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Regina Tribaco

2000 -31679
EnE 270 Sustainable Sanitation

Critique on: The Sanitation Ladder: Need for a Revamp?

Author: E. Kvanstrom, J. McConville, P. Bracken, M. Johansson and M. M.

In the UN Summit in 2000, leaders have developed and adopted 8 Millenium

Development Goals (MDG). Recognized as a priority, sanitation and access
to water was the 7th in the list, both included in Ensure Environmental
Sustainability . Sanitation and water affects human health and dignity, and
the proper or improper management of the two could affect our resources
and the environment.
While the world is close to achieving its targets in water access, we are way
behind in attaining our goal in sanitation by 2015. According to UNICEF
(2010), 291 million people don’t have access to improved sanitation included
of which the 101 million who have absolutely no access to a sanitation
facility. No country is on track to achieve its MDG target for sanitation.
Having such, child mortality increases due to water-borne diseases
particularly diarrhea, where 2 out of 10 children don’t reach their 5th birthday
because of death (UNICEF, 2010).
The global progress towards the MDG target and how each country is fairing
is measured by the Joint UNICEF-WHO Monitoring Program (JMP). However,
due to the disparity in financial and economic capability between countries, a
standard format and indicators is a major challenge for the JMP. To address
this they have divided the basis of improvement and attainment of goals in
to two categories:
Table 1. JMP Assessment - Improved Sanitation Facilities vs.
Unimproved Sanitation Facilities

Improved Sanitation Facilities

Flush or Pour Flush into
Piped sewer system
Septic tank
Pit latrine
Ventilated Improved Pit
Pit Latrine with Slab
Composting Toilet
Unimproved Sanitation
Flush or Pour Flush to
Pit Latrine without Slab or
Open Pit
Hanging Toilet or Hanging
As observed the basis of rating Latrine
progress is by pre-defined Open Defecation
sanitation technologies and not in terms of quality, reliability and
sustainability of the sanitation facilities. It was pointed out by Kvanstrom, et.
al., that by listing and specify such facilities limits the possible technologies
that could be applicable in attaining the MDG goal. A technology-based
approach does not encourage innovation limiting and discouraging inventors
from pursuing a sanitation facility that is of quality and financially and
economically viable. Likewise, such approach may lead to a bias in terms of
legislation and regulations of government in what infrastructure to adopt
basing on what infrastructure is specified and recognized in achieving the
MDG goal. Thus, technology based approach hamper governments in
providing sanitation with minimum acceptable basic level because of its
limitations to the specified facilities.
To counter, the JMP utilized the sanitation ladder, a visual tool used by the
sanitation sector to illustrate progress as depicted by how a household
moves up and down the ladder. Going further up the ladder means the
greater the benefit for people and the environment.
JMP uses a four-step sanitation ladder that includes 1) Open Defecation
which is defecation in fields, forests, bushes, water bodies, and other open
spaces; 2) Unimproved sanitation facilities which do not have separation of
excreta and human contact, included of which are pit latrines without a
platform or slab and hanging and bucket latrines; 3) Shared sanitation
facilities are of acceptable type yet shared between two or more household,
including public toilets; and 4) Improved sanitation facilities are those that
ensure that human excreta is contained and separated from human contact,
which include flush or pour-flush latrine to piped sewer, septic tank or pit
latrine, VIP latrine, pit latrine with slab and composting toilet (UNICEF and
WHO, 2008).
Kvanstrom, et. al., recognizes the importance of the sanitation ladder,
however, they recommend that a function approach should be employed
rather than a limiting technology based approach leaving room for new,
creative and innovative technologies that meet the needs of a local public.
With such approach, what is focused on is the effect or outcome of the
functioning technology.
Based on the Swedish Environmental Protection Agency, a redo of the
sanitation ladder is suggested and would be divided into user function as the
lower rungs, and the environmental function being the top rungs. Because
the ladder is technology unbiased, it is possible that a sewage treatment
plant may not appear on top suggesting that the technology for the highest
rung or the ultimate rung may not yet invented. Table 2 shows the function
based sanitation ladder.
Table 2 Function Based Assessment on Sanitation

Environmental 7 Integrated Resource Management
Function 6 Nutrient Containment
5 Nutrient Reuse
4 Pathogen Elimination
User Function 3 Greywater Management
2 Access
1 Excreta Containment

In this new format of the sanitation ladder, it is noted that it encompasses

the rungs defined by JMP’s technology based sanitation ladder and goes
beyond that. Going up the ladder means attainment of the specified
functions of the rungs below it. Thus in the ultimate and topmost part of the
sanitation ladder, its attributes addresses all issues pertaining to the rungs 1-
6 in addition to the issues address in the topmost rung. Also it includes
important factors like user satisfaction attributed by aesthetic function which
become a basis whether a technology is properly used and meets the
objective. As mentioned, it excedes beyond the JMP sanitation ladder. From
rungs 3 to 7, it addresses not just waste separation from human contact but
also treatment and disposal and returning the nutrient to the environment
where it becomes usable.
Another suggested sanitation assessment approach by Von Munch (2008)
contradicts the JMP’s sanitation ladder which only focuses on excreta
containment separating it from human contact. Sanitation encompasses
excreta management and containment, greywater management, solid waste
management, and drainage management. The assessment of achievement
towards the MDG goal should not be based solely on structure but
sustainability, health and environment (Potter, A., et al, 2010)
Table 3 Von Munch's Sanitation Assessment

Improved Sanitation Access to Sanitation

Sustainability Robust Construction
Easy to Use
Health No contact with excreta
Easy to Clean
Controlled Downstream Effect
Environment Controlled sludge disposal
Provision against flooding
Low Risk of groundwater pollution
Sustainable Sanitation Alliance has four considerations when assessing
exisitng and proposed sanitation systems. These are 1) Health and Hygiene,
2) Environment and Natural Resources, 3) Financial and Economic Issues and
4) Socio-cultural and institutional aspects. It is noticeable that the
assessment is based on the sustainable development framework:


Environment and
Natural Resources


Health and
SD Economy
Financial and
and Institutional
Figure 1 Sustainable Development Framework

The function-based sanitation ladder, like the technology-based sanitation

ladder connotes a progressive shift as one moves up a rung. This is in terms
complexity of operation and management, awareness and understanding,
and institutional capacity. Also there is a difference in application between
the rural and the urban areas because of their difference in economic and
financial capability. The population density of an area would also affect the
implementation and delivery of sanitation in terms of complexity of
management since the volume of waste and the rate of generation is in
proportion to its generator size.

Moving the people to the next level rung means raising the yearning of the
individual to pursue the more advanced rung. It is a must then that people
needs to understand what are the benefits of the next level rung in order for
them to proceed for it. The concept must be packaged such that there is a
problem in the rung they are in for them to move in to the next rung.
Incorporation of creative message like advertisement, education of children
and mothers, community campaign, tapping government leaders and icons
in the media are key interlinks between rungs.
Though function-based sanitation ladder is an improvement from the JMP’s
technology-based sanitation ladder, further improvement should be
proposed which includes parameters and indicators of which will be the basis
of progress. And because the function-based sanitation ladder goes beyond
separation of excreta from human contact, and encompasses greywater and
solid waste management, a different criteria for each aspect of sanitation
should be used.

Sanitation is an important issue and must be a priority. It is a stepping stone

to achieving better health and saving the public from mortality. It is a key in
achieving gender equity, protecting women from molestation and rape. And
most importantly, sanitation enhances investments made in other sectors
like education and health. It is a must then that a comprehensive sanitation
ladder should be utilized to measure global progress to further help and
motivate a country in achieving the MDG goal. It should not be limited
based on available technology but be based on the objectives of:

- protection and promotion of human health through the provision of

clean environment.
- Economically viable, socially acceptable and technically and
institutionally appropriate.
- Protection of environment and natural resources
- Employment of a wide selection of technologies.

Also education on hygiene and sanitation is equally important as the above

objectives in assessing progress of a nation towards sanitation. It is not only
owning a toilet that is a sign of progress but also understanding its
importance towards health, environment and the economy.


Kvarnstrom, E., McConville J., Johansson M., and Fodge, M. “The Sanitation
Ladder – Need for a Revamp”

Potter, Alana, Klutse, A., Snehalatha M., Batchelor, C., Uandela, A., Naafs, A.,
and Fonseca, C., and Moriarty, P. “Assessing sanitation service
levels”. IRC Interantional Water and Sanitation Centre. September
2010. http://www.reliefweb.int/rw/ lib.nsf/db900sid/ASAZ-

UNICEF. www.unicef.org. 2010

UNICEF and WHO. 2008. “Progress on Drinking Water and Sanitation, Special
Focus on Sanitation”

“Water and Sanitation.” March 2010. UNICEF. http://www.unicef.org/wcaro/