Health, Hygiene and Appropriate Sanitation: Experiences and Perceptions of the Urban Poor

April 2011

… what is currently packaged and delivered as sanitation too often meets neither the health needs nor the basic human rights of large sections of the poorest and most vulnerable among the urban poor.

‘Don’t teach us what is sanitation and hygiene.’ This quote from Maqbul, a middle-aged man living in Modher Bosti, a slum in Dhaka city, Bangladesh, summed up the frustration felt by many people living in urban poverty towards sanitation and hygiene (S&H) programmes. In the light of their experiences, such programmes provide ‘inappropriate sanitation’, or demand personal investments in situations of highly insecure tenure, and/or teach ‘hygiene practices’ that relate neither to local beliefs nor to the daily realities of living in urban poverty.

A three-year ethnographic study in Chittagong and Dhaka, Nairobi (Kenya) and Hyderabad (India) showed that faeces disposal systems, packaged and delivered as low-cost ‘safe sanitation’, do not match the sanitation needs of a very diverse group of urban men, women and children.

It is of little surprise that the delivered systems are neither appropriate nor used, and are not sustained beyond the life of the projects. This mismatch — far more than an assumed lack of user demand for sanitation — contributes to the elusiveness of the goal of sanitation and health for all.

The analysis in this article indicates that unless and until the technical, financial and ethical discrepancies relating to sanitation for the urban poor are resolved, there is little reason to celebrate the recent global declaration on the human right to water and sanitation and health for all.

Additional details

PublisherEnvironment and Urbanization
CountryBangladesh, India, Kenya
ThemesHealth, Homeless people, Hygiene, Leave no one behind, Sanitation and health impacts

Joshi, D.; Fawcett, B. and Mannan, F. (2011) ‘Health, Hygiene and Appropriate Sanitation: Experiences and Perceptions of the Urban Poor’, Environment and Urbanization 23.1: 91-111


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