Public Disclosure Authorized Public Disclosure Authorized shared and public toilets CHAMPIONING DELIVERY MODELS THAT WORK Public Disclosure Authorized Rachel Cardone Alyse Schrecongost Rebecca Gilsdorf Public Disclosure Authorized About the Water Global Practice Launched in 2014, the World Bank Group's Water Global Practice brings together nancing, knowledge, and implementation in one platform. By combining the Bank's global knowledge with country investments, this model generates more repower for transformational solutions to help countries grow sustainably. Please visit us at www.worldbank.org/water or follow us on Twitter @WorldBankWater. About the Citywide Inclusive Sanitation Initiative The Water Global Practice, in conjunction with sector partners, has developed an approach to urban sanitation termed Citywide Inclusive Sanitation (CWIS). This comprehensive approach aims to shift the paradigm around urban sanitation interventions by promoting a range of technical solutions that help ensure everyone in a city bene ts from safely managed sanitation service delivery. The CWIS approach integrates nancial, institutional, regulatory and social dimensions, requiring that cities demonstrate political will and technical and managerial leadership to identify new and creative ways of providing sanitation services for all. shared and public toilets CHAMPIONING DELIVERY MODELS THAT WORK Rachel Cardone, Alyse Schrecongost, and Rebecca Gilsdorf © 2018 International Bank for Reconstruction and Development / The World Bank 1818 H Street NW, Washington, DC 20433 Telephone: 202-473-1000; Internet: www.worldbank.org This work is a product of the staff of The World Bank with external contributions. The findings, interpretations, and conclusions expressed in this work do not necessarily reflect the views of The World Bank, its Board of Executive Directors, or the governments they represent. The World Bank does not guarantee the accuracy of the data included in this work. The boundaries, colors, denomi- nations, and other information shown on any map in this work do not imply any judgment on the part of The World Bank concerning the legal status of any territory or the endorsement or acceptance of such boundaries. Rights and Permissions The material in this work is subject to copyright. Because The World Bank encourages dissemination of its knowledge, this work may be reproduced, in whole or in part, for noncommercial purposes as long as full attribution to this work is given. Please cite the work as follows: Cardone, Rachel, Alyse Schrecongost, and Rebecca Gilsdorf. 2018. “Shared and Public Toilets: Championing Delivery Models that Work.” World Bank, Washington, DC. Any queries on rights and licenses, including subsidiary rights, should be addressed to World Bank Publications, The World Bank Group, 1818 H Street NW, Washington, DC 20433, USA; fax: 202-522-2625; e-mail: pubrights@www. worldbank.org. Cover photos: © Kathy Eales / World Bank, Mirva Tuulia Moilanen / World Bank. Cover design: Trese Gloriod, Graphic World, Inc. CONTENTS ABBREVIATIONS • iv ACKNOWLEDGMENTS • v 1. INTRODUCTION • 1 2. SHARED TOILET MODELS IN URBAN SANITATION • 5 3. UNDERSTANDING THE SANITATION MARKET • 10 4. SANITATION FROM A USER PERSPECTIVE • 15 5. SANITATION FROM THE PERSPECTIVE OF SERVICE PROVIDERS • 21 6. SANITATION FROM A SERVICE AUTHORITY PERSPECTIVE • 32 7. CONCLUSION • 36 APPENDIX A • Design Approach • 37 APPENDIX B • Review of Practice • 38 APPENDIX C • Indicative Questions to Ask as Part of a Sanitation Situation Assessment To Inform Shared Toilet Model Design, Planning, Implementation, and Management • 43 APPENDIX D • A Day In The Life • 46 BIBLIOGRAPHY • 50 SHARED AND PUBLIC TOILETS: CHAMPIONING DELIVERY MODELS THAT WORK iii Figures 1.1 • Decision Point Indicators for Decision Frameworks • 2 1.2 • Features Linking Analysis with Action • 3 2.1 • A User-Centric Approach to Defining Toilet Models as Used in This Guide • 6 2.2 • The Sanitation Service Chain • 7 2.3 • Decisions and Alternatives Connecting Toilet Models with the Sanitation Service Chain • 8 3.1 • Decisions and Alternatives to Guide a Situational Assessment for Residential Sanitation • 13 4.1 • Decisions and Alternatives for User Inclusion in Shared Toilet Models • 19 5.1 • Possibilities How Different Management Models Can Be Applied to a Similar Physical Asset • 23 5.2 • Decisions and Alternatives for Shared Household Toilet Models • 27 5.3 • Decisions and Alternatives for Community Toilet Models • 29 5.4 • Decisions and Alternatives for Public Toilet Models • 30 6.1 • Decisions and Alternatives for Service Authorities • 35 Tables 5.1 • Landscape of Business Model Options along the Shared-Community-Public Toilet Continuum • 25 D.1 • A Day in the Life of a Family that Uses an IHHT as a primary form of sanitation • 46 D.2 • A Day in the Life of a Family that Uses a Shared Household Toilet Model as a Primary Form of Sanitation • 47 D.3 • A Day in the Life of a Family that Uses a Community Toilet Model as a Primary Form of Sanitation • 48 D.4 • A Day in the Life of a Family that Uses a Public Toilet Model as a Primary Form of Sanitation • 49 iv SHARED AND PUBLIC TOILETS: CHAMPIONING DELIVERY MODELS THAT WORK ABBREVIATIONS BOT build-operate-transfer CAPEX capital expenditures CBO community-based organization CWIS citywide inclusive sanitation DBO design-build-operate FSM fecal sludge management GBV gender-based violence GPS global positioning system IHHT individual household toilet JMP Joint Monitoring Programme MHM menstrual hygiene management NGO nongovernmental organization OD open defecation PA Practical Action SAIS School of Advanced International Studies SAT stand-alone toilet SDGs Sustainable Development Goals WSUP Water and Sanitation for the Urban Poor SHARED AND PUBLIC TOILETS: CHAMPIONING DELIVERY MODELS THAT WORK v ACKNOWLEDGMENTS This primer benefited from contributions of literature as well as experience and feedback on initial and later-stage drafts from many people. We are grateful for contributions and insights from conversations with Tanvi Nagpal, Meera Mehta, Dinesh Mehta, Neil Macleod, M. Elangovan, Prof. V. Srivinas Chary, and Swapnil Chaturvedi, the excerpts of which are captured in several examples provided throughout. Georges Mikhael and Baghirathan Vanniasingham provided deep insight from their extensive experience and shared useful literature and case studies from Water & Sanitation for the Urban Poor’s (WSUP) work as well as constructive feedback that shaped the process. We also extend gratitude to Christopher Ancheta, Gulilat Birhane Eshetu, Edkarl Galing, Peter Hawkins, Chris Heymans, Bill Kingdom, Maraita Listyasari, Sanyu Lutalo, Nishtha Mehta, Joseph Ravikumar, and Yitbarek Tessema, who provided extensive and useful feedback for the development and drafting of this piece. Finally, we are very thankful to Shafick Hoossein and Martin Gambrill for their consistent support and valuable advice throughout the development process. All omissions and errors rest with the authors. vi SHARED AND PUBLIC TOILETS: CHAMPIONING DELIVERY MODELS THAT WORK 1. INTRODUCTION The Sustainable Development Goals (SDGs) call for uni- checklists, high-level decision trees, and tips based on versal sanitation access and ending open defecation by research and experience. It is accompanied by a series 2030. Shared toilet models are not currently an accept- of appendixes, which offer a summary of findings from able form of safely managed sanitation. The ambition a literature search, additional graphics, and a checklist for the goals is thus set against an urban reality where of things to consider when planning, implementing, and hundreds of millions of people regularly rely on shared managing shared toilet models. It is built on an assump- toilet models, but aren’t counted, and where policy mak- tion that with an experimental mindset and operational ers lack incentives to support shared toilet models, even flexibility to innovate, shared toilet models can offer when these are more suitable, for technical and geo- safe sanitation services as part of CWIS and contribute graphic reasons. The alternative to not having any form meaningfully to the SDGs. of sanitation is open defecation, with associated human and environmental health impacts. The logic behind Notably, this document does not explicitly address the exclusion of shared toilet models is that they fail to container-based sanitation service models, which are deliver safe sanitation services to their users. For exam- evolving to meet urban sanitation needs for shared and ple, there is evidence that health outcomes from shared individual household situations. This topic is the subject models are worse than from individual household toi- of a separate World Bank report titled Evaluating the lets. The market structure and underlying dynamics that Potential of Container-Based Sanitation (forthcoming). cause shared toilet models to succeed or fail are messy Nor is this document a stepwise guide to implement- and often context specific, which makes shared toilet ing shared toilet models, considering legal, regulatory, 1 models hard to justify at a global level. Still, there are policy, financial, technical, and social issues. Rather, it examples where shared toilet models can and do work offers a pragmatic introduction to thestarting questions and are preferable to individual household toilets. Often, a policy maker or planner should ask. models that provide safely managed sanitation have evolved through deep community engagement, iterative