Safely Managed Sanitation for All Means Fecal Sludge Management for At Least 1.8 Billion People in Low and Middle Income Countries

Abstract

Although global access to sanitation is increasing, safe management of fecal waste is a rapidly growing challenge in low- and middle-income countries (LMICs). The goal of this study was to evaluate the current need for fecal sludge management (FSM) in LMICs by region, urban/rural status, and wealth. Recent Demographic and Health Survey data from 58 countries (847 685 surveys) were used to classify households by sanitation facility (facilities needing FSM, sewered facilities, ecological sanitation/other, or no facilities). Onsite piped water infrastructure was quantified to approximate need for wastewater management and downstream treatment. Over all surveyed nations, 63% of households used facilities requiring FSM, totaling approximately 1.8 billion people. Rural areas had similar proportions of toilets requiring FSM as urban areas. FSM needs scaled inversely with wealth: in the poorest quintile, households' sanitation facilities were almost 170 times more likely to require FSM (vs sewerage) than in the richest quintile. About one out of five households needing FSM had onsite piped water infrastructure, indicating domestic or reticulated wastewater infrastructure may be required if lacking for safe management of aqueous waste streams. FSM strategies must be included in future sanitation investment to achieve safe management of fecal wastes and protect public health.

Groundwater as a Source of Drinking Water in Southeast Asia and the Pacific: A Multi-Country Review of Current Reliance and Resource Concerns

“…As such, the focus was on interpreting the findings to inform how water services are conceptualized, planned and managed. We also note that although pollution from unsafe sanitation emerged as a common threat to groundwater resources across case study countries, there is substantial ongoing work in the WASH sector focused on progressing safe sanitation [82,83], so we focus this discussion on other implications from the analysis. To contextualize the discussion within current WASH sector framing, where relevant, we draw on the service delivery approach framework of three institutional levels [18,19] to identify implications for national WASH agencies, service authorities and service providers.…”

Establishing Sustainable Development Goal Baselines for Household Drinking Water, Sanitation and Hygiene Services

“…The safely managed sanitation services indicator includes not only the type of sanitation facility but also how excreta are disposed of and whether they are treated. This reflects concerns relating to faecal sludge management in many parts of the world [17,18] and the recognition that a large proportion of wastewater collected by sewer networks is not treated at all or receives insufficient treatment to protect public health [5].…”

Cryptosporidium in rivers of the world: the GloWPa-Crypto model

“…Human faeces on land, from the population practicing open defecation, is also considered a nonpoint source. On-site sanitation systems, such as septic tanks and pit latrines, could also contribute to the environmental load when these systems overflow or their contents are discharged unsafely (Berendes et al, 2017). Wastewater treatment can reduce oocyst numbers, but not all types of treatment are equally effective (Nasser, 2016).…”

“…An estimate on how much of the faeces of the population using on-site systems (septic tanks and pit latrines) reaches rivers should be included in GloWPa-Crypto. It is very difficult to estimate the occurrence of leakages and the proportion of safe faecal management, especially of on-site systems, as there is a lack of data (Berendes et al, 2017; WHO/UNICEF JMP, 2017). For this reason it has been ignored so far in the model under the assumption that residence time in the system is sufficiently long for most of the organisms to have decayed.…”

“…The GloWPa model currently bases estimates of wastewater treatment on Van Drecht et al 2009, and it would be worthwhile to look into updating this part of the model to be consistent with the newer JMP data. Looking into on-site sanitation systems is also relevant, as these are often poorly managed in developing regions, as the costs and responsibilities are often borne directly by the users themselves (Berendes et al, 2017). More JMP data on the safe and unsafe management of faecal waste from on-site systems would therefore be valuable input for the GloWPa-Crypto model.…”