding the linear and hierarchical nature of the classic sanitation ladder. I think the ladders as they were and are used when working with communities do intentionally have a certain aspirational character. The conventional wisdom for a long time has been that households will get on the bottom rung and "start climbing". However as the recent Plan four-country study on the sustainability of CLTS found "households almost universally built simple pit latrines using locally available materials. There was no evidence to suggest that households were moving up the sanitation ladder to any significant extent." Now this could be simply because there was no further information on "the next possible steps" or because households could not afford the next step, or were even satisfied with the step they are on, but I would say that in my experience I've never seen a spontaneous advancement up the sanitation ladder within a community.

I do think that this metaphor is perhaps from today's standpoint a poor choice in some respects. Currently, I personally prefer to think of service levels rather than a ladder to climb (what is the point of a ladder if its not to be climbed?). Different households or communities then decide on the desired, appropriate service level for them (based on prioritized criteria of their own setting and criteria set by law). For me then this does not represent a "linear development" way of thinking. However I would still say that different levels of service do offer greater benefits, with lower service levels benefitting the household and higher levels then benefitting the community in general. I think another strength of this kind of approach is that each service level defines the minimum need for that level and in order to proceed to the next then these minimum requirements must be fulfilled. If I understood your score-card idea, this would not necessarily be the case?

Joe, I'm hoping the Ricard Gine will join us soon to answer your point regarding how the proposed sdgs on sanitation fit into this discussion. He'd do a much better job answering that than I.
But I would say, regarding the "flush toilet as top rung" thing - I don't think any specific technology should be mentioned for any particular rung. It presupposes a "one-size fits all" approach and ignores the context in which the technology is used. Would a flush toilet be the top rung in an arid region, with no piped water supply and no sewer system? This example illustrates very well the necessity of concentrating on the function of the entire sanitation system, and not just the "user interface" (in this case the flush toilet). In this context a correctly used dry toilet would certainly provide a much better level of service with regards to health and environmental protection, and I think communities and individuals within communities would recognize this, probably quicker than the experts or politicians.

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  • joeturner
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Re: TDS: Week 1 Theme - Evolution and Further Development of the Sanitation Ladder

But I would say, regarding the "flush toilet as top rung" thing - I don't think any specific technology should be mentioned for any particular rung. It presupposes a "one-size fits all" approach and ignores the context in which the technology is used. Would a flush toilet be the top rung in an arid region, with no piped water supply and no sewer system? This example illustrates very well the necessity of concentrating on the function of the entire sanitation system, and not just the "user interface" (in this case the flush toilet). In this context a correctly used dry toilet would certainly provide a much better level of service with regards to health and environmental protection, and I think communities and individuals within communities would recognize this, probably quicker than the experts or politicians.


I agree, to some extent, Patrick, although it seems to me that many applications of dry toilets are not in the extreme situation you describe here.

I also think there is quite a lot of evidence that some communities do not recognise the benefits of alternative aspirations to 'flush' toilets. Indeed, it seems to me that often it is the experts who are trying to persuade communities of the benefits of alternatives rather than the other way around.

Of course, I'd also agree that there are many reasons why flush toilets are objectively not the best choice. But I'm talking about perception and aspiration not objective analysis by experts.
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  • elkv
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Re: TDS: Week 1 Theme - Evolution and Further Development of the Sanitation Ladder

Hi Joe, Krischan and Patrick!
Just some quick reflections from my side. The reason we used the ladder for the suggested functional-based approach was because it was already in use and the objective with the paper was to inspire to a change from technology-focus to function-focus, using a well-known tool and showing how it could be changed to measure outcomes of use of technology rather than construction of infrastructure. I don't think that there has to be any contradiction in using the same approach but without the linear ladder, and I look forward to seeing a scorecard example of that!The ladder idea, however, as Patrick pointed out, was that the services on one rung should be maintained when moving up the next rung in order for that second rung to "count".

Joe, the current MDG on sanitation is measured in the first rung of the function-based ladder. However, since the actual MDG is only focused on separation between the human and its feces, without looking into hygiene, improved sanitation as per the MDGs is not enough to fully achieve the first rung of the function-based ladder.

On the suggested SDGs and the ladder, I agree with Patrick. Ricard is more the expert, I look forward to his input! Here are, however, some of my thoughts on that issue. There seems to be a difference between what is suggested as SDGs related to sanitation from the Open Working Group of the SDGs (see link: sustainabledevelopment.un.org/focussdgs.html ) and the suggestions coming out from WASH professionals involved through the Joint Monitoring Program (see attachment). The JMP WASH professionals come from an expansion of the MDG perspective, where hygiene, equity, excreta management are in focus. It is clear that the JMP WASH professionals are not talking about technologies any longer ("basic sanitation facility not shared by more than five families" is the current formulation), and service delivery is the focus, which is already along the lines as discussed in the functional sanitation ladder paper. Target 3.2 in the JMP document is talking about "percentage of population using a safe management of excreta sanitation service", which could be said to cover 1, 2 and partly 4 (maybe 5 and 6 depending on what happens in the "safely managed excreta services", how ambitious it is) in the function-based ladder. The weakness of the JMP WASH group's suggestion is that it ignores greywater and its impact on health and life quality especially in peri-urban and urban informal settlements. If greywater is not included into the post MDG agenda it also will not be high on the agenda of development organizations, and a full on-site alternative to centralized wastewater collection will not be invested in for informal settlements, and centralized wastewater collection will, for good reasons (in an urban setting it is not enough to deal only with the fecal matter, especially not if richer neighborhoods get subsidized wastewater collection and treatment!), continue to be the one and only aspiration.Target 4 in the JMP paper talks about elimination of inequalities, which also is somewhat addressed in our rung 2 in the function-based ladder, where safe access and availability for all is addressed. The JMP document has two targets addressed at schools and health facilities. The function-based ladder can of course be applied both for households and for any other institution. The key is the function of the system, wherever it may be located.

The Open Working Group of the SDGs' formulations of suggested sanitation-related SDGs do, as Joe pointed out, aim much higher, including transboundary water management, restoration of water eco systems etc. They are also, by their formulations, technology-prescriptive, since they talk about "wastewater". This means that systems generating other types of wastewater fractions than wastewater fall outside the SDGs (unless one bends the interpretation a lot, which I suspect won't be done by utilities or development agencies focused today on centralized sewer and treatment investments...), that wastewater-generating systems will continue to be the norm also through the SDGs.

I do understand that there is an aspiration for wastewater collection and the flush toilet, but to my experience this aspiration is not so simple that it sits in a piece of flush toilet or not. One reason, mentioned above, is of course that a latrine only does not solve the problem with greywater management. It is also about equity in service delivery, and how much you have to pay for services. Some brilliant research from Senegal (see attachment) shows that on-site customers pay 5 times more for their services compared to centralized sewer serviced customers. I think it is super important to bring up customer equity on the agenda, and one important piece in the puzzle of working for this, and for opening utilities up to service delivery irrespective of which technology they use, is that goals, targets and indicators should be technology-neutral. The suggested SDGs as per the Open Working Group, therefore, I think, definitely should reformulate their suggested goals to allow for sanitation service delivery also for systems not necessarily generating classical wastewater.

Kind regards

Elisabeth

Elisabeth Kvarnström

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  • joeturner
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Re: TDS: Week 1 Theme - Evolution and Further Development of the Sanitation Ladder

Thanks Elisabeth, that is very interesting.

My understanding from the UN Zaragoza meeting was that the UN D-G (on behalf of the UN GA) accepted that the negotiations in 2015 will be based on the OWG recommendations in Dec 2014. Is that not correct?
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  • JKMakowka
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Re: TDS: Week 1 Theme - Evolution and Further Development of the Sanitation Ladder

As understandable as an upgrade to the well known ladder is, I think it is crucial to think about who is actually going to the the user and/or target group of the proposed rebooted and function based concept.
Contrary to the original purpose of the ladder, the use through the JMP and ultimately also the shift to a function based approach makes it more of an monitoring, advocacy and policy influencing tool in my eyes... and for that a score card system is probably more appropriate than the ladder metaphor (but there is no need to scrap it completely
;) ).

So for example a municipality (or a civil society group trying to influence them) might use the "rebooted function based sanitation ladder" to assess the status quo, identify gaps and based on this propose new sanitation interventions. It might also be used to compare different neighbourhoods or cities in an "objective" fashion in order to lobby for funds allocation from national governments, donors etc. (buzz word: "evidence based advocacy").

Ultimately if such a system is widely accepted and in use, it could also inform nation wide monitoring efforts and maybe also the SDG's JMP equivalent.

However this is only what I am currently imagining as the most likely and pragmatic use of a rebooted sanitation ladder.
A function based sanitation ladder will probably not be used as a community IEC material anymore (too complex) and a purely academic descriptive use would not yield much impact in my opinion. Therefore the actual use-cases and target group should form the basis of the concept and the metaphors used.

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  • elkv
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Re: TDS: Week 1 Theme - Evolution and Further Development of the Sanitation Ladder

Hi Joe,
I am not closely enough involved (not at all, except giving some feedback on the JMP WASH process some years back and another on the SDG process also a few years back) in the SDG process to give you an answer. I hope Ricard can come to a rescue with a more informed answer on the SDG process! :)

Kind regards

Elisabeth

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  • JKMakowka
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Re: TDS: Week 1 Theme - Evolution and Further Development of the Sanitation Ladder

Regarding the score-card concept as an evolution of the function based sanitation ladder:
I can't claim that it is a fully thought through idea, but it is based on:
1. "Sanitary assessment forms", a simplified semiquantitative field monitoring tool from the WHO water safety plan concept to assess and compare potential risks in water supply infrastructure.
2. "Community score cards", a concept by the World Bank (and others) developed as a tool for communities to assess and give feedback on the perceived level of service offered by municipalities and public utilities.

OK so how could it work?
It could come with several equal functional dimensions that are scored for example on a 0-3 scale (from "non existent" to "state of the art"). This is more of an qualitative scoring, but various quantitative factors (for example effluent water quality) and/or technology options could be suggested to inform the qualitative score.

The quantitative part then comes in by adding up the numerical scores and ranking different system along several service level threshold values, e.g. inadequate, simple, improved, advanced, sustainable etc. In part the general idea of a linear progression of service levels is partially retained, but it is more generic and lower levels can be reached through a combination of different scores from different dimensions.

A critical point here might be that for example minimum health standards should not be replaced by other dimensions to reach a higher service quality level (the main reason for the linear progression in the lower levels of the functional sanitation ladder I think). With the score card system on the other hand this is theoretically possible, i.e. a system could score really
high on reuse factors and other non directly health related dimensions, but very badly on pathogen containment and thus reach a relatively high service level in the semi quantitative scoring.
A solution to this issue might be to have certain dimensions with a special weight, or come up with a clever multiplying instead of adding scoring system (as 0*something is always zero), but I think this is more of an theoretical concern and will rarely surface in real world applications of the score card system.

Additionally the issues from this could be further mitigated by a condition based score weighting system, that is custom correction factors for each category (a sub-sum of dimensions) to adjust for climatic, environmental and other factors, for example multiply a specific category score by 1.2 if in dry area or multiply other score by 0.8 if in area with population density higher than...
Such correction factors would for example make a system with bad pathogen containment score very low in an urban area, but less so in a dry, sparsely settled rural area. It could also allow to factor in some "community" aspects into an otherwise individual/on-site system assessment.

It is important to note that such a scorecard system should not be too descriptive to allow for sufficient flexibility by the implementers. The very nature of it being a somewhat qualitative assessment requires it to be done by (or under the supervision of) skilled personnel, which makes it crucial that the system is not a pure top down "mechanical" scoring.

Furthermore, nationally agreed on correction factors (see above) would also allow different countries to express their sovereign priorities and special circumstances while still retaining a somewhat comparable monitoring score for international efforts like the JMP.

I know this sounds complicated at first, but with a well made assessment form template (or maybe even a computerised form on a smartphone) this should be quite practical to implement and use.

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  • ricardgine
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Re: TDS: Week 1 Theme - Evolution and Further Development of the Sanitation Ladder

Good morning,

I have enjoyed reading all your posts … I am very sorry for my slow reaction!

Let me share with you few comments in relation to the previous debates:

A. As regards the likely utility of a ladder to assess the SDGs, I believe that Elisabeth has nicely described the two different approaches that are currently in place. On the one hand, the Open Working Group of the SDGs has proposed various targets related to Goal 6. “Ensure availability and sustainable management of water and sanitation for all”. In parallel, the JMP has been working on the definition of post-2015 WASH targets and indicators, to particularly cover the two first targets defined by the OWG. The final proposal of the JMP is now available at their website (and previously attached by Elisabeth), where you can also find the interesting reports elaborated by all different working groups consulted during this process ( www.wssinfo.org/ ).

It is worth mentioning that, as Joe pointed out, the negotiations in 2015 in relation to the SDGs will be based on the OWG recommendations, but inputs from other parallel processes will be also considered. Surely, the proposal elaborated by the JMP will be a relevant input for the specific definition of WASH-related targets.

In any case, I would suggest postponing the discussion related to the post-2015 agenda and the SDGs for the second week of this forum, and keep the focus during this first week on the potential evolution of the ladder …

B. My feeling in relation to the ladder is that it may be a powerful tool for monitoring sanitation status and therefore for decision-making support. However, I completely agree with JMK that we need to define very clearly the final users of such tool. In this regard the technology-based ladder has, in my opinion, one clear advantage: it is simple and it can be easily applied everywhere. It has numerous disadvantages, but we need to be aware of the fact that the transition from technology to service level-based approaches will require more information to assess the facility, and this information may be not easily accessible. This mayhinder the use of the tool for decision-making purposes. Another "worry" related to the function-based sanitation ladder is that for decision-making purposes, the interest will probably be on the two lowest rungs of the ladder, as they account for the majority of population. Therefore, my feeling is that keeping in mind a functional-based approach, these two rungs at the bottom of the ladder could be further disaggregated to clearly distinguish between open defecation and different "basic" service levels. On the other hand, the top rungs of the ladder seem to have more interesting from an academic point-of-view than from a policy-making perspective ...

It would be great to learn from those who have applied this kind of tools in the field ...

C. I found the alternative to the ladder suggested by JMK, the “score card”, very interesting. This different approach based on combination of different data to yield a single final score (i.e. the index approach) is certainly more flexible and allows the combination of different data. It may be used, as the sanitation ladder, for monitoring purposes, as it can be easily disseminated to non-technical audiences. However, as JMK states, there are different aspects that need to be carefully considered in index construction: the utility functions employed to assess single indicators, the weights assigned to each indicator, and the aggregation function (compensatory versus non-compensatory aggregation). The final index / score can otherwise be easily misunderstood. I personally have experience in proposing composite indicators for the WASH sector, and my feeling is that at the end of the day, one needs to be very careful when it comes to keep the simplicity of the tool. That is, I would not recommend combining many indicators but 4 to 5 core indicators, and employ a clear and transparent method for index construction …

All the best,

Ricard
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  • Florian
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Re: TDS: Week 1 Theme - Evolution and Further Development of the Sanitation Ladder

Hi All!

Thanks a lot for that initiative, I've been looking forward to this discussion. I'm a bit late to join (too much work) but I try to catch up. I also hope you manage to get more people onto the discussion, perhaps also people not yet registered to the forum, to have a lively discussion.

Rather than commenting on the other very interesting contributions, I'd like to expand a bit on some of the ideas I developed a while when pondering about sanitation in Moldova, particularly as Patrick mentionned this in his starting post.

We run a Swiss funded water and sanitation project in Moldova. Moldova is interesting, as in many aspects it is a bit particlar:
- The situation in rural areas is comparable to many developing countries (pit latrines in poor shape is the standard sanitation type, sewers are few and wastewater treatment inexisitant).
- Government people still think along Soviet lines: sewers or nothing.
- Part of the donor community thinks along the classical development perspective, which means MDGs and JMP sanitation ladder
- However, the bigger (in terms of funds) part of the donors is EU driven, the logic is clearly along the lines of EU enlargement or EU association, which for sanitation means a exclusive focus on environmental protection via wastewater treatment.
(this description is of course a little simplifying)

In this context, we as implementer of a project, are always wondering: what is actually our goal for sanitation in these villages? The answer from government and donor strategies is diffuse (see above). So we tried to look at the issue a bit more sistematically, with the hope to come to a more clear way of defining the objective of sanitation, of minimum standards or service levels that we (and the local governments) should aim at. So I think this is very much what this discussion on sanitation ladders is about, just starting from a specfic example rather than from the global perspective.

Ok, that was the introduction ;)


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