Willingness to pay for improvements in rural sanitation: Evidence from a cross-sectional survey of three rural counties in Kenya

Navigating Taxpayers Attitude: Exploring Support for Urban Sanitation Surcharge in Kumasi

Background

Urban sanitation challenges persist in Ghana, prompting Metropolitan, Municipal, and District Assemblies (MMDAs) to explore innovative funding mechanisms such as surcharges to fund sanitation services. This study assesses property owners' attitudes toward the imposition of sanitation surcharge for pro-poor sanitation improvement in the Kumasi Metropolis.

Method

An analytical cross-sectional study was conducted among 424 property owners in the Kumasi metropolis. Structured questionnaires were utilized to solicit information from respondents using multi-stage sampling techniques.

Results

Findings indicated that 36.1% of respondents were willing to pay the sanitation surcharge, while 63.9% opposed its implementation in the Metropolis. Property ownership and support for a sanitation surcharge were associated with higher odds of willingness to pay. Participants paying property rates had decreased odds of supporting the sanitation surcharge. Factors associated with pro-poor spending support included age (61-80 years) [AOR = 1.81, 95%CI = 1.60-3.82] and willingness to pay sanitation surcharge [AOR = 11.07, 95%CI = 6.63-18.49]. Protective factors against supporting pro-poor spending included residing in medium-class communities [AOR = 0.25, 95%CI = 0.08-0.81], perceiving improvement in sanitation status [AOR = 0.41, 95%CI = 0.21-0.81) and having a home toilet facility (OR = 0.65, 95%CI = 0.36-0.95).

Conclusion

The study revealed a nuanced landscape where concerns about fund utilization, perceived tax burdens, and trust in local institutions significantly shape public sentiment. To enhance public acceptance and participation, policymakers should prioritize transparent communication to build trust and convey the effective utilization of funds from the sanitation surcharge.

Understanding Households' Willingness to Pay for Improved Sanitation Services in Benin: A Study Protocol

Nowadays, in Benin, latrine construction by households highly depends on their financial contributions. However, empirical evidence shows that many households are unwilling to invest in adequate sanitation services. The study aims to determine the household's willingness to pay for improved sanitation services and the associated factors. The study population will include households lacking unimproved sanitation facilities. The household heads will be eligible for survey participation. We will perform a contingent valuation to determine households' willingness to pay for a Ventilated Improved Pit (VIP) latrine. Following a description of the surveyed population, we will assess willingness to pay using the 'doubleb' command in Stata. Subsequently, we will conduct multivariate logistic regression to determine the factors associated with willingness to pay. The expected results will be: a description of the basic characteristics of households without improved sanitation services, an estimation of household willingness to pay for VIP latrines using the contingent valuation, and factors associated with household willingness to pay for VIP latrines. This study will contribute to the literature on household demand for improved sanitation services in Benin.

Evaluation of SaTo pans as a new latrine technology in Kisumu County healthcare facilities, Kenya

OBJECTIVES

Innovations to improve public sanitation facilities, especially in healthcare facilities (HCFs) in low-income countries, are limited. SaTo pans represent novel, largely untested, modifications to reduce odour and flies and improve acceptability of HCF sanitation facilities. We conducted a pilot project to evaluate acceptability, cleanliness, flies and odour within latrines in 37 HCFs in Kisumu, Kenya, randomised into intervention (SaTo pan modifications) and control arms by sub-county and HCF level.

METHODS

At baseline (pre-intervention) and endline (>3 months after completion of SaTo pan installations in latrines in intervention HCFs), we surveyed users, cleaners and in-charges, observed odour and cleanliness, and assessed flies using fly tape. Unadjusted difference-in-difference analysis compared changes from baseline to endline in patient-reported acceptability and observed latrine conditions between intervention and control HCFs. A secondary assessment compared patient-reported acceptability following use of SaTo pan versus non-SaTo pan latrines within intervention HCFs.

RESULTS

Patient-reported acceptability of latrines was higher following the intervention (baseline: 87%, endline: 96%, p = 0.05). However, patient-reported acceptability was also high in the control arm (79%, 86%, p = 0.34), and the between-arm difference-in-difference was not significant. Enumerator-observed odour declined in intervention latrines (32%-14%) compared with controls (36%-51%, difference-in-difference ratio: 0.32, 95% confidence interval: 0.12-0.84), but changes in flies, puddling of urine and visible faeces did not differ between arms. In the secondary assessment, fewer intervention than control latrines had patient-reported flies (0% vs. 26%) and odour (18% vs. 50%), and reported satisfaction was greater. Most cleaners reported dropholes and floors were easier to clean in intervention versus controls; limited challenges with water for flushing were reported.

CONCLUSIONS

Our results suggest SaTo pans may be acceptable by cleaners and users and reduce odour in HCF sanitation facilities, though challenges exist and further evaluation with larger sample sizes is needed.

Assessing Sustainability Factors for Rural Household Sanitation Coverage in Bhutan, Kenya, Nepal, and Zambia: A Qualitative Analysis

BACKGROUND

Few countries are likely to achieve universal sanitation within the next decade as sustaining household sanitation coverage remains a critical challenge. This study aimed to investigate factors that may have supported or hindered sustainability of sanitation coverage 1-2 years after the completion of an integrated, area-wide sanitation program in 4 countries.

METHODS

We conducted qualitative analyses to identify factors related to the sustainability of sanitation coverage in Bhutan, Kenya, Nepal, and Zambia, 2 years after completion of the Sustainable Sanitation and Hygiene for All program. From November 2019 to March 2020, we conducted focus group discussions and key informant interviews with community members, project implementers, and decision makers. We triangulated the qualitative findings with data from household surveys to characterize subnational sanitation coverage throughout implementation and 1-2 years after.

RESULTS

Our data revealed behavioral, contextual, and service delivery factors that were related to the sustainability of sanitation improvements. Service delivery factors included follow-up hygiene promotion, access to construction materials, local government commitment postimplementation, functioning monitoring systems, private sector uptake of supply chain improvements, and capacity for innovation. Contextual and behavioral factors included poverty, soil type, road networks, social cohesion, desire for improved latrines, maintenance and cleaning, and knowledge of sanitation benefits.

CONCLUSION

The presence or absence of sustainability factors identified through this research may have implications on where certain programmatic approaches will work and where adaptations may be required. By comparing sustainability factors with subnational slippage rates, we were able to illustrate how local service delivery systems may respond to barriers and enablers. Understanding the programmatic and contextual factors that either drive or hinder long-term sanitation coverage may allow for greater program impact through adapting implementation based on existing challenges in service delivery and context.