Eradicating open defecation in Nigeria: community-led total sanitation programmes alone will not solve the problem, but could be part of the solution
In November 2018, Nigeria declared that its water supply, sanitation and hygiene sector was in crisis. This was partly prompted by the fact that the country has struggled to make progress towards ending open defecation. Almost one in four Nigerians – around 50 million people – defecates in open areas. They do so because access to proper sanitation, like private indoor toilets or outdoor communal toilets, has not improved in recent years. In fact, it’s got worse: in 2000, 36.5% of Nigerians had access to sanitation facilities that hygienically separate human excreta from human contact. By 2015 the figure had dropped to 32.6%, likely driven by rapid population growth and a lack of sufficient private and public investment. Open defecation comes with many risks. It can lead to waterborne diseases, cause preventable deaths, and hamper education and economic growth. It also infringes on people’s privacy and dignity.
IFS assessed the impacts of WaterAid sanitation interventions
We collaborated with WaterAid, an international non-governmental organisation focused on water, sanitation and hygiene to evaluate the impact of two of its main interventions within the programme ‘Sustainable Total Sanitation Nigeria – implementation, learning, research, and influence on practice and policy’. The two interventions under evaluation are Community-Led Total Sanitation (CLTS) and Sanitation Marketing. CLTS is the main national strategy of the Nigerian Government to combat open defecation and WaterAid Nigeria is one of their key implementing partners. Both interventions aim at increasing the level of improved toilet ownership and its sustained usage, with the final goal of eliminating community-wide open defecation.
Our main findings are as follows:
Reducing open defecation is intimately tied to increasing toilet ownership in Nigeria
· In Nigeria, almost 100% of the households who own toilets use them.
· Reductions in open defecation are only achieved through increased ownership of functioning toilets.
· At the time of study completion, by the end of 2017, 48% of the households in our sample did not own a functioning toilet (55% in poor communities).
Community-Led Total Sanitation (CLTS) improved sanitation and reduced open defecation in poor communities
· CLTS increased the ownership of functioning toilets by 10 percentage points and the ownership of improved toilets by 7 percentage points in the poorest half of study communities.
· In these poor communities, CLTS decreased open defecation by 9–10 percentage points.
· These impacts are sustained over time and detectable almost 3 years after CLTS triggering meetings took place.
· Households in these study communities are poor by Nigerian standards. Half of them belong to the poorest 20% of the country.
· Evidence suggests that CLTS directed these households towards cheaper, more affordable toilet models, or that it corrected their perceptions of construction costs downwards.
· Community-level wealth is a stronger predictor of CLTS impacts than other community characteristics such as baseline toilet ownership, social capital and religious fragmentation, and household-level wealth.
CLTS had no impact in rich communities
· No CLTS impacts are observed among the richest half of the study communities, which explains why there is no effect on average over the whole sample.
· Households in these richer communities are not all rich, but the communities exhibit a distribution of wealth moderately representative of the wider Nigerian context: that is they are evenly distributed over the five countrywide wealth quintiles. However, even though there are some poor households in these richer communities, the results suggest that CLTS would not lead to significant impacts in these communities. CLTS seems to unfold its potential to a measurable degree only in communities that have average wealth levels similar to the first quintile of the countrywide Nigerian wealth distribution.
Households with no toilets report financial constraints as the main barrier to toilet ownership
· The vast majority of households with no toilet report that the main reason they do not invest in a toilet is financial constraints (toilets being too expensive or not affordable).
· This is true in both poor and rich communities within this study.
Sanitation Marketing (SanMark) Water Easy Toilets (WET) products are increasingly being sold by businesses, but sales remain low, leading to low WET ownership among households
· One out of six businesses approached to participate in SanMark is selling WET products on a monthly basis.
· Total sales were of the order of 400 units at the end of 2017. Less than 1% of households in our sample owned WET products 9 December 2017.
· Monthly sales of WET products peaked 4–5 months after the rollout of market-level activities and door-to-door (D2D) sales agents.
· Businesses exposed to SanMark perform similarly to those not exposed in terms of revenues, costs and innovation.
· WET products are recognised by potential users as more affordable and attractive.
· Financial constraints are the main limiting factor behind investment in WET products.
Door-to-door sales agents are important
· Sales agents appear to play an important role in facilitating WET sales, being involved in every second WET products sale.
· They are primarily involved in the sale of WET products to households who previously did not own private sanitation facilities of any kind and to households with unimproved toilets that want to upgrade their facilities.
Lessons for policy
· Targeting CLTS interventions based on community characteristics (in particular their relative wealth status) can increase policy impacts.
· CLTS increased toilet ownership among households in poor areas without actually removing financial constraints, but these constraints remain important for households with no toilet.
· SanMark is still a young intervention, and it is difficult to assess its effectiveness at addressing the sanitation gap at this stage. Policymakers should monitor and continue to evaluate the cost effectiveness of this intervention further before considering a SanMark scale-up.
· Policymakers should consider alternative policies that address financial constraints in both poor and richer areas, such as targeted subsidies or credit lines. These policies could complement the efforts of both CLTS and SanMark by alleviating households’ main constraints.
· In poorer areas, a combination of CLTS with targeted subsidies or credit might prove effective.