The status of Water, Sanitation, and Hygiene (WASH) in schools in sub-Saharan Africa remains dire. Only 46% have access to basic water services, 44% to basic sanitation services, and 26% to basic hygienic services. Although integrating these services with other water and waste streams could benefit service provision, a systematic methodology for such integration does not exist yet. This research approaches a first step–a methodology for an integrated assessment of water, sanitation, and solid waste management (SWM) services in schools. In addition, a modified version of the Joint Monitoring Program’s WASH service ladder for schools is provided for a detailed understanding of the service levels. A total of 16 schools from two small towns in Uganda are taken as case studies to identify the current service levels, interlinkages between the sectors as well as their enabling environment. Using surveys, stakeholder interviews, observations, and water quality measurements, the results show several cross-contamination pathways leading to exposure of pupils to pathogens. Finance and policies are major inhibitors of positive interlinkages and limited skills and capacities amplify negative interlinkages. The results emphasize the need for a shift toward further integrated planning of the water and waste services in schools and other institutions.

This study reviews the status of access to water supply, sanitation, and solid waste management (SWM) services in Uganda, examining the influence of national government policies, institutional frameworks, and financing mechanisms. It employs a mixed-methods approach, combining qualitative analysis of primary data from key informant interviews with secondary data from systematically reviewed literature, including performance reports, project data from ministries, development partner websites, and peer-reviewed journal articles. The findings reveal persistent challenges related to intersectoral coordination, overlapping roles, policy inconsistencies, stakeholder conflicts, and funding inefficiencies. Water services receive a disproportionately high percentage of funding (over 80%), whereas sanitation and SWM receive significantly less (approximately 5% and 10%, respectively). Regulations advocate for sustainability, but their implementation in small towns remains weak. Policy analysis at the local level suggests a misalignment that prioritizes SWM over individual water and sanitation services. Decentralization empowers local authorities, but successful service delivery depends on robust enforcement of available policies. The analysis of funding and service delivery gaps underscores the need for equitable resource allocation and integrated approaches. The study concludes by emphasizing the need for active engagement by governments, development partners, local communities, and the private sector to achieve equitable access to basic services.

In urbanising areas, siloed planning for water supply, sanitation, and solid waste management impedes sustainable development. This study examines barriers to integrating services in urban Uganda, focusing on Wobulenzi and Kakooge with different service models. A mixed-method approach using qualitative and quantitative data was applied. Document reviews and interviews with 48 stakeholders were conducted. The Problem-Driven Political Economy Analysis framework was used with thematic analysis and quantitative assessment of political economy attributes. Findings showed fragmented institutions, insufficient resources, and poor coordination hinder integration. Small towns face financial constraints, technological gaps, and political interference. Key attributes influencing integration include implementation dynamics (19/20), accountability (12/20), and collaboration (10/20). An enabling political economy is crucial for integrated services in urban Uganda. Addressing fragmented governance through policies, coordination, decentralisation, capacity building, and financing is essential. Realigning resource planning can enable strategic solutions, promote service integration, and ensure sustainable WASH and SWM services.

Climate change, rapid urbanization and other grand challenges increasingly force cities to rethink their urban (water) infrastructure. In particular, decentralized urban water management solutions, which can recover valuable resources close to the source are increasingly applied to remediate water scarcity, sanitation or environmental pollution challenges. Yet, although interesting demonstration projects with decentralized solutions (from here on labeled ‘decentralized UWM solutions’) are underway in several world regions, actors developing and implementing this transformative innovation are not effectively coordinating their efforts and sharing the latest knowledge. While effective technologies, business models, or regulative frameworks increasingly exist that could inform, inspire and improve similar activities elsewhere, details of local successes and failures are still (too) rarely shared or transferred across space. Drawing from experience on the mainstreaming of other transformative infrastructure solutions (like renewable energies, electric mobility or circular waste management), we posit that the global diffusion of decentralized UWM solutions has been significantly slowed down by this lack of interaction among key stakeholders, and the resulting lack of an effective innovation ecosystem.

Building resilience of sanitation systems and services to changing climate is necessary to ensuring continuity of essential sanitation services in the face of hazardous events. An approach towards this solution is to create a robust enabling environment through policies for planning and implementing adaptation measures. The objective of this study is to review the climate change and water and sanitation policies in Nepal to assess the adequacy of the documents in addressing climate resilience in sanitation, with focus on the on-site sanitation. This paper is based on the desk review of existing policy and plan documents related to climate change and water, sanitation, and hygiene (WASH) in Nepal. The review has revealed that sanitation and climate change are addressed only to a limited extent, while focus on on-site sanitation is inadequate. These documents are therefore insufficient to provide guidance to build resilience in sanitation systems and services. The paper concludes that sanitation-specific policies and programmes can tackle the sanitation challenges more effectively and address climate-related vulnerabilities in on-site sanitation systems and services. Enhanced collaboration among different stakeholders can create an environment conducive for policy changes and investments.

The banana tree circle (BTC) is a low-cost system for local greywater management, using a natural treatment and disposal process, providing additional resource recovery benefits. However, there are no standard design criteria for BTC that would allow for quality control of its efficiency and sustainability, and little is currently known about the full-scale performance of BTC. Based on the scoping literature review of 31 documents in the scientific database and eight documents from grey literature, a standard design model was proposed for the BTC technology based on the concept of water balance, greywater flows, rain, infiltration, and evapotranspiration. The first two steps of the BTC design were determining the areas required for infiltration and evapotranspiration. A cylindrical form trench, the soil percolation rate, and the hydraulic loading rate were considered for the infiltration area. The banana trees' evapotranspiration rate was taken into consideration for the evapotranspiration area. The proposed model was applied in a case study where we used a trench with 0.8 m depth and 1.5 m diameter. This study proposes a standard design criterion for the BTC based on environmental factors, and the scoping of the literature provides the basis for future studies to evaluate its environmental sustainability.

San Francisco is spearheading the city-wide installation of onsite non-potable water reuse systems (ONWS). Through a city ordinance, local authorities have induced a quickly growing ONWS market and initiated stakeholder networks that support the diffusion of ONWS solutions in San Francisco and beyond. [...]

Multilateral development banks (MDBs) play a pivotal role in financing water and sanitation infrastructure projects and thus have a major impact on the development of basic services. Although information about the MDBs' investments is publicly available, it is dispersed and not easily comparable. A comprehensive compilation of MDBs' water and sanitation investments has long been lacking. To address this gap, we assess water and sanitation financing by the three MDBs most relevant to Africa and Asia between 1960 and 2020: the World Bank, the African Development Bank, and the Asian Development Bank. We compile a new dataset by drawing on 3,639 water and sanitation projects and assess territorial trends, technology choices, distribution of financial burdens, and reforms to institutional arrangements. We find that MDBs' investments align with changing patterns of urbanization and increasingly finance sanitation infrastructures including non-sewered technologies. However, our results also suggest that institutional reforms have addressed utility efficiency through investment in equipment and skills rather than through increased commercialization and private sector participation. The leverage effect of MDB investment on private financing is negligible, whereas co-financing from local governments dominates.

Citywide inclusive sanitation (CWIS) is becoming the dominant paradigm for achieving safe sanitation for all by 2030. Its technical benefits have been explored, but the bargaining over financial and organizational changes CWIS entails have not yet been adequately addressed. Our case study explains the stalled rollout of CWIS in Dhaka, Bangladesh. We analyse policy pathways over the past 30 years through a combined territorial political economy and power perspective to understand their effects on equality. We highlight how donors link the introduction of CWIS to the organization of sanitation through a market; how the utility uses CWIS as an opportunity to avoid costly responsibilities in non-sewered sanitation; and how service co-production through community-based solutions is neglected. CWIS has successfully overcome the dogmatic technological focus in the sanitation system, but for citywide sanitation to be scaled inclusively, the dogmatic focus in the organization and financing of the sanitation sector must also be overcome.

Bengaluru represents a globally unique context for the diffusion of on-site wastewater treatment and reuse systems (ONWS). Local authorities have introduced a series of mandates that triggered a dynamically evolving mass-market for ONWS. [...]

The H+ area in Helsingborg, Sweden, is a sustainable city development project, served by "Tre-Rör-Ut" (Three-Pipes-Out), a world-unique source-separation and resource-recovery system for water, wastewater and food waste. [...]

The Jenfelder Au in Hamburg, Germany is a sustainable city development project, served by the "Hamburg Water Cycle" (HWC), a spearheading template for resource-recovery from source-separated water and wastewater, first of its kind at neighbourhood scale. [...]

Climate change, rapid urbanization and other grand challenges increasingly show that urban water and wastewater man-agement needs to be deeply rethought. A transformative shift is needed away from linear end-of-pipe to more circular system designs. Actors around the world have thus started developing decentralised urban wastewater treatment and reuse systems (DUWTRS). DUWTRS improve the flexibility, resilience and circularity of water and sanitation infrastructure and can thus play a key role in developing more sustainable cities. Yet, despite their high potential in solving multiple urban development challenges at once, only a few cities worldwide have successfully implemented them at scale. We thus lack well-documented templates and best practices of successful DUWTRS implementation. The Lighthouse Project aimed at filling this gap by assessing promising examples from around the world. To generate practice-oriented lessons, we compared six projects at different scales (city-wide vs. neighbourhood), in different contexts (high-income vs. low-/middle-income) and using different technological set-ups. We selected four neighbourhood-scale and two city-scale projects, equally distributed across high- and middle-income contexts. Data was collected between November 2021 and August 2022 through an extensive literature review and more than 100 semi-structured expert interviews. An integrative assess-ment framework was developed and used to derive key success conditions for DUWTRS implementation.

Nirvana Country Township is a high-end residential colony in Haryana State, which reuses treated effluent from on-site wastewater treatment facilities for urban greening in several residential areas. [...]

SaniChoice is an open source web tool that enables informed sanitation technology and system choices as inputs in strategic planning. It can be used both for capacity development (e.g. in trainings and workshops) and as a decision support tool. This Practitioners' Guide is for engineering and planning consultants who aim to apply SaniChoice as a decision support tool in a facilitated multi-stakeholder Structured Decision-Making (SDM) process that is part of such frameworks as City Sanitation Planning (CSP), Sanitation 21 or Community-Led Environmental Sanitation (CLUES). [...]

Not all the challenges of informal settlement upgrading programmes can be anticipated from the start. It calls for cumulative learning within the programme's timeline. This paper investigates the role of organizational learning in influencing programme outcomes. The analysis of the Kenya Informal Settlement Improvement Programme (KISIP) shows that a lack of organizational learning routines can lead to reduced programme success, and that programme learning can improve programme outcomes. Well-conceptualized processes that include participation, coordination, communication and the synthesis of information are essential, though insufficient alone. Additional barriers, including a sudden increase in the number and diversity of actors and projects, their deteriorating commitment, inequitable incentives and inadequate tools to support programme learning, can further exacerbate the absence of established programme learning routines. There is a need for explicit and transparent programme learning procedures across organizational levels in order to improve overall programme success.

The presence of septic tank effluents in open spaces and roads due to poor fecal sludge management (FSM) in low-income cities represents a source of fecal contamination and potential risk of fecal-oral disease transmission. This study aimed at assessing fecal contamination exposure through six exposure pathways in Abobo, District of Abidjan in Côte d’Ivoire. The public health risk was evaluated in two clusters to identify the dominant exposure pathways and to compare which populations were most exposed. The SaniPath approach used included behavioral surveys (transect walk, household survey, school survey and community survey) and laboratory analysis. Surveys were conducted among 200 households, 6 schools and 4 community groups. In addition, 120 environmental samples were collected (in 2 clusters of 6 pathways with 10 samples per pathway per cluster). The colony forming unit (CFU) of E. coli was determined in samples using the surface plating technique on agar medium. Bayesian analyses were performed to estimate the distributions of fecal concentration and contact frequency, and exposure to fecal contamination was estimated using the Monte Carlo method with 1000 iterations. The highest concentrations of E. coli were observed in open drains (6.1 log CFU/ml), gullies (6 log CFU/ml) and soil (5.8 log CFU/ml) samples. The dominant exposure pathways were determined by multiplying the dose and the percentage of the population exposed, which was then log-transformed and denoted by (E). The study found that street food and gullies are the two dominant exposure pathways among the population living in Abobo. 100% of the children and between 73% and 91% of the adults are exposed to these dominant pathways in low and poor areas. In middle and high-income areas this concerns 75% to 95% of children and between 26% and 70% of adults. As well, the risk of exposure to the dominant pathways hits 9.2 in children and 8.6 for adults living in poor areas. While it reaches 8.1 and 7.1 respectively in children and adults living in middle and high-income areas. The study outcomes could help the authorities to structure how to target municipal wide interventions toward improving the sanitation conditions in the different neighborhoods.

In recent years, shared facilities have contributed substantially to increased access to sanitation in urban areas. While shared sanitation is often the only viable option in densely-populated, low-income urban areas, it is currently considered a "limited" solution by the international community. In this paper, we analyze the conditions under which shared sanitation could be considered of adequate quality and propose a set of indicators associated with sanitation quality to be included in national household surveys. We conducted a survey with 3600 households and 2026 observational spot-checks of shared and individual household toilets in Kisumu (Kenya), Kumasi (Ghana), and Dhaka (Bangladesh). We develop a composite sanitation quality outcome measure based on observational data. Using regression analysis, we identify self-reported indicators that correlate with the spot-checked composite measure and are, therefore, robust with regard to reporting bias. Results show that (pour-) flush toilets are a highly informative indicator for sanitation quality compared to other toilet technologies. In contrast to previous arguments and depending on the context, sharing a toilet has a comparatively lower correlation with sanitation quality. Toilets still show good quality if shared among only 2-3 households. Toilet location and lighting, as well as the presence of a lockable door, are equally strong indicators for sanitation quality and could serve as alternative indicators. The findings suggest that the sanitation service levels defined by the WHO and UNICEF might be reconsidered to better capture the quality of sanitation facilities in low-income urban settlements.

Sanitation is a universal need and thus requires universal access. Despite having the world’s largest sanitation campaign, only 37% of urban India has access to safely managed sanitation systems. Due to the heterogeneity of Indian cities, a mix of different sanitation systems is required to meet the demands of these rapidly urbanising cities. The Manila principles on Citywide Inclusive Sanitation (CWIS) propose a mix of technologies as a key pillar in achieving the Sustainable Development Goals on urban sanitation. However, there is a lack of understanding on the criteria to consider when planning the technological options for CWIS. The mega-city of Chennai is chosen as a case study, and mixed methods including a Faecal Waste Flow diagram (SFD), Social Network Analysis (SNA) and interviews are applied. This study then presents a set of 14 contextually relevant criteria for the implementation of sewered and non-sewered technologies in the city. The SFD shows that 35% of Chennai’s faecal waste remains unsafely managed while using SNA identified that the water and sanitation utility, the municipal corporation and the slum clearance board are the best placed stakeholders in the city to create a change in the sanitation situation. Furthermore, 17 drivers and barriers for the implementation of non-sewered technologies are identified. The criteria catalogue was also theoretically tested for an example ward in Chennai. The findings of the study show that a catalogue of physical, technical, institutional and financial criteria is useful for planning a mix of technologies with the CWIS approach.

Sanitation is a fundamental determinant of human health and well-being, and is essential for protecting the environment and enabling economic and social development. Ensuring universal, equitable and sustainable access to safe sanitation in all settings is a political priority in the pan-European region. This publication aims to support implementation of the provisions on sanitation under the Protocol on Water and Health, as well as national and international goals and targets on sanitation by providing an overview of the situation of sanitation and wastewater management in the region, describing current and emerging issues in ensuring access to safe and sustainable sanitation services, and proposing key action areas to strengthen sanitation governance. It is primarily targeted at national decision-makers and supports public health and environment authorities, surveillance agencies, sanitation service providers and other relevant stakeholder.

The academic literature largely acknowledges participation as a key condition for the successful upgrading of informal settlements. However, how individual participative actions of different actor groups and reactions of dwellers combine to influence project outcomes of upgrading processes has not been studied. This article posits that different combinations of presence or absence of collaborative interactions between dwellers and other actors will decisively predict the success and failure of projects. Specifically, we argue that interactions between different groups of implementers and dwellers are conditioned by distinctive value systems - institutional logics - , which provide specific challenges to establishing collaborative interactions with dwellers as the actors conduct their roles. We identify sufficient combinations of participative actions that may lead to successful upgrading using qualitative comparative analysis (QCA) on 15 informal settlements in Kenya's secondary towns that were recently upgraded. Our findings indicate that participation has to consider a multiplicity of actors, who are guided by different logics; it has to span over the whole implementation cycle. It also has to deal reflexively with the issue of representation of the community. This extends the understanding of participation to a perspective that emphasizes the capabilities of implementers to enact collaborative relationships by bridging between their own and the community's institutional logic.

This policy brief presents the main results of a three-country study on Quality Indicators of Shared Sanitation (QUISS). QUISS assessed when shared sanitation is acceptable and what is needed to establish minimal acceptability requirements. Qualitative and quantitative data were collected in Ghana, Kenya and Bangladesh in 2019. This brief highlights the research findings for Bangladesh and provides recommendations for strengthening the acceptability, functionality and sustainability of Bangladesh’s shared sanitation facilities in low-income urban settlements.

This policy brief presents the main results of a three-country study on Quality Indicators of Shared Sanitation (QUISS). QUISS assessed when shared sanitation is acceptable and what is needed to establish minimal acceptability requirements. Qualitative and quantitative data were collected in Ghana, Kenya and Bangladesh in 2019. This brief highlights the research findings for Ghana and provides recommendations for strengthening the acceptability, functionality and sustainability of Ghana’s shared sanitation facilities in low-income urban settlements.

Community involvement is recognized as a core condition for success in informal settlements upgrading. However, the wider ramifications of this requirement are not well understood. Mostly, community involvement has been equated with a narrow interpretation of participation, largely focusing on the elicitation of dwellers’ preferences at the planning stages. We argue that this approach overlooks the actual needs for livelihoods reconstruction in the course of upgrading. To better conceptualize these requirements, we propose to analyse the time–space configuration of practices, which we frame as constituting Oscillating Domestic Spaces. The concept illustrates the contingent nature of daily activities to meet livelihoods needs and how people navigate these conditions. Challenges associated with reconstructing new domestic spaces are illustrated using the Kenyan Slum Upgrading (Kensup) initiative in Nairobi, Kenya. The findings suggest that an inadequate understanding and consideration of livelihoods reconstruction reduced legitimacy of the initiative, resulted in rapid deterioration of physical amenities and relegated most of the alleged ‘beneficiaries’ deeper into poverty. We suggest that, for successful settlements upgrading, livelihoods reconstruction should be a core process in the planning, implementation and post-implementation stages.

The water, sanitation, and solid waste sectors are closely related and have many interactions between their respective service chains in low-and middle-income countries. Currently, these interactions mostly lead to cross-contamination, and opportunities for co-benefits are seldom realized. This review presents the key advancements within each of these three development sectors in the past two decades. We identify numerous similarities such as decentralization, resource recovery, community involved planning, and digitalization. Despite the potential for synergies and the opportunities to maximize positive interactions, there have been few attempts to break the existing sectoral silos in order to integrate these three service chains. We argue that, with the right enabling environment, an integrated approach to holistically planning and implementing water supply, sanitation, and solid waste management can create positive interactions resulting in co-benefits among complementary development goals.

Sanitation in India has received national attention for over a decade, especially with the Swachh Bharat Mission (SBM) making it a political priority. However, due to the lack of appropriate sanitation planning practices, there have been little long-term gains made in urban sanitation beyond the ending of open defaecation. In this paper, we analyse the key barriers to sanitation planning, in India, in the context of the emerging paradigm of Citywide Inclusive Sanitation (CWIS). A mixed method approach of shit flow diagrams, social network analysis, policy analysis, interviews and workshops at the national, state (2) and city (4) levels was conducted. Eight factors were identified as important barriers for planning including inadequate planning capacities, lack of ownership of city sanitation plans among city governments, poor community involvement, absence of a uniform planning framework, unreliable political and financial support, overlapping jurisdictions, and scheme-based funding. The paper also proposes the CWIS Planning Framework which offers a perspective at overcoming these barriers with the recommendation of bridging top-down and bottom-up planning approaches. While there is increasingly more clarity on what CWIS means, there is little understanding on how to plan for it. Therefore, this framework provides the theoretical basis for planning with the CWIS approach.

NoMix toilets separate urine and feces at the source and are a promising resource recovery technology. However, design issues hamper the transformation from unattractive to aspirational products. Little effort has been done to design toilets that account for physiological differences, leading to adverse effects on user-friendliness and urine separation efficiency. We used infrared recordings to assess gender-specific urination practices. Based on field data, we developed the Urinator, a simple device that allows simulating male and female urine streams. This supports engineers in developing more user- and gender-friendly and reuse-oriented sanitation technologies.

Shared sanitation has immensely contributed to sanitation access in urban areas. However, due to the lack of quality standards within Sustainable Development Goal #6 and the WHO/UNICEF Joint Monitoring Programme (JMP), which evaluates progress on the SDGs, shared sanitation is at best considered a 'limited' solution. This policy brief presents the main results of the Quality Indicators of Shared Sanitation (QUISS) project: a three-country comparative mixed-methods study that identifies the key criteria of what constitutes ‘acceptable quality’ shared toilets in low-income urban contexts and provides recommendations for strengthening the acceptability, functionality and sustainability of shared sanitation facilities.

Shared sanitation has immensely contributed to sanitation access in urban areas, but is at best considered a "limited" solution due to the lack of quality standards within Sustainable Development Goal #6.
This policy brief presents the main results of the QUISS project (Quality Indicators of Shared Sanitation), a three-country com-parative mixed-methods study that identified the key criteria of what constitutes "accept-able quality" shared toilets in urban low-income contexts and provides recommen-dations for strengthening the acceptability, functionality and sustainability of shared sanitation facilities.

Although the number of urban dwellers in the Global South with access to improved sanitation increased significantly over the last three decades, progress has been outpaced by rapid urban growth. The number of people in urban areas lacking improved sanitation has steadily increased and today over 1.8 billion urban dwellers do not use safely managed services. Progress has not only been slow, but also uneven between different segments of the population. The focus of ministries, urban authorities and financing agencies has been mostly on incremental expansion of sewers, benefitting non-poor segments of the population, and in most places, utilities have failed to provide citywide services mainly because they have stayed within the sewer paradigm. [...]

This policy brief presents the main results of a three-country study on Quality Indicators of Shared Sanitation (QUISS). QUISS assessed when shared sanitation is acceptable and what is needed to establish minimal acceptability requirements. Qualitative and quantitative data were collected in Ghana, Kenya and Bangladesh in 2019. This brief highlights the research findings for Kenya and provides recommendations for strengthening the acceptability, functionality and sustainability of Kenya’s shared sanitation facilities in low-income urban settlements.

The water, sanitation and hygiene (WASH) sector is facing a shortfall of several million appropriately skilled professionals. Massive open online courses (MOOCs) can play a crucial role in addressing this. This paper presents the case study of the MOOC series "Sanitation, Water and Solid Waste for Development", which has reached over 120,000 learners within six years. It has attracted mainly well-educated, employed learners, under 34 years old, from Asia, Latin America and Africa. Underrepresentation of female learners remains a challenge. While MOOCs have proven excellent for delivering WASH education at scale, some alternative formats (e.g. blended learning, small private online courses) allow more collaborative, interactive learning environments. Three practical examples from Nigeria, Indonesia and Mozambique indicate the potential for synergies among MOOCs and further learning formats. With the global shift towards digital learning due to the COVID-19 pandemic, MOOCs have gained further traction.

Small-scale sanitation (SSS) systems are making an increasingly important contribution to urban sanitation coverage in India, alongside large-scale sewage (wastewater) treatment plants (STPs) and the management of faecal sludge and septage from non-sewered sanitation systems. Such systems consist of small-scale sewerage networks and STPs. They represent a wastewater management solution for buildings and neighbourhoods in rapidly growing cities, especially where a connection to the centralised sewerage network is not feasible in the short to medium term. SSS systems can be implemented incrementally and flexibly, offering significant potential for cost-effective local wastewater treatment and reuse.