Chances are – if you are reading this brief post – that you have never really had to worry about a full bladder (or worse). Of course, you would have needed to find a toilet at some point, possibly urgently, but there would have been at least one or two options. About 900 million people worldwide have no such choice; either at home or in their local environment. Another 1.4 billion people use toilets that do not meet basic standards. In short, we are facing a global sanitation crisis.
UNICEF estimates that some 1,800 children under the age of five die every day from the consequences of unsafe water, sanitation and hygiene. Additionally, children who lack adequate sanitation suffer from significant developmental impacts, both in the short- and long-term.
The human cost in lives is also reflected in the reduced GDP of countries where open defecation is common. Some 76% of those who defecate in the open live in just seven countries, and their governments have focussed on improving sanitation through various national strategies.
I was alerted to this problem in 2009, when I started work on the evaluation of a sanitation intervention, jointly with UNU-MERIT, in India. Never would I have thought then that the topic would dominate my research in the coming 10 years and counting.
Since then I have visited numerous toilets – in India, Pakistan, and Nigeria – and fielded surveys that interviewed thousands of households about their various practices and constraints.
For World Toilet Day 2019, my collaborators and I took stock of what we have learned so far and what we still do not know. We focused in particular on three studies that we conducted, which evaluate different approaches to improving sanitation uptake. First, a demand-creation intervention in rural Nigeria; second, an intervention that provides finance (in the form of micro-credit) for sanitation investment in rural India; third, an intervention that focuses on sustainability of previously changed sanitation habits in rural Pakistan.
The Thomson Reuters Foundation published the piece, highlighting our conclusion that a smart balance of microcredit, subsidies and behaviour change activities is likely to get us a good step closer to tackling the sanitation crisis. Read the full op-ed here.
The opinions expressed here are the author’s own; they do not necessarily reflect the views of UNU.
A family with a low-cost toilet in Mullakad, India. Earlier the women and children used to defecate in the hills behind the house. Flickr / Asian Development Bank