Technical Note: Area-wide Programming for Safely Managed Sanitation

Exposure to human faeces is hazardous to human health. An estimated 564,000 children die from diarrhoeal diseases caused by unsafe sanitation annually. A lack of access to safe sanitation is also a major cause of cholera outbreaks, with almost all cases coming from countries with the lowest levels of safe sanitation and water services. Despite this recognition, progress towards universal access to a safely managed sanitation service (SMSS) is alarmingly off track. It is estimated that combined efforts need to increase fivefold to achieve the 2030 target. Yet, service delivery projects are often fragmented, mismatched, development partner-led and donor-driven rather than consistent, comprehensive government-led programming designed to strengthen the system as a whole.

A shift is needed from a select number of communities or villages to universal access for everyone in a given administrative area, and from stopping open defecation towards durable and climate-resilient sanitation infrastructure, services and behaviours that support safely managed sanitation services (SMSS).

Area-wide sanitation (AWS) aims to accelerate progress by strengthening subnational government leadership, aligning stakeholders and resources, pushing for universal access to resilient, safely managed sanitation infrastructure and services and prioritizing equity and inclusion in an administrative area.

This technical note presents ideas to encourage the necessary shift towards area-wide programming for SMSS at subnational level. The note complements existing resources designed for governments (especially those at subnational level), development partners, the private sector and other stakeholders to support area-wide programming for SMSS.

An executive summary can be found here: Technical Note Executive Summary