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Several rural technology options exist on the sanitation market with different characteristics, yet project failures in some developing countries were attributable to inappropriate technology choices. Frameworks that are used to select sanitation technology options (hard copy, computer programmes) were developed by researchers and project implementers. They vary in design and application as there is no standard format. This appears to create a gap between science and practice. Frameworks should have some key elements needed to select appropriate sanitation technologies. We evaluated 12 available frameworks (2000-2019) used to select sanitation technologies in rural communities of low- and middle-income countries against 22 assessment criteria derived from literature. Criteria that were not fully addressed by some of the reviewed frameworks (scores of 8-50%) included equity, sanitation demand, sanitation behaviour change, ongoing contact, replicability, framework limitations, personnel selection and flexibility. Addressing such limitations may assist in future framework development.

The ongoing Toilet Revolution in China offers an opportunity to improve sanitation in rural areas by introducing new approaches, such as urine source separation, that can contribute to achieving SDG6. However, few studies have systematically assessed the social acceptability of managing human excreta collected in new sanitation systems. Therefore, in this study we performed face-to-face interviews with 414 local residents from 13 villages across three provinces in western China, to analyze the current situation and attitudes to possible changes in the rural sanitation service chain. We found that the sanitation chain was predominantly pit latrine-based, with 86.2% of households surveyed collecting their excreta in a simple pit, 82% manually emptying their pits, and 80.2% reusing excreta in agriculture without adequate pre-treatment. A majority (72%) of the households had a generally positive attitude to production of human excreta-derived fertilizer, but only 24% agreed that urine and feces should be collected separately. Multivariate logistic regression indicated that three factors (level of education, number of permanent household residents, perceived social acceptability) significantly influenced respondents' attitudes to reuse of excreta, although only perceived social acceptability had a high strength of association. Overall, our survey revealed that rural households often misuse toilet systems, fail to comply with government-specified sanitation guidelines, have low awareness of alternative solutions, and are over-reliant on the government to fix problems in the service chain. Thus while new sanitation technologies should be developed and implemented, information campaigns that encourage rural households to manage their excreta safely are also important., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Unsafe management of human faecal waste represents a major risk for public health, particularly in low- and middle-income countries. Efforts to improve sanitation conditions are considerably sensitive to contextual specifics of natural and social environments. This review operationalises, analyses, and synthesises evidence of how contextual factors and motivations affect different sanitation outcomes with a specific focus on community approaches to rural sanitation., Methods and Findings: We operationalised contextual factors and motivations as determinants that influence sanitation conditions independently of the examined intervention. We conducted a systematic search of both peer-reviewed and grey literature with no restriction on the methods After screening the titles and abstracts of 19,198 records obtained through initial searches, we scrutinised the full content of 621 studies for relevance. While 102 of these studies qualified to be assessed for risk of bias and information content, ultimately, just 40 studies met our eligibility criteria. Of these 40 studies from 16 countries, 26 analysed specific interventions and 14 were non-interventional. None of the experimental studies reported the effects of contextual factors or motivations as operationalised in this study and only observational evidence was thus used in our review. We found that sanitation interventions are typically seen as the principal vehicles of change, the main instruments to fix 'deviant' behaviour or ensure access to infrastructure. The programmatic focus of this study on sanitation determinants that act independently of specific interventions questions this narrow understanding of sanitation dynamics. We identified 613 unique observations of quantitatively or qualitatively established relationships between certain contextual factors or motivations and 12 different types of sanitation outcomes. The sanitation determinants were classified into 77 typologically similar groups clustered into 12 broader types and descriptively characterised. We developed a graphical synthesis of evidence in the form of a network model referred to as the sanitation nexus. The sanitation nexus depicts how different groups of determinants interlink different sanitation outcomes. It provides an empirically derived conceptual model of sanitation with an aggregate structure indicating similarities and dissimilarities between sanitation outcomes with respect to how their sets of underlying determinants overlap., Conclusion: This study challenged the understanding of context as merely something that should be controlled for. Factors that affect targeted outcomes independently of the analysed interventions should be scrutinised and reported. This particularly applies to interventions involving complex human-environment interactions where generalisability is necessarily indirect. We presented a novel approach to comprehending the contextual factors and motivations which influence sanitation outcomes. Our approach can be analogously applied when mapping and organising underlying drivers in other areas of public and environmental health. The sanitation nexus derived in this study is designed to inform practitioners and researchers about sanitation determinants and the outcomes they influence., (Copyright © 2017 Elsevier GmbH. All rights reserved.)

Climate change is a real, emerging issue in the rural sanitation sector. In an already stressed context, they threaten sustained sanitation progress and outcomes. Yet, evidence gaps continue to exist on how climate impacts affect rural sanitation and hygiene practices and the narratives of people and households at the forefront, experiencing climate impacts on sanitation in rural areas are largely absent. The sector also needs more thinking on how programming can adapt to consider climate hazards. This paper builds evidence on climate impacts on rural sanitation practices through case studies in Burkina Faso, Bangladesh and Lao PDR. Studies were undertaken through various participatory methodologies to understand and respond to lived experience, differentially experienced impacts and tacit knowledge of climate impacts on rural sanitation. Climate hazards affect sanitation via numerous, dynamic interlinking pathways. The social context and local anthropogenic activities shape how these hazards impact physical access to sanitation infrastructure, access to local resources and markets, and livelihoods needed to support safe sanitation. These impacts include behaviours and practices, infrastructure, and people's capacity to invest in sanitation. Strong implications have emerged for how sanitation practice, research and policy must evolve to account for climate hazards to ensure sustained sanitation outcomes, systemic resilience and programme delivery. The rural sanitation sector must recognize the various interlinkages and distinct experiences of climate across people's daily lives as they have cascading impacts on sanitation practice. Climate considerations must be integrated at every stage of sanitation project delivery, and more holistic pathways must be explored, to ensure root causes of systemic issues such as poverty and vulnerability are considered for sustained and transformative outcomes. [ABSTRACT FROM AUTHOR]

Copyright of Environmental & Social Management Journal / Revista de Gestão Social e Ambiental is the property of Environmental & Social Management Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Saúde e Sociedade is the property of Universidade de Sao Paulo, Faculdade de Saude Publica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The design principles of decentralised wastewater treatment systems (DEWATS) make them a practical sanitation option for municipalities to adopt in fast-growing cities in South Africa. Since 2014, a demonstrationscale DEWATS with a modular design consisting of a settler, anaerobic baffled reactor (ABR), anaerobic filter (AF), vertical down-flow constructed wetland (VFCW) and horizontal flow constructed wetland (HFCW) has been in operation in eThekwini. A performance evaluation after the long-term operation was undertaken in 2019 by comparing the final effluent with national regulatory requirements. Despite limitations in characterising the raw wastewater, a comparison of the settler and final effluent quality indicated high (≥ 85%) removal efficiencies of total chemical oxygen demand (CODt), ammonium-N (NH4-N) and orthophosphate-P (PO4-P), 75% removal of total suspended solids (TSS) and 83.3% log10 removal of Escherichia coli. Lack of exogenous and endogenous carbon and high dissolved oxygen (DO) concentrations (> 0.5 mg·L−1) inhibited denitrification in the HFCW, resulting in 12.5% of the effluent samples achieving compliance for nitrate-N (NO3-N). Moreover, mixed aggregate media and low residence times in the HFCW may have also contributed to poor NO3-N removal. During the COVID-19 lockdown, an unexpected shutdown and subsequent resumption of flow to the DEWATS indicated a 16-week recovery time based on achieving full nitrification in the HFCW. Although design modifications are necessary for the HFCW, the installation of urine diversion flushing toilets at the household level will reduce the nutrient loading to the DEWATS and potentially achieve fully compliant effluent. Alternatively, the application of two-stage vertical flow constructed wetlands to improve denitrification should also be explored in the South African context. With an improved design, DEWATS has the potential to fill the gap in both urban and rural sanitation in South Africa, where waterborne sanitation is still desired but connections to conventional wastewater treatment works (WWTWs) are not possible. [ABSTRACT FROM AUTHOR]

• This study provides new insight of the environmental governance on community levels. • Higher cadmium content of soil affect the sustainability of community. • Community characteristics with cluster analysis help identify relevant recommendations. • Hierarchical control strategies are recommended to improve rural sanitation. Equitable access to sanitation for all is a goal of sustainable development, notably in rural areas. However, studies including economic, socio-cultural, and other factors that have been conducted to comprehensively assess rural sanitation at the community level in developing countries are limited. This study aimed to investigate the current state of rural environmental sanitation on the community level and to evaluate the characteristics of the diverse sub-clusters. A multidimensional environmental sanitation survey was conducted on 400 communities in Chongqing, China in 2020, and the priority options for improving sub-clusters' sanitation were explored using cluster analysis. Among all communities, more than 60 % had positive village appearance, 50.50 % had domestic sewage treatment, and the coverage rate of household sanitary toilets was 72.28 %. The average content for lead, cadmium (Cd), and chromium in soil was 26.01, 0.53, and 54.47 mg/kg, respectively. The communities were clustered into 3 groups (I, II, III) based on similar characteristics including basic information, village appearance, water, sanitation, hygiene management, bio-vector control, and soil pollution. The proportion of cluster I, II, and III was 39.25 % (157/400), 31.75 % (127/400), and 29.00 % (116/400), respectively. Each cluster had its sanitation characteristics, and significant differences among the sub-clusters were observed in Cd of soil (p = 0.001), domestic sewage disposal ratio (p < 0.001), and environmental health funding (p = 0.001). To sum up, the environmental sanitation in rural areas of Chongqing was better than that of the national average in China, but the Cd content of farmland soil was higher. Our study provides novel evidence for assessing the characteristics of rural sanitation at the community level, and communities with similar environmental health status were clustered into the same group, while the heterogeneity of different sub-cluster was thoroughly characterized. The hierarchical control strategy should be performed in communities based on different characteristics and deficiencies of the clusters to improve environmental sanitation. [ABSTRACT FROM AUTHOR]

This paper presents a case study concerning multivariate analysis, including social and financial aspects, as well as environmental impacts, of the organized sanitation development under conditions of the selected rural settlement in Poland. Three technologically up-to-date variants of sanitary sewerage network concepts with the different assumed sewage transport, i.e., pressure, pressure-gravity and gravity, were proposed together with the investment and operation and maintenance costs estimation. The willingness-to-accept (WTA) and willingness-to-pay (WTP) survey was used to analyze the level of social acceptance and involvement. The financial analysis covered two economic and cost-efficiency dynamic indicators, benefits–costs ratio (BCR) and dynamic generation cost (DGC), commonly used to support the decision-making process. The environmental aspects were assessed by the possible anthropopressure caused by sewerage leakage and odor emissions. Results of the WTA and WTP survey presented a significant level of acceptance and involvement of the local population to sustain the improved sanitation. The determined values of DGC indicated low cost-efficiency of the gravity system, while obtained values of BCR for all variants and the actual regional sewage fees showed the low profitability of improved sanitation, i.e., BCR < 1.0. All studied sanitation systems were assessed positively due to their environmental impacts. The performed studies showed that, despite the declared willingness to accept the organized sanitation and to pay the sewage fees, the economical sustainability of the proposed designs is doubtful over the longer time duration due to the significant capital and operation costs affecting the sewerage payment value. [ABSTRACT FROM AUTHOR]

The rural water and sanitation systems are administered by district municipalities and community organizations, but the service provided by most of these systems has not been efficient, since the drinking water they offer is not healthy, safe, continuous, or fully social access, solid waste is not properly disposed of, wastewater is not treated and the natural sources that provide this service are not protected, so the comprehensive sustainability of these systems is not assured. The national norm establishes that in rural areas the district municipalities are in charge of providing water and sanitation services to the population in their jurisdiction, directly through the municipal management units (UGM) and indirectly through of community organizations such as the administrative boards of sanitation services (JASS), to which the municipality entrusts the responsibility but must provide them with technical assistance, training and supervision so that they can perform the service well. The district municipality of Leimebamba, in the province of Chachapoyas, department of Amazonas, is a local government in rural areas that is in charge of technical assistance, training and supervision of water and sanitation services provided by all seven communitarian organizations recognized as JASS by the mayor authority. The fulfilment of these municipal functions requires that the municipality has a set of capacities, resources, instruments, equipment and materials that allow it to assist, monitor and evaluate the integral and sustainable management that the JASS must develop during the provision of water services. and sanitation in their communities. An essential element to fulfil this guiding role is to have an instrument to periodically assess whether the management carried out by the JASS is implemented in a comprehensive and sustainable manner. To this end, this ongoing research is experimentally developing, together with the Municipal Technical Assistance Office (ATM) of Leimebamba, an index for evaluating the sustainability of rural sanitation systems in the district. This index considers the social, economic, environmental, technical and institutional dimensions as the most important aspects to assess the comprehensiveness and sustainability of rural sanitation systems, identifying in each of these dimensions the key factors and indicators to be taken into account. The index was subjected to expert judgment by 3 specialists using a Linkert scale to assess the clarity, coherence and relevance of the indicators. The values found in each allowed a selection of indicators, choosing 77 according to the experts' assessments. Likewise, the values obtained indicate that the index allows estimating the comprehensiveness and sustainability of rural sanitation systems. A first experimental application of this index has been carried out in the 2 main JASS of Leimebamba, the JASS Palmira that serves 512 residents and the JASS Dos de Mayo that serves 912, which together serve 75% of the rural population served. by JASS, the main reason why these two community organizations were selected as subjects of the experimental application. For this first application of the instrument, the index was compared with the information provided by the regional supervisory entity, SUNASS Amazonas in its supervision reports, and with the information obtained in the interviews held with the leaders of both JASS and the responsible municipal official. from the ATM office. The results of the application indicated that the sustainability levels of both JASS are at the stable level. [ABSTRACT FROM AUTHOR]

Access to safe drinking water and adequate sanitation is considered as a basic human right. Swachh Bharat Mission - Gramin (Rural), launched by the Government of India in 2014, is hailed as an attempt towards that direction. On 2nd October 2019, India was declared free from open defecation, with rural households having full toilet coverage. However, despite Government claims, the existing literature indicates the presence of slippage: where households practice open defecation despite having access to toilets. Equating progress in sanitation interventions with mere toilet provision presents a partial assessment of sanitation. To address the gap, the 'Sanitation Well-being' framework, based on Amartya Sen's concept of justice, has been proposed. It identifies slippage as an outcome of various underlying factors across the sanitation life-cycle. The framework provides a lens to analyse existing frameworks and secondary data sets and finds that they do not capture the dynamism inherent in the sector. The efficacy of the framework has been tested in the rural district of Shravasti, Uttar Pradesh, India, through the rapid rural appraisal method. Through our investigation, we found that slippage exists in the field, and that the framework is a feasible instrument to assess sanitation as a comprehensive phenomenon. [ABSTRACT FROM AUTHOR]

Copyright of Revista Retratos de Assentamentos is the property of Revista Retratos de Assentamentos and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Backgorund: Access to improved sanitation facility for all is an essential to maintain good health and wellbeing. However in India, millions of people suffer from diseases and infections due to lack of adequate sanitation. Realising the importance of sanitation and hygiene, Government of India announced the flagship programme Swachh Bharat Mission (SBM) in 2014. One of the important features of SBM is to provide financial assistance to construct individual household latrine facility. It is important to understand the impact of SBM on pattern and access of households to latrine facility in Indian states. Objective: This paper tries to examine the pattern and trends in access to individual household latrine facility from an inter-state perspective and convergence in access to latrine facility among the states after the implementation of SBM. Methods: Data have been obtained from Census, reports from Ministry of Drinking Water and Sanitation, GOI and Swachh Bharat Mission Gramin website for the period 2011 to 2018. Sigma and beta convergence techniques have been employed to analyse the convergence in access to toilet facility and percent and ratios are employed to analyse the pattern. Results: The findings of the study confirmed the positive impact of SBM in increasing the access to toilet facility in rural India and convergence in access to toilet facility among Indian states in post SBM implementation. During the period 2014-2018, ie, after implementation of SBM, the increase in sanitation coverage at national level is four times higher than the progress made during the decade of 2001 to 2011. Many of the States have reported 100 percent open defection free Villages in the year 2018. So Implementation of SBM not only improves the share of households having latrine facility, but it has widely reduced the gap between high and low income states in access to the sanitation facility. [ABSTRACT FROM AUTHOR]

Recent sanitation situations in Nigeria present public health problems, especially in rural and semi‐urban centers. Local and national government bodies in the country have defined policies to provide adequate sanitation for the populations under their control as stated in relevant decrees and policies. However, those who work as health providers in Nigeria regard conditions in many parts of the country as unhygienic and unhealthy due to a lack of adequate sanitation and because the sanitation facilities that are in place are often ineffective. Interviews with householders in rural and semi‐urban centers showed that more than 72% of the people in rural communities lack access to adequate sanitation and toilet systems, especially in public institutions. While in semi‐urban centers about 91% of the residents use septic tanks without treatment facility, the remaining 8% use toilet systems such as community toilets, wet pit latrines, and open defecation. Both rural and semi‐urban centers do not use urine‐diverting dry toilets or septic tanks with treatment facilities. Given the present sanitation situation, this study proposes a modern toilet system in rural communities that will enhance the recovery of biogas and nutrients as fertilizer for soil amendment through appropriate implementation, use, and maintenance. The results could be useful as a support for decisions on policies and strategies for adequate and improved sanitation facilities in rural and semi‐urban centers in South South Nigeria. [ABSTRACT FROM AUTHOR]

In many urban and peri-urban areas of developing countries, shallow wells and untreated water from urban rivers are used for domestic purposes, including drinking water supply, population bathing and irrigation for urban agriculture. The evaluation and monitoring of water quality are therefore necessary for preventing potential human risk associated with the exposure to contaminated water. In this study, physicochemical and bacteriological parameters were assessed in an urban river (named Kokolo Canal/Jerusalem River) draining the municipality of Lingwala (City of Kinshasa, Democratic Republic of the Congo) and in two shallow wells used as drinking water supplies, during the wet and dry seasons in order to estimate the seasonal variation of contamination. The faecal indicator bacteria (FIB) isolated strains (Escherichia coli (E. coli) and Enterococcus (ENT)) from water and surface sediment, were characterized for human-specific bacteroides by molecular approach. The results revealed very high faecal contamination of water from the shallow wells, and of water and sediments from the river, during both wet and dry seasons. During the wet season, E. coli reached the values of 18.6 × 105 and 4.9 × 105 CFU 100 mL-1 in Kokolo Canal and shallow wells, respectively; and Enterococcus reached the values of 7.4 × 104 and 2.7 × 104 CFU 100 mL-1. Strong mutually positive correlation was observed between E. coli and ENT, with the range of R-value being 0.93 < r < 0.97 (p-value < 0.001, n = 15). The PCR assays for human-specific Bacteroides indicated that more than 98% of 500 isolated FIB strains were of human origin, pointing out the effect of poor household sanitation practices on surface water but also on groundwater contamination. The water samples from the shallow wells and Kokolo Canal were highly polluted with faecal matter in both seasons. However, the pollution level was significantly higher during the wet season compared to the dry season. Physicochemical analysis revealed also very high water electrical conductivity, with values much higher than the recommended limits of the World Health Organization guideline for drinking water. These results highlight the potential human health risk associated with the exposure to water contamination from shallow wells and Kokolo Canal, due to the very high level of human FIB. Rapid, unplanned and uncontrolled population growth in the city of Kinshasa is increasing considerably the water demand, whereas there is a dramatic lack of appropriate sanitation and wastewater facilities, as well as of faecal sludge (and solid waste) management and treatment. The lack of hygiene and the practice of open defecation is leading to the degradation of water quality, consequently the persistence of waterborne diseases in the neighbourhoods of sub-rural municipalities, and there is a growing threat to the sustainability to water resources and water quality. The results of this study should encourage municipality policy and strategy on increasing the access to safely managed sanitation services; in order to better protect surface water and groundwater sources, and limit the proliferation of epidemics touching regularly the city. [ABSTRACT FROM AUTHOR]

Abstract: The Community‐Led Total Sanitation (CLTS) programme aims to end open defecation through facilitating activities that evoke a sense of shame, shock and disgust. The programme's initial success and low‐cost design has seen it become hegemonic in donor‐supported rural sanitation. However, the theoretical basis of the use of shame has not been critically evaluated. Supporters claim that shame helps form and maintain social relationships, yet contemporary psychosocial literature highlights that it is a volatile and often harmful emotion, particularly in conditions of poverty. Using a case study of Cambodia, which rejected the coercive elements of shame in CLTS, we explore the problems of shame and limits of local ownership of development. [ABSTRACT FROM AUTHOR]

Abstract: Different stakeholders tried participatory approaches to boost progress in rural sanitation in India. The policy processes around these experiences, despite shaping their outcomes, remain a knowledge gap this article addresses. Evidence shows that the interests of the actors involved resulted in the national campaign being focused on construction. Therefore, participatory approaches could only be successfully introduced through networks with political champions at their centre. Moreover, political dynamics determined the success of the different introduction strategies. A better understanding of these policy processes, using analytical frameworks such as the one we propose, will lead to smarter influencing strategies in the sanitation sector. [ABSTRACT FROM AUTHOR]

On May 2, 2009 an outbreak of typhoid fever began in rural villages along the Malawi-Mozambique border resulting in 748 illnesses and 44 deaths by September 2010. Despite numerous interventions, including distribution of WaterGuard (WG) for in-home water treatment and education on its use, cases of typhoid fever continued. To inform response activities during the ongoing Typhoid outbreak information on knowledge, attitudes, and practices surrounding typhoid fever, safe water, and hygiene were necessary to plan future outbreak interventions. In September 2010, a survey was administered to female heads in randomly selected households in 17 villages in Neno District, Malawi. Stored household drinking water was tested for free chlorine residual (FCR) levels using the N,N diethyl-p-phenylene diamine colorimetric method (HACH Company, Loveland, CO, USA). Attendance at community-wide educational meetings was reported by 56% of household respondents. Respondents reported that typhoid fever is caused by poor hygiene (77%), drinking unsafe water (49%), and consuming unsafe food (25%), and that treating drinking water can prevent it (68%). WaterGuard, a chlorination solution for drinking water treatment, was observed in 112 (56%) households, among which 34% reported treating drinking water. FCR levels were adequate (FCR ≥ 0.2 mg/L) in 29 (76%) of the 38 households who reported treatment of stored water and had stored water available for testing and an observed bottle of WaterGuard in the home. Soap was observed in 154 (77%) households, among which 51% reported using soap for hand washing. Educational interventions did not reach almost one-half of target households and knowledge remains low. Despite distribution and promotion of WaterGuard and soap during the outbreak response, usage was low. Future interventions should focus on improving water, sanitation and hygiene knowledge, practices, and infrastructure. Typhoid vaccination should be considered. [ABSTRACT FROM AUTHOR]

Access to safe sanitation services is fundamental for healthy and productive lives, but in rural Burkina Faso only around 7% of the population uses improved sanitation. Ecological sanitation (ecosan) systems that allow safe agricultural reuse of nutrients in human waste have been promoted in these areas, as a way to meet sanitation needs while contributing to food security. However, little is known about the success of these interventions in terms of both sustained use of the toilet and safe excreta reuse practices. We assessed the use of ecosan systems in 44 rural communities where such interventions had taken place. Structured interviews and observations conducted at 520 randomly selected concessions (residential properties), suggested a large-scale shift from open defecation to ecosan toilet use. However, only 58% of surveyed concessions reported ever emptying the ecosan toilet vault, which is required for optimal long-term functioning. Concessions that received ecosan training programmes with a greater emphasis on agricultural reuse were more strongly associated with toilet use and emptying than those that whose training focused more on sanitation access and health benefits. The findings suggest that the safe agricultural reuse of nutrients can provide a strong motivation for long-term adoption of improved sanitation among rural smallholders. [ABSTRACT FROM AUTHOR]

Parallel global rise in pit-latrine sanitation and groundwater-supply provision is of concern due to the frequent spatial proximity of these activities. Study of such an area in Malawi has allowed understanding of risks posed to groundwater from the recent implementation of a typical developing-country pit-latrine sanitation policy to be gained. This has assisted the development of a risk-assessment framework approach pragmatic to regulatory-practitioner management of this issue. The framework involves water-supply and pit-latrine mapping, monitoring of key groundwater contamination indicators and surveys of possible environmental site-condition factors and culminates in an integrated statistical evaluation of these datasets to identify the significant factors controlling risks posed. Our approach usefully establishes groundwater-quality baseline conditions of a potentially emergent issue for the study area. Such baselines are foundational to future trend discernment and contaminant natural attenuation verification critical to policies globally. Attribution of borehole contamination to pit-latrine loading should involve, as illustrated, the use of the range of contamination (chemical, microbiological) tracers available recognising none are ideal and several radial and capture-zone metrics that together may provide a weight of evidence. Elevated, albeit low-concentration, nitrate correlated with some radial metrics and was tentatively suggestive of emerging latrine influences. Longer term monitoring is, however, necessary to verify that the commonly observed latrine-borehole separation distances (29–58 m), alongside statutory guidelines, do not constitute significant risk. Borehole contamination was limited and correlation with various environmental-site condition factors also limited. This was potentially ascribed to effectiveness of attenuation to date, monitoring of an emergent problem yet to manifest, or else contamination from other sources. High borehole usage and protective wall absence correlated with observed microbiological contamination incidence, but could relate to increased human/animal activity close to these poorly protected boreholes. Additional to factors assessed, a groundwater-vulnerability factor is recommended that critically relies upon improved proactive securing of underpinning data during borehole/latrine installations. On-going concerns are wide ranging, including poorly constrained pit-latrine input, difficulties in assessing in-situ plume natural attenuation and possible disposal of used motor oils to latrines. [ABSTRACT FROM AUTHOR]

On-site sanitation is generally advocated as a means to eradicate the health hazards associated with open defecation. While this has provided a welcome upgrade to the livelihoods of millions of people in low-income countries, improved sanitation facilities are increasingly becoming a threat to domestic groundwater-based supplies. Within this context, a survey of pit latrines, domestic wells and improved water sources was carried out in a large rural village of southern Mali. All households were surveyed for water, sanitation and hygiene habits. Domestic wells and improved water sources were georeferenced and sampled for water quality (pH, electric conductivity, temperature, turbidity, total dissolved solids, thermotolerant coliforms, chloride and nitrate) and groundwater level, while all latrines were inspected and georeferenced. A GIS database was then used to evaluate the proportion of water points within the influence area of latrines, as well as to underpin multiple regression models to establish the determinants for fecal contamination in drinking supplies. Moreover, an appraisal of domestic water treatment practices was carried out. This revealed that nearly two-thirds of the population uses bleach to purify drinking supplies, but also that domestic-scale treatment as currently implemented by the population is far from effective. It is thus concluded that existing habits could be enhanced as a means to make water supplies safer. Furthermore, population, well and latrine density were all identified as statistically significant predictors for fecal pollution at different spatial scales. These findings are policy-relevant in the context of groundwater-dependent human settlements, since many countries in the developing world currently pursue the objective of eliminating open defecation. [ABSTRACT FROM AUTHOR]

This article examines the history of debates around the creation of a ‘native village’ in Pietermaritzburg culminating in the construction of the city's first formal township. This, and the decision to locate the new township next to the city's main dump, have commonly been interpreted to corroborate Maynard Swanson's influential concept of the ‘sanitation syndrome’. Swanson first coined that term to explain the origins of racial segregation in Durban, but it struck a chord very widely, not only because it problematized science as metaphorical, but also because it shifted responsibility for the antecedents of apartheid onto urban, self-styled progressive English-speaking officials and voters. From the Pietermaritzburg evidence, however, I argue that the concept ‘sanitation syndrome’ now unhelpfully elides or oversimplifies a complex history. I thus question its continued utility as a critique of cultural racism within liberal or modernization discourses in the wider contemporary regional context. [ABSTRACT FROM AUTHOR]

New types of sanitation services are emerging to tackle the sanitation crisis in informal settlements. These services link toilet facilities to semi-decentralized treatment plants via frequent, road-based transport of excreta. However, information for the planning of such sanitation services is scarce, and their future operating conditions are highly uncertain. The key questions of this paper are therefore: a) what are the drivers behind success or failure of a service-based sanitation system in informal settlements and b) on what scales and under which conditions can such a system operate successfully? To answer these questions, already at an early stage of the planning process, we introduce a stochastic model to analyze a wide range of system designs under varying technical designs, socio-economic factors, and spatial condition. Based on these initial results, we design a sanitation service and use the numeric model to study its reliability and costs over a wide range of scales, i.e., system capacities, from very few to many hundred users per semi-decentralized treatment unit. Key findings are that such a system can only operate within a narrow, but realistic range of conditions. Key requirements are toilet facilities, which can be serviced rapidly, and a flexible workforce. A high density of facilities will also lower the costs. Under these premises, we develop a road-based sanitation service and model its functionality in different settings and under many scenarios. Results show that the developed sanitation system using a single vehicle is scalable (100–700 users), can provide reliable service, and can be cheap (<1.5 c/p/day). Hence, this paper demonstrates opportunities for road-based sanitation in informal settlements and presents a quantitative framework for designing such systems. [ABSTRACT FROM AUTHOR]

The article discusses a shift in sanitation and hygiene improvement initiatives focusing on the approach taken by natural resource specialist Kamal Kar called the Community-Led Total Sanitation (CLTS). The effectiveness of CLTS is discussed as it provides individuals with latrine subsidies and a monitoring system mobile to web application (M2W). The causes of diarrhea and its association with unhygienic condition are discussed along with CLTS approach to defecation in Zambia, Africa.

The article focuses on the prevention of schistosomiasis, a parasitic disease affecting both men and animals worldwide. It is inferred that it is due to unawareness in uneducated rural communities about the risk of poor sanitation. Intensive research has been made to prevent the epidemy by providing protected water supply to the individual home. However, it requires extensive changes in social habits and customs before protection can be assured. Thus, a pilot project has been made with current knowledge and techniques in addition to present research and experimentation to demonstrate control in selected areas, such as the Caribbean island of St. Lucia, which contain heavily infested population of people and cattle, sufficiently isolated to minimize reinfection as the control progress.

The technical performance and user acceptance of a novel on-site sanitation system based on vermifiltration was tested for over 12 months in rural India. Ten households (mean household size = 5.6 people) who had previously practised open defecation trialled a pour flush toilet linked to a vermifilter, together known as a 'Tiger Toilet'. Technical parameters which were monitored over this period included: usage, temperature, accumulation of faecal matter and vermicompost, presence of worms, and influent and effluent quality. User satisfaction was evaluated relative to a baseline survey and through focus group discussions. The vermifilters processed human waste products effectively in a real life scenario. After 12 months there was little accumulation of faecal solids (0-10 per cent surface coverage) and effluent quality was good (chemical oxygen demand reduction = 57 per cent, faecal coliforms reduction = 99 per cent). Vermicompost accumulation was low and suggested that emptying would only be necessary every five years. User satisfaction levels were high, with 100 per cent of respondents being either very satisfied (60 per cent) or satisfied (40 per cent) with the 'Tiger Toilet'. The main reasons given were the use of worms and the lack of smells. [ABSTRACT FROM AUTHOR]

The world's remaining open defecation is increasingly concentrated in rural India. The Indian Government's efforts to reduce open defecation by providing subsidies for latrine construction have been largely unsuccessful in addressing the problem. It is now clear that behaviour change must be the priority if progress on ending open defecation is to be made. While community-led strategies have proven effective in various developing country contexts, there are serious reasons to question whether similar methods can work in rural India. Through both quantitative and qualitative analyses, we find that strict social hierarchies that continue to govern daily interactions in rural life today obstruct the spirit of cooperation upon which such methods rely. Additionally, caste-based notions of purity and pollution make the simple latrines used all over the developing world unattractive to rural Indians. In a context where people identify most closely with their caste and religious groups rather than their geographical villages, our findings suggest that a more nuanced understanding of the idea of 'community' is required. More experimentation, both with community-led and other strategies, is needed in order to effectively move from open defecation to latrine use in rural India. [ABSTRACT FROM AUTHOR]

Background: In India, Village Health Sanitation and Nutrition Committees (VHSNCs) are participatory community health forums, but there is little information about their composition, functioning and effectiveness. Our study examined VHSNCs as enablers of participatory action for community health in two rural districts in two states of eastern India - West Singhbhum in Jharkhand and Kendujhar, in Odisha.Methods: We conducted a cross-sectional survey of 169 VHSNCs and ten qualitative focus group discussions with purposively selected better and poorer performing committees, across the two states. We analysed the quantitative data using descriptive statistics and the qualitative data using a Framework approach.Results: We found that VHSNCs comprised equitable representation from vulnerable groups when they were formed. More than 75 % members were women. Almost all members belonged to socially disadvantaged classes. Less than 1 % members had received any training. Supervision of committees by district or block officials was rare. Their work focused largely on strengthening village sanitation, conducting health awareness activities, and supporting medical treatment for ill or malnourished children and pregnant mothers. In reality, 62 % committees monitored community health workers, 6.5 % checked sub-centres and 2.4 % monitored drug availability with community health workers. Virtually none monitored data on malnutrition. Community health and nutrition workers acted as conveners and record keepers. Links with the community involved awareness generation and community monitoring of VHSNC activities. Key challenges included irregular meetings, members' limited understanding of their roles and responsibilities, restrictions on planning and fund utilisation, and weak linkages with the broader health system.Conclusions: Our study suggests that VHSNCs perform few of their specified functions for decentralized planning and action. If VHSNCs are to be instrumental in improving community health, sanitation and nutrition, they need education, mobilisation and monitoring for formal links with the wider health system. [ABSTRACT FROM AUTHOR]

This paper applies cost-efficiency analysis to an intervention that promotes behaviour change for rural sanitation in Tanzania. The campaign targets a number of potential beneficiaries, out of which some are effectively encouraged to adopt the new practices (beneficiaries). As a result, the cost-efficiency of the programme depends on the extent of take-up of improved sanitation by the target population, unknown in advance. To correctly account for the costs of households gaining access under this demand-driven approach, both costs (investments) and increased access to sanitation are considered outcomes and are estimated from samples of beneficiary and control populations, using a randomised-controlled trial design. Results show that sanitation promotion did not lead to higher investment relative to the control group and that the cost-per-person effectively gaining access to sanitation is substantially higher than the cost-per-person targeted or at-reach of the campaign. Using these estimates, the authors found that universal coverage can be obtained for the equivalent of 4 per cent of Tanzania’s national GDP (2013). They also used parameters estimated from the study to simulate cost-per-person of the programme when take-up increases (efficiency gains). [ABSTRACT FROM AUTHOR]

This paper summarizes the findings from a meta-analysis of 22 rural sanitation supply studies commissioned by the Water and Sanitation Program (WSP) of the World Bank over the past seven years in South America, sub-Saharan Africa, East Asia, and South Asia. By building a comprehensive analytical framework for the sanitation market, the article identifies globally relevant weaknesses in the sanitation market, gives examples of positive interventions, and identifies key areas of activities that could lead to a strengthening of a relevant sanitation market for the base of the pyramid (BoP). The study also identified global knowledge gaps on how to enable, facilitate, and engage rural sanitation markets for the BoP. The full report is expected to be published by WSP later in 2015. [ABSTRACT FROM AUTHOR]

UNICEF Pakistan adopted a conceptual framework for global qualitative research to advance their ongoing exploratory research work on menstrual hygiene management (MHM) in 2013-14. The findings of qualitative research informed the design of certain interventions in schools to improve MHM. These interventions were implemented as action research so that the benefits of these interventions can be studied. Qualitative research gave an in-depth understanding of girls' needs and their preferences to address MHM-related issues. Data analysis of qualitative research helped a team of sanitation practitioners and social scientists in understanding different factors influencing MHM in girls' schools. A few simple and focused interventions were hence designed and implemented. Six weeks after the implementation of hard and soft activities on the ground the results were studied. Results showed significant improvement in MHM conditions in girls' schools. Girls and teachers welcomed the initiatives and there were indicators for future sustainability. Areas of improvement were also noted by UNICEF before taking these interventions to scale. This research was documented as 'learning, acting, and learning' (LAL: literally meaning 'Red' in the local language, Urdu) research. [ABSTRACT FROM AUTHOR]

Market research is the foundation for the design, implementation, and evaluation of evidencebased sanitation marketing programmes. Limited financial resources combined with time constraints may result in some organizations neglecting this fundamental stage. This paper describes how UNICEF Malawi's government partners were supported to implement market research over five days in Mangochi and Dowa districts, Malawi. The paper presents the six stages of the market research and provides the strengths and challenges of each stage. The market research provided government staff with an opportunity to dispel misperceptions by hearing, recording, and analysing qualitative and quantitative information about the existing sanitation market [ABSTRACT FROM AUTHOR]

In the period of collectivization, the New China government carried out extensive sanitation science popularization in rural areas. The rural sanitation science popularization in the period highlighted the practical functions of sanitation in health improvement and, at the same time, vested sanitation with rich meanings and make it a symbol of rich meanings. The operation of such symbolized rural science popularization was the core strategy for the rural sanitation science popularization in the period. [ABSTRACT FROM AUTHOR]

Introduction: In Ethiopia up to 60% of the current disease burden is attributable to poor sanitation. Latrine facility coverage is increasing since Health Extension Program started, whereas less attention to quality and utilization of latrine facilities in rural Ethiopia. Methods: A community based cross-sectional study design with multistage sampling technique was employed to collect data from total of 806 households. Results: A total of 801 households with latrines were assessed for their latrine utilization status. The extent of latrine utilization among 490 (61.2%) households was satisfactory. Presence of ≤5 children (AOR: 0.379, 95% CI :(0.196, 0.732)), job of mothers (being farmer) (AOR: 0.321, 95%CI :(0.136, 0.757)) and rare cleaning frequency (AOR: 0.055, 95% CI :(0.005, 0.620)) were a factor negatively associated with latrine utilization. Whereas the presence of secondary school children (AOR: 3.739, 95% CI (1.884, 7.419), educational status of mothers (AOR: 2.437, 95% CI (1.032, 5.756), latrine constructed for the second time (AOR: 2.676, 95% CI :(1.352, 5.299)), presence of door (AOR: 3.201, 95% CI: (1.437, 7.130)), the hygienic condition of latrine (AOR: 4.327, 95% CI: (2.05, 9.134)) were factors positively associated with latrine utilization. Conclusion: Latrine utilization rate of household latrines was satisfactory. The presence of ≤ 5 years children, job of mother (farmer), educational status of mothers, presence of secondary school student, the presence of the door, frequency of latrine construction, and hygienic condition of latrine were significant predictors of latrine utilization. [ABSTRACT FROM AUTHOR]

The Total Sanitation and Sanitation Marketing (TSSM) programme launched in the province of East Java, Indonesia in 2007. The TSSM promoted collective behaviour change moving from open defecation to more hygienic practices. This paper expands the analysis of a previous rigorous impact evaluation based on a cluster randomized controlled trial by studying programme differential impacts by female-headed households and three main ethnic groups. Because previous TSSM impacts found were relatively small, this led to small improvement in morbidity and child growth effects among poor households. This study examines two subgroups within the sample, female-headed households and ethnic populations (GEG), to explore whether the effects can be identified for both of these subgroups. The paper shows that female-headed TSSM households experienced a reduction of 5.8 per cent in diarrhoea prevalence of children under 5 years old. Ethnicities benefited differently from the programme: the Javanese ethnicity experienced no improvements in outcomes while the Madurese ethnic group showed significant improvements of one-sixth of one standard deviation (8.6 cm) of height-for-age in children (1.43 cm average) and one-fifth of a standard deviation (3.7 cm) increase in head circumference. Other ethnic groups showed a 20.6 per cent reduction in open defecation compared to non-exposed households. Because sanitation campaigns reach households and the intra-household responsibilities for sanitation practices depend partly on culture and social norms, certain components of TSSM can be mainstreamed to achieve behaviour change effectively towards gender and ethnic groups. [ABSTRACT FROM AUTHOR]

In China, over 47 million toilets in rural areas have been upgraded since the nationwide sanitation program, popularly referred to as the "toilet revolution", was launched in 2015. However, little is known about the perceptions of rural households regarding these new toilets or the fate of human excreta collected using them. To investigate the other side of the toilet revolution, we surveyed 980 rural households from 22 provinces across China in 2020. We found that most households used an on-site sanitation system (i.e. septic tanks and pit latrines), where urine and feces were mixed and collected (88%), stored in pits or tanks (79%), emptied by the households themselves (60%), applied on farmland as fertilizer (45%), or used for biogas production (5%). Despite the toilet revolution-driven infrastructure upgrade, only 25% of the households were satisfied with their sanitation system and pointed to health risks from issues in the toilet interface and the treatment and reuse of excreta as areas of concern. The majority preferred an "out of sight, out of mind" approach, in which the local government handles excreta without involving the households and without asking them to pay for such management. Meanwhile, 80% supported the idea of local nutrient recycling and believed that human excreta should return to farmland as fertilizer or used for biogas production. Our findings suggest that decision makers in local governments across China must urgently explore ways to upgrade all parts of the sanitation service chain so that rural sanitation can be truly improved to positively influence the progress on other national sustainability goals. [Display omitted] [ABSTRACT FROM AUTHOR]

Background: Lack of sanitation facilities is a serious health risk and obliges people to practice open defecation, thereby increasing the risk of disease transmission. The aim of this study was to assess latrine coverage and the associated factors among the rural communities in district of Bahir Dar Zuria, Ethiopia. Methods: A community-based cross-sectional study was conducted on 608 households in district of Bahir Dar Zuria. First, the district was stratified based on the distance from Bahir Dar city. Then, ten kebeles (the smallest administrative units) were selected from the 32 rural kebeles in the district. After the kebeles had been identified, the households were selected by systematic sampling method using existing list of all households as a sampling frame. Intervals (Kth)) for selecting households were determined by dividing the number of households with the sample size allocated for each kebele. After determining the Kth interval, the first household was selected randomly. The next households were identified systematically onwards by adding cumulatively Kth intervals to the first selected household .Data were collected by means of a pretested, standardized questionnaire and observation checklist. Data analysis was carried out using SPSS version 16. Results: Of the 608 households, 355 (58.4%) had pit latrines and only 220 (62.0%) were functional (providing services during data collection). One hundred eighty seven (52.7%) had been constructed two or more years prior to the time of the study and 202 (56.9%) latrines required maintenance. The availability of latrines was twice higher in households with an income of 5000 or more Ethiopian Birr (1USD = 17.5 Ethiopian Birr) per year (adjusted odds ratio [AOR], 1.55; 95% confidence interval [CI], 1.06-2.27) than those who hand an income less than 5000 Birr per year; the availability of latrines was twofold higher in households visited by health professional at least three times a month (AOR, 2.29; 95% CI, 1.33-3.93) than those that received no visits. The latrine coverage was about two times higher in households that were less than 30 minutes walk from a health institution (AOR, 1.57; 95% CI, 1.11-2.22) than households that were over 30 minutes walk. The latrine coverage was lower in households located in distant areas (AOR, 0.53; 95% CI, 0.36-0.77) than in households closer to the city. Conclusions: Latrine coverage in District of Bahir Dar Zuria was far from the national target of 100%. The availability of latrines was affected by income level, frequency of visits by health workers, walking time from local health institutions, and distance from Bahir Dar. Therefore, it is recommended that the frequency of supportive visits be increased and that special attention be given to households in inaccessible areas. [ABSTRACT FROM AUTHOR]

Abstract: There is an emerging body of literature on product innovations for the poor at the bottom of the income pyramid. However, there is little on why delivery systems succeed or fail in this context and the present paper attempts to fill this void by examining why and how sanitation entrepreneurs are succeeding in India to diffuse toilets — an innovation for rural households, which never had access to one before. The literature is analyzed and confronted with the actual field practices. We demonstrate that the common thread that unifies progressive sanitation entrepreneurs is their adoption of a ‘market based approach’. There are market failures stemming from the demand side due to problems in expression of demand and its mismatch with the perceived value of the innovation. In response, sanitation entrepreneurs go beyond the standard linear model of assessing need and appropriateness of technology. They create innovations in ‘technological design’ as well as in the ‘delivery platforms’ to include practices for ‘accompaniment’, ‘sustainable maintenance’ and ‘generation of knowledge''. Thus, they make-up for sluggish or missing markets and informational asymmetries to ensure sustained use of toilets. [Copyright &y& Elsevier]

Lack of sanitation affects the lives of billions of people worldwide. It is now generally agreed that sustainable solutions to this complex problem require social and cultural factors to be addressed in addition to the habitual economic and technical aspects. Increasingly, sector professionals view the fragmented approaches to sanitation as a limiting factor. This refers to the fragmentation of the knowledge on the subject among often hermetic disciplines and to the distribution of political mandates on sanitation across many institutions, which independently tackle specific aspects of the issue. Holistic approaches have often been suggested as a solution. This paper presents the development of such a holistic approach, designed to assess sanitation development in rural and peri-urban settings. Tested in three Mexican communities, it relies on qualitative research tools to identify critical influences to sanitation development. This article presents generic results about micro and macro-factors affecting sanitation development in Mexican villages, and reflexively examines the research process as well as the strengths and limitations of the approach. The conceptual map developed for each case study successfully highlights the interconnectedness of all factors affecting sanitation development. Despite some weaknesses, these maps constitute a practical assessment tool for interdisciplinary teams deployed in integrated water and sanitation development programs and a valuable didactic tool for training activities. [Copyright &y& Elsevier]

The study has assessed the progress of Total Sanitation Campaign (TSC), which is implemented by pursuing decentralised delivery mechanism. Based on the macro and micro level data, Birbhum district of West Bengal in India has been chosen as the study area. The evidences suggest that the progress of the sanitation programme was hampered due to low allocation and utilisation of funds for demand generation and supply of materials. Furthermore, laxity of local government (Panchayats) and motivators in demand generation for sanitary facilities have also led to underperformance of the programme. Lack of affordability of low-cost toilets and lack of consciousness appeared to be the major constraints in the progress of the programme. Low participation in local government meetings has also been observed to have thwarted the progress of TSC. [ABSTRACT FROM AUTHOR]

Abstract: Improving sanitation and hygiene to prevent infectious diseases is of high priority in developing countries. This study attempts to gain in-depth understanding of hygiene and sanitation perceptions and practices among four Ethnic Minority Groups (EMGs) in a rural area of northern Vietnam. It is based on extensive participatory observations in 4 villages and 20 case households over a period of six months (May–October 2008). In addition, 10 key informants and 60 household-members were interviewed and 4 focus group discussions conducted. The study found that among the four selected EMGs the cultural perceptions of hygiene and sanitation which inform everyday hygiene practices did not differ substantially and were similar to hygiene explanations found in the rural majority population elsewhere in Vietnam. However, the difficult living conditions, particularly in highland communities, reinforce a sense of marginalization among the EMGs, which had great impact on how they perceive and respond to government sanitation interventions. The enclosed latrines promoted by authorities are met with reluctance by the EMGs due to cultural perceptions of the body as permeable and therefore, vulnerable to ’dirty air’ such as bad smells from human faeces. In addition, the prioritization of specific sanitation hardware solutions by the central government aimed at increasing coverage creates expectations and dependency among the EMGs that hygiene ’comes from the outside society’, resulting in low levels of community initiated actions. Based on these findings, we suggest that future hygiene promotion strategies aim for a closer match between community priorities and government hygiene policies, e.g. by allowing for a larger diversity of low-cost sanitation solutions. Scaling up participatory community-based hygiene promotion is also recommended to curb dependency and spark initiatives in ethnic minority communities. Finally, interventions should focus on hygiene “software” - promoting hygiene behaviour changes known to effectively prevent hygiene related diseases. [Copyright &y& Elsevier]

The principles of democracy and social justice demand that the legitimacy of a popularly elected government, rest on a claim to represent the desires of its citizens; to guarantee the majority of the citizens decent living standard. In line with the above principles, the policy directions and documents were produced such as the NEEDS, SEEDS and LEEDS to ensure good governance, which is expected to enhance water supply and sanitation. Taking cognizance of the above fact, the Nigerian democratic government articulated, "National rural water supply and sanitation programme" to cater for the needs of rural communities. This programme is composed of key components of hygiene promotion and education, sanitation and water supply encompassing: Government; ESAs, and private sector/NGO programmes. However, it has been observed that departs government effort at providing adequate water supply, the water coverage in the country appears to be decreasing and deteriorating. This is a result of enormous socio-economic rate of development, which far outstrips the level of water supply development, low investment level in operation and maintenance, which accounts for frequent break down of the production facilities and the lack of the proper management of the nation's water resources to improve livelihood. This raise the question of, what government at all levels are doing or failed to do to alleviate the situation of about 71% of those living in rural communities that have no access to safe water supply or adequate sanitation. Consequently, the lack of clean water and poor sanitation contributes to poverty because of the resultant disease burden, negative impact on human capital development and ultimately restriction on production. Five decades since independence in 1960, rural water supply and sanitation development in Nigeria has proceeded inconsistently. It suffered from poor coordination, lack of clear policy direction, lack of focus in terms of the rural population with safe water and improved sanitation services. In all, inadequate drinking water and sanitation services rob poor families of opportunities to comfortable life. Inspite of the fact that Nigeria is one of the signatories to the United Nations International drinking water to all citizen of the country between 2000 and 2015 the road ahead to achieve the target is elusive. [ABSTRACT FROM AUTHOR]