Approach for scaling up citywide safely managed sanitation access and services: A study of Lusaka, Zambia

Attaining global sanitation goals implies delivering safely managed services for all. This requires considerable financial resources, with funds often limited and inequitably allocated. Sanitation access, equity of public spending, affordability and financial viability of services are well documented. However, the challenges facing the delivery of citywide sanitation are not sufficiently addressed. Because
planning is not responsive to the different urban realities within cities, uptake of current approaches at scale still lags, while conditions underpinning service sustainability are often missing from delivery frameworks.

This case study used mixed research methods to establish an approach that helps decision-makers compare citywide safely managed sanitation options to scale services in Lusaka. Two household surveys - area-level (596) and city-level (1495) and 37 key informant interviews complemented by secondary data
informed the study. The aim was to understand the costs to deliver and sustain services, the enabling environment to facilitate the delivery and the community responsiveness to different services and modes of delivery.

A simplified approach prioritising the scaling-up of citywide services was established using multi-criteria analysis. Specifically, the analytical hierarchy process (AHP) provided the framework to compare sanitation options and summarise the effect of moving populations between sanitation systems across the city. Criteria were limited to cost, fit with the enabling environment, and community responsiveness of each option.

Results showed that a fully sewered system adoption is responsive to community needs and fits the enabling environment well but would be costly to implement. A fully non-sewered system does not fit well with the enabling environment but performs well on costs, as most people use on-site sanitation. A fully non-sewered system would be responsive to community needs, but communities have never experienced fully operational services. The analyses provided a path towards a solution comprising sewered and non-sewered options. Six pathways, a blend of services, were established that make incremental improvements on an area-by-area basis by optimising the performance criteria of existing sewered and non-sewered services. The established pathways ensure citywide safely managed sanitation services, with
the overall responsibility for services taken away from households to the public sector as a sole provider or on a delegated basis. The approach allows decision-makers to decide the optimal solution based on criteria prioritisation.

As the body of literature grows, with little traction for approaches, these results demonstrate the need to have adaptive planning by pulling together strands of existing approaches to meet sanitation needs in a specific context.