Looking at the scale of the needs and the constraints of urban settings, achieving universal access to basic sanitation by 2030 – let alone increasing access to safely managed services – seems overly optimistic. Unless certain basic requirements fall into place quickly, some countries will find themselves still trailing behind. The scoping studies commissioned by WSUP have highlighted a number of gaps related to the policy environment as well as institutional and financing arrangements for the urban sanitation sector, which need to be addressed if fast-track progress towards the SDG is to be achieved.
]]>Furthermore, well-developed legal, policy, and strategy frameworks exist but need to be fully implemented. It’s important to note that sanitation has not been a public funding priority and households bear the bulk of the costs. To conclude, from lack of prioritisation to insufficient demand and limited supply, barriers to developing pro-poor sanitation services remain significant.
]]>In addition, the legal framework for sanitation remains fragmented and focuses on sewerage services. The policy framework sets high ambitions and recognises a range of solutions and service provision models. There is significant institutional fragmentation and overlap, especially between the Ministry of Health and the Ministry of Water and Irrigation and investments in sanitation for low-income areas are almost entirely donor-funded. To conclude, inadequate institutional capacity, inadequate sector financing and insufficient data are major barriers to pro-poor sanitation.
]]>In addition, there is significant overlap in institutional responsibilities, contributing to the limited supply of FSM services. Funding has focused on rural sanitation, and sewerage services to urban areas. Rapid urbanisation, low decentralisation, lack of demand for and supply of FSM services and lack of investment are all major barriers to pro-poor urban sanitation. To conclude, despite challenges, the sector has an opportunity to bring about change.
]]>This is one article in a four-part PLoS Medicine series on water and sanitation.
Summary Points
2.6 billion people in the world lack adequate sanitation—the safe disposal of human excreta. Lack of sanitation contributes to about 10% of the global disease burden, causing mainly diarrhoeal diseases.
In the past, government agencies have typically built sanitation infrastructure, but sanitation professionals are now concentrating on helping people to improve their own sanitation and to change their behaviour.
Improved sanitation has significant impacts not only on health, but on social and economic development, particularly in developing countries.
The health sector has a strong role to play in improving sanitation in developing countries through policy development and the implementation of sanitation programmes.
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