We need better financial strategies for sanitation
Dr Lucy Stevens
Covid-19 has reminded us all of the vital importance of the basics of life that keep us healthy. It feels as if there are daily reminders about how easily disease transmission can happen from contaminated surface to fingers to face.
I feel as if I am constantly reminding myself not to touch my face – wipe an itchy eye, scratch a nose, and think how I’m brushing my hair out of the way.
These messages are integral to the well-known ‘F-Diagram’ (faeces-fingers-face), illustrating how diseases easily transmit from contaminated places.
If you have access to a decent, safe, dignified toilet which safely keeps excreta separate from you and your family – along with a good place to wash your hands with soap and water, you’re among the fortunate.
Globally. 4.2 billion people live without access to safely managed sanitation.
As if the pandemic were not enough, climate change makes the future even more challenging.
Extreme events such as intense rainfall can damage toilets and pits, and spread contents creating misery and significant health risks.
This was the case a few months ago in Kisumu, where we work, and where our baseline study of three informal settlements in 2018 found 92 per cent of households are using pit latrines, and 69 per cent share with more than four households.
A similar study in 2016 found that 43 per cent of toilets were either dirty or filled up.
In responding to and recovering from the pandemic, however, we have an opportunity to step to a better future.
We should be working to ensure communities have a better chance by getting the basics in place, including ensuring everyone has access to a decent, safe toilet and a place to wash their hands.
Done right, this will also improve resilience to the threats of climate change.
However, this requires new financial commitments- something the global WASH community has been addressing recently.
Finance ministers from dozens of countries have been meeting online through sanitation and water for all initiative to discuss ideas for how to channel money more effectively to the sector.
A handbook gives ideas and examples of how to make public investment work.
Sadly it seems the need to use government funds is growing as aid appears to have been directed to healthcare at expense of sectors such as WASH in the first half of this year.
In Kisumu, we have been exploring how more and better financing could reach the sanitation sector under our Safe Pair of Hands project supported by UK Aid.
While often investments in sanitation come from households or landlords, there is need for public investments in supporting infrastructure and services.
This could be well-managed community toilets, safe pit emptying services, support for vulnerable households to build toilets, or support for builders to improve on quality.
Our analysis of the financing of sanitation in the county revealed that while 2.9 per cent of the budget was allocated to water supply, the portion for sanitation was negligible at around 0.5 per cent.
The county has been receiving declining amounts from national government for its WASH responsibilities.
A budget tracking exercise we did found that vast majority of budgets of county departments of health and water went towards new infrastructure construction, rather than preventative health and sanitation. Most funding tagged as ‘sanitation’ is spent on solid waste management.
To compound matters, the county also struggles to disburse allocated funds, with 55 per cent executed in 2013-18.
This was due to factors such as delays in procurement and in receipt of national finances, inadequate planning and slow pace of large-scale infrastructure projects.
Improving access to sanitation for those most in need, living in poor conditions in informal settlements, will require more money including from public sources. This alone will not be enough.
Our briefing paper, to be published soon calls for revisions to budget allocations for sanitation; improvements in strategic and financial planning ; strengthening implementation capacity, and improvements in monitoring. — The writer is head of urban services, Practical Services — [email protected]