Rethinking Sanitation: Lessons and Innovation for Sustainability and Success in the New Millennium

This report highlights some of the key lessons learned from the past about sustainable sanitation solutions, new thinking emerging from consolidated learning and innovative experimentation on-the-ground, and some of the conditions necessary for success if real improvements in sanitation are to be achieved and sustained in rural and urban areas. Special attention is placed on the shift from supply-led sanitation projects to demand-led and market-oriented projects. The report concludes that with much deeper attention and broadened interest in sanitation, a more realistic view of the complexity, time, resources and effort needed to meet the challenge of large-scale sustainable changes in sanitation at the household level.

• Overwhelming evidence and common sense have clearly shown that households decide to change their sanitation practices to gain a variety of different benefits, mostly having little to do with avoiding excreta-related diseases. Tweet
• Trying to motivate private behaviour using public interests usually doesn't work and may explain why health education campaigns achieve little permanent change in sanitation and hygiene behaviours. Tweet
• The sector has much to gain by recognizing the value of what is already going on in the market place and the significant contributions private households and commercial suppliers have made to improving global access. Tweet
• Core funding for sanitation really needs to be a integral part of public budgets, where realistic amounts of money are allocated annually, such as with financing hospitals, schools, or a sewer system, towards the continuous management, repair and development of an area's excreta collection and treatment system. Tweet
• In high density urban areas, a project that simply provides latrines cannot be even said to be achieving sustainable toilets. Tweet
• The starting point for thinking about subsidy is to first stop focusing on subsidizing the construction of private home sanitation facilities and start considering other ways to use public finance more effectively to encourage home owners to build and use latrines on their own, help them overcome the constraints they may face, and address the public service problem of safely and efficiently managing excreta at the larger community and municipality scales, especially in dense urban slums, once it leaves the private domain of households. Tweet
• The piggy backing of sanitation and hygiene on water interventions has brought some significant disadvantages: different time horizons; different decision making processes; less time to create demand; and different skill sets. Tweet
• The "stool of stools" is a conceptual model that helps programme designers to understand excreta management: to support toilet acquisition, maintenance, and use, must have supply chain, user demand AND supportive institutional policy environment. Tweet