AMCOW AfricaSan

July 30, 2023

Leave No One Behind – Inclusive Sanitation Policy: The Fundamental Step To Leaving No One Behind

By Kitch Bawa – Sanitation Project Manager

Not every day is World Toilet Day. But every day, everyone, everywhere needs a toilet. This simple tool has been described as one of the greatest public health inventions of all time. The impact of the absence or inadequacy of this public health invention, has been a source of catastrophic public health problems in many parts of the world, especially in Africa.

In the continent, about 760 million people lack this simple tool and 220 million people still practice open defecation. This is in a continent which has only a seventh of the world population. A big part of this huge number are the people within the lowest wealth quintiles. Others are from vulnerable groups cutting across the physically challenged, women, children, people behind bars, people in geographically hard to rich areas and other vulnerable groups. They often face many forms of discriminations and other barriers to access and management of sanitation services.

What can we do?

To ensure that this gap is filled, there are critical bottlenecks that need to be surmounted. Although the provision of the infrastructure for sanitation services is the primary duty of the individual, the responsibility for creating the enabling environment for effective sanitation service delivery rests with the primary duty bearer which is the government. Government creates the enabling environment for sanitation improvement by putting in place the necessary policy and institutional frameworks.

Access to toilets alone do not meet the criteria for the sustainable access to sanitation service. Access to sanitation service starts from the containment stage of the faecal matter to transport and safe reuse or disposal. Access to the toilet alone (containment) can become a hazard in the absence of the other services along the value chain of sanitation service delivery. Bearing in mind this challenge, the dialogue on the need for a toilet therefore goes beyond a toilet to the services along the value chain of sanitation service delivery. These are also at different service levels according to a ladder of the nature or level of sophistication of the service.

To ensure that sanitation services meet the needs of different groups of people at different quintiles, deliberate steps must be taken to ensure their participation in all processes. One key approach to do this is by consulting them in policy making process. This is based on the principle that the fundamental foundation on which service delivery is built is a strong policy.

Inclusive policy making involves a consultative process that looks at the peculiar needs of the different groups within the society. This often takes deliberate and intentional steps to meet the needs of these special groups who otherwise, may tend to be marginalized.

To strengthen policy for improved sanitation service delivery, AMCOW has taken steps to improve policy in some selected countries with special cases. In that trial, AMCOW directly facilitated the development of sanitation policy in 4 countries in Sub-Saharan Africa.

Learning from this initial direct sanitation policy making initiative, and following the outcomes of the monitoring of high-level commitments (eThekwini in particular), AMCOW initiated the Africa Sanitation Policy Guidelines (ASPG). The ASPG development process is in collaboration with the World Health organization (WHO), Center for Water Security and Corporation (CSWC) and Speak Up Africa (SUA). This initiative will when fully in place, become the process where countries access the template for an inclusive sanitation policy and strategy and a guide for how developing the same. It will provide the minimum standard of the inclusive sanitation policy that will be needed at national and subnational levels to achieve the SDG 6.2. The ASPG will cover broadly the essential elements of a sanitation policy ranging from basic principles, funding and financing, capacity, regulation, institutional roles and responsibilities, monitoring, reporting and periodic reviews, hygiene mainly focusing on handwashing and Menstrual Hygiene Management. The ASPG development process will go through intensive consultations including different stakeholders at country level, including the High-level Ministerial dialogue. It will also involve consultation with different experts across the continent and globally to ensure that it takes into account the experiences from other regions. This is done to ensure it includes the voices from all groups and stakeholders for buy in and ownership. The ASPG development process plans to have a system for request and backstopping for countries to develop or update their sanitation policies.

It is hope that when this is completed and rolled out, it will lay out an enabling environment to accelerate the process for fast tracking progress to sustainable access to sanitation facilities including toilets for everyone, everywhere on the African continent. Especially for those who are left behind.


Kitch Bawa is AMCOW Sanitation project manager and leads our work on sanitation in Africa. He tweets @keachbauer

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