Guide to the Development of On-site Sanitation (WHO, 1992, 245 p.) Part III - Planning and development of on-site sanitation projects Chapter 9 - Planning Chapter 10 - Institutional, economic and financial factors Chapter 11 - Development

Guide to the Development of On-site Sanitation (WHO, 1992, 245 p.)

Part III - Planning and development of on-site sanitation projects

Chapter 9 - Planning

The demand for sanitation
Project definition
Background information
Comparison and selection of systems

Many methods are used to provide or improve on-site sanitation. At one extreme, a project may involve detailed documentation (Grover, 1983) using the "project cycle" approach. At the other extreme, sanitation advances when individual householders build their own improved latrines, often because they have seen similar latrines built by neighbours. Many projects and programmes for improving sanitation lie between these extremes. Planning involves consideration of the local situation leading to selection of suitable types of sanitation. Designs are prepared and construction follows. On completion, and sometimes at intermediate stages, evaluation takes place.

With some projects, the form of planning and development is laid down by procedures which must be rigidly followed if external funds are to be released. However, in many successful programmes, development depends on the action of householders. Planning then leads to selection of appropriate forms of sanitation. Householders may be encouraged to adopt the selected types of sanitation by health education programmes, by technical or material support, or by other measures. The ways in which the different stages of planning and development may be regarded at various levels are shown in Table 9.1.

The demand for sanitation

The initial demand for provision or improvement of sanitation in a particular area may come from the local people themselves or from a small group of active leaders in the community. Alternatively, the initiative may come from health officials, a government department, the organization responsible for water and sanitation, a bilateral aid agency, or a national or international voluntary organization. Ideally, sanitation improvements should be carried out in accordance with a national or regional sector plan and the adopted primary health care programme. A sector plan often covers both sanitation and water supply. It indicates the number of facilities to be provided, the number of people to be served in each district on a year-by-year basis during the planning period, and the resources needed. Particular attention is usually given to requirements for internal and external funding and to deficiencies in personnel of various categories.

There may be several reasons for a sanitation programme.

· There may be a genuine concern for health accompanied by an awareness that a high local level of disease is associated with existing sanitation practices.

Table 9.1. The project cycle

Government ministries and donor agencies	Implementing agency	Community
Identification
Definition of target population		Felt need for improved sanitation
Determination of economic and health indicators, present service coverage and standards, objectives and policies, financial implications, staffing requirements, and training needs Assignment of planning responsibilities		Exposure to health education
Pre-feasibility surveys
Consideration of alternative projects to meet objectives taking into account technical social health, environmental financial and economic criteria	Technical and social surveys Planning with the community	Response to questions by health workers and government officials about health wealth water and sanitation
Feasibility demonstration
Detailed design and analysis of preferred/chosen project price to satisfaction of representatives of proposed target group	Proving of recommendead range of technologies at affordable	Discussion regarding experimentation with affordable means of improving sanitation
Appraisal and approval
Independent check on planning, usually by representatives of funding source Investment decision Release of funds for project implementation
Implementation
Consolidation	Training, administrative support procedures, proving technology Determination of financial, material and technical support	Training of local people to assist with programme Invitation to local artisans and contractors to participate Drawings made available
Expansion	Mass promotion in the community Health education, use of media Demonstration units as" sanitation super- market" Financial, material and technical assistance where appropriate	Publicity about the programme Systems available to copy Drawings made available Local artisans and contractors available to help with building Household decision as to purchase of sanitation system
Operation and maintenance	Advice on responsibility of household to use and care for on-site system	Use of facilities
Evaluation
Identification of further projects	Identification of positive and negative aspects; reformulation of design criteria	Comments regarding desired improvements

· Household latrines may be called for because of the convenience they offer to users.

· Good sanitation may be a status symbol.

· Existing excrete disposal methods may result in unacceptable pollution of surface water, soil or groundwater.

· Sometimes a demand for improved sanitation is associated with water supply. For example, a funding agency may require latrines to be constructed before it will provide piped water, or a water authority may wish to protect the catchment area for the supply to a nearby town by eliminating indiscriminate defecation. An increase in the amount of water provided to an area may lead to a demand for better wastewater disposal.

Project definition

Scope

Early in the planning process the extent of the programme or project must be assessed. This involves making an estimate of the number of people or households who will be covered. A house-by-house survey may be undertaken, or the necessary information obtained from health staff, government departments or local leaders.

Priority areas

A list is drawn up comparing the needs of different areas. Priority should be given to people with especially poor facilities for excrete disposal and areas with a high incidence of diseases associated with poor sanitation. Areas with a high population density or congested housing may justify special attention. However, houses intended for temporary occupation may warrant less attention than permanent buildings.

Other factors that influence the selection of priority areas are the interest of the local communities in sanitation improvements and their record of participation in other projects. Ability and willingness to contribute financially may be other criteria for the selection of priority areas. Projects generally depend on a financial contribution from householders; occasionally priority is given to people most likely to pay or those willing to try new ideas. For projects that are externally funded, the poorest people may be selected for preferential treatment, on the assumption that better-off families should pay for their own latrines.

Background information

Careful consideration should be given to all relevant factors in order to decide on the most appropriate form of sanitation and the most effective way of providing it. These factors include public health, socioeconomic, cultural, financial, technological, institutional, and other considerations, as described on pages 148-154.

A large unified project may require several reports by agency officers or consultants. Long written reports are unnecessary for small projects and for programmes that consist of a succession of small schemes. However, whether a large or small scheme is planned, all relevant factors need to be carefully considered.

The responsible agency

The planning and implementation of a simple programme for a few households may be within the capacity of a small committee of interested people, preferably with an enthusiastic leader. Larger programmes may depend on government initiative, or on the support of an external body such as a bilateral agency, one of the international organizations, or a local nongovernmental organization. The degree of involvement of an agency varies considerably according to the nature of the project, the type of agency and other national and local conditions.

Staff

Staff employed to plan sanitation projects should be carefully selected and prepared. Unless they have previously worked on similar programmes, the people appointed should receive formal or informal training, preferably on site with an existing sanitation project. It cannot be too strongly emphasized that the staff involved in all stages of a low-cost sanitation programme should be familiar with technological, management and sociological issues. They should also be familiar with the local financial and socioeconomic conditions, i.e., the standard of living of the local communities, and be aware of the important role that women, social workers and nongovernmental organizations can play.

Community participation

The involvement of the community in any project is essential for its success, because almost all on-site sanitation work depends on decisions made by individual householders. The extent of involvement will vary in different countries. Urban communities often play a role that is quite different from that undertaken by village people, and this is likely to be different again from that of those living in dispersed family units. Some groups of people are homogeneous; others comprise various cultures and socioeconomic levels.

Key leaders

Early contact should be made with key leaders, who may sometimes be identified with the assistance of the local health officials. The key leaders may be the chiefs and elders of villages, or people appointed by the government or political party. In some areas local schoolteachers or business people with education above the average may be useful as sources of local information and for an exchange of views.

Minority groups

Whoever are selected as key leaders, care must be taken to ensure that the views of all sections of the community are represented. It may be necessary to seek out leaders of minority groups and representatives of those without political influence. In particular, the views and support of women should be sought. These are often best obtained by women social workers.

Community needs and aspirations

Initial assumptions regarding the need for improved sanitation in the area as a whole and particularly in priority areas should be verified through contacts with key leaders and health workers. In particular, the incidence of excrete-related disease should be checked, as should awareness of relationships between sanitation and disease and of other disadvantages of existing excrete disposal practices, such as fly nuisance.

Care must be taken to avoid raising unreasonable expectations. At the same time, the local people should be made aware of the potential benefits of improved sanitation. When possible, even at the initial survey stage, key leaders should visit nearby completed projects to see good latrines in use. Simple drawings and models may also be used so that alternative technologies can be discussed.

Some idea of the readiness of the community to provide labour, money and materials for a latrine-construction programme should be obtained. Considerable skill is required to find out the true aspirations and priorities of the people. Answers to questions are often distorted because the interviewees wish to please the questioners. Small group discussions with minimum intervention by outsiders may be an effective means of finding out the true local opinion.

Survey of the area

The most appropriate sanitation is that which best meets the needs and aspirations of the people within all local constraints. In order to assess what is most appropriate, a survey of the district should be carried out.

The survey may include both secondary and primary data. Secondary data are obtained from existing reports, maps and statistics. These should be critically examined and due allowance made for possible inaccuracy. For example, the information may not be up to date, or it may have been obtained from unreliable sources or collected hurriedly. Study of the available secondary data will reveal gaps that need to be filled by primary data.

Primary data are obtained by direct and indirect observation, measurement, household surveys, interviews and informal conversations. Care should be taken to ensure that those carrying out the survey have been properly trained. Any questionnaires used should be carefully planned to ensure that the answers reflect the true opinions of respondents.

A survey for a sanitation project may include the items listed below. In addition to information about the existing situation, any proposals for changes (and when they are likely to occur) should be noted.

Physical factors

Of greatest importance is the local geology - the underlying rocks and the nature of the soil, in particular, how easy it is to dig and how stable the soil remains after excavation. It is also important to determine whether the soil is permeable so that water drains away, the depth of the top soil, how the soil varies with depth, the depth of hard rocks in which it is difficult to dig, and whether there are any fissures or boulders.

Natural gradients and the natural surface water drainage system should be noted, especially if there is much local variation. This may involve a study of the surface water hydrology and the climate, particularly the seasonal rainfall pattern. Areas that are subject to regular or occasional flooding should be noted. Any information that can be obtained about groundwater may also be useful, for example, the depth of the groundwater table, whether there is any seasonal variation or long-term change, the directions in which the groundwater flows, and its quality.

Existing excreta disposal methods

It is essential to obtain as much information as possible about existing sanitation. A programme is usually intended to rectify an unsatisfactory situation and the extent of deficiency in sanitary provision is the baseline from which it starts. Any existing local sanitation that is satisfactory could give an indication of the most appropriate general solution. Improvements to existing systems are likely to be more acceptable than completely new ideas. In addition, examination of existing sanitation may provide useful technical information regarding such matters as soil infiltration capacity and rates of accumulation of solids.

Another advantage of obtaining accurate and complete information about existing sanitation is that it can contribute to the evaluation of the completed programme.

Water supply

The service most closely related to sanitation is water supply, and careful note should be made of all water sources in the community. If possible, water sources should be visited and inspected. Claims by water authorities regarding the piped water supply service are often exaggerated, and the existence of water pipes and fittings should not be taken as evidence of satisfactory delivery of water. Pressure at the end of a long pipeline is often low, and the supply may be intermittent. Many people find it difficult to estimate distances in rural areas, so whenever possible the journey to collect water should be observed and timed.

Special care should be taken to check information relating to dependence on groundwater as a source of drinking-water. The depth of the water table and the location of wells and boreholes are particularly important because of the risk of pollution from pit latrines and soakpits. If possible, an analysis of the groundwater, including bacterial contamination and nitrate concentration, should be obtained. Comparison with analyses after the sanitation project has been implemented can then be used to monitor any groundwater pollution.

Health and disease

The need for improved sanitation may be gauged from information about the prevalence of excrete-related diseases. Sometimes attendance records at local health centres yield this information, particularly in relation to diarrhoeal and parasitic diseases. However, the value of records depends upon the accuracy of diagnosis, the care with which records are kept, and the location of the health centre relative to the area served.

Data obtained in a health survey carried out before the start of a project may be compared with data from another survey after the project has been implemented as a means of assessing the effectiveness of improvements in sanitation. However, such baseline surveys are expensive and difficult to carry out successfully. They are normally only required where governments or donors require evidence of the efficacy of simple sanitation.

Population and dwellings

Information obtained previously about the number of people and the number of houses to be served by the project should be checked and supplemented as necessary. Detailed demographic data, such as age and sex distribution may be significant, especially if it is customary for workers to move away from the area temporarily or permanently. Trends in any migration patterns should also be noted.

Aspects of housing that most affect sanitation are density, quality and level of occupancy. While low densities overall are usual in rural areas, it is not uncommon for dwellings in villages, and even in isolated family compounds, to be clustered at high density. The most relevant statistics are the open space belonging to each dwelling and the number of people occupying each dwelling. The quality of housing may indicate the economic level of the people and the efforts they are likely to put into improvements, including the construction of latrines. In many rural and periurban areas the majority of dwellings have been built by the occupants, who are therefore responsible for their own sanitation facilities. Improving the sanitation may be complicated where the occupant is not the owner, where a single dwelling is shared by several families, or where people occupy the upper storeys of multistorey buildings.

Culture and traditions

Customs that influence the selection of the most appropriate type of latrine include:

· the preferred method of anal cleaning (water or solid material such as paper, leaves, stones, grass or corncobs);

· whether it is customary to defecate squatting or sitting;

· the degree of privacy favoured;

· the preferred location of latrines in relation to dwellings;

· any preference for bathing in the latrine after defecating;

· traditional use of human excrete or compost derived from human excrete as a fertilizer;

· objections to handling excrete, even when they have completely decomposed;

· any restriction regarding the use of the same defecation place by different groups, for example a taboo on use of the same place by men and women, adults and children, or even more specific categories such as fathers-in-law and daughters-in-law;

· any objections to the use of communal or family defecation places by certain people at certain times, such as women while menstruating.

Communication and education

The ability and willingness of communities to accept new ideas, including new ideas about excrete disposal, are likely to be influenced by the extent of their outside contacts. In many places there is regular exchange of information through meeting people from other areas at markets, or when attending social functions. Literacy levels may determine the extent to which written or printed advice or instructions can be understood. It may be useful to find out how many members of the community own radios and television sets and whether they are in working order, and how many people read newspapers or see film shows, and in which languages. Understanding local terminology and traditional modes of communication, such as drama and song, may also be useful.

Employment

While full information about employment of the local people is useful as background, of particular importance to sanitation planning is the location of workplaces. The practice of spending a high proportion of each day on farms that are distant from dwellings may influence the design of household sanitation. Similarly the extent of other activities away from home, such as attendance at markets or industrial employment, may point to a need to provide latrines at these places. Any seasonal variation in economic activity, income level, and location of workplace should be noted.

The environment

Cleanliness of private dwellings and yards, and also of public roads, footpaths and open spaces, may give a good indication of the likely interest of communities in improving excrete disposal facilities. Methods commonly used for disposal of solid waste should be noted.

Infrastructure

Ease of access by vehicles should also be checked, bearing in mind that many rural roads that are reasonably good in dry weather may be impassable for several weeks or months during the rainy season. Vehicular access to properties may affect the choice of type of latrine, for example, where full pits need to be emptied by vacuum tanker.

Construction

While some householders may be able to build their own simple latrines, in many places construction will be undertaken by contractors or self-employed artisans. An assessment of the ability and reliability of local contractors and artisans is therefore required. The financial status of contractors may be relevant. Apart from latrine construction, firms or individuals may be able to prefabricate components, such as slabs, blocks, pans and pipes.

The availability and market price of materials and components likely to be used in the construction of latrines should be ascertained as accurately as possible. For material that can be obtained locally, such as sand and gravel, the actual cost of extraction and transport may be more relevant than market prices. Wage rates for skilled and unskilled labour should be noted.

Availability of Internal finance

An assessment should be made of the likely contribution that beneficiaries will make to the cost of latrine construction and maintenance. Money available in rural communities usually depends on the sale of agricultural produce and its seasonal variation; cash may only be available at harvest-time. In any community there may be income from wages and salaries, and from remittances received from absent members of families.

Attempts should be made to estimate willingness to spend money on sanitation, although it must be realized that statements made by individuals or community leaders regarding ability or willingness to pay are often unreliable. Responders usually answer questions in a way they think will give them greatest benefit. They may think that if they claim to be poorer than they are they will receive more outside help. Alternatively, they may exaggerate their ability to pay if they expect that this will ensure the implementation of outside-funded improvements.

Ability to pay may be based on the income of poorer sections of the community. In some places it has been found that payments for improved sanitation by the poorest people should not exceed 1% of their income, but up to 3% is acceptable for other economic groups (Kalbermatten et al., 1982).

Availability of external finance

The fullest possible information should be obtained regarding grants, loans and subsidies likely to be available from local and central governments, bilateral donors, international and commercial banks, and other external sources.

Comparison and selection of systems

Careful consideration should be given to all the technical factors described in Chapter 5 in order to select a number of appropriate types of latrine from those described in Chapters 4 and 6. A decision tree, like that shown in Fig. 9.1, may serve as a framework for selection. In effect, use of such an approach may eliminate some forms of sanitation, leaving others for further consideration.

Factors that are relevant in deciding whether a sanitation system that is technically feasible should be offered to householders and communities include the following:

· whether the system appears to be popular, as demonstrated by the number of householders who have already adopted it or by widespread interest in possessing it;

· the extent to which its use would fit in with local cultural and religious customs;

· the extent to which it would reduce pollution and health risks;

· the ease with which it can be provided by the people themselves, having regard to local skills and easily available materials;

· the cost, and particularly the cost of any materials, components and labour that cannot be provided by the householders;

· the ease with which it can be operated and maintained.

Having selected a number of options that are appropriate, the costs of each option can then be estimated. These should relate to a range of construction methods and materials. The total cost in both financial and economic terms of providing the required number of units for the project may then be calculated. Some agencies may favour least-cost solutions for externally funded projects, as discussed in Chapter 10.

When suitable options have been selected, the agency or the community itself must then go on to provide the latrines, giving each individual householder the maximum possible opportunity of choosing between alternative types, materials, finishes and other details. The stages in the implementation process are discussed in Chapter II.

Fig. 9.1. Decision tree for selection of sanitation

Chapter 10 - Institutional, economic and financial factors

Institutional responsibilities
Human resources development
Economic factors
Financial factors
Examples

Institutional responsibilities

Any work on sanitation improvement is carried out within a framework of household, community and governmental relationships, all of which affect the manner in which a programme is executed. Of major importance are the organizations or institutions that have been given responsibility for or have an interest in some aspect of sanitation improvement. Such bodies may be governmental ministries, departments of ministries, urban municipalities, rural councils, nongovernmental agencies or recognized organizations.
In this book, a body outside the local community which takes primary responsibility for initiating, promoting, supervising or otherwise supporting a sanitation improvement project is generally referred to as an agency in order to distinguish it from other interested institutions. This agency may be a sectoral institution or a part of an institution. It may also be a special multidisciplinary team drawn from several institutions or even a nongovernmental organization working under the authority of a governmental institution.

Projects or programmes

Improvements to sanitation practices involve projects and programmes. Projects are specific tasks with realizable goals within a specified time period. Programmes are continuous undertakings with long-term objectives. Protecting people and their environment from excrete-related disease and pollution is a continuous task which requires the responsible agency to take a long-term, programme approach.

Projects may be of vital importance to give a short-term boost to the sanitation programme and to enable people to make the next incremental improvement in their facilities. However, every project should be clearly related to existing sanitation programmes, with the relevant staff and institutions understanding its nature and objectives.

Governmental involvement
Allocation of responsibility

Government ministries of health, water supply, rural development, local government, agriculture, and social welfare, and local government councils may all have an interest in sanitation. This concern may be at central, regional or local level. Ministries of finance and economic planning may also wish to exert some control. For a programme to succeed, there should be one lead agency, with a designated officer or management committee which has the responsibility and authority to take executive action.

Integration of sectoral responsibilities

Nomination of a lead agency does not free other institutions from responsibility for a programme. Under their own terms of reference, they may want to play an active role in the promotion of sanitation, and may be able to provide specialist skills and inputs that are of vital importance. Consequently, it is necessary to define the responsibilities of all associated institutions, agencies and government officers at an early stage. The degree of involvement of any body will vary considerably according to the nature of the programme, the type of organization and other national and local conditions.

A forum or meeting for open discussion of needs and concerns may be of value. From this an intersectoral advisory committee can be drawn for more regular discussions of progress. However, it remains advisable to have a single lead agency responsible for decision-making rather than an intersectoral committee.

Specialized sanitation support teams

Where a sanitation programme is being given a new impetus it is often found that the staff already have too many duties to be able to take on significant roles in a new project. Staff must either be released from other duties or new personnel appointed. The creation of a multidisciplinary "sanitation improvement team" may be an effective means of encouraging progress. However, the relation of such a team to the existing organizational structure should be defined, particularly with regard to its eventual re-absorption as part of the overall programme.

Specialized teams or agencies, where properly constituted, are often able to bypass the bureaucratic procedures and delays that exist in all institutions. Particularly where unconventional, community based approaches are used, considerable flexibility is required from the facilitating agency. For example, staff may need to attend community meetings in the evenings or extension workers may need to make home visits when householders are home from work. Extra payment for overtime, or time off in exchange for late working, may have to be arranged.

Flexibility within the Institution and support team

As discussed in Chapter II, there are considerable advantages in mobilizing the people, particularly with regard to the long-term sustainability of the improvements. However, in the short term there is no guarantee that the people will respond to the extent and at the rate desired by the agency.

The role of the agency may be made more difficult by nonacceptance of the preferred design standards, slow take-up of credits or materials, unfulfilled budgets, lengthy construction times and uncompleted objectives. Particularly where outside donors are involved, there will be a pressure to produce measurable results. The agency has to organize its budgets and work plans in such a way that donors and any sponsoring institutions are able to understand what is happening and why, while retaining the flexibility required by the people.

Multilateral and nongovernmental organizations

Many aid and development organizations become involved in sanitation programmes with the aim of improving the health of the people. Some may be based within the country, while others are externally supported. Some are able to draw on considerable experience over many years in different parts of the world, with funds and skilled personnel from different countries. Others have limited experience and/or funds but demonstrate a strong desire to assist the people. Their enthusiasm and ability to respond quickly to new ideas may be usefully harnessed for the good of the project.

The sponsoring institution has to decide how best to use all offers of help. The crucial task is to integrate the multilateral and nongovernmental organizations and the sectoral institutions, where appropriate, into the long-term programme, with the objective of limiting any tendency the smaller organizations may have to promote one-off projects that are not sustainable.

Institution-householder linkage

To be effective, government institutions must have contacts with householders and the wider community that go beyond simply instructing the people what they must do. This is discussed more fully in Chapter 11. The lead agency should be constituted so that it can manage:

- community surveys, interviews, meetings, household visits;

- demonstration centres, sanitation "supermarkets", component purchase and/or production and sales;

- general or task-specific support staff, for example technical, social, financial and health staff;

- training of community members as facilitators;

- financial assistance; material assistance; technical assistance in construction; - identification of contractors and skilled builders;

- standard specifications and target prices;

- ongoing support, in terms of technical assistance, and health education; and

- evaluation and monitoring.

Human resources development

Human resources development includes the employment, supervision, continuing education and training, and occupational welfare of the people needed to do a job properly. The process should embrace planning, development of skills and training, and human resources management, with all aspects harmoniously geared to the achievement of specific goals.

Shortcomings in the preparation, implementation, operation and maintenance of sanitation schemes are often blamed on poor performance of programme staff and the ignorance of the people using the system. The usual response is to plan a training programme to educate all those involved in how to carry out their tasks correctly. However, such teaching may not in itself solve difficulties of performance. There are many factors to be considered in enabling people to perform to their full potential, and it is one of the roles of the programme manager to consider all aspects of human resources development.

Carefoot (1987) suggested that deficiencies in human performance, particularly with regard to water and sanitation activities, can generally be traced to one or more of the following: lack of skill or knowledge; environmental and/or management difficulties; or motivational, incentive or attitudinal causes. If lack of skills or knowledge is the primary cause of a problem, training is the likely solution. However, if problems stem from environmental and/or management causes, or from motivational causes, they will probably not be solved by training alone. In a number of surveys, managers involved with water and sanitation programmes have estimated that only 10-30% of performance difficulties are due to lack of skills or knowledge which can be rectified through training.

A "dual-focus" approach - on both the individual and the system within which the individual works - was therefore suggested by Carefoot in seeking solutions to performance problems. Development of skill should be complemented by the strengthening of the organizational environment, whether formal or informal, in which the person works.

Programme participants

Before looking at the requirements for human resources development in more detail, the people who might need to be involved in a programme must be considered.

Householders

One of the advantages of many on-site sanitation systems is that much of the work can be undertaken by the beneficiaries. Householders can plan, design and construct many elements of a latrine. Support is therefore required both for the individual householders and for the community to impart the necessary confidence that they can complete the task.

The special role of women in many countries in running the home, collecting water, and managing the sanitation system should not be underestimated. Many training programmes are automatically biased towards men or, by including men, exclude women. However, women have a vital part to play in the appropriate design, construction, operation and maintenance of excrete-disposal systems. Any human resources development programme must cater for the particular needs of women. Some programmes have also benefited from paying particular attention to the needs and role of children, both within formal education and informally in the community.

Community leaders and councillors

Community leaders have their own special interests, particularly where communal decisions have to be made about some aspects of a sanitation scheme or where leaders can set an example to other householders.

Artisans

In many projects there is a need for masons, bricklayers, drain-layers, carpenters, plumbers and other artisans to carry out part of the work. These workers often have experience in construction of houses and other buildings. Special skills may be required for the construction of latrines and associated works.

Local contractors
Householders may require local contractors to carry out certain tasks for them, such as lining pits or constructing slabs. Where new techniques are being introduced or new forms of project support and funding used, contractors and subcontractors will require support.

Programme and project staff

The numbers and categories of people needed to prepare and implement a project are largely determined by the nature and size of the project, type of agency, involvement of central and local government, whether the project forms part of an ongoing programme, and the degree to which the community participates.

Government health officers often play an essential part in sanitation improvement schemes, especially where the ministry of health is responsible for sanitation. Where a technical arm of government (such as a public works department) or an independent agency is responsible, management and supervision may be in the hands of technical officers. In some countries, health assistants, community and development officers and extension officers may be the link between an agency and the community. There is considerable variation in the terms used for different groups of workers and in the allocation of duties between these intermediate-level staff.

Professional staff

Several kinds of professional staff may be concerned with sanitation improvement projects:

- public health engineers who are employed by an agency or by consultants working for an agency, with primary responsibility for the technical aspects of the programme;

- architects, planners, medical officers and development staff who, because of their jobs with agencies or government departments, are involved with the planning and implementation of sanitation;

- behavioural scientists, anthropologists, health staff, geologists, economists and others having specialist expertise that can be beneficially employed at some stage of planning or implementation; and

- administrators.

Skills and knowledge training

If training is to be relevant and is to produce the desired results, it must be planned systematically. The objectives are to enhance people's breadth and depth of knowledge about their particular responsibilities, and to improve their ability to carry out particular tasks. In order to achieve these it is useful to follow a training cycle. This same cycle may be followed for householders as well as for professional engineers (Fig. 10.1).

The training cycle

Preparation of any training prograrnme begins with an assessment of training needs. This requires an organizational chart describing the different jobs to be carried out in order to complete the objective. The objective should not be limited to completion of initial construction but should also include operation and maintenance. Each of the jobs listed then requires a job description, that is, a detailed list of the tasks to be carried out by the person in that position (whether or not employed by the programme). Comparison of the job description with the knowledge and skills of people likely to be available to do a task leads to a list of training needs. A training plan is then prepared from the list of training needs, bearing in mind the priorities of the programme. The plan should specify the people to be trained, with target dates for completion and objectives for what the training should accomplish.

Fig. 10.1. The training cycle

Implementation of training depends on whether the needs are for:

· knowledge - where lectures and books are particularly useful;

· manual skills - step-by-step development through demonstration, practice and correction of faults, concentrating on key areas;

· social skills - use of role-playing, case studies, discussion, practice under supervision;

· attitude change - group discussion, personal interview, case studies and feedback; or for

· systems (for example clerical procedures and stock control) - checklists, demonstration and practice with correction.

The final phase of the training cycle is evaluation of what the participants have learned and determination of what they are able to do. I his leads to a reassessment of training needs for the next training session or programme. Of course, training and education form a continuous process which starts from what people know and enables them to build upon that foundation of knowledge. There is always opportunity for further learning; it cannot ever be said to have been completed.

Management requirements

However well people have been trained, they will not be able to reach the objectives of effective sanitation unless their working environment is geared towards meeting those objectives. For example, if there is no transport for project staff to visit sites when required, the community will become disheartened when the expected visitors do not arrive. Similarly, if there is no money to disburse loans to householders when promised, or if there is a lack of supplies, materials and tools, the project will lose momentum. To overcome such problems requires a willingness on the part of management to use all possible means to overcome institutional difficulties.

In addition, project staff, particularly those working directly with the community, require constant encouragement and recognition of their contribution to the project. Suggestions for improving work conditions include:

· regular visits by supervisors and colleagues to those working in isolated situations;
· regular meetings and seminars so that all staff on a project feel part of a team;
· the provision and maintenance of appropriate transport (car, van, motorbike or bicycle);
· alternation of work at rural and urban locations;
· payment of overtime where necessary; and
· ensuring that personnel have occasional postings near their home.

Motivation

Adequate motivation of agency staff and householders is a prerequisite for successful training. Of particular importance to project staff is the possibility of future career development beyond the present project. If the staff can see a chance of transfer to other projects within a continuous programme, they are more likely to be prepared to learn and improve their skills, and to share their expertise with colleagues and householders. It is important that status, conditions of service and salary scales should compare favourably with those for other available employment. This is particularly important for senior posts where the holders have to work away from home.

Economic factors

Choosing between alternatives

Different sanitation techniques may be equally acceptable from the health, social, technical and institutional points of view. The final choice between different techniques is therefore often made on the grounds of cost.

Financial costs, that is, in general terms, what a householder or agency has to pay in cash for a sanitation facility, are discussed on pages 169 176. Economic costs represent the total resource cost to the national economy, that is, what the country as a whole has to pay in terms of labour, materials, health, environment and imports.

Economic comparative costing aims to assign a cost to all the elements that go to make up a system, thus enabling comparisons to be made between competing technologies. It is important for planners and project staff to consider all the alternatives in order to recommend the most economic systems for demonstration and promotion. This then allows the householders to make the final decision on grounds of affordability, convenience and attractiveness.

It should be noted that detailed economic analysis is normally undertaken only for large projects in high-density urban and periurban areas. Because of uncertainties in the basic economic data in many countries, it is inadvisable to make final decisions regarding sanitation technology on the basis of economic analysis alone. However, the discipline of thought required to carry out an analysis of the full life-cycle costs of any system can be of great benefit to the planning team by leading to a fuller understanding of all the issues involved.

Least-cost analysis of alternatives

It is difficult to quantify the benefits obtained from improvements in sanitation. Where there is a choice of technology available to achieve the objective of safe disposal of excrete in an acceptable manner, the benefits obtained from the different options may be presumed to be equivalent. Economic comparison of the alternatives may then be restricted to a "least-cost analysis", which focuses solely on the costs of providing sanitation. There may be variations in the convenience with which this is achieved. For example, a flyless, odourless improved latrine may be far preferable to a flush toilet and septic tank where the water supply is intermittent. However, such situations are so site specific that it may be generally assumed that the systems outlined in this book (unless specified differently in Chapter 4) have similar benefits with regard to excrete disposal.

Each alternative should be considered according to consistent factors using economic analysis. Non-monetary contributions by householders, for example digging their own pits, should be quantified. Similarly, imported fittings for a pedestal toilet and septic tank should be recorded at their true cost to the national economy, taking into account "real" exchange rates. The values thus assigned may not directly reflect the financial cost involved.

Detailed information on economic analysis and methods of determining "real" values is given in the Guide to practical project appraisal (UNIDO, 1978). The main areas that need to be considered are outlined below.

Economic costs of sanitation systems

Labour

Where a householder is to contribute labour, e.g., by digging the pit or building the superstructure, this work should be costed at the shadow wage rate. This is the rate at which people would be hired to work if there were no artificially controlled wage rates. In a country with high unemployment, the shadow labour rate is likely to be between 40% and 70% of the government minimum wage. Similarly, where agency staff or direct labour is to be used for construction, the costs should be charged at the shadow rate rather than the amount actually to be paid to them. If a labour-only subcontractor is to be employed, the amount to be paid less profit to the subcontractor should be used. Profit represents a "transfer payment" and does not reflect any real transfer of wealth within the economy.

Building materials

The costs of both the superstructure and the substructure must be considered. Where a toilet is to be installed in part of a house, the proportion of the house value represented by the toilet (in terms of the proportion of the floor area) should be included in the calculation.

Building materials may be collected locally without financial charge. There is, however, a labour charge according to the time taken, based on the shadow labour rate. Where the materials to be collected are scarce and efforts are being made to renew them, for example through a reforestation programme, some costs should be assigned to these "free" materials.

For items manufactured in the country, the amount charged by the manufacturer, including transport to the site (less all profit margins), should be used. However, if the item is subsidized by the government, the subsidy should be added to the total cost. Where an item carries a sales tax, the amount of the tax should be subtracted to reflect the real value of the item to the economy.

Where imported items are to be used, the total cost, including freight charges and insurance, should be used, but not including customs duties, local taxes or traders' profits. In some countries, the foreign currency exchange rate may be kept artificially high in order to reduce the financial costs of imports. To reflect the real value of any imported materials, a shadow exchange rate should be used, which is likely to increase the apparent cost of imports. The shadow exchange factor is often in the range 1.2-1.8.

Water

Where water is to be used for flushing the sanitation system, the cost of this water has to be included. If it is to be obtained free of charge from an unimproved source, there is a labour charge for carrying the water to the latrine - calculated from the total time taken, costed at the shadow wage rate. If water is to be obtained from a standpipe or other improved source, the economic cost of delivering that water to the standpipe should be used, in addition to the labour cost of transfer to the latrine. Similarly, where a household has an individual water connection, the economic cost of delivering water to the house must be used. This economic or marginal cost of the extra water used for sanitation is normally higher than the actual tariff paid by the householder. The cost of any pipework and fittings to be used specifically to transfer the water to the toilet should also be considered.

Land use

Where land is scarce, particularly in urban areas, there is a cost associated with it, which should be included in the analysis.

Cost of money and the timing of costs

In economic terms, there is a cost involved in using money for one purpose, such as sanitation, as opposed to using it for an alternative purpose. This cost of using money is known as the opportunity cost of capital, and may be defined as the return on an investment in the best alternative use, that is, what could be earned by that money if it was used elsewhere. This cost influences the choice between alternatives with regard to the balance between initial capital investment costs and recurrent operation and maintenance costs. For example, some facilities are expensive to build but cheap to run, while others cost very little to construct but have to be rebuilt and/or emptied at regular intervals.

The influence of the opportunity cost of money on the timing of payments for a sanitation scheme is determined through the mechanism of discounting. This is a technique whereby all future payments made are given a current value by discounting in order to assess fairly the different streams of payments.

In economic analysis, the discount factor is the opportunity cost of capital. Where money invested increases in value over a period of time, the technique of discounting quantifies the money required at the present time in order to obtain a given amount at a set time in the future. Discount factors are normally obtained from tables, but may be calculated directly from the formula:

Discount factor = 1/(1 + r)^t

where

r = discount rate
t = period in years.

The example given on page 173 (example 10.1) demonstrates how the technique might be applied to the practical problems of judging alternative systems.

Design life of the system

As different facilities are designed to last for different periods, the principles of discounting may also be applied to differing design lives so as to give a fair comparison.

Emptying and disposal

Pits and tanks may be emptied by hand, for which there are shadow labour charges, or by vacuum tankers, for which there are hourly running costs, including labour, fuel and maintenance. In addition, replacement costs have to be considered, allowing for shadow exchange rates where the machine and spare parts are imported. There is also a cost relating to the disposal of the sludge, whether it is to be discharged to land or to a wastewater treatment plant.

Groundwater pollution

Wastes that drain through the soil may cause pollution, leading to the need for an alternative water source. If this possibility only applies to one alternative, the possible costs should be estimated and allowed for.

Sullage disposal

Some systems accept sullage water as well as excrete, thus obviating the need to invest further in sullage removal. This difference should be included where necessary.

Waste reuse

If the waste products can be reused, for example, sold to farmers as fertilizer or used in a biogas plant, the benefit to be gained should be offset against the costs.

Governmental and agency management

Most sanitation schemes bear some hidden costs of agency management and promotion. Where alternatives have markedly different charges associated with them, these should be included.

Analysis

The economic cost of each alternative is determined by calculating all the costs involved in the construction, operation, emptying and maintenance of a particular system over a specified period of time, modified by any appropriate shadow factors. All costs are then discounted by multiplying by a discount factor according to the year in which they will be incurred. This gives the present value of those costs. The present value represents the amount of money required now to be able to pay all expected costs in the future. The present values for each year are then summed to give a single figure of the total present value of the entire life-cycle cash flow, that is, the economic cost for each alternative.

Where alternative systems being compared are expected to last for different periods of time (that is, they have different design lives), it is necessary to take a standard duration in order to make a fair comparison. For on-site sanitation, periods of 10 or 15 years are appropriate. All the costs likely to be incurred during this period for each alternative should be calculated. If the time period is longer than the design life of a system, it is necessary to include rebuilding costs. For a fair comparison it is advisable to choose a standard time that best fits the design life or as nearly as possible a whole multiple of a design life of the alternatives.

Least-cost analysis may be used to compare on-site sanitation with a conventional sewerage system. The nature of the discounting technique, where future costs have a much lower economic impact, tends to favour systems with low initial investment and higher recurrent costs.

Total annual cost per household

An extension of the least-cost analysis approach is to consider the total annual cost per household (TACH) (Kalbermatten et al., 1982). The initial construction costs are calculated as described above. Because the maintenance costs of most on-site sanitation systems are dependent on the number of people using the system, an average household size appropriate to the area should be selected, usually in the range 6 10 people.

The TACH is calculated by considering the total present value (PV) of the life-cycle cash flow (as described above) as the equivalent of a loan which has to be paid back over the design life of the system at constant, non-inflated prices. The value of yearly repayments, including interest, is obtained by multiplying the present value by a capital recovery factor. This factor is taken from capital recovery factor tables which are based on the equation:

Capital recovery factor = r (1 + r)^t/[(1 + r)^t - 1]

where

r = discount rate
t = design life in years

An example of a TACH calculation may be found at the end of this chapter (example 10.2).

Analysis by TACH may be used to compare on-site sanitation systems with conventional sewerage systems. Kalbermatten et al. (1982) calculated that the cost of on-site sanitation was between 5% and 10% of that of conventional waterborne sewerage systems.

Cost-benefit analysis

Having determined by least-cost analysis the present values of alternative systems, it is normal practice to compare the costs with the present values of the expected benefits. Investment appraisal requires that the present values of benefits should be greater than the present values of the costs. Where alternatives are being considered, the system with the highest margin of benefits over costs should be chosen.

Benefits to be considered include enhanced privacy and convenience for the users, and environmental protection, as well as the reduction and anticipated eventual elimination of excrete-related diseases. Multiple benefits from a single intervention are extremely difficult to isolate and determine, especially where benefits such as improvements in health are interrelated with other basic needs such as nutrition and water supply. Quantification of the benefits of sanitation therefore tends to focus on the more readily measurable reduction of disease and the subsequent increase in productive life expectancy, increase in work capacity, and the reduction of demand for medical facilities and drugs.

Quantification of perceived improvements in the quality of life (for example, not having to squat at the edge of the street before dawn) is based on the value attached to the improvement by the users. Logically this can only be measured by considering the amount people are prepared to pay for those elements of a sanitation system that are most closely related to comfort. However, in most cultures, the investment decisions will be made by men according to their priorities, whereas the greatest benefit is likely to be felt by women who may be unable to declare their preferences.

There are other sanitation benefits to be added, such as reuse of composted or digested excrete for agricultural purposes, or production of biogas for energy needs. However, the benefit to be obtained from this reuse is only occasionally significant.

Quantification of the benefits to be derived from sanitation is extremely difficult. Low-cost sanitation is usually considered as a basic human need, required for human dignity and development as a whole. Economic analysis is therefore best used to compare alternative techniques to determine the least-cost method. This approach is particularly necessary where many of the anticipated environmental or public health benefits will not be realized immediately owing to the necessarily slow pace of community involvement.

A suitable approach to economic analysis is described in the Guide to practical project appraisal (UNIDO, 1978) in which it is stated that the literature of project (economic) appraisal commonly gives the impression that the goal is to produce a set of numbers that show whether a project is good or bad but that in reality it is not the numbers themselves that are important, but rather the appreciation of the project's relative strengths and weaknesses that is gained. The numbers are simply an instrument that forces analysts to examine all relevant factors, and a means of communicating their conclusions to others.

Financial factors

Financial costs represent the money or cash that has to be paid by householders and donor agencies to build and operate a sanitation system (together with allowances for depreciation and bad debts). Financial costs are the main concern of householders and donor agencies whereas economic costs are of greater interest to project planners.

Financial costs of sanitation systems

Labour

Although it is often assumed that the householders can provide much of the labour themselves, this is usually only correct in rural areas. Particularly among disadvantaged groups, such as the disabled, the elderly, and households headed by women in urban areas, skilled and unskilled labour has to be paid for.

Building materials

Most items, such as concrete blocks or bricks for pit linings or superstructures, cement for the slabs, water seals, vent pipes, fly screens, roof sheeting and doors, have to be paid for. Only in the rural areas are timber and other materials normally free of cost. Routine maintenance, such as repair of superstructures and renewal of fly screens, will involve costs in the future.

Water

For septic tank systems in particular, but also for pour-flush latrines, an allowance must be made for extra payments for the water required for flushing.

Cost of money

Interest rates may be payable on loans either at market rates or at subsidized project rates.

Emptying and disposal

Allowance should be made for possible future hiring of labourers for the emptying of double pits and the removal of digested sludge, or for the hiring of a vacuum tanker for sludge disposal.

Waste reuse

In certain limited situations there may be a cash income from selling sludge to farmers.

Governmental and agency management

Management costs are not normally passed on to householders but remain as a hidden subsidy. Mara (1985b) suggested that the institutional and project delivery costs may be assumed to be about 45 % of the sum of labour and material costs.

Affordability and financial assistance policy

Economic analysis of development projects attempts to show where scarce resources such as capital might be used to best effect. Economic theory requires that, to maximize the benefit to a nation, the financial costs charged to the users should reflect economic costs as closely as possible. However, if the users cannot afford to pay the recommended costs, they will never install a sanitation system and the society as a whole, as well as individual households, will fail to receive the anticipated benefits.

The general policy of international lending agencies is that if the cost of the minimal sanitation facility necessary to ensure adequate health is more than a small part of the household income, then the central or local government should subsidize its construction to make it affordable. Any operation or maintenance costs should be borne by the beneficiary. If, however, some consumers wish to have better or more convenient facilities, they should pay the additional cost themselves. Similarly, if more affluent communities decide that, beyond meeting basic health needs, they wish to safeguard the cleanliness of their rivers or more general environment by building a more expensive sanitation system, they should pay for that system either through direct user charges or through general municipal revenues (Kalbermatten et al., 1982).

Affordability is generally believed to be in the region of 1.5 3% of total household income, that is, total financial costs incurred in a year (initially high investment costs may be spread over a period by use of loans) should not be higher than 3% of total household income for that year. Among the poorest in a poor community, this figure of affordability falls to 1-1.5% of household income.

In many countries, any subsidy of costs over and above this level of affordability has to be rigorously controlled. Development budgets are normally insufficient to subsidize to any significant extent a large number of latrines. There is a danger that small-scale pilot projects with external donor assistance might be given a large subsidy, on the basis of the need to promote the concepts of effective sanitation, when such subsidies could not be extended to a larger scale during expansion of the implementation programme.

There are two other reasons for carefully controlling the level of any subsidy. (1) In some countries, private enterprise can become involved in making and selling the components for sanitation on a large scale. Any subsidy to government projects reduces the profit potential and, therefore, the incentive for private contractors to become involved. Direct subsidies to nongovernment enterprises are usually unacceptable in countries where there is a risk of poor administration. (2) Where a system is not affordable it is usually not maintainable, that is, where the people cannot afford the technology chosen, it is likely that they will also not have the funds to maintain the structure and empty the pits or tanks. The system will then quickly fall into disrepair and the investment will be wasted.

The financial costs of any proposed sanitation system therefore need to be examined very closely. If necessary, installation of pit linings, water seals, vent pipes, cement slabs and superstructures may have to be postponed in order that, at the initial stage, the maximum number of people may benefit from a system which, however simple, leads to a reduction in excrete-related disease.

Where financial subsidies are employed, they should not favour one sanitation system over another in such a way that the economic ranking of alternatives is chanced (Kalbermatten et al., 1982).

Financial assistance

Financial assistance may be necessary to start a sanitation programme and, in countries with appropriate resources, subsidies may be a useful means of quickly propagating public health improvement. Where people cannot afford even the simplest form of sanitation, particularly in urban areas, society as a whole has to pay for the required social benefits through general taxation. However, the use of direct grants is not recommended because of the danger of funds being diverted for purposes other than sanitation.

From India, Roy et al. (1984) suggested that if a programme is designed to serve the poorest groups, a subsidy has to be provided. One method of determining the extent of the subsidy is to use a means test. This may be based on the public utilities (water, electricity, etc.) available in the household. For example, households with no utilities might receive a 75% grant and a 25% loan. Where more utilities are available, the proportion given as a grant decreases. However, even for the poorest households, a small loan component requiring repayment is generally recognized as being vital to ensure effective care and use of the latrines, which only occurs when ownership is clearly vested in the householder rather than the agency.

A revolving fund or loan scheme, whereby money is lent at normal or subsidized interest rates for varying periods of time, may be of great importance. Monthly repayments on loans should be fixed at an affordable level. It is recommended that, if possible, loans for latrines should have a shorter repayment period (for example two years) than loans for housing. This is because benefits perceived by the householder are often limited and they may therefore lack motivation to continue payments over a longer period. Where the people have been fully involved in the construction of their latrines, small loans are usually repaid. If a programme is pushed through by an agency without effective community participation, it is likely that there will be a low return.

Revolving funds are a particular form of loan scheme where initial finance from government or a donor is distributed. The fact that there is only a certain amount of money available provides added incentive for borrowers to repay their loans, since other borrowers may have to wait for a loan while their neighbours repay.

There are many possibilities for combining the different types of financial assistance. A government agency might implement and maintain a sanitation system with full or partial cost recovery through tariffs or local taxation. This is more usually the case with a waterborne sewerage system than with on-site sanitation. The householders might do all the work themselves, assisted by grants or loans. They may achieve viable systems simply by accepting advice from external sources. Or the substructure might be constructed by an agency with costs recovered through a tariff, and with the householders building the superstructure with the help of a loan.

Wherever possible, financial assistance should be kept to a minimum, with design and technology appropriate to affordability in the various income groups targeted.

Costs of sanitation systems

A survey of sanitation by WHO (1987c) suggested that funding limitations are still the most serious constraint on achieving the goal of sanitation for all. The costs of different sanitation systems vary greatly according to country, current exchange rates, and skills needed for designing and implementing on-site technology. The figures given here (from WHO, 1987c, and other sources) are an indication of current costs per person served. However, it should be recognized that these costs are liable to considerable change, even over a short period. The WHO survey discovered increases in median figures between 1980 and 1985 of 131% for individual urban household sanitation in the least developed countries. The survey also noted a 30% decrease in per capita costs for rural sanitation in one region.

In South-East Asia, the per capita cost of sewer connections in urban areas in 1985 varied from US$ 45 to US$ 400 with a median cost of approximately US$ 80. To this must be added an annual water charge in the region of US$ 5 per person served. Low-cost on-site alternatives were costing US$ 13 30 per person in urban areas, and US$ 5-20 per person in rural areas.

In Africa south of the Sahara, sewer connections were reported to cost US$ 120-300 with accompanying water costs in the region of

US$ 8 per year per person. The median sewer connection cost was US$ 150, with urban on-site alternatives ranging from US$ 25 to US$ 70. Rural sanitation costs were in the range US$ 10 45 with a median of US$ 25 per person.

In Central and South America, sewer connection costs varied from US$ 120 to US$ 235 with a median cost of US$ 150, the same as for Africa. Urban on-site sanitation cost US$ 20 80 and rural sanitation ranged from US$ 10 to US$ 50, with an average of about US$ 25 per person served.

Examples

Example 10.1. Least-cost analysis

Two alternative on-site sanitation systems (A and B) are to be considered. The discount rate is taken to be 10%, the shadow exchange factor (SEF) for imported goods is 1.3, the shadow wage rate (SWR) for labour is 0.6, and the institutional and promotional costs are 30% of the initial capital cost. All costs are in dollars.

System A costs $ 71.80 at the initial construction stage and $ 10 for the use of a vacuum tanker every 5 years. The anticipated life of the system is 20 years. Note: the effects of inflation may be ignored.

		Materials			Labour
		Coat	SEF	Shadow cost	Cost	SWR	Shadow cost
Costs of pit:	excavation				5.00	0.6	3.00
	lining - bricks	15.50		15.50
	lining - cement	5.00	1 3	6.50
	construction				2.00	0.6	1.20
Costs of slab:	cement	10.00	1.3	13.00
	steel reinforcing bar	3.00	1.3	3.90
	aggregate	0.50		0.50
	construction				2.00	0.6	1.20
		34.00		39.40	9.00		5.40
Total economic cost		44.80
Cost of superstructure (calculated in a similar manner)		27.00
Subtotal		71.80
Cost of institutional support and sanitation promotion (at 30%)		21.50
Total economic investment cost		93.30

System B costs $ 55 for pit, slab and superstructure at the initial stage, with the same amount for a new pit and superstructure after 10 years, at the end of the original design life.

Total economic cost	55.00
Total economic investment cost (calculated in a similar manner to System A above)	71.50

Least-cost analysis

System A			System B
Costs (a)	Discounted costs (a) x DF	Year	Discount factor DF	Costs (b)	Discounted costs (b) x DF
93.30	84.80	1	0.909	71.50	65.00
10.00	6.20	5	0.621
10.00	3.90	10	0.386	55.00	21.20
10.00	2.40	15	0.239
123.30	97.30 (present value)			126.50	86.20 (present value)

By least-cost analysis, the present value of system B is slightly less than the present value of system A. However, the difference is not enough to allow one system to be chosen in preference to the other on economic grounds alone.

Example 10.2. Total annual cost per household

The total annual cost per household (TACH) is determined by multiplying the present value of each system by the capital recovery factor (CRF). Using the formula given in the text (page 167), and at an interest rate of 10% over 20 years, CRF = 0.118.

From the figures calculated in Example 10.1:

System A	System B
Present value = $ 97.30	Present value = $ 86.20
TACH = 97.30 x 0.118	TACH = 86.20 x 0.118
= $ 11.50 per household	= $ 10.20 per household
per year	per year

Example 10.3. Financial and affordability analysis

Using the figures given in Example 10.1 for system A, it is assumed that the householder is contributing time to excavate the pit and to construct the slab and superstructure.

Financial costs to be paid by household

	$
Labour	0.00 (given by household)
Bricks	15.50
Cement	5.00
	10.00
Steel	3.00
Aggregate	0.00 (collected by household)
Total	33.50
Superstructure	14.50 (assumes household labour contribution of 12.50)
Total	48.00

Determination of repayments

Assuming a subsidized interest rate of 5% with the loan to be paid off over two years:

Capital recovery factor = 0.538
Annual loan repayments = 0.538 x $ 48.00 = $ 25.80
Check on affordability: annual average household income estimated for this example as $ 380.
Repayment as percentage of annual income = (25.80 x 100)/380 = 6.8%

This would normally be too high for a household to pay, so repayments over four years at a subsidized rate of interest of 3% should be considered:

Capital recovery factor = 0.270
Annual repayments = 0.270 x $ 48.00 = $13.00
As percentage of annual income = (13.00 x 100)/380 = 3.4%

This may be acceptable, depending upon the cost of living, and repayments would be completed before the first pit-emptying cost is incurred. As an alternative to subsidizing the rate of interest, it might be possible to sell the latrine slab at a reduced cost. It would be unwise to sell the cement or steel at reduced cost because of the dangers of the materials being used for other purposes. Another alternative is to encourage the use of different building materials to reduce the cost of the superstructure.

Affordability with loan at full rate of interest, repayable over 4 years, slab sold at half price and reduced cost superstructure:

Financial costs to be paid by household

	$
Labour	0.00
Bricks	15.50
Cement	5.00
Cement\
>> as half price slab	6.50
Steel	//
Aggregate	00.0
Total	27.00
Superstructure	9.50 (reduced-cost design)
Total	36.50

Capital recovery factor = 0.315
Annual loan repayments = 0.315 x $ 36.50 = $ 11.50
Repayment as percentage of annual income = (11.50 x 100)/380 = 3%

Determination of subsidy

With subsidized rate of interest: assuming a real interest rate of 10%, capital recovery factor = 0.315 for four years. Without subsidy, annual repayments would be $ 15.10. With a subsidized rate of interest of 3%, subsidy = $ 2.10 annually for four years in addition to the institutional and promotional costs paid by the agency of approximately $ 22.

With subsidized slab cost: the subsidy represents half the cost of a householder making a slab. Therefore the agency has to pay labour charges as well as half the material costs. Subsidy = $ 2.00, labour and materials = $ 6.50, total subsidy = $ 8.50, in addition to the institutional and promotional costs.

Chapter 11 - Development

Implementation
Operation and maintenance
Evaluation

Implementation of a successful sanitation project usually follows a recognizable pattern. After the initial surveys, as described in Chapter 9, a demonstration or experimentation phase is required. The demonstration phase is a practical test of the feasibility of the recommended options. This is followed by a consolidation period (Glennie, 1983), primarily to organize the institutional aspects of the project, leading on to the mobilization or expansion phase, when most of the sanitation facilities are constructed.

For the benefit of the agencies involved, it is always advisable to conclude the project with some form of monitoring or evaluation in order to determine how effective it has been. The time scale can vary according to the size of population to be served, its receptivity to development ideas and the financial resources available. However, it is usual to find that the whole sequence takes years rather than months.

Implementation

The purposes of the preliminary surveys are to determine the extent to which a sanitation programme might be effective and to begin to determine the most appropriate means of meeting public health needs. If the surveys indicate that there is a possibility of a programme being successful, a demonstration phase is required. This phase has three main objectives:

- to identify the techniques and materials that will be most cost effective;
- to demonstrate the resulting sanitation systems to the community and the government;
- to begin to stimulate demand for sanitation from individual householders.

Experimental period

An experimental period is normally required for a new sanitation project, during which field staff investigate whether the proposed combination of materials and techniques will work effectively at an affordable level in the particular sociocultural and geographical situation. For example, different systems may need to be compared, and certain elements, such as pit linings, concrete slabs or water seals, may need to be adapted in order to use locally available materials.

Particularly where new techniques or materials are being introduced, the initiators need to carry out a pilot project to work out the technical details to their own satisfaction before promoting the idea to others. Low-income communities cannot afford the risk of installing an unproved system at their own expense.

The period of experimentation also provides an opportunity for informal training of field staff. Those involved in trying out the various alternatives learn the advantages and disadvantages of many different techniques. They can then subsequently explain in convincing detail and from first-hand experience why certain options are being recommended to the prospective users.

If an affordable design is already well recognized and accepted by the prospective users, the experimental phase may be omitted.

Demonstration

As the project staff gain confidence in the technologies they are promoting, the experimentation period will merge into the demonstration phase, when all interested parties can see the proposed facilities and make their own recommendations and decisions. This enables the promoters to ensure that the technology selected is socially and culturally acceptable to the people. In particular, community representatives and leaders should be given the opportunity to see and discuss the proposals. Results of surveys (which respondents may not always have understood) can be checked against the reality of a demonstration unit.

Government officials from both the sponsoring ministry and related departments and ministries should be encouraged to participate in discussions about the demonstrated systems. Particularly where officials believe that the only acceptable form of sanitation is a high-cost waterborne sewerage system, it is necessary to show that low-cost on-site systems are viable alternatives. Where nongovernmental organizations are involved in the provision of sanitation, it is important that the appropriate government departments have the opportunity to comment at this stage.

The experimental trials are most effective when carried out within the target area at a workshop belonging to the agency or a sympathetic institution, and where prospective users can see the alternatives being tried. The subsequent demonstration sanitation system may be a completed experimental unit or a new system at a new location. The demonstration unit is best installed where local people can try it out in something approaching normal conditions. This may reveal further problems or limitations.

Pilot projects or demonstration systems should be located where people who are committed to the programme can regularly monitor and maintain the latrines. Because a demonstration unit, used by different people, can so easily become fouled, locations that may seem suitable, such as health centres, schools or community buildings, are not always effective sites. More usefully, a health worker's home or the compound of a community development officer who is prepared to care for and maintain the system can be used. Alternatively, the home of a motivated member of the community might be suitable. Where there are village development committees, and particularly where there are water and sanitation committees, prominent members may host demonstration units.

The experimental phase may produce several designs that appear to be suitable for a particular project area. Alternatively, one option that can use a range of different materials may be viable. Variety of design should be encouraged if it enables householders of differing income levels to participate. For example, a ventilated pit latrine can work equally well with a concrete slab or a maintained earth and pole slab. The demonstration phase should show how each solution can be used within the community and at the same time draw attention to possible ways of upgrading the system when financial circumstances permit.

Stimulating demand

The selection of an appropriate sanitation system should be the responsibility of the people who will ultimately use it. The demonstration phase may be considered as a shop window where potential consumers can see what is on offer at a particular price and determine the model they require. Although most of the selling will go on during the full implementation phase, it is useful, even at this preliminary stage of the project, to begin to stimulate demand.

In many sanitation projects, the public health professionals take a strong lead in initiating the feasibility and demonstration phases. However, the responsibility for successful construction, operation and maintenance should be transferred to the community at the earliest opportunity, preferably before the full implementation or expansion phase starts. Experience has shown that the most successful sanitation projects involve a partnership between the people who will use the scheme and an assisting agency. The agency may be tempted to take too strong a lead role and to attempt to move the programme along too quickly. Working without adequate community involvement may appear to achieve progress in the short term, but it is often to the detriment of the project in the long term.

Wherever possible, low-cost on-site sanitation should be planned and built by the people, operated by the people and maintained by the people. The aim is for minimal agency participation in a community project. As described above, the agency can significantly assist with experimentation and demonstrations to aid people in the decision making process. The agency can attempt to ensure that the right people have visited demonstration projects. It can help local organizations and government bodies to be aware of the issues by preparing clearly presented documentation. However, to be certain that the people know that the project belongs to them and is under their control, it is important for the agency to restrict its role and not try to direct the project. The community and particularly the individual householders have to sort out their own priorities and move forward at their own pace. This may appear to delay progress and it may frustrate helpers, but true community decisions take time.

Glennie (1983) commented that programmes in which people have been forced to build latrines or where latrines have been provided free of cost have generally failed. "It is essential that a villager builds a latrine only as a result of a conscious decision that he wants to use one. It is the use, rather than the construction, of the latrine that is crucial. The strategy to be adopted therefore, is to encourage at least some villagers to decide that they want to use latrines, thereby stimulating a genuine demand."

In terms of the project cycle, information derived from the demonstration phase concludes the feasibility stage. At this stage, some governments and donor agencies may require an appraisal of the proposals, in the form of an independent check on the work that has been carried out. This appraisal normally covers technical, social, health, environmental, institutional, financial and economic criteria to determine whether the project is well planned and worthy of further investment. On the basis of the appraisal, the donor or government ministry may subsequently approve the decision to proceed with the project. This enables the consolidation phase to commence.

Consolidation

At the community level the distinction between the demonstration phase and the consolidation phase may appear blurred. However, there comes a point where the basic technology has been proved to be feasible and the project is generally acceptable. Before widespread implementation can begin a period of consolidation is required, primarily to organize the institutional aspects of the project. The demonstration units should continue to be operated and cared for, but the primary thrust at this stage is to determine the support (technical, financial, material and administrative) that the agency will have to provide in order to enable householders to build their own latrines. Training of community personnel and technicians, identification of community leaders, involvement of staff from the health, education and other sectors, confirmation of sanitary codes and regulations, testing of promotional materials, and general administrative support all have to be considered.

Governmental approval

The agency should finalize, as far as possible, the recommended designs for latrines, and seek the widest possible governmental acceptance for the programme. This approval should be sought not only from the institution directly responsible for sanitation but from all interested ministries, councils and committees. However, following on from the demonstration phase and initial contacts with community leaders, the agency and other institutions have to recognize that householders are unlikely to come to a clear-cut decision. Unless the community is unusually homogeneous, it is probable that the people will want a range of options at varying costs. For example, at the simplest level a lined pit could be constructed with a wood and mud slab and only a screen for privacy. At a later date, the household may be able to afford a concrete slab to replace the timber and mud, and then later still a permanent superstructure could be built. On the other hand, some families may be able to afford a concrete slab from the outset.

In certain situations, some latrines may later be upgraded by connection to a main sewerage system, but it is normally impracticable to make specific plans for such improvements in the early stages.

Institutional support

The flexibility required to meet the differing expectations of householders makes the agency's work more difficult. The assistance proffered has to take into account the various income levels and preparedness of the different groups to invest. The agency therefore needs to focus on the aspects of the programme that are crucial to its success. These may be technical, financial, institutional, social or promotional, but the agency would do well not to be diverted into trying to enforce one set solution. In many projects this means that the superstructure, design and construction are left to individual householders, while the agency concentrates on general promotional work and helping with slabs and linings along with the water seal (and connecting pipe) or vent pipe, where required.

The approach adopted by the agency must be worked out in advance of widespread promotion within the community so as to minimize any confusion. Whichever approach is taken, standardized procedures should be fixed during the consolidation period. Agency staff can then be trained in these procedures to enable them to give clear and coherent advice to householders.

Any necessary administration required to support the field staff should also be determined on the understanding that it will be there to assist rather than to restrict or limit.

Training

Sanitarians and technical staff who were not involved in the demonstration phase should be told about the results and techniques developed earlier. Related staff, such as health workers and sociologists, should also be given an introduction to the programme. The extent of training needed will depend on their proposed role within the programme, but at the least they should be fully informed as to what is expected of the householders.

Similarly, teachers in local educational establishments should be introduced to the programme and ideally provided with suitable educational material to use with their students. Artisans not directly responsible to the agency but who may become involved as small contractors should be trained in any specialized techniques that may have been developed during the experimentation. Training programmes for householders should be prepared and tested for later use.

Pre-testing of promotional materials

Any leaflets, plans, posters or other explanatory or promotional material should be pre-tested during the consolidation phase to ensure that the message being received by the readers is the one intended by the promoters. Similarly any teaching materials for schools should also be tested.

Sanitary codes and regulations

Basic legislation is necessary to enable a public health agency to initiate and develop activities in the field of public health and sanitation. Enabling legislation is normally confined to statements of broad principles, responsibilities and penalties. On the basis of such legislation, the public health agency concerned is in a position to formulate more detailed rules, regulations and standards.

Any existing sanitary code may exert a strong influence on the nature and content of an excrete disposal programme. If the sanitary regulations are outdated, or too elaborate or exacting, they may restrict both the technical and the administrative aspects of the project. Such regulations may defeat their own purpose and are often ignored by the population. When suitably drafted, regulations are useful in helping to ensure a basic minimum of sanitary safeguards and the elimination of potential health hazards, especially in densely populated communities. They usually deal with and prescribe standards for such matters as: the prevention of soil and water pollution; the disposal of human and animal wastes; the hygiene aspects of housing; the protection of food supplies; the control of arthropod, rodent and mollusc hosts of disease; and the use of surface water.
When elaborating sanitary regulations it is important to keep in mind the following principles:

· No regulation should be made that cannot be enforced.
· No law can be enforced without the cooperation of most of the people concerned.

Rules and regulations applying to excrete disposal in low-income areas should be reasonable and no stricter than necessary; above all they should be in accordance with the basic principles of sanitation. It is important to consider every contigency that may occur within the foreseeable future, and the best way to do so is to consult the people for whose benefit the regulations are formulated. While the experience of others may be useful in drafting new regulations, it is always a mistake to adopt the regulations of another country without making necessary modifications.

On the need for the cooperation of the people in the enforcement of legislation, Lethem (1956) wrote, "No form of control can be effective without the support of most of the people concerned, backed by an enlightened public opinion. Hence, education must precede legislation; in fact it might be described as the father of legislation. The lower the standard of education, the greater the need for careful preparation before new regulations can be introduced and enforced. It is better to start in a small way and work up, than to introduce a multiplicity of rules and raise a wall of opposition, which makes enforcement difficult. Legislation alone cannot improve hygiene. To launch regulations without first preparing the way, is like sowing seed without first ploughing the ground. Old traditions die hard, and bad habits are not easy to change."

This statement is particularly applicable to excrete disposal programmes, which are designed to bring about changes in people's attitudes and practices. In this field, public health instruction is more important than compulsion, and sanitary inspection should not have as its primary aim the enforcement of regulations by means of sanctions.

There may be particular areas of concern in existing by-laws which may limit the freedom to introduce low-cost sanitation programmes. For instance, regulations may specify that only water closets connected to a sewer or septic tank are acceptable in urban areas. Other rules may specify a minimum depth for pit latrines which would be unrealistic in particular ground conditions. It is important that these points are amended after full consultation. The most suitable time to make changes is during the consolidation phase, after the various technologies have been tested but before the expansion phase.

Other points to be considered for legislation include the following:

· Defecation in streets and public places should be illegal once sanitary facilities have been made available. Households should be required to install sanitation systems within a specified time of the sanitation programme commencing.

· No new housing developments should be allowed to proceed without suitable sanitation provision.

· The letting of any house or part of a house or household plot for residential purposes without sanitation facilities should be illegal.

· Where a landlord fails to provide sanitation within a specified time, tenants should be empowered to construct facilities and deduct the expense, as agreed with the agency's officers, from the rent payable to the landlord.

· In certain circumstances, local authorities may be empowered to recover loans for construction of latrines from the beneficiaries through local taxation (Roy et al., 1984).

Mobilization or expansion

The mobilization or expansion phase aims to encourage and enable every householder and institution in the target area to acquire satisfactory sanitation facilities within a certain period of time. This period of expansion may be considered in terms of promotion and construction. Promotion consists of convincing individual householders that they need to improve their sanitation and have the capability to do so. Once the householders make their decision, the individual construction phase begins with particular requirements for support.

Promotion

The mobilization phase is a time of mass communication. It is an opportunity to share information and lessons learnt from the preceding stages with the target group for the programme. Health education to explain the need for sanitation usually has to be stressed as strongly as the proposed solutions. Until people understand the objectives of the project and why sanitation is so important to them, they are unlikely to be fully committed to it. However, in considering the methods of health education and promotion listed below, it is helpful to remember that the primary motivation for sanitation is often the desire for privacy and convenience. Ultimately it has been found that most people choose to improve their sanitation when they see that their neighbour has a clean affordable system which is pleasant to use.

Sanitation may therefore be seen in certain circumstances as a consumer product. The technology that is successful in terms of user take-up has to have some of the attractiveness of any consumer product in addition to being effective and of good value (Franceys, 1987). A valid approach to the promotion of latrines is to consider them as products to be marketed to individual households using all the skills of the advertising and marketing industry.

This approach has been taken in programmes where the experimentation or demonstration workshops have been turned into sanitation centres. These are effectively shops where prospective customers can come to inspect the options available in the various price ranges. They can then discuss with a "salesman" the possibilities of purchasing a system and hear of the special offers open to them regarding technical assistance and financial help. This approach is particularly appropriate for on-site sanitation where each system stands on its own, unconnected to any sewer lines or communal facilities.

A more conventional approach is to consider initial promotion as part of a health education programme which has the following purposes:

· to demonstrate the possibility of improving the health status of the individual and the household;

· to demonstrate the link between well-being, health and sanitation practices;

· to create a desire for improvement in sanitary habits;

· to help determine what changes are needed and desirable for improving sanitation and how they can be implemented;

· to encourage people to put into practice good habits of personal hygiene, and measures to improve personal, home and community sanitary conditions;

· to secure sustained interest and participation in a community programme of environmental health improvement.

There are many methods of promoting health and improved sanitation as a means to health. The ideas listed below should be used in a mixture that suits the culture and aspirations of the people at the time of the programme. It is important to note that the extent of promotional activities should be linked to the agency's capacity to assist with construction of sanitation systems. Otherwise considerable frustration may build up which could be counterproductive.

Meetings and visits

Various types of meetings can be used, for example, individual discussions with community leaders, house-to-house visits by community development officers or sanitarians, visits by women health workers to the women in the community, and general public meetings where the wider issues can be discussed by the whole community.

Role of schools and teachers

Schoolteachers, especially at primary level, should be trained to prepare the children to use sanitation facilities correctly at school and to understand the need for hygiene and latrines at home. Special lessons should be given to help children understand that a clean water supply with effective sanitation can lead to improved health. This will not only be of benefit to the children but will also serve to reinforce the health message to the community as the children report back to their parents.

Demonstrations and mass treatment

Demonstrations may be held using microscopes to show what can be seen in apparently clean water. This is most effective when what is seen can be shown to result from inadequate sanitation. Where such demonstrations can be linked with special clinics to treat people who are ill from excrete-related diseases, a powerful lesson can be provided.

Community groups

Selected target groups within the community may be invited to participate in drama or role-playing related to health education and the need for sanitation. Stories and songs can also be effective ways of communicating ideas.

Leaflets

Simple technical information leaflets are required, containing illustrations and drawings that have been pre-tested. The leaflets should describe the different parts of the system, and explain how they work together and how they can be constructed. Written information may also be supplied detailing the help that each household can obtain from the agency. Even if householders are illiterate they are likely to be able to call upon others to explain. It is important that everybody has equal access to details of assistance. Vague promises given at public meetings are not sufficient.

The information given should stress that any solution can eventually be upgraded. Even if householders find that they do not have the required piped water or that they cannot immediately afford the type of sanitation they desire, they should be able to see that there are ways to upgrade their facilities in stages while enjoying the benefits of improved sanitation.

Training

Ideally, the skills that may be required by local artisans or technicians should be transferred during the consolidation stage. However, where training is also required during the expansion phase, simple practical sessions or demonstrations, where participants construct components and complete systems in selected households in the target area, are effective as a form of promotion as well as training.

Use of the mass media

There are many forms of the mass media that can be used for promoting specific sanitation options as well as for health education. Their use and the balance between them will depend on the size of the target group, the relative wealth of the people and the availability of funding. Posters, billboards, newspapers, radio, loudspeaker trucks, slides, flip-charts, film, video, and broadcast television have all been used successfully in differing mixes. Careful planning is necessary, as too much information and health education coming too soon may lead to a build-up of resistance against the ideas. Karlin &Isely (1984) considered in detail the use of audiovisual materials for use in sanitation programmes.

Care should be taken to ensure that all the agencies, institutions and health-related bodies have prepared their staff to give the same message. Any conflict between them will lead to mistrust on the part of prospective users.

Construction

Selection of system by householders

In the majority of cases individual householders will be responsible for organizing the building of sanitation systems at their own houses. Having chosen the system they feel best fits their needs, they will benefit from continued assistance and support during the construction period.

Technical assistance

Technical advice regarding the choice of system, the best site for a unit, the depth to which any pit should be dug, and requirements for lining, ventilating, sealing and covering the pit should be available from technicians who can visit the household for detailed discussions. This information should also be available in the form of a written leaflet.

Where required, an auger kit for drilling trial holes may be used by the technical staff to determine the best place to dig the pit.

Training for householders

Short training sessions may be held at the demonstration workshop to teach householders how to dig and line pits and how to make slabs, vent pipes or seals. Alternatively, householders may be helped to make their own components at the demonstration site.

Identification of contractors and artisans

Although the skills required for latrine construction are relatively simple, many householders may prefer to pay others to carry out the work. A project can assist by identifying pit excavators, masons or contractors who are trained and able to carry out the work to a satisfactory standard. Agreements and pricing levels may also be negotiated by the agency on behalf of the householders.

Tools and moulds

Special tools, such as iron bars, pickaxes, spirit levels, or plumb-bobs, that are not normally available in the community, may be provided, for loan, hire or sale. Similarly, reusable moulds for concrete lining rings, slabs or water seals may also be made available by the agency.

Materials

Where the cost or a shortage of materials necessary for construction causes difficulties, the agency may help with procurement. There is, however, a danger that such materials will be misused, either by incorporation in nonsanitary household building work or through resale to traders. Because of this, materials support is often limited to the provision of precast components of a sanitation system, such as slabs, seals and vent pipes. These may be sold at commercial rates to encourage their production by local businesses, thus fostering industrial development (International Development Research Centre, 1983). Another alternative is to sell at cost price to ensure that people are paying the real cost of their sanitation and to enable a revolving fund to be set up to help others.

Where ventilated pits are recommended, PVC-coated glass fibre or stainless steel fly screens should be readily available from the agency. It is unlikely that householders will be able to purchase such material from local merchants. The alternative mild steel fly screens corrode quickly, giving rise to a significant problem with flies.

Finance and subsidies

As discussed in Chapter 10, the financial costs to be paid by the householder usually reflect the economic costs (that is, the overall cost to the nation) as closely as possible. However, where it is considered necessary for reasons of social welfare, subsidies may be employed.

Subsidies may be used where the poorest people in the community would not otherwise be able to afford a sanitation system, though care must be taken to ensure this is not simply an excuse to promote inappropriate technology (e.g., to use a more expensive alternative). Subsidies may also be employed where people are unwilling to invest in sanitation because they remain unconvinced as to the benefits to be gained, or where householders are reluctant to invest in what is perceived to be a temporary form of sanitation which does not confer the desired benefits of status and convenience. Finally, subsidies may be used where the agency desires to speed up the development process, to encourage more people to install systems at a faster rate than would otherwise be possible.

The methods used have included subsidized (low-interest) loans for construction of the complete system or loans for the purchase of specific materials or components. These loans usually form part of a revolving fund, set up by a donor, a proportion of which is made available for further projects in other areas. Loans may be totally free of interest or may include a nominal rate of interest to pay overhead charges. Where loans are charged at full commercial rates of interest there is no direct subsidy involved.

A subsidy may also be in the form of a grant for materials or components or as materials or components provided at reduced cost. One approach has been for grants to be made to householders on completion of an acceptable latrine, as an added incentive. Indirect grants may be given in the form of technical assistance or general project assistance which is not charged to the householder. Similarly, some projects may establish shops to sell building materials at cost price, avoiding normal trader profits. There is, however, a subsidy in the form of the overhead costs of the materials store.

The aim of subsidies is to enable householders to construct an acceptable sanitation system at the earliest opportunity. The resultant system has to be at a level where the householder can afford the recurrent costs of operation and maintenance. The level of the subsidy is gauged as the level that enables a sustainable system to be built which is still perceived by the householders as being under their ownership and control.

In India, experience suggests that if a programme is designed to serve the poorest of the poor, a subsidy has to be provided (Roy et al., 1984). But even for the poorest households, a small loan component requiring repayment is recognized as being vital to ensure effective participation and use of the latrines.

Site supervision

Information leaflets and training courses alone are not sufficient to ensure that latrines will be built correctly. Technical helpers need to pay visits to households where latrines are being constructed to advise and check on the technical details. Such personnel should provide constructive suggestions and encouragement, rather than negative comments and criticism.

Institutional support

The lead agency which is promoting sanitation has the major role. However, other government departments, councils, health and educational establishments can also support the project. They should ensure that their own sanitation facilities are adequate for the use of their staff, students and visitors. Such institutions can also assist by providing space for temporary storage of materials.

There are various other forms of institutional support. Government employees have been given time off from work to construct their own sanitation systems as a model for their neighbours to copy. Similarly, it has been known for a government to declare a public holiday for all employees, both private and public, to spend time building latrines. However, there is a strong likelihood that the results of such special events will be less than hoped for unless the correct preparation (surveys and demonstrations) has been done.

Loan repayments

Monthly instalments to pay back loans should be fixed at levels that are affordable rather than at rates designed to ensure quick repayment. However, this has to be balanced by the need to ensure that repayment periods are not excessive, since householders may be reluctant to continue paying over a long period for a facility such as sanitation.

Where the people have been fully involved in the construction of their latrines, it is usual to find that small loans for latrine construction are repaid. If a programme is forced through by an agency without full community involvement, it is likely that there will be a low return rate on loans.

Completion of the programme

Within most programmes, the rate of completion of individual sanitation units tends to follow an "S" curve (Fig. 11.1). In the initial demonstration and consolidation phases there is little progress in terms of numbers of systems completed. During the expansion phase the majority of the population are expected to install latrines. However, the rate of installation normally falls as the 80% completion level is neared. During the completion stage additional positive inducements should not be used, since this would be unfair to those who have already constructed their facilities on their own. Unless the failure to complete is due to particular social disadvantage, in urban and periurban areas legal action may have to be taken to ensure completion by all households. As the health benefits cannot be fully realized unless all members of the community use improved sanitation (particularly in areas of high population density), it is reasonable to expect substantial compliance.

Fig. 11.1. Pattern of installation of latrines in a sanitation programme

There are many different approaches to assisting householders to construct their own sanitation facilities. For each project the right mix of assistance, motivation and legislation has to be determined in order to produce the desired results.

Operation and maintenance

Household responsibility

Completion of latrine construction marks the beginning of the real sanitation programme in that it is the point at which people can start to realize the benefits of their investment. Continuing health education and technical assistance are required to ensure that new systems function properly. For example, longer-term assistance may be required to ensure that double pits are emptied and used in rotation.

Some householders may benefit from advice as to how to encourage all members of their family to use the facility in a clean and safe way. Laver (1986) described how local potters were taught to make ceramic tiles depicting good habits of latrine use, which could be fixed permanently on the latrine walls to act as a constant reminder of good practice.

Use of hard cleaning materials such as stones and corncobs leads to increased rate of sludge accumulation, and hence to a shortened life for the pit or tank before emptying or to blockages in water seals or pipes. Members of the community should be told about the effects of using such bulky cleansing materials, and encouraged to find alternatives. Where it is not the custom to use water for anal cleansing, leaves, grass or paper are preferable. Details of the maintenance required for different types of latrine can be found in Chapter 6.

The latrine superstructure, like all buildings, needs regular maintenance to ensure that it remains structurally sound and pleasing to use.

Responsibility for maintenance must never be left undecided until the need becomes apparent. By that time many people will have stopped using the facility and returned to their old places. The latrine itself may have become so unpleasant that it is more difficult to find somebody to care for it regularly. Maintenance becomes a particular problem where an agency has been constructing sanitation systems for people without their full involvement in planning and design. If householders are unsure of the ownership of the system they are less likely to accept responsibility for looking after it.

Agency responsibility

The householder or user has primary responsibility for using and maintaining the latrine. The agency may have to assist in two areas: (1) ensuring the availability of special items such as vent-pipe screening; and (2) the provision of services requiring special equipment, such as pit emptying. Initial demand may not be sufficient for private traders to stock specialized vent screening or plastic water seals. While this demand builds up, the agency should ensure that such items may still be purchased from a public health department after completion of the construction phase. Where double pits are used, the householder should empty the pit at regular intervals, using the dry sludge on the land as a fertilizer. Where single pits require mechanical emptying, particularly in urban areas, an organization should be established or the local council should run vacuum tankers at an affordable cost to the householder.

Evaluation

As a sanitation project nears the end of the implementation phase, it is helpful to carry out an evaluation or review of what has occurred. Evaluation, by personnel who have not been directly involved with the project, is only of relevance to the community if the agency is prepared to correct any mistakes identified, particularly those of a technical nature that may lead to difficulties with operation or maintenance in later years. Evaluation is important for the agency, as it gives staff a better understanding of what has been effective and why, and at the same time pinpoints any failures that could be avoided in future programmes.

In the sense that evaluation is an ongoing management tool to ensure effective use of resources, it is sometimes considered necessary to engage in constant evaluation of all stages of a programme. Regular monitoring should be carried out as routine by the management of any agency involved. Constant evaluation is normally only justified in large programmes. Evaluation carried out during or at the end of the project should be done by people who are familiar with the project or other similar projects but who have not been closely associated with the planning and implementation. This is to avoid the natural tendency for people to make allowances for shortcomings and weaknesses in any scheme with which they have been involved.

Because of the pressures on project budgets and professional staff time, the evaluation has to give the required information at minimum cost. Occasionally it may be of interest to carry out a number of evaluations over a period of years subsequent to completion of the project. However, the results rarely justify the costs involved.

The World Health Organization has developed a minimum evaluation procedure (MEP) for water supply and sanitation projects (WHO, 1983). In this, evaluation is defined as "a systematic way of learning from experience and of using the lessons learned both to improve the planning of future projects and also to take corrective action to improve the functioning, utilization and impact of existing projects." Using the MEP, the first consideration is how effectively the facilities are working or functioning. This is followed by an investigation as to how well the sanitation system is being used and maintained by the people; and finally the impact on the health and welfare of the community is considered. A protocol for inspection of latrines, included in the MEP, is shown in Fig. 11.2.

Evaluation normally leads to recommendations for further action to improve the effectiveness of sanitary facilities. There should be a readiness within the programme institutions to make the recommended alterations if the time and expense of carrying out the evaluation are to be justified.

Functioning

Evaluation of functioning, that is, determination of how well the different systems are working, can be considered in terms of the proportion of households in the target area who have constructed a sanitation system, and the reliability of the facilities (Fig. 11.3). Failure to reach at least 80% of the target population may be because the facilities are unaffordable or are not considered of immediate priority by the community in terms of expected benefits.

Technical confusion over the design, use of inappropriate materials, a high groundwater table and hard rock all lead to a lower than anticipated response. Where the facilities are unhygienic (for example, because of constant fouling, flooding or fly nuisance), reasons for this failure should be investigated. Reliability should be considered in terms of operation and maintenance, rate of filling of pits, convenience of superstructures, and functioning of items such as water seals and vent pipes.

Fig. 11.2. Protocol for the inspection of latrines

Utilization

In recording the proportion of people using the systems, particular attention should be paid to the different categories in the community, such as women, men, children and old people. However, such information is often difficult to collect, as people may give replies they think the evaluator requires. Watching who uses a latrine may be considered an invasion of privacy. A careful combination of interviewing and observation is needed. Low rates of use may be due to technical inadequacies, sociological issues, lack of health education, or a general uncertainty regarding the system. It is important to distinguish between these different factors.

Fig. 11.3. Evaluation of sanitation facilities

Health impact

Evaluation of health impact is only worth while when the factors hindering functioning and utilization have been overcome. The aim is to determine whether there has been any improvement in health and well-being as a result of the sanitation programme. Such studies tend to be expensive and normally require specially trained personnel such as medical officers and epidemiologists. Briscoe et al. (1986) gave detailed information on the complexities of measuring health impact. In particular, the authors looked at the conditions under which health impact evaluations should be carried out, the preferred indicators for measuring impact on health, appropriate methods for study, and means of interpreting the results. They concluded that such detailed evaluations are justified where further large investments are contemplated and economic criteria are not sufficient to decide between alternative options, where systems are functioning and being utilized, and where sufficient resources (including scientific personnel) are available.

The ultimate evaluation is that of the householders themselves. A project can be considered successful where householders, by their own choice, have invested a significant amount of time and money in the implementation of their own sanitation systems, and demonstrate their satisfaction by their continued willingness to use, operate and maintain their latrines.