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GOAL AND TARGET ADDRESSED

Goal 7. Ensure environmental sustainability Target 7.C. Halve, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation

DEFINITION AND METHOD OF COMPUTATION

Definition
The indicator is defined as the proportion of population using an improved sanitation facility.

This indicator is expressed as a percentage.

Concepts
An improved sanitation facility is defined as a facility that hygienically separates human excreta from human, animal and insect contact. Improved sanitation facilities include flush/pour-flush toilets or latrines connected to a sewer, septic tank or pit; ventilated improved pit latrines; pit latrines with a slab or platform of any material which covers the pit entirely, except for the drop hole; and composting toilets/latrines. Unimproved facilities include public or shared facilities of an otherwise improved type; flush/pour-flush toilets that discharge directly into an open sewer or ditch or elsewhere; pit latrines without a slab; bucket latrines; hanging toilets or latrines; and the practice of open defecation in the bush, field or bodies of water.

Definitions and detailed descriptions of these facilities can be found at the website of the World Health Organisation/United Nations Children’s Fund (WHO/UNICEF) Joint Monitoring Programme (JMP) for Water Supply and Sanitation at www.wssinfo.org.

Method of computation
This indicator is computed for both urban and rural areas by dividing the number of people using improved sanitation facilities by the total urban or rural population and multiplying by 100.

RATIONALE AND INTERPRETATION

Studies suggest that the use of improved sanitation facilities reduces diarrhoea-related morbidity in young children by more than one-third. If hygiene promotion is added, such as teaching proper hand washing, the morbidity could be reduced even further Improved sanitation would also help accelerate economic and social development in countries where poor sanitation is a major cause for missed work and school days because of illness. Girls in particular—especially during puberty—miss out on schooling because of the lack of clean and safe latrines.

Millions of people—especially the poor in developing countries—defecate in bags, buckets, fields or roadside ditches, because they lack access to improved sanitation facilities, causing serious health risks to themselves and others. Adequate sanitation is important for both urban and rural populations, but the risks of poor sanitation practices, notably open defecation, are considered greater in populated peri-urban and slum areas where it is more difficult to avoid contact with waste.

SOURCES AND DATA COLLECTION

Since the late 1990s, population-based data on use of sanitation facilities have routinely been collected at national and sub-national levels in more than 150 countries using censuses and surveys by national governments, often with support from international development agencies. National-level household surveys are generally conducted every 3-5 years in most developing countries, while censuses are generally conducted every 10 years.

Nationally representative household surveys which typically collect information about water and sanitation include Multiple Indicator Cluster Surveys (MICS), Demographic Health Surveys (DHS), World Health Surveys (WHS), Living Standards and Measurement Surveys (LSMS), Core Welfare Indicator Questionnaires (CWIQ), and the Pan Arab Project for Family Health Surveys (PAPFAM). The survey questions and response categories pertaining to access to basic sanitation are fully harmonized between MICS and DHS. The same standard questions are being promoted for inclusion in other survey instruments and can be found at www.wssinfo.org.

Line-ministries and utility companies usually keep records based on the number and type of facilities constructed. In the developing regions, using such data would be error-prone. Administrative or provider-based data are often based on cumulative totals of facilities constructed multiplied by a fixed number of users per type of facility. Administrative data often exclude facilities constructed under NGO supported programmes or those constructed by individual households without outside support. In addition, cumulative reporting does not reflect facilities that have fallen into disrepair. Provider-based data are only used for countries in developing regions when there are no survey or census data available.

In contrast, sample surveys and censuses provide an estimate of what facilities are actually used at the time of measurement, including those constructed by different actors and excluding those that have fallen into disrepair and are no longer in use. For these reasons, data from surveys and censuses are deemed more reliable and objective than administrative records.

In order to classify sanitation service categories as “improved” or “not improved”, as required for the MDG indicator, data need to be collected by facility type. DHS and MICS surveys use response categories to collect data consistent with the MDG classification of improved and unimproved facilities (see the “Definition” and “Concept” sections above for the disaggregated categories). Other sample survey instruments and censuses are encouraged to use the same or at least a harmonised classification. Insufficient disaggregation of service categories is the most common problem for adequately assessing progress using this indicator.

Starting in 2008, the World Health Organisation/United Nations Children’s Fund (WHO/UNICEF) Joint Monitoring Programme for Water Supply and Sanitation (JMP) separates sanitation facilities into four categories:.
  • Improved sanitation facilities;
  • Shared sanitation facilities;
  • Unimproved sanitation facilities; and
  • Open defecation.

Trends in the use of these four categories provide valuable information to programme managers and policy makers, but trend analysis is possible only when an adequate level of disaggregation of service categories is included in surveys.

Improved sanitation facilities exclude facilities of an otherwise acceptable type that are public or shared between two or more households. DHS and MICS collect information on how many families use the same sanitation facility. Based on such information, the total proportion of the population that shares a facility of an otherwise acceptable type can be estimated. Since 2009, DHS and MICS have distinguished between the use of public and shared facilities. Other sample survey instruments and censuses are encouraged to add similar questions. Sample questions can be found at: http://www.childinfo.org/files/MICS4_Household_Questionnaire_v3.0.doc.

DISAGGREGATION

The indicator should be monitored separately for urban and rural areas. Because of national differences in characteristics that distinguish urban from rural areas a single definition does not apply to all countries.

Geographical and socio-economic disaggregation is also possible. Censuses allow for the highest level of geographical or administrative disaggregation. Depending on the sample size and design of nationally representative sample surveys, they can support regional or, in exceptional cases, provincial disaggregation. Censuses and most sample surveys allow for disaggregation by wealth quintile, level of education of the head of household, or ethnic group.

COMMENTS AND LIMITATIONS

The MDG target calls for halving the proportion of the population without sustainable access to basic sanitation. An all encompassing and widely supported definition for sustainable access to basic sanitation is so broad that it includes no less than 24 criteria, all of which have to be met to qualify as sustainable access. The “use of an improved sanitation facility” has been adopted as a reasonable and measurable proxy measure of sustainable access to basic sanitation.

Surveys and censuses often fail to adequately define service categories. The failure to properly define responses or service categories in a survey hampers international efforts to compare survey results over time and across countries.

The JMP estimates of open defecation rates are particularly valuable for policy purposes. However, the category of open defecation is grouped together with other facilities that do not meet the national definition of “access to sanitation” under one category, as “other”.

GENDER EQUALITY ISSUES

Several studies and anecdotal evidence have found that in many societies, women and girls are deterred from using public sanitation facilities or facilities too far away from their household for fear of harassment. In some cultures women are not allowed to use the same sanitation facilities as men. In addition, some types of facilities may impact women more than men. Open defecation does not only represent a lack of facilities for dealing with urine and feces, but also implies, in the case of women, a lack of privacy and facilities to manage menstrual hygiene. Depending on who responds to a survey question about the type of toilet facility members of the household usually use, a response may or may not capture the use of a facility by all household members at all times. Current survey instruments are time-limited and therefore do not allow surveyors to obtain sex specific information about toilet use. Only sanitation specific surveys can provide such information.

DATA FOR GLOBAL AND REGIONAL MONITORING

The WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation (JMP) is charged with international monitoring of the MDG drinking water and sanitation target.

The primary data sources used for international monitoring include nationally representative surveys and censuses. When the JMP receives new survey or census data, the validity of the data is assessed based on objective criteria, including national representativeness; adequate sample size; implementing institution; questionnaire design; adequate disaggregation by urban, rural and type of facility. New survey data are entered into the JMP database only if these criteria are met.

Coverage estimates are based on data from nationally representative household surveys and national censuses. In some cases, adjustments are made to improve data comparability over time and when the survey / census records can not readily be compared with international definition. When the definition for a particular category is not precise enough to determine whether a category is improved or not, information from other surveys in that country are used to interpret the category in question. Where additional information is not available, half of the users of the category in question are classified as using an improved facility and half as using an unimproved one. Data from available survey / census are plotted for each country on a time scales from 1990 to the present. A linear trend line, based on the least-squares method, is drawn through these data points to estimate urban and rural coverage for the baseline year 1990 and for the year of the most recent estimate.

Regional and global estimates are aggregated from national estimates using population-weighted averages. These estimates are presented only if available data cover at least 50 per cent of the total population in the regional or global grouping. Population estimates are provided by the United Nations Population Division. For the purpose of regional aggregation, countries with missing data weigh in at the regional average for the purpose of determining the regional population with and without access.

SUPPLEMENTARY INFORMATION



EXAMPLES



REFERENCES

See REFERENCES for Indicator 7.8.

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