State of Sanitation in Baringo County

County Sanitation Profiles

MINISTRY OF HEALTH

POPULATION1 Sanitation coverage2 Why does coverage matter? 555,561 Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the Urban 22.2% County Government. 43.0% 11% Universal access to improved 16.0% sanitation yields maximum health, Population under 5 years social and economic benefits. 9.9% 18.8%

Population density Improved % Unimproved % 2 50 / km Shared % Open Defecation %

Baringo is ranked number 38 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

38 0 0 0 3 3 3 5 0 0 0 0 0

Baringo County loses 538 million KES each year Why does stunting matter? due to poor sanitation4. This includes losses due to access time, premature death, health care costs and productivity. This Unimproved sanitation and open defecation estimate does not include some costs that could be significant have been linked to low height for age scores (such as water pollution and tourism) and is therefore likely to in children. Stunted children suffer a higher under-estimate the true cost of poor sanitation. mortality due to infectious diseases such as diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Baringo are stunted and educational outcomes. Adults who are 48.2% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Baringo County showed the following The Water and Sanitation Program is a multi- strengths and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Baringo water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

The county has a dedicated budget line for REFERENCES sanitation in place. 1Kenya County Factsheets, Commission of Program The program methodology for sanitation in the Resource Allocation, June 2013 methodology county has been established. 22009 Kenya population and housing census, The program methodology is being implemented Kenya National Bureau of Statistics by government. The program methodology is being implemented 3Sanitation County Benchmarking, Ministry by all stakeholders. of Health, 2013. For details see full national Implementation There is a sanitation capacity building plan in benchmarking or contact Ministry of Health capacity place for the county. 4Economics of Poor Sanitation in Kenya, WSP There is a sufficient number of government staff 5Kenya County Factsheets, Commission of in place to implement sanitation activities Resource Allocation, June 2013 (inverse adequate Government staff have the required knowledge, height for age data) skills and experience to implement sanitation activities. DISCLAIMER: Availability of Sanitation products and services exist in the Water and Sanitation Program (WSP) reports are products and tools county which respond to consumer preferences. published to communicate the results of WSP’s work to There are sanitation products and services the development community. Some sources cited may be available in the county which are affordable to informal documents that are not readily available. the poorest members of the community. The findings, interpretations, and conclusions expressed The county undertakes quality assurance herein are entirely those of the author and should not be controls of sanitation products and services. attributed to the World Bank or its affiliated organizations, or to members of the Board of Executive Directors of Financing The county has developed a sanitation funding the World Bank or the governments they represent. plan. The World Bank does not guarantee the accuracy of Adequate funding is available from county the data included in this work. The boundaries, colors, denominations, and other information shown on any government to implement planned sanitation map in this work do not imply any judgment on the part activities. of the World Bank Group concerning the legal status of Funding is being utilized effectively for sanitation any territory or the endorsement or acceptance of such activities. boundaries.

M&E A monitoring and evaluation system for The material in this publication is copyrighted. Requests sanitation is in place. for permission to reproduce portions of it should be sent to [email protected]. WSP encourages The county has the capacity and resources to the dissemination of its work and will normally grant carry out M&E activities. permission promptly. For more information, please visit M&E results are used to inform and improve www.wsp.org sanitation program implementation in the county. © 2014 Water and Sanitation Program KEY: Strongly agree Agree Partially Agree Disagree

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Bomet County

POPULATION1 Sanitation coverage2 Why does coverage matter?

724,186 5.0% Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the Urban County Government. 30.8% 36.3% 18% Universal access to improved sanitation yields maximum health, Population under 5 years social and economic benefits. 27.9% 10.0%

Population density Improved % Unimproved % 2 319 / km Shared % Open Defecation %

Bomet is ranked number 35 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

35 3 0 0 0 3 3 5 0 3 0 0 0

Bomet County loses 600 million KES each year Why does stunting matter? due to poor sanitation4. This includes losses due to access time, premature death, health care costs and productivity. This Unimproved sanitation and open defecation estimate does not include some costs that could be significant have been linked to low height for age scores (such as water pollution and tourism) and is therefore likely to in children. Stunted children suffer a higher under-estimate the true cost of poor sanitation. mortality due to infectious diseases such as diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Bomet are stunted and educational outcomes. Adults who are 39.8% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Bomet County showed the following strengths The Water and Sanitation Program is a multi- and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Bomet water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Bungoma County

POPULATION1 Sanitation coverage2 Why does coverage matter?

1,375,063 3.3% Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the Urban County Government.

22% 32.8% 38.7% Universal access to improved sanitation yields maximum health, Population under 5 years social and economic benefits. 25.2% 11.0%

Population density Improved % Unimproved % 2 454 / km Shared % Open Defecation %

Bungoma is ranked number 33 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

33 0 5 0 0 0 0 15 0 3 0 0 0

Bungoma County loses 882 million KES each Why does stunting matter? year due to poor sanitation4. This includes losses due to access time, premature death, health care costs and Unimproved sanitation and open defecation productivity. This estimate does not include some costs that have been linked to low height for age scores could be significant (such as water pollution and tourism) in children. Stunted children suffer a higher and is therefore likely to under-estimate the true cost of poor mortality due to infectious diseases such as sanitation. diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Bungoma are stunted and educational outcomes. Adults who are 36.7% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Bungoma County showed the following The Water and Sanitation Program is a multi- strengths and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Bungoma water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Busia County

POPULATION1 Sanitation coverage2 Why does coverage matter?

743,946 8.0% Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the Urban County Government. 27.8% 16% 32.8% Universal access to improved sanitation yields maximum health, Population under 5 years social and economic benefits. 31.4% 11.1%

Population density Improved % Unimproved % 2 439 / km Shared % Open Defecation %

Busia is ranked number 3 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

3 5 10 10 3 5 5 15 0 3 10 10 8

Busia County loses 536 million KES each year due Why does stunting matter? to poor sanitation4. This includes losses due to access time, premature death, health care costs and productivity. This Unimproved sanitation and open defecation estimate does not include some costs that could be significant have been linked to low height for age scores (such as water pollution and tourism) and is therefore likely to in children. Stunted children suffer a higher under-estimate the true cost of poor sanitation. mortality due to infectious diseases such as diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Busia are stunted and educational outcomes. Adults who are 39.3% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Busia County showed the following strengths The Water and Sanitation Program is a multi- and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Busia water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

The county has a dedicated budget line for REFERENCES sanitation in place. 1Kenya County Factsheets, Commission of Program The program methodology for sanitation in the Resource Allocation, June 2013 methodology county has been established. 22009 Kenya population and housing census, The program methodology is being implemented Kenya National Bureau of Statistics by government. The program methodology is being implemented 3Sanitation County Benchmarking, Ministry by all stakeholders. of Health, 2013. For details see full national Implementation There is a sanitation capacity building plan in benchmarking or contact Ministry of Health capacity place for the county. 4Economics of Poor Sanitation in Kenya, WSP There is a sufficient number of government staff in 5Kenya County Factsheets, Commission of place to implement sanitation activities Resource Allocation, June 2013 (inverse adequate Government staff have the required knowledge, height for age data) skills and experience to implement sanitation activities. DISCLAIMER: Availability of Sanitation products and services exist in the Water and Sanitation Program (WSP) reports are products and tools county which respond to consumer preferences. published to communicate the results of WSP’s work to There are sanitation products and services the development community. Some sources cited may be available in the county which are affordable to the informal documents that are not readily available. poorest members of the community. The findings, interpretations, and conclusions expressed The county undertakes quality assurance controls herein are entirely those of the author and should not be of sanitation products and services. attributed to the World Bank or its affiliated organizations, or to members of the Board of Executive Directors of Financing The county has developed a sanitation funding the World Bank or the governments they represent. plan. The World Bank does not guarantee the accuracy of Adequate funding is available from county the data included in this work. The boundaries, colors, denominations, and other information shown on any government to implement planned sanitation map in this work do not imply any judgment on the part activities. of the World Bank Group concerning the legal status of Funding is being utilized effectively for sanitation any territory or the endorsement or acceptance of such activities. boundaries.

M&E A monitoring and evaluation system for sanitation The material in this publication is copyrighted. Requests is in place. for permission to reproduce portions of it should be sent to [email protected]. WSP encourages The county has the capacity and resources to the dissemination of its work and will normally grant carry out M&E activities. permission promptly. For more information, please visit M&E results are used to inform and improve www.wsp.org sanitation program implementation in the county. © 2014 Water and Sanitation Program KEY: Strongly agree Agree Partially Agree Disagree

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Embu County

POPULATION1 Sanitation coverage2 Why does coverage matter?

516,212 1.7% Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the Urban County Government.

16% 30.1% 35.5% Universal access to improved sanitation yields maximum health, Population under 5 years social and economic benefits. 8.0% 32.7%

Population density Improved % Unimproved % 2 183 / km Shared % Open Defecation %

Embu is ranked number 40 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

40 0 0 0 5 0 0 0 0 5 0 0 0

Embu County loses 345 million KES each year due Why does stunting matter? to poor sanitation4. This includes losses due to access time, premature death, health care costs and productivity. This Unimproved sanitation and open defecation estimate does not include some costs that could be significant have been linked to low height for age scores (such as water pollution and tourism) and is therefore likely to in children. Stunted children suffer a higher under-estimate the true cost of poor sanitation. mortality due to infectious diseases such as diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Embu are stunted and educational outcomes. Adults who are 29.2% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Embu County showed the following strengths The Water and Sanitation Program is a multi- and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Embu water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Garissa County

POPULATION1 Sanitation coverage2 Why does coverage matter? 623,060 Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the 16.8% Urban County Government. 48.2% 24% Universal access to improved 20.8% sanitation yields maximum health, Population under 5 years social and economic benefits. 8.3% 14.2%

Population density Improved % Unimproved % 2 14 / km Shared % Open Defecation %

Garissa is ranked number 44 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

44 0 0 0 0 0 0 0 0 0 0 0 0

Garissa County loses 652 million KES each year Why does stunting matter? due to poor sanitation4. This includes losses due to access time, premature death, health care costs and productivity. This Unimproved sanitation and open defecation estimate does not include some costs that could be significant have been linked to low height for age scores (such as water pollution and tourism) and is therefore likely to in children. Stunted children suffer a higher under-estimate the true cost of poor sanitation. mortality due to infectious diseases such as diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Garissa are stunted and educational outcomes. Adults who are 50.7% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Garissa County showed the following The Water and Sanitation Program is a multi- strengths and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Garissa water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Homa Bay County

POPULATION1 Sanitation coverage2 Why does coverage matter? 963,794 Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the Urban 22.0% County Government.

14% 38.8% Universal access to improved sanitation yields maximum health, 20.5% Population under 5 years social and economic benefits. 18.7% 11.1%

Population density Improved % Unimproved % 2 303 / km Shared % Open Defecation %

Homa Bay is ranked number 17 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

17 0 10 3 0 3 3 10 5 0 10 5 5

Homa Bay County loses 920 million KES each Why does stunting matter? year due to poor sanitation4. This includes losses due to access time, premature death, health care costs and Unimproved sanitation and open defecation productivity. This estimate does not include some costs that have been linked to low height for age scores could be significant (such as water pollution and tourism) in children. Stunted children suffer a higher and is therefore likely to under-estimate the true cost of poor mortality due to infectious diseases such as sanitation. diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Homa Bay are stunted and educational outcomes. Adults who are 46.3% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Homa Bay County showed the following The Water and Sanitation Program is a multi- strengths and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling Homa affordable, safe, and sustainable access to Environment Indicator Bay water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Isiolo County

POPULATION1 Sanitation coverage2 Why does coverage matter? 143,294 Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the Urban County Government. 22.8% 44% 44.2% Universal access to improved 13.7% sanitation yields maximum health, Population under 5 years social and economic benefits. 19.3% 10.4%

Population density Improved % Unimproved % 2 6 / km Shared % Open Defecation %

Isiolo is ranked number 20 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

20 0 8 0 10 0 0 10 0 0 8 5 5

Isiolo County loses 139 million KES each year due Why does stunting matter? to poor sanitation4. This includes losses due to access time, premature death, health care costs and productivity. This Unimproved sanitation and open defecation estimate does not include some costs that could be significant have been linked to low height for age scores (such as water pollution and tourism) and is therefore likely to in children. Stunted children suffer a higher under-estimate the true cost of poor sanitation. mortality due to infectious diseases such as diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Isiolo are stunted and educational outcomes. Adults who are 23.9% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Isiolo County showed the following strengths The Water and Sanitation Program is a multi- and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Isiolo water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Kajiado County

POPULATION1 Sanitation coverage2 Why does coverage matter? 687,312 Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the Urban County Government. 25.7% 33.0% 41% Universal access to improved sanitation yields maximum health, Population under 5 years 28.0% social and economic benefits. 13.3% 10.3%

Population density Improved % Unimproved % 2 31 / km Shared % Open Defecation %

Kajiado is ranked number 29 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

29 0 8 0 3 0 0 0 0 0 8 5 5

Kajiado County loses 542 million KES each year Why does stunting matter? due to poor sanitation4. This includes losses due to access time, premature death, health care costs and productivity. This Unimproved sanitation and open defecation estimate does not include some costs that could be significant have been linked to low height for age scores (such as water pollution and tourism) and is therefore likely to in children. Stunted children suffer a higher under-estimate the true cost of poor sanitation. mortality due to infectious diseases such as diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Kajiado are stunted and educational outcomes. Adults who are 27.0% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Kajiado County showed the following The Water and Sanitation Program is a multi- strengths and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Kajiado water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Kakamega County

POPULATION1 Sanitation coverage2 Why does coverage matter?

1,660,651 1.5% Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the Urban County Government. 38.3% 15% 45.2% Universal access to improved sanitation yields maximum health, Population under 5 years social and economic benefits. 15.0% 10.8%

Population density Improved % Unimproved % 2 550 / km Shared % Open Defecation %

Kakamega is ranked number 5 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

5 0 10 3 0 10 10 15 0 8 8 5 5

Kakamega County loses 943 million KES each Why does stunting matter? year due to poor sanitation4. This includes losses due to access time, premature death, health care costs and Unimproved sanitation and open defecation productivity. This estimate does not include some costs that have been linked to low height for age scores could be significant (such as water pollution and tourism) in children. Stunted children suffer a higher and is therefore likely to under-estimate the true cost of poor mortality due to infectious diseases such as sanitation. diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Kakamega are stunted and educational outcomes. Adults who are 40.4% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Kakamega County showed the following The Water and Sanitation Program is a multi- strengths and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Kakamega water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Kericho County

POPULATION1 Sanitation coverage2 Why does coverage matter? 758,339 Sanitation is a constitutional right in Kenya, the responsibility for 8.0% which rests on the shoulders of the Urban County Government. 35.6% Universal access to improved 28% 30.2% sanitation yields maximum health, Population under 5 years social and economic benefits. 26.2% 9.9%

Population density Improved % Unimproved % 2 274 / km Shared % Open Defecation %

Kericho is ranked number 30 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

30 0 0 0 5 10 10 0 0 3 0 0 0

Kericho County loses 409 million KES each year Why does stunting matter? due to poor sanitation4. This includes losses due to access time, premature death, health care costs and productivity. This Unimproved sanitation and open defecation estimate does not include some costs that could be significant have been linked to low height for age scores (such as water pollution and tourism) and is therefore likely to in children. Stunted children suffer a higher under-estimate the true cost of poor sanitation. mortality due to infectious diseases such as diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Kericho are stunted and educational outcomes. Adults who are 45.2% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Kericho County showed the following The Water and Sanitation Program is a multi- strengths and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Kericho water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Kiambu County

POPULATION1 Sanitation coverage2 Why does coverage matter? Sanitation is a constitutional right 0.3% 1,623,282 in Kenya, the responsibility for which rests on the shoulders of the Urban County Government. 61% 36.9% 43.5% Universal access to improved sanitation yields maximum health, Population under 5 years social and economic benefits. 19.3% 7.8%

Population density Improved % Unimproved % 2 638 / km Shared % Open Defecation %

Kiambu is ranked number 4 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

4 1 5 10 0 8 3 15 8 10 5 5 5

Kiambu County loses 941 million KES each year Why does stunting matter? due to poor sanitation4. This includes losses due to access time, premature death, health care costs and productivity. This Unimproved sanitation and open defecation estimate does not include some costs that could be significant have been linked to low height for age scores (such as water pollution and tourism) and is therefore likely to in children. Stunted children suffer a higher under-estimate the true cost of poor sanitation. mortality due to infectious diseases such as diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Kiambu are stunted and educational outcomes. Adults who are 30.7% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Kiambu County showed the following The Water and Sanitation Program is a multi- strengths and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Kiambu water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

The county has a dedicated budget line for REFERENCES sanitation in place. 1Kenya County Factsheets, Commission of Program The program methodology for sanitation in the Resource Allocation, June 2013 methodology county has been established. 22009 Kenya population and housing census, The program methodology is being implemented Kenya National Bureau of Statistics by government. The program methodology is being implemented 3Sanitation County Benchmarking, Ministry by all stakeholders. of Health, 2013. For details see full national Implementation There is a sanitation capacity building plan in benchmarking or contact Ministry of Health capacity place for the county. 4Economics of Poor Sanitation in Kenya, WSP There is a sufficient number of government staff in 5Kenya County Factsheets, Commission of place to implement sanitation activities Resource Allocation, June 2013 (inverse adequate Government staff have the required knowledge, height for age data) skills and experience to implement sanitation activities. DISCLAIMER: Availability of Sanitation products and services exist in the Water and Sanitation Program (WSP) reports are products and tools county which respond to consumer preferences. published to communicate the results of WSP’s work to There are sanitation products and services the development community. Some sources cited may be available in the county which are affordable to the informal documents that are not readily available. poorest members of the community. The findings, interpretations, and conclusions expressed The county undertakes quality assurance controls herein are entirely those of the author and should not be of sanitation products and services. attributed to the World Bank or its affiliated organizations, or to members of the Board of Executive Directors of Financing The county has developed a sanitation funding the World Bank or the governments they represent. plan. The World Bank does not guarantee the accuracy of Adequate funding is available from county the data included in this work. The boundaries, colors, denominations, and other information shown on any government to implement planned sanitation map in this work do not imply any judgment on the part activities. of the World Bank Group concerning the legal status of Funding is being utilized effectively for sanitation any territory or the endorsement or acceptance of such activities. boundaries.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Kilifi County

POPULATION1 Sanitation coverage2 Why does coverage matter? 1,109,735 Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the Urban County Government. 25.9% 26% 34.0% Universal access to improved sanitation yields maximum health, Population under 5 years 18.1% social and economic benefits. 22.0% 10.8%

Population density Improved % Unimproved % 2 88 / km Shared % Open Defecation %

Kilifi is ranked number 33 out of473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

33 0 5 0 0 0 0 0 0 0 8 5 5

Kilifi County loses 993 million KES each year due Why does stunting matter? to poor sanitation4. This includes losses due to access time, premature death, health care costs and productivity. This Unimproved sanitation and open defecation estimate does not include some costs that could be significant have been linked to low height for age scores (such as water pollution and tourism) and is therefore likely to in children. Stunted children suffer a higher under-estimate the true cost of poor sanitation. mortality due to infectious diseases such as diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Kilifi are stunted and educational outcomes. Adults who are 64.0% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Kilifi County showed the following strengths The Water and Sanitation Program is a multi- and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Kilifi water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Kirinyaga County

POPULATION1 Sanitation coverage2 Why does coverage matter?

528,054 0.6% Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the Urban County Government. 38.1% 16% 44.8% Universal access to improved sanitation yields maximum health, Population under 5 years social and economic benefits. 16.5% 6.8%

Population density Improved % Unimproved % 2 357 / km Shared % Open Defecation %

Kirinyaga is ranked number 5 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

5 0 5 10 8 10 10 0 8 8 5 5 5

Kirinyaga County loses 300 million KES each Why does stunting matter? year due to poor sanitation4. This includes losses due to access time, premature death, health care costs and Unimproved sanitation and open defecation productivity. This estimate does not include some costs that have been linked to low height for age scores could be significant (such as water pollution and tourism) in children. Stunted children suffer a higher and is therefore likely to under-estimate the true cost of poor mortality due to infectious diseases such as sanitation. diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Kirinyaga are stunted and educational outcomes. Adults who are 23.9% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Kirinyaga County showed the following The Water and Sanitation Program is a multi- strengths and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Kirinyaga water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Kisii County

POPULATION1 Sanitation coverage2 Why does coverage matter?

1,152,282 0.8% Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the Urban County Government. 29.4% 22% 34.6% Universal access to improved sanitation yields maximum health, Population under 5 years social and economic benefits. 35.2% 10.3%

Population density Improved % Unimproved % 2 874 / km Shared % Open Defecation %

Kisii is ranked number 19 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

19 0 0 0 0 10 10 10 10 8 0 0 0

Kisii County loses 776 million KES each year due Why does stunting matter? to poor sanitation4. This includes losses due to access time, premature death, health care costs and productivity. This Unimproved sanitation and open defecation estimate does not include some costs that could be significant have been linked to low height for age scores (such as water pollution and tourism) and is therefore likely to in children. Stunted children suffer a higher under-estimate the true cost of poor sanitation. mortality due to infectious diseases such as diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Kisii are stunted and educational outcomes. Adults who are 39.3% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Kisii County showed the following strengths The Water and Sanitation Program is a multi- and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Kisii water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Kisumu County

POPULATION1 Sanitation coverage2 Why does coverage matter? 968,909 Sanitation is a constitutional right in Kenya, the responsibility for 12.4% which rests on the shoulders of the Urban County Government. 30.4% 52% Universal access to improved 25.9% sanitation yields maximum health, social and economic benefits. Population under 5 years 31.3% 10.9%

Population density Improved % Unimproved % 2 464 / km Shared % Open Defecation %

Kisumu is ranked number 10 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

10 5 10 8 0 3 3 10 0 3 10 10 8

Kisumu County loses 740 million KES each year Why does stunting matter? due to poor sanitation4. This includes losses due to access time, premature death, health care costs and productivity. This Unimproved sanitation and open defecation estimate does not include some costs that could be significant have been linked to low height for age scores (such as water pollution and tourism) and is therefore likely to in children. Stunted children suffer a higher under-estimate the true cost of poor sanitation. mortality due to infectious diseases such as diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Kisumu are stunted and educational outcomes. Adults who are 23.6% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Kisumu County showed the following The Water and Sanitation Program is a multi- strengths and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Kisumu water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Kitui County

POPULATION1 Sanitation coverage2 Why does coverage matter? 1,012,709 Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the Urban County Government. 30.9% 29.2% 14% Universal access to improved sanitation yields maximum health, Population under 5 years 15.1% social and economic benefits. 24.8% 9.9%

Population density Improved % Unimproved % 2 33 / km Shared % Open Defecation %

Kitui is ranked number 9 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

9 5 10 5 0 3 5 15 5 0 10 8 5

Kitui County loses 859 million KES each year due Why does stunting matter? to poor sanitation4. This includes losses due to access time, premature death, health care costs and productivity. This Unimproved sanitation and open defecation estimate does not include some costs that could be significant have been linked to low height for age scores (such as water pollution and tourism) and is therefore likely to in children. Stunted children suffer a higher under-estimate the true cost of poor sanitation. mortality due to infectious diseases such as diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Kitui are stunted and educational outcomes. Adults who are 42.0% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Kitui County showed the following strengths The Water and Sanitation Program is a multi- and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Kitui water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Kwale County

POPULATION1 Sanitation coverage2 Why does coverage matter? 649,931 Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the Urban 18.4% County Government.

18% 51.2% Universal access to improved 14.8% sanitation yields maximum health, Population under 5 years social and economic benefits. 15.6% 11.2%

Population density Improved % Unimproved % 2 79 / km Shared % Open Defecation %

Kwale is ranked number 23 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

23 3 10 8 0 3 3 0 0 0 5 5 5

Kwale County loses 677 million KES each year due Why does stunting matter? to poor sanitation4. This includes losses due to access time, premature death, health care costs and productivity. This Unimproved sanitation and open defecation estimate does not include some costs that could be significant have been linked to low height for age scores (such as water pollution and tourism) and is therefore likely to in children. Stunted children suffer a higher under-estimate the true cost of poor sanitation. mortality due to infectious diseases such as diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Kwale are stunted and educational outcomes. Adults who are 31.4% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Kwale County showed the following strengths The Water and Sanitation Program is a multi- and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Kwale water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Laikipia County

POPULATION1 Sanitation coverage2 Why does coverage matter? 399,227 Sanitation is a constitutional right in Kenya, the responsibility for 11.3% which rests on the shoulders of the Urban County Government.

25% 39.1% Universal access to improved 33.2% sanitation yields maximum health, Population under 5 years social and economic benefits. 9.3% 16.4%

Population density Improved % Unimproved % 2 42 / km Shared % Open Defecation %

Laikipia is ranked number 25 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

25 0 0 0 10 10 10 0 5 3 0 0 0

Laikipia County loses 267 million KES each year Why does stunting matter? due to poor sanitation4. This includes losses due to access time, premature death, health care costs and productivity. This Unimproved sanitation and open defecation estimate does not include some costs that could be significant have been linked to low height for age scores (such as water pollution and tourism) and is therefore likely to in children. Stunted children suffer a higher under-estimate the true cost of poor sanitation. mortality due to infectious diseases such as diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Laikipia are stunted and educational outcomes. Adults who are 26.7% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Laikipia County showed the following The Water and Sanitation Program is a multi- strengths and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Laikipia water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Lamu County

POPULATION1 Sanitation coverage2 Why does coverage matter? 101,539 Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the Urban 22.1% County Government. 30.9% 20% Universal access to improved sanitation yields maximum health, 26.2% Population under 5 years social and economic benefits. 20.8% 10.0%

Population density Improved % Unimproved % 2 16 / km Shared % Open Defecation %

Lamu is ranked number 40 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

40 0 0 0 10 0 0 0 0 0 0 0 0

Lamu County loses 81 million KES each year due Why does stunting matter? to poor sanitation4. This includes losses due to access time, premature death, health care costs and productivity. This Unimproved sanitation and open defecation estimate does not include some costs that could be significant have been linked to low height for age scores (such as water pollution and tourism) and is therefore likely to in children. Stunted children suffer a higher under-estimate the true cost of poor sanitation. mortality due to infectious diseases such as diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Lamu are stunted and educational outcomes. Adults who are 34.8% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Lamu County showed the following strengths The Water and Sanitation Program is a multi- and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Lamu water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Machakos County

POPULATION1 Sanitation coverage2 Why does coverage matter?

1,098,584 2.8% Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the Urban County Government. 28.8% 52% 33.9% Universal access to improved sanitation yields maximum health, Population under 5 years social and economic benefits. 34.4% 8.3%

Population density Improved % Unimproved % 2 177 / km Shared % Open Defecation %

Machakos is ranked number 5 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

5 3 5 10 0 10 10 15 8 3 5 5 0

Machakos County loses 757 million KES each Why does stunting matter? year due to poor sanitation4. This includes losses due to access time, premature death, health care costs and Unimproved sanitation and open defecation productivity. This estimate does not include some costs that have been linked to low height for age scores could be significant (such as water pollution and tourism) in children. Stunted children suffer a higher and is therefore likely to under-estimate the true cost of poor mortality due to infectious diseases such as sanitation. diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Machakos are stunted and educational outcomes. Adults who are 52.9% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Machakos County showed the following The Water and Sanitation Program is a multi- strengths and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Machakos water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Makueni County

POPULATION1 Sanitation coverage2 Why does coverage matter?

884,527 2.0% Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the Urban County Government. 25.9% 30.5% 12% Universal access to improved sanitation yields maximum health, social and economic benefits. Population under 5 years 41.6% 8.9%

Population density Improved % Unimproved % 2 110 / km Shared % Open Defecation %

Makueni is ranked number 27 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

27 0 0 0 0 5 8 15 0 5 0 0 0

Makueni County loses 638 million KES each year Why does stunting matter? due to poor sanitation4. This includes losses due to access time, premature death, health care costs and productivity. This Unimproved sanitation and open defecation estimate does not include some costs that could be significant have been linked to low height for age scores (such as water pollution and tourism) and is therefore likely to in children. Stunted children suffer a higher under-estimate the true cost of poor sanitation. mortality due to infectious diseases such as diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Makueni are stunted and educational outcomes. Adults who are 58.6% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Makueni County showed the following The Water and Sanitation Program is a multi- strengths and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Makueni water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Mandera County

POPULATION1 Sanitation coverage2 Why does coverage matter? 1,025,756 Sanitation is a constitutional right in Kenya, the responsibility for 8.9% which rests on the shoulders of the Urban County Government. 17.6% 18% 66.0% Universal access to improved 7.5% sanitation yields maximum health, Population under 5 years social and economic benefits. 7.3%

Population density Improved % Unimproved % 2 39 / km Shared % Open Defecation %

Mandera is ranked number 44 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

44 0 0 0 0 0 0 0 0 0 0 0 0

Mandera County loses 1.3 Billion KES each year Why does stunting matter? due to poor sanitation4. This includes losses due to access time, premature death, health care costs and productivity. This Unimproved sanitation and open defecation estimate does not include some costs that could be significant have been linked to low height for age scores (such as water pollution and tourism) and is therefore likely to in children. Stunted children suffer a higher under-estimate the true cost of poor sanitation. mortality due to infectious diseases such as diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Mandera are stunted and educational outcomes. Adults who are 30.3% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Mandera County showed the following The Water and Sanitation Program is a multi- strengths and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Mandera water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Elgeyo Marakwet County

POPULATION1 Sanitation coverage2 Why does coverage matter? 369,998 Sanitation is a constitutional right in Kenya, the responsibility for 18.7% which rests on the shoulders of the Urban County Government. 26.2% 14% Universal access to improved 22.2% sanitation yields maximum health, social and economic benefits. Population under 5 years 32.9% 9.9%

Population density Improved % Unimproved % 2 122 / km Shared % Open Defecation %

Elgeyo Marakwet is ranked number 10 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

10 1 10 8 8 8 10 15 0 0 5 0 5

Elgeyo Marakwet County loses 308 million KES Why does stunting matter? each year due to poor sanitation4. This includes losses due to access time, premature death, health care costs Unimproved sanitation and open defecation and productivity. This estimate does not include some costs have been linked to low height for age scores that could be significant (such as water pollution and tourism) in children. Stunted children suffer a higher and is therefore likely to under-estimate the true cost of poor mortality due to infectious diseases such as sanitation. diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Elgeyo Marakwet are stunted and educational outcomes. Adults who are 33.9% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Elgeyo Marakwet County showed the The Water and Sanitation Program is a multi- following strengths and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling Elgeyo affordable, safe, and sustainable access to Environment Indicator Marakwet water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Marsabit County

POPULATION1 Sanitation coverage2 Why does coverage matter? 291,166 Sanitation is a constitutional right in Kenya, the responsibility for 14.0% which rests on the shoulders of the Urban County Government. 9.6% 22% Universal access to improved 64.6% 11.9% sanitation yields maximum health, Population under 5 years social and economic benefits. 9.3%

Population density Improved % Unimproved % 2 4 / km Shared % Open Defecation %

Marsabit is ranked number 15 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

15 0 8 5 5 8 5 10 0 0 8 5 5

Marsabit County loses 332 million KES each year Why does stunting matter? due to poor sanitation4. This includes losses due to access time, premature death, health care costs and productivity. This Unimproved sanitation and open defecation estimate does not include some costs that could be significant have been linked to low height for age scores (such as water pollution and tourism) and is therefore likely to in children. Stunted children suffer a higher under-estimate the true cost of poor sanitation. mortality due to infectious diseases such as diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Marsabit are stunted and educational outcomes. Adults who are 33.1% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Marsabit County showed the following The Water and Sanitation Program is a multi- strengths and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Marsabit water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Meru County

POPULATION1 Sanitation coverage2 Why does coverage matter?

1,356,301 2.5% Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the Urban County Government. 35.9% 42.2% 12% Universal access to improved sanitation yields maximum health, Population under 5 years social and economic benefits. 8.7% 19.4%

Population density Improved % Unimproved % 2 196 / km Shared % Open Defecation %

Meru is ranked number 43 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

43 0 0 0 0 0 0 0 0 5 0 0 0

Meru County loses 816 million KES each year due Why does stunting matter? to poor sanitation4. This includes losses due to access time, premature death, health care costs and productivity. This Unimproved sanitation and open defecation estimate does not include some costs that could be significant have been linked to low height for age scores (such as water pollution and tourism) and is therefore likely to in children. Stunted children suffer a higher under-estimate the true cost of poor sanitation. mortality due to infectious diseases such as diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Meru are stunted and educational outcomes. Adults who are 51.0% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Meru County showed the following strengths The Water and Sanitation Program is a multi- and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Meru water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Migori County

POPULATION1 Sanitation coverage2 Why does coverage matter? 917,170 Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the Urban County Government. 33.1% 27.8% 34% Universal access to improved sanitation yields maximum health, 15.5% social and economic benefits. Population under 5 years 23.6% 12.0%

Population density Improved % Unimproved % 2 353 / km Shared % Open Defecation %

Migori is ranked number 14 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

14 1 10 5 0 5 5 15 10 0 8 5 0

Migori County loses 800 million KES each year Why does stunting matter? due to poor sanitation4. This includes losses due to access time, premature death, health care costs and productivity. This Unimproved sanitation and open defecation estimate does not include some costs that could be significant have been linked to low height for age scores (such as water pollution and tourism) and is therefore likely to in children. Stunted children suffer a higher under-estimate the true cost of poor sanitation. mortality due to infectious diseases such as diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Migori are stunted and educational outcomes. Adults who are 38.5% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Migori County showed the following strengths The Water and Sanitation Program is a multi- and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Migori water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Mombasa County

POPULATION1 Sanitation coverage2 Why does coverage matter?

939,370 2.3% Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the Urban County Government.

100% 37.3% 43.9% Universal access to improved sanitation yields maximum health, Population under 5 years social and economic benefits. 16.5% 9.8%

Population density Improved % Unimproved % 2 4,289 / km Shared % Open Defecation %

Mombasa is ranked number 24 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

24 3 0 0 0 10 8 5 8 5 0 0 0

Mombasa County loses 548 million KES each Why does stunting matter? year due to poor sanitation4. This includes losses due to access time, premature death, health care costs and Unimproved sanitation and open defecation productivity. This estimate does not include some costs that have been linked to low height for age scores could be significant (such as water pollution and tourism) in children. Stunted children suffer a higher and is therefore likely to under-estimate the true cost of poor mortality due to infectious diseases such as sanitation. diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Mombasa are stunted and educational outcomes. Adults who are 15.7% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Mombasa County showed the following The Water and Sanitation Program is a multi- strengths and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Mombasa water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Murang’a County

POPULATION1 Sanitation coverage2 Why does coverage matter?

942,581 0.3% Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the Urban County Government. 31.7% 16% 37.4% Universal access to improved sanitation yields maximum health, Population under 5 years social and economic benefits. 30.6% 7.2%

Population density Improved % Unimproved % 2 368 / km Shared % Open Defecation %

Murang’a is ranked number 8 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

8 0 5 5 0 10 10 10 8 10 5 5 5

Murang’a County loses 606 million KES each Why does stunting matter? year due to poor sanitation4. This includes losses due to access time, premature death, health care costs and Unimproved sanitation and open defecation productivity. This estimate does not include some costs that have been linked to low height for age scores could be significant (such as water pollution and tourism) in children. Stunted children suffer a higher and is therefore likely to under-estimate the true cost of poor mortality due to infectious diseases such as sanitation. diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Murang’a are stunted and educational outcomes. Adults who are 37.1% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Murang’a County showed the following The Water and Sanitation Program is a multi- strengths and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Murang’a water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Nairobi County

POPULATION1 Sanitation coverage2 Why does coverage matter?

3,138,369 0.7% Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the Urban County Government. 39.9% 47.0% 100% Universal access to improved sanitation yields maximum health, Population under 5 years social and economic benefits. 8.7% 12.4%

Population density Improved % Unimproved % 2 4,516 / km Shared % Open Defecation %

Nairobi is ranked number 42 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

42 0 0 0 0 0 0 0 0 8 0 0 0

Nairobi County loses 1.7 Billion KES each year due Why does stunting matter? to poor sanitation4. This includes losses due to access time, premature death, health care costs and productivity. This Unimproved sanitation and open defecation estimate does not include some costs that could be significant have been linked to low height for age scores (such as water pollution and tourism) and is therefore likely to in children. Stunted children suffer a higher under-estimate the true cost of poor sanitation. mortality due to infectious diseases such as diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Nairobi are stunted and educational outcomes. Adults who are 34.2% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Nairobi County showed the following The Water and Sanitation Program is a multi- strengths and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Nairobi water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Nakuru County

POPULATION1 Sanitation coverage2 Why does coverage matter?

1,603,325 2.8% Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the Urban County Government. 35.3% 46% 41.6% Universal access to improved sanitation yields maximum health, Population under 5 years social and economic benefits. 20.3% 9.5 %

Population density Improved % Unimproved % 2 214 / km Shared % Open Defecation %

Nakuru is ranked number 2 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

2 5 10 10 0 10 10 15 10 3 5 5 5

Nakuru County loses 978 million KES each year Why does stunting matter? due to poor sanitation4. This includes losses due to access time, premature death, health care costs and productivity. This Unimproved sanitation and open defecation estimate does not include some costs that could be significant have been linked to low height for age scores (such as water pollution and tourism) and is therefore likely to in children. Stunted children suffer a higher under-estimate the true cost of poor sanitation. mortality due to infectious diseases such as diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Nakuru are stunted and educational outcomes. Adults who are 50.7% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Nakuru County showed the following The Water and Sanitation Program is a multi- strengths and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Nakuru water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

The county has a dedicated budget line for REFERENCES sanitation in place. 1Kenya County Factsheets, Commission of Program The program methodology for sanitation in the Resource Allocation, June 2013 methodology county has been established. 22009 Kenya population and housing census, The program methodology is being implemented Kenya National Bureau of Statistics by government. The program methodology is being implemented 3Sanitation County Benchmarking, Ministry by all stakeholders. of Health, 2013. For details see full national Implementation There is a sanitation capacity building plan in benchmarking or contact Ministry of Health capacity place for the county. 4Economics of Poor Sanitation in Kenya, WSP There is a sufficient number of government staff in 5Kenya County Factsheets, Commission of place to implement sanitation activities Resource Allocation, June 2013 (inverse adequate Government staff have the required knowledge, height for age data) skills and experience to implement sanitation activities. DISCLAIMER: Availability of Sanitation products and services exist in the Water and Sanitation Program (WSP) reports are products and tools county which respond to consumer preferences. published to communicate the results of WSP’s work to There are sanitation products and services the development community. Some sources cited may be available in the county which are affordable to the informal documents that are not readily available. poorest members of the community. The findings, interpretations, and conclusions expressed The county undertakes quality assurance controls herein are entirely those of the author and should not be of sanitation products and services. attributed to the World Bank or its affiliated organizations, or to members of the Board of Executive Directors of Financing The county has developed a sanitation funding the World Bank or the governments they represent. plan. The World Bank does not guarantee the accuracy of Adequate funding is available from county the data included in this work. The boundaries, colors, denominations, and other information shown on any government to implement planned sanitation map in this work do not imply any judgment on the part activities. of the World Bank Group concerning the legal status of Funding is being utilized effectively for sanitation any territory or the endorsement or acceptance of such activities. boundaries.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Nandi County

POPULATION1 Sanitation coverage2 Why does coverage matter?

752,965 4.8% Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the Urban County Government. 39.3% 14% 33.4% Universal access to improved sanitation yields maximum health, Population under 5 years social and economic benefits. 22.5% 9.9%

Population density Improved % Unimproved % 2 261 / km Shared % Open Defecation %

Nandi is ranked number 15 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

15 0 5 8 3 10 10 15 0 3 5 0 0

Nandi County loses 483 million KES each year due Why does stunting matter? to poor sanitation4. This includes losses due to access time, premature death, health care costs and productivity. This Unimproved sanitation and open defecation estimate does not include some costs that could be significant have been linked to low height for age scores (such as water pollution and tourism) and is therefore likely to in children. Stunted children suffer a higher under-estimate the true cost of poor sanitation. mortality due to infectious diseases such as diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Nandi are stunted and educational outcomes. Adults who are 31.7% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Nandi County showed the following strengths The Water and Sanitation Program is a multi- and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Nandi water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Narok County

POPULATION1 Sanitation coverage2 Why does coverage matter? 850,920 Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the Urban 19.9% County Government.

7% 48.4% Universal access to improved 14.9% sanitation yields maximum health, Population under 5 years social and economic benefits. 16.8% 12.4%

Population density Improved % Unimproved % 2 47 / km Shared % Open Defecation %

Narok is ranked number 30 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

30 0 0 0 5 5 3 15 0 0 0 0 0

Narok County loses 864 million KES each year due Why does stunting matter? to poor sanitation4. This includes losses due to access time, premature death, health care costs and productivity. This Unimproved sanitation and open defecation estimate does not include some costs that could be significant have been linked to low height for age scores (such as water pollution and tourism) and is therefore likely to in children. Stunted children suffer a higher under-estimate the true cost of poor sanitation. mortality due to infectious diseases such as diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Narok are stunted and educational outcomes. Adults who are 34.6% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Narok County showed the following strengths The Water and Sanitation Program is a multi- and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Narok water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Nyamira County

POPULATION1 Sanitation coverage2 Why does coverage matter?

598,252 0.5% Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the Urban County Government. 30.7% 36.2% 14% Universal access to improved sanitation yields maximum health, Population under 5 years social and economic benefits. 32.6% 9.6%

Population density Improved % Unimproved % 2 665 / km Shared % Open Defecation %

Nyamira is ranked number 10 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

10 1 5 8 5 8 8 15 0 10 5 5 0

Nyamira County loses 393 million KES each year Why does stunting matter? due to poor sanitation4. This includes losses due to access time, premature death, health care costs and productivity. This Unimproved sanitation and open defecation estimate does not include some costs that could be significant have been linked to low height for age scores (such as water pollution and tourism) and is therefore likely to in children. Stunted children suffer a higher under-estimate the true cost of poor sanitation. mortality due to infectious diseases such as diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Nyamira are stunted and educational outcomes. Adults who are 34.7% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Nyamira County showed the following The Water and Sanitation Program is a multi- strengths and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Nyamira water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Nyandarua County

POPULATION1 Sanitation coverage2 Why does coverage matter?

596,268 0.2% Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the Urban County Government. 34.0% 19% 40.1% Universal access to improved sanitation yields maximum health, Population under 5 years social and economic benefits. 25.7% 8.0%

Population density Improved % Unimproved % 2 184 / km Shared % Open Defecation %

Nyandarua is ranked number 18 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

18 1 0 0 5 10 10 5 10 10 0 0 0

Nyandarua County loses 367 million KES each Why does stunting matter? year due to poor sanitation4. This includes losses due to access time, premature death, health care costs and Unimproved sanitation and open defecation productivity. This estimate does not include some costs that have been linked to low height for age scores could be significant (such as water pollution and tourism) in children. Stunted children suffer a higher and is therefore likely to under-estimate the true cost of poor mortality due to infectious diseases such as sanitation. diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Nyandarua are stunted and educational outcomes. Adults who are 42.1% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Nyandarua County showed the following The Water and Sanitation Program is a multi- strengths and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Nyandarua water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Nyeri County

POPULATION1 Sanitation coverage2 Why does coverage matter?

693,558 0.3% Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of Urban the County Government. 34.1% 24% 40.2% Universal access to improved sanitation yields maximum health, Population under 5 years social and economic benefits. 25.4% 7.0%

Population density Improved % Unimproved % 2 208 / km Shared % Open Defecation %

Nyeri is ranked number 1 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

1 3 10 5 8 10 10 10 5 10 10 10 5

Nyeri County loses 426 million KES each year due Why does stunting matter? to poor sanitation4. This includes losses due to access time, premature death, health care costs and productivity. This Unimproved sanitation and open defecation estimate does not include some costs that could be significant have been linked to low height for age scores (such as water pollution and tourism) and is therefore likely to in children. Stunted children suffer a higher under-estimate the true cost of poor sanitation. mortality due to infectious diseases such as diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Nyeri are stunted and educational outcomes. Adults who are 55.2% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Nyeri County showed the following strengths The Water and Sanitation Program is a multi- and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Nyeri water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

The county has a dedicated budget line for REFERENCES sanitation in place. 1Kenya County Factsheets, Commission of Program The program methodology for sanitation in the Resource Allocation, June 2013 methodology county has been established. 22009 Kenya population and housing census, The program methodology is being implemented Kenya National Bureau of Statistics by government. The program methodology is being implemented 3Sanitation County Benchmarking, Ministry by all stakeholders. of Health, 2013. For details see full national Implementation There is a sanitation capacity building plan in benchmarking or contact Ministry of Health capacity place for the county. 4Economics of Poor Sanitation in Kenya, WSP There is a sufficient number of government staff in 5Kenya County Factsheets, Commission of place to implement sanitation activities Resource Allocation, June 2013 (inverse adequate Government staff have the required knowledge, height for age data) skills and experience to implement sanitation activities. DISCLAIMER: Availability of Sanitation products and services exist in the Water and Sanitation Program (WSP) reports are products and tools county which respond to consumer preferences. published to communicate the results of WSP’s work to There are sanitation products and services the development community. Some sources cited may be available in the county which are affordable to the informal documents that are not readily available. poorest members of the community. The findings, interpretations, and conclusions expressed The county undertakes quality assurance controls herein are entirely those of the author and should not be of sanitation products and services. attributed to the World Bank or its affiliated organizations, or to members of the Board of Executive Directors of Financing The county has developed a sanitation funding the World Bank or the governments they represent. plan. The World Bank does not guarantee the accuracy of Adequate funding is available from county the data included in this work. The boundaries, colors, denominations, and other information shown on any government to implement planned sanitation map in this work do not imply any judgment on the part activities. of the World Bank Group concerning the legal status of Funding is being utilized effectively for sanitation any territory or the endorsement or acceptance of such activities. boundaries.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Samburu County

POPULATION1 Sanitation coverage2 Why does coverage matter? 223,947 Sanitation is a constitutional right in Kenya, the responsibility for 11.7% which rests on the shoulders of the Urban 5.0% County Government.

17% 9.9% Universal access to improved 73.4% sanitation yields maximum health, Population under 5 years social and economic benefits. 11.6%

Population density Improved % Unimproved % 2 11 / km Shared % Open Defecation %

Samburu is ranked number 32 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

32 0 0 0 8 3 3 0 10 0 0 0 0

Samburu County loses 268 million KES each year Why does stunting matter? due to poor sanitation4. This includes losses due to access time, premature death, health care costs and productivity. This Unimproved sanitation and open defecation estimate does not include some costs that could be significant have been linked to low height for age scores (such as water pollution and tourism) and is therefore likely to in children. Stunted children suffer a higher under-estimate the true cost of poor sanitation. mortality due to infectious diseases such as diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Samburu are stunted and educational outcomes. Adults who are 42.2% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Samburu County showed the following The Water and Sanitation Program is a multi- strengths and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Samburu water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Siaya County

POPULATION1 Sanitation coverage2 Why does coverage matter? 842,304 Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the Urban 20.2% County Government. 25.9% 11% Universal access to improved 22.0% sanitation yields maximum health, social and economic benefits. Population under 5 years 31.9% 10.5%

Population density Improved % Unimproved % 2 333 / km Shared % Open Defecation %

Siaya is ranked number 13 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

13 0 10 3 0 3 3 10 10 0 10 10 8

Siaya County loses 708 million KES each year due Why does stunting matter? to poor sanitation4. This includes losses due to access time, premature death, health care costs and productivity. This Unimproved sanitation and open defecation estimate does not include some costs that could be significant have been linked to low height for age scores (such as water pollution and tourism) and is therefore likely to in children. Stunted children suffer a higher under-estimate the true cost of poor sanitation. mortality due to infectious diseases such as diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Siaya are stunted and educational outcomes. Adults who are 43.8% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Siaya County showed the following strengths The Water and Sanitation Program is a multi- and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Siaya water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Taita Taveta County

POPULATION1 Sanitation coverage2 Why does coverage matter?

284,657 5.7% Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the Urban County Government. 36.7% 23% 31.1% Universal access to improved sanitation yields maximum health, Population under 5 years social and economic benefits. 26.5% 10.4%

Population density Improved % Unimproved % 2 17 / km Shared % Open Defecation %

Taita Taveta is ranked number 27 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

27 0 5 0 8 0 0 0 0 0 5 10 5

Taita Taveta County loses 283 million KES each Why does stunting matter? year due to poor sanitation4. This includes losses due to access time, premature death, health care costs and Unimproved sanitation and open defecation productivity. This estimate does not include some costs that have been linked to low height for age scores could be significant (such as water pollution and tourism) in children. Stunted children suffer a higher and is therefore likely to under-estimate the true cost of poor mortality due to infectious diseases such as sanitation. diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Taita Taveta are stunted and educational outcomes. Adults who are 50.4% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Taita Taveta County showed the following The Water and Sanitation Program is a multi- strengths and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling Taita affordable, safe, and sustainable access to Environment Indicator Taveta water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Tana River County

POPULATION1 Sanitation coverage2 Why does coverage matter?

240,075 5.7% Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the Urban County Government. 36.7% 15% 31.1% Universal access to improved sanitation yields maximum health, Population under 5 years social and economic benefits. 26.5% 9.8%

Population density Improved % Unimproved % 2 6 / km Shared % Open Defecation %

Tana River is ranked number 22 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

22 0 0 0 10 10 10 10 0 3 0 0 0

Tana River County loses 257 million KES each Why does stunting matter? year due to poor sanitation4. This includes losses due to access time, premature death, health care costs and Unimproved sanitation and open defecation productivity. This estimate does not include some costs that have been linked to low height for age scores could be significant (such as water pollution and tourism) in children. Stunted children suffer a higher and is therefore likely to under-estimate the true cost of poor mortality due to infectious diseases such as sanitation. diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Tana River are stunted and educational outcomes. Adults who are 50.3% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Tana River County showed the following The Water and Sanitation Program is a multi- strengths and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling Tana affordable, safe, and sustainable access to Environment Indicator River water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Tharaka Nithi County

POPULATION1 Sanitation coverage2 Why does coverage matter?

365,330 3.8% Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the Urban County Government. 32.8% 7% 27.8% Universal access to improved sanitation yields maximum health, Population under 5 years social and economic benefits. 35.6% 8.3%

Population density Improved % Unimproved % 2 138 / km Shared % Open Defecation %

Tharaka Nithi is ranked number 21 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

21 0 0 0 10 10 10 0 5 10 0 0 0

Tharaka Nithi County loses 191 million KES each Why does stunting matter? year due to poor sanitation4. This includes losses due to access time, premature death, health care costs and Unimproved sanitation and open defecation productivity. This estimate does not include some costs that have been linked to low height for age scores could be significant (such as water pollution and tourism) in children. Stunted children suffer a higher and is therefore likely to under-estimate the true cost of poor mortality due to infectious diseases such as sanitation. diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Tharaka Nithi are stunted and educational outcomes. Adults who are 56.1% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Tharaka Nithi County showed the following The Water and Sanitation Program is a multi- strengths and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling Tharaka affordable, safe, and sustainable access to Environment Indicator Nithi water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Trans Nzoia County

POPULATION1 Sanitation coverage2 Why does coverage matter?

818,757 2.7% Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the Urban County Government. 34.4% 40.6% 20% Universal access to improved sanitation yields maximum health, Population under 5 years social and economic benefits. 22.3% 10.6%

Population density Improved % Unimproved % 2 328 / km Shared % Open Defecation %

Trans Nzoia is ranked number 35 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

35 5 0 0 3 3 3 0 0 3 0 0 0

Trans Nzoia County loses 506 million KES each Why does stunting matter? year due to poor sanitation4. This includes losses due to access time, premature death, health care costs and Unimproved sanitation and open defecation productivity. This estimate does not include some costs that have been linked to low height for age scores could be significant (such as water pollution and tourism) in children. Stunted children suffer a higher and is therefore likely to under-estimate the true cost of poor mortality due to infectious diseases such as sanitation. diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Trans Nzoia are stunted and educational outcomes. Adults who are 47.4% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Trans Nzoia County showed the following The Water and Sanitation Program is a multi- strengths and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling Trans affordable, safe, and sustainable access to Environment Indicator Nzoia water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Turkana County

POPULATION1 Sanitation coverage2 Why does coverage matter? 855,399 6.6% 5.6% Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the Urban 5.7% County Government.

14% 82.1% Universal access to improved sanitation yields maximum health, Population under 5 years social and economic benefits. 7.5%

Population density Improved % Unimproved % 2 12 / km Shared % Open Defecation %

Turkana is ranked number 44 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

44 0 0 0 0 0 0 0 0 0 0 0 0

Turkana County loses 1.1 Billion KES each year Why does stunting matter? due to poor sanitation4. This includes losses due to access time, premature death, health care costs and productivity. This Unimproved sanitation and open defecation estimate does not include some costs that could be significant have been linked to low height for age scores (such as water pollution and tourism) and is therefore likely to in children. Stunted children suffer a higher under-estimate the true cost of poor sanitation. mortality due to infectious diseases such as diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Turkana are stunted and educational outcomes. Adults who are 34.2% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Turkana County showed the following The Water and Sanitation Program is a multi- strengths and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Turkana water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Uasin Gishu County

POPULATION1 Sanitation coverage2 Why does coverage matter?

894,179 1.8% Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the Urban County Government.

39% 36.1% 42.5% Universal access to improved sanitation yields maximum health, Population under 5 years social and economic benefits. 9.7% 19.6%

Population density Improved % Unimproved % 2 267 / km Shared % Open Defecation %

Uasin Gishu is ranked number 38 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

38 0 0 0 3 3 3 0 0 5 0 0 0

Uasin Gishu County loses 533 million KES each Why does stunting matter? year due to poor sanitation4. This includes losses due to access time, premature death, health care costs and Unimproved sanitation and open defecation productivity. This estimate does not include some costs that have been linked to low height for age scores could be significant (such as water pollution and tourism) in children. Stunted children suffer a higher and is therefore likely to under-estimate the true cost of poor mortality due to infectious diseases such as sanitation. diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Uasin Gishu are stunted and educational outcomes. Adults who are 25.1% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Uasin Gishu County showed the following The Water and Sanitation Program is a multi- strengths and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling Uasin affordable, safe, and sustainable access to Environment Indicator Gishu water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Vihiga County

POPULATION1 Sanitation coverage2 Why does coverage matter?

554,622 0.8% Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the Urban County Government. 39.3% 31% 46.3% Universal access to improved sanitation yields maximum health, Population under 5 years social and economic benefits. 9.4% 13.5%

Population density Improved % Unimproved % 2 983 / km Shared % Open Defecation %

Vihiga is ranked number 37 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

37 0 0 0 8 0 0 0 0 8 0 0 0

Vihiga County loses 307 million KES each year due Why does stunting matter? to poor sanitation4. This includes losses due to access time, premature death, health care costs and productivity. This Unimproved sanitation and open defecation estimate does not include some costs that could be significant have been linked to low height for age scores (such as water pollution and tourism) and is therefore likely to in children. Stunted children suffer a higher under-estimate the true cost of poor sanitation. mortality due to infectious diseases such as diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Vihiga are stunted and educational outcomes. Adults who are 37.8% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Vihiga County showed the following strengths The Water and Sanitation Program is a multi- and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Vihiga water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in Wajir County

POPULATION1 Sanitation coverage2 Why does coverage matter? 661,941 4.0% 3.4% Sanitation is a constitutional right in Kenya, the responsibility for which rests on the shoulders of the Urban 15.8% County Government.

15% 76.7% Universal access to improved sanitation yields maximum health, Population under 5 years social and economic benefits. 7.6%

Population density Improved % Unimproved % 2 12 / km Shared % Open Defecation %

Wajir is ranked number 44 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

44 0 0 0 0 0 0 0 0 0 0 0 0

Wajir County loses 854 million KES each year due Why does stunting matter? to poor sanitation4. This includes losses due to access time, premature death, health care costs and productivity. This Unimproved sanitation and open defecation estimate does not include some costs that could be significant have been linked to low height for age scores (such as water pollution and tourism) and is therefore likely to in children. Stunted children suffer a higher under-estimate the true cost of poor sanitation. mortality due to infectious diseases such as diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in Wajir are stunted and educational outcomes. Adults who are 78.3% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in Wajir County showed the following strengths The Water and Sanitation Program is a multi- and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling affordable, safe, and sustainable access to Environment Indicator Wajir water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH County Sanitation Profiles

MINISTRY OF HEALTH

State of Sanitation in West Pokot County

POPULATION1 Sanitation coverage2 Why does coverage matter? 512,690 Sanitation is a constitutional right in Kenya, the responsibility for 14.5% which rests on the shoulders of the Urban County Government. 6.1% 8% Universal access to improved 12.3% 67.1% sanitation yields maximum health, Population under 5 years social and economic benefits. 11.3%

Population density Improved % Unimproved % 2 56 / km Shared % Open Defecation %

West Pokot is ranked number 26 out of 473 in the county sanitation benchmarking by the MOH according to the following key indicators: RANK out of 47 Timely Reporting Budget for Sanitation /5 Number of ODF Claim /10 Cost per ODF Claim /10 Economic Costs of Poor Sanitation /10 Pupil: Latrine Coverage Girls /10 Pupil: Latrine Coverage Boys /10 Household Latrine Coverage Rate /15 Number of Handwashing facilities per school /10 Rate of Open Defecation /10 Number of ODF Villages (DPHO Certified) /10 of ODF Targets Percent Achieved /10 of ODF Villages Percent /10

26 0 10 0 0 3 3 0 0 0 8 5 5

West Pokot County loses 587 million KES each Why does stunting matter? year due to poor sanitation4. This includes losses due to access time, premature death, health care costs and Unimproved sanitation and open defecation productivity. This estimate does not include some costs that have been linked to low height for age scores could be significant (such as water pollution and tourism) in children. Stunted children suffer a higher and is therefore likely to under-estimate the true cost of poor mortality due to infectious diseases such as sanitation. diarrhoea, pneumonia and measles as well as being more likely to have poorer cognitive 5 of children in West Pokot are stunted and educational outcomes. Adults who are 47.3% stunted are more likely to earn less. Self evaluation of the enabling environment for April 2014 sanitation in West Pokot County showed the following The Water and Sanitation Program is a multi- strengths and challenges. donor partnership administered by the World Bank to support poor people in obtaining Enabling West affordable, safe, and sustainable access to Environment Indicator Pokot water and sanitation services. Area Policy, strategy The county has a clear advocacy plan to gain About the county sanitation profiles and direction support for sanitation. This county sanitation profile has been compiled As a county, we have a shared vision for as part of a series of information sheets to sanitation. provide an overview of the state of sanitation in The county strategic plan includes sanitation each of the 47 counties in Kenya. The sanitation targets. information sheets have been prepared by the Ministry of Health, with technical support from Institutional In the county, roles and responsibilities the Water and Sanitation Program. The county arrangements for sanitation are clear and there is a clear operational structure. sanitation profiles were prepared by Sophie Hickling (consultant) and Pascal Riungu, under the There is a clear mechanism for coordinating task management of Yolande Coombes (WSP). sanitation in the county.

Design/Layout: Eric Lugaka

Why does this matter?

A thorough understanding of the strengths and challenges of coverage rates, ranking and enabling environment provides the county with an opportunity to put the building blocks in place

for accelerated access to improved sanitation. MINISTRY OF HEALTH