Module 8: Innovations in Sanitation

Case Study 1: Creating Low-Cost Urban Water Supply and Sanitation

Low-income families cannot afford to invest in sewage systems. Thus, ideally water supply and sanitation in urban areas and large villages provide services for groups of households, not to individual households, to alleviate costs. Groups of households could form water and sanitation cooperatives. In this way, very poor households would be served by community-managed sandpipes and sanitation blocks.(1) This type of grouping helps to reduce costs. For example, in the city of Parauapebas, Brazil, significant cost savings were achieved because there was a much lower total pipe length for the public distribution network. This meant that substantially less “public” excavation was required.

Not everyone agrees that water and sanitation cooperatives will work. Some people say that “you will not get poor households in this country to cooperate with each other” and “it could not possibly work here as our situation is so very different.”(2) It is correct that each household should, wherever possible, have access to its own sanitation facility. A water cooperative, however, can enable member households to decide which service level they will each have. Examples of on-site systems include VIP latrines, pour-flush toilets, and ecological sanitation toilets. VIP latrine alternatives may include urine-diverting, ventilated improved vault (VIV) latrines.(3) These types of alternatives provide a cooperative, cost-effective, yet individualized option for households.

Case Study 2: The World Toilet Organization (WTO)

The World Toilet Organization (WTO) is a global non-profit organization committed to improving toilet and sanitation conditions worldwide. WTO aims to connect with poor by branding toilets as status symbol and an object of desire. WTO is building a market infrastructure where the poor demand toilets, thereby breaking the taboo about toilets and sanitation and instead making it a mainstream topic. WTO organizes successful World Toilet Summits where organizations can learn from one another. The summits address critical issues about toilets and sanitation technology, development, funding for design and maintenance, social entrepreneurship, research, and various other related topics. WTO started the first World Toilet College (WTC) to provide training in toilet design, maintenance, school sanitation, disaster sanitation, and implementation of sustainable sanitation systems. WTO was honored as an Ashoka Global Fellow for its excellence in social entrepreneurship. 

Field implementation of the sanitation project began in April 2009. The purpose of the project was to initiate and strengthen behavior change activities by building on Community-Led Total Sanitation initiatives where possible. An additional goal was to reduce cost of water and sanitation components by creating upgradable latrine designs and by developing social enterprises to improve technical and business management skills. The project sought to empower households to participate in the creation and prototype development of latrines.(4)

Case Study 3: Sanitation in India and African Countries: Achieving the Sanitation Millennium Development Goal

In 1990, global coverage of the use of improved sanitation facilities was 54% and the Millennium Development Goal was to increase to 77% by 2015. According to the UN, as of 2008, there was greater access to cell phones than access to toilets in India.(5) In India, in 2008 only 31% of the population had access to improved sanitation.(6)

“It is tragic irony to think that in India, a country now wealthy enough that roughly half of the people own phones, about half cannot afford the basic necessity and dignity of a toilet,” says Zafar Adeel. It is also important to provide education about the health dangers of poor sanitation. Cultural taboos surround this issue in some countries, preventing progress.

The final MDG report on sanitation indicated that 68% of the global population used an improved sanitation facility in 2015. That is, the global MDG target for sanitation was missed by almost 700 million people worldwide. Although 2.1 billion people gained access to an improved sanitation facility since 1990, as of 2015 2.4 billion people still lack improved sanitation facilities. Specifically, 82% of the global urban population and 51% of the rural population used improved sanitation facilities as of 2015.(7)

Case Study 4: Ikotoilet- “Toilet Here” in Nairobi (8)

Ecotact is a Nairobi-based company that aims to improve the urban landscape for low-income communities through environmentally friendly projects in sanitation and housing. Using the Ikotoilet project, Ecotact builds and operates high-quality, public, pay-per-use toilet and shower facilities on public land in urban centers. Ecotact uses a Build-Operate-Transfer model of public-private partnership, entering into long-term contracts with municipalities to secure use of public lands. In exchange for use of public land, the company agrees to cover facility construction costs, but renounces ownership of the facilities to the municipalities. The contracts give Ecotact the right to operate the toilet and shower facilities for a certain number of years and charge user fees. The company hires staff to operate and clean the units after each use, and complements the sanitation offerings with other revenue-generating products such as shoeshine services, soft drink sales and newspaper sales.

Ecotact’s facilities are creating a new standard of hygiene in target communities, reducing urban pollution from human waste, generating employment opportunities for low-income individuals, and restoring dignity to sanitation services among the urban poor. Ecotact plans to replicate its model to 200 facilities across Kenya over the next five years.

Case Study 5: SOIL (9)

Using waste transformed into soil as inspiration, Sustainable Organic Integrated Livelihoods (SOIL) transforms discarded materials and pollutants into valuable resources. Specifically, SOIL develops social business models around ecological sanitation, a process wherein nutrients from human wastes are returned to the soil rather than polluting fresh water resources.

SOIL has installed more than 50 public ecological toilets for schools and community groups in five of Haiti’s ten departments. By 2017, SOIL’s EkoLakay household toilet social business had reached more than 1,000 households. SOIL continues to focus on these sanitation programs:


(1) Mara D., & Alabaster G. “A new paradigm for low-cost urban water supplies and sanitation in developing countries.” Water Policy. 10. 2008. 119-129. Accessed 8 August  2018. 

(2) Ibid.

(3) Ibid.

(4)“World Toilet Organization.” . Accessed on 8 August 2018. 

(5) UNICEF and WHO. “25 Years Progress Update and MDG Assessment.” Accessed on 25 July 2018.

(6) United Nations University. “Greater access to cell phones than toilets in India: UN.”  14 April 2010. Accessed on 8 August 2018. 

(7) UNICEF and WHO. “25 Years Progress Update and MDG Assessment.” Accessed on 25 July 2018.

(8) “Kenyan architect goes a long was in solving sanitation issues in slums.”, Accessed on 25 July 2018. See also, Crossroads Global Hand. “Ecotact's  Ikotoilet concept -- Sustainable sanitation services in Kenya.” Accessed on 25 July 2018.

(9) SOIL. “About SOIL.” Accessed on 8 August 2018.