Baskovich M. 2011. Sanitation Markets at the Bottom of the Pyramid: A Win-Win Scenario for Government, the Private Sector, and Communities. Water and Sanitation Program. World Bank.

Some of the key findings in this paper that drew on research done in Peru included, first, looking at people as “consumers” and not “beneficiaries” can produce changes in mentality and business; however, the complete effects of this paradigm shift have not been completely explored.  Second, the bottom pyramid–extremely poor—can participate in sanitation markets if local entrepreneurship is supported, awareness of the long-term investment is defined, new business models are used, shared investments within public-private-community partnerships are included, and community resources and networks are utilized.

One focus of the paper that I probably should explore was how financial solutions should vary according to income. They broke the groups up into three different categories, which then had different financial solutions that were tested: extreme poverty, poverty: lower level, and poverty. The solutions were market-based subsidies, credits through Community Water Councils, Hardware Stores, and NGOs, and Microfinance loans respectively. However, this research did support the conclusion addressed in other sources, such as Cairncross, and the claim I have made that the poor are willing, and have purchased sanitation facilities using their own resources. Their statistic was that despite 87 percent of the clientele in the Creating Sanitation Markets program being below the poverty line in Peru, 86 percent purchased sanitation facilities with their own funds.

Other claims made in this paper that I plan to utilize to support my point are again that
“the nurturing of markets for sanitation generates local development, improved business opportunities, local employment and income, and interest in other home improvement investments” (Baskovitch 2011: 7). All of these outcomes can therefore contribute creating an affordable supply chain, which can help with accessibility for the poor.

Cairncross S. 2004. The Case for Marketing Sanitation. Water and Sanitation Program- Africa. World Bank.

Cairncross makes the case that marketing has proven to be a successful way to get people to change their behavior in relation to sanitation adoption. Some of the reasons why people are initially skeptical of adopting sanitation have to do with lack of available information about both the costs and the benefits of sanitation (often benefits are underestimated and costs are overestimated), in addition to the lack of credibility sanitation tradesmen or service providers have within the community. This source acknowledges that the poor are often the least able to afford sanitation, but stresses the importance of having a range of products of varying prices available. To support this claim he cites a study of a Bangladeshi program focused on providing sanitation products at a cheaper price than the formerly used subsidized model, which go for one price and comes in one model. Overall, sanitation marketing is more sustainable than subsidy and it’s cost-effective and scalable.
Due to sanitation demand increase in some places such as Malawi and India ‘sanitation marts’ have been established to provide costumers with products and services and in Mozambique, training for artisans has become available and it is these artisans who often provide the service to their communities. I will particularly hone in on this finding to support my claim that creating a market for sanitation increases business opportunity, professional development, and affordable options.

Other researchers and implementers in the sanitation sector repeatedly cite this source (including the following sources), thus lending to its credibility as the go to source for understanding the benefits of sanitation marketing.

Frais J and Mukherjee N. 2005. Harnessing Market Power for Rural Sanitation: Private Sector Sanitation Delivery in Vietnam. Water and Sanitation Program-East Asia and the Pacific. World Bank.

This source is a field note from the NGO International Development Enterprises (IDE) that worked in two Vietnam provinces in 2003 to increase demand and implementation of sanitation in rural villages. After only a year they reported a 100 percent increase in sanitation acquisition—even among the poor—due to the availability of a range of low-cost options marketed and delivered by local masons. Four major claims were made in this field note: 1) Infrastructure-focused and subsidy-dependent sanitation interventions sponsored by governments and donors are neither effective nor sustainable, especially among the rural poor. 2) Market-based approaches are cost-effective, easily scalable, and sustainable. This approach also stimulates the local economy and allows for the flow of private sector resources. 3) An external subsidy used for business development—including marketing expertise—is more effective than hardware subsidies, and eventually there will be no need for such subsides once the market grows because the sector will absorb those costs. 4) Developing a market for sanitation increases entrepreneurial opportunities, increases the likelihood of credit schemes, and reduces prices of materials. These findings were also present in Cairncross (2004).

In terms of assessing the relevance of this field study to my thesis claim, the claims made in this paper support the notion stated in my proposal that sanitation marketing will increase demand from consumers, thereby creating a market for sanitation technologies. The proliferation of sanitation technologies can increase the availability of jobs and also decrease the prices so that the poor will both be able to benefit from the technology and the emergence of a new sector where they can potentially make money.

Jenkins MW. and Scott B. 2007. Behavioral Indicators of Household Decision-Making and Demand for Sanitation and Potential Gains from Sanitation Marketing in Ghana. Social Science & Medicine, 64: 2427–2442

Jenkins and Scott developed a model of household sanitation adoption decision making that looks at factors such as motivation, opportunity, and ability, so that sanitation managers can better “measure, understand, and predict behavioral determinants of demand for sanitation” (Jenkins and Scott 2007: 2428) and subsequently undertake appropriate planning for a market-based approach. They applied this model to Ghana by way of survey “to measure the three adoption stages and the determinants” (Jenkins and Scott 2007: 2431). Within each of the stages of the adoption model—preference, intention, and choice—the authors make claims that support the necessity of marketing programs to find out why people would adopt sanitation, what are the perceived barriers to that adoption, provide knowledge of benefits and services, and showcase a range of options.

In the preference stage, the claim made by Jenkins and Scott that supports earlier research conducted by the duo in Benin, states, “Motivation to change sanitation arises from dissatisfaction with current household defecation or excreta management practices coupled with sufficient awareness of advantages of new options” (Jenkins and Scott 2007: 2430).  In the intention stage, “starting a plan to change home sanitation technology or practice depends directly on the availability quality, and cost of opportunities to acquire materials products, construction services, financing, skills, and knowledge, and on the personal resources experience, and abilities of individual households to take advantage of these opportunities” (Jenkins and Scott 2007: 2430).  And finally, choice “requires a well-developed intention and concrete actions consistent with a strong imminent intention to change sanitation practice, including acquisition of relevant knowledge (e.g. cost), saving money, and site and toilet technology or service provider selection” (Jenkins and Scott 2007: 2431). In order to increase preference, intention to build, and final choice, large-scale marketing campaigns that understand household motivations and alert non-adopting households to options and benefits are a necessity as well as way to address supply issues (they mention developing private sector).

Marketing is unlikely to be able to address structural problems such as genuine poverty and lack of financing and credit options for the poor, according to Jenkins and Scott. This claim I do agree with but it is only because I believe marketing should be used to create the demand for the sanitation services. Where subsidies can come in, I will argue, is developing the local supply chain through small-scale service providers to allow for cheaper options for the poor in addition to financing schemes. Overall, the major claim of their study is that “marketing strategies aimed at the preference and choice stages are promising ways to increase household sanitation demand and coverage in Ghana” (Jenkins and Scott 2007: 2441). However, based on their analysis, marketing strategies should take care to target particular segments of the population based on where they are in the process.

This case study will be used as an introduction to the potential of sanitation marketing, as its focus is to understand consumer behavior through modeling typical stages in behavior change and dictate the roles that sanitation promotion can play. This study was more a theoretical framework and did not provide an intervention; they only made projections of what sanitation marketing could do by 2015.

Mehta M and Knapp A. 2004. The Challenge of Financing Sanitation for Meeting the Millennium Development Goals. Commissioned by the Norwegian Ministry of the Environment. WSP-Africa.

This report was presented at the 12^th Session of the United Nations Commission on Sustainable Development (CSD-12) and focuses on the progress of the sanitation in the context of the Millennium Development Goals. It highlights what financing mechanisms exists and are needed to scale up efforts for sanitation in both the rural and urban areas. It further discusses strategic issues to address the challenging nature of financing sanitation.

Many claims were made throughout this report, but of particular relevance to this thesis are the following:

• Rural sanitation and urban sanitation require different promotion approaches; Rural sanitation must focus on generating demand and developing an effective supply chain.
• Public policies need to be used in order to leverage household resources through using appropriate demand promotion strategies and to facilitate access to credit, especially through micro or housing finance.
• Supply-driven approaches to sanitation (hardware subsidies) may lead to unused facilities and ‘crowd-out’ household resources.
• Governments, even with external support, do not have the capacity alone to scale up sanitation products and services and so need to help develop the local private sector to handle demand.

The report consolidated reports of evidence to support it’s claim, including case studies on the National Sanitation Promotion program in Lesotho, the Total Sanitation Campaign in India, and the national program of Mozambique. Because this report mainly includes reports of evidence it will be necessary to cite the initial studies or researchers.

Scott B, Jenkins M, and Kpinsoton G. 2011. Sanitation Marketing At Scale: Experiences from Rural Benin. Water and Sanitation Program. World Bank.

This study discusses the development of sanitation marketing in Benin, which has its origins in the PADEAR (Project Support to the Development of the Rural Water and Sanitation Sector, 1996-1999) initiative, a government program funded by the World Bank and Danish government to undertake sanitation promotion through social marketing and use of small-scale sanitation providers to deliver the services. The success of the PADEAR initiative led to the implementation of more market-based approaches by donors.

In my thesis I will use a table highlighting the elements of Benin’s rural sanitation program to show how one rural program has approached the problem of sanitation access through a market-based approach, as well as the statistics gathered over the program’s impact to assess its success as evidence. Some of the claims to arise out of the report on the current program are that “the combination of latrine promotion, technical facilitation, masons’ training, and quality assurance is essential in order tor each households at varying stages in the process of deciding to install a latrine.”  While evidence is alluded to in some degree in this report, this claim is better supported by the study from Jenkins and Scott 2006 in Ghana that discusses sanitation adoption stages and their relation to marketing.

A very important claim to come out of Scott, Jenkins and Kpinsoton (2011) that I have yet to explore is that while the doubling and tripling of latrine numbers that result from the implementation of marketing and adequate demand response are important to the success of the program, a social norm around latrine adoption will develop, thus spurring outside communities (those not receiving the immediate intervention) to further adopt them. As a result, data about program impact may be under-representative. This phenomenon they supported with data from two masons who had built three times as many latrines outside their community than in. They explained this by using the Diffusion of Innovations Theory, with special emphasis on the multiplier effect—‘early adopters’, the risk takers and innovators of a group, build latrines and others observe and increasingly trust the innovation later moving on to building their own.

Interventions should not be done in or around communities that have received hardware subsidies in the past, as this decreases willingness to pay due to the perception that the toilet will paid for or cheaper. This claim was made after an observation that in Zou Department (one of the intervention areas), adoption of latrines was markedly lower than the other areas given its hardware-subsidy past. Studies that do not take into account this claim will not adequately support the claim others and I make that people are willing to pay if given adequate information and options.

I Am Consumer:

An Exploration of the Sanitation Marketing Approach in the Sanitation Sector

There is a special group of people in this world who care where people deposit their shit. Shit in this case is not a swearword, but the technical term used by development specialists who work in water and sanitation. For decades, multilateral organizations such as UNICEF, The World Bank, USAID, and various nonprofits have tried to figure out how adequate sanitation can be adopted and implemented in the developing world. Currently, 2.4 billion people in the world lack adequate sanitation (UN 2003), which could mean no sanitation mechanism at all or current sanitation systems in place are not sufficient to handle human waste.  This statistic is particularly troubling as water-related diseases cause 80% of sickness and death in the developing world (UN 2003), due most often to contaminated water sources. One need look no further than the recent outbreaks of cholera in the Democratic Republic of Congo, Kenya, and Haiti to see how improper disposal of human waste can lead to public health crises.

When water and sanitation first became a priority in international development, development organizations did not take into account consumer demand for sanitation services. In fact, villagers were not looked at as consumers of products, but rather beneficiaries of technology. Thus, the building of latrines by aid agencies failed to reduce open defecation and increase latrine usage significantly because of the lack of consultation with local people about preferences and motivations, the non-ownership of the latrines by the local people, and the lack of knowledge and access to materials to repair broken latrines. After decades of failed approaches that did not involve the participation of the aid recipients, the current millennium has latched on to the idea of participatory approach, and more specifically the idea of treating aid recipients as consumers that are a part of adopting the appropriate sanitation for them.

Approximately 500 million households require improved sanitation worldwide in order to meet the Millennium Development Goal (MDG) for sanitation by 2015 (Tobias and Israel 2010), thus making the need to find out what sanitation approach will work to ameliorate this situation, urgent. This research will study the impact that treating aid recipients as consumers has on the increased adoption of adequate sanitation through the approach of sanitation marketing. The focus of the study will be how sanitation marketing influences the decision by the poor in developing countries—particularly rural area dwellers—to purchase latrines, while additionally looking at the role subsidies can play in facilitating the availability of the hardware necessary to address their sanitation needs. This study will help to consolidate important research done on sanitation marketing to the poor in order to gather further support for sanitation marketing and appropriate subsidy targeting as potential solutions to meeting the sanitation MDG by 2015.

Throughout current literature on sanitation marketing one of the main concerns has been that the poor can still struggle with the lack of funds to purchase sanitation systems. While this is certainly a reality, sanitation marketing can be used as a tool to generate the demand within communities and because that can lead to the development of more small-scale providers of sanitation services, the poor can step into this niche market with the use of subsidies to encourage sanitation business ventures. Furthermore, the growth of this market can provide more affordable options for sanitation than non market-based approaches, thus helping the poor to have more access to improved sanitation services.

The type of data I will be using to support my claims include field observations/reports from aid agencies—particularly The World Bank, USAID and UNICEF—, including evaluations of programs or strategies related to the water and sanitation sector by certain nonprofits. The analysis done in this field is quantitative and qualitative. Quantitative in the sense that data is collected to find out about sanitation coverage and costs of varying sanitation technologies—most often this data is also represented in graphs; qualitative because people are interviewed to find out about their preferences and attitudes toward sanitation. Essentially, this thesis will be based on a literature view of these various types of sources.

In terms of the limitations of this study, many of the sources that will be used contain country case studies. As each country is unique, and even within a country urban and rural approaches to problems vary, this study can only speak to particular data found in those countries and hopefully apply some outcomes to the sanitation situation at-large. For purposes of making the data pool more precise, the focus of this paper is on sanitation marketing in rural areas and not urban, though where appropriate, research findings from urban area studies may be applied.

At the core of this research endeavor is the desire to further validate the approaches of sanitation marketing and targeted subsidies so that discussions can begin to take place around the issue of scalability, which is especially relevant when looking at how these methods can be used to push countries with inadequate sanitation further toward the Millennium Development Goal for sanitation by 2015.

To read the full thesis, click Oti-Thesis.

References:

Cairncross, Sandy. 2004. The case for marketing sanitation. Water and Sanitation Program- Africa. World Bank.

Curtis, Val and Jenkins, Marion W. 2005. Achieving the ‘good life’: Why some people want latrines in rural Benin. Social Science & Medicine, 61: 2446-2459.

Jenkins, Marion W. and Scott, Beth. 2007. Behavioral Indicators of Household Decision-Making and Demand for Sanitation and Potential Gains from Sanitation Marketing in Ghana. Social Science & Medicine, 64: 2427–2442

The World Bank. 2005. Harnessing Market Power for Rural Sanitation. Water and Sanitation Program-East Asia and the Pacific.

The World Bank. 2004. Who Buys Latrines, When and Why?. Water and Sanitation Program-Africa.

Tobias, Scott and Israel, Morris. 2010. Experiences and Lessons Learned in Sanitation Marketing Programs – 2008 to 2010. Webinar. USAID.

When I got to college I was fortunate enough to have some idea of what I wanted to do. I knew after travelling to Nigeria the summer before my junior year of high school that I wanted to study environmental health and sustainable development. My father’s homeland taught me my first public health lesson: our health is inextricably linked to the environment around us. On a car ride with my cousin we found ourselves idling on the dense traffic highways of Lagos and me gasping for air. My cousin did everything in her power to cover my mouth and nose, even telling the driver to roll up the windows in a non-air conditioned car caught in the sizzling heat of a typical Lagos summer. After that experience, and a few high school environmental science courses later, I began to imagine the ways this pollution could affect the health of a population constantly subjected to it. What a degree or career in sustainable development would look like, of course, I had no idea. All I knew was that whatever career I’d end up having, I would want it to be one where I could address harmful conditions that affect people’s health, both domestically and abroad.

Freshman year I enthusiastically declared a major in International Studies, the closest field of study I could find at CUNY that focused on development. I walked into then director Dr. Marina Fernando’s office and told her I wanted to fill out the major declaration form. By spring semester I was already taking on my first international studies internship at a nonprofit called charity: water. This internship was my introduction to the world of water and sanitation, and even larger the world of global health. Suddenly, everything wasn’t about the impact of pollution on our health, but about how having access to basic necessities can dramatically alter our standard of living. What does one do when they learn that over 1 billion people in the world do not have access to clean water, 2.6 billion don’t have access to adequate sanitation, and water-related diseases cause 80% of illness in the developing world? Naturally, I wanted to know why and turned to global health reports distributed by the UN and nonprofits and articles delivered to my inbox by UN Wire—my daily portal into international development. Meanwhile, I began focusing my academic interests on sanitation and water-related illnesses as environmental health issues and was given the opportunity to do so by creating majors in International Environmental Public Health and Human Ecology through CUNY Baccalaureate.

My objective in writing my thesis is for my audience to think about how we can effectively scale up the provision of sanitation in developing countries to combat a public health crisis that has persisted for far too long when the solutions are available.