The Sustainability and Scalability of Private Sector Sanitation Delivery in Urban Informal Settlement Schools: A Mixed Methods Follow Up of a Randomized Trial in Nairobi, Kenya

There are considerable challenges to achieving the Sustainable Development Goals’ target of universal access to basic sanitation in schools. Schools require safe, clean, and sex-segregated facilities for a large number of students. Robust and affordable solutions are needed to address the economic,...

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Main Authors: Jedidiah S. Snyder, Graeme Prentice-Mott, Charles Boera, Alex Mwaki, Kelly T. Alexander, Matthew C. Freeman
Format: Article
Language:English
Published: MDPI AG 2020-07-01
Series:International Journal of Environmental Research and Public Health
Subjects:
Online Access:https://www.mdpi.com/1660-4601/17/15/5298
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spelling doaj-4954d41ea18047b8b153ce3794d778f92020-11-25T02:48:06ZengMDPI AGInternational Journal of Environmental Research and Public Health1661-78271660-46012020-07-01175298529810.3390/ijerph17155298The Sustainability and Scalability of Private Sector Sanitation Delivery in Urban Informal Settlement Schools: A Mixed Methods Follow Up of a Randomized Trial in Nairobi, KenyaJedidiah S. Snyder0Graeme Prentice-Mott1Charles Boera2Alex Mwaki3Kelly T. Alexander4Matthew C. Freeman5Gangarosa Department of Environmental Health, Emory University, Atlanta, GA 30322, USAGangarosa Department of Environmental Health, Emory University, Atlanta, GA 30322, USAConsultant, Nairobi 00100, KenyaSafe Water & AIDS Project, Kisumu 40100, KenyaCARE, Atlanta, GA 30307, USAGangarosa Department of Environmental Health, Emory University, Atlanta, GA 30322, USAThere are considerable challenges to achieving the Sustainable Development Goals’ target of universal access to basic sanitation in schools. Schools require safe, clean, and sex-segregated facilities for a large number of students. Robust and affordable solutions are needed to address the economic, spatial, social, institutional, and political factors which contribute to poor sanitary conditions in informal settlements. In 2015, we undertook a randomized controlled trial to assess the feasibility of private sector sanitation delivery (PSSD) in 20 primary schools, in informal settlements of Nairobi, Kenya. Our preliminary evaluation after one year of service delivery suggested that PSSD of urine-diverting dry latrines with routine waste collection and maintenance provided a feasible, lower-cost alternative to the government standard delivery (GSD) of cistern-flush toilets or ventilated improved pit latrines. We conducted a mixed-methods follow-up study to assess sanitation delivery over 3–4 years and investigate prevailing drivers and barriers that may influence the scalability of PSSD. The conditions of newly constructed and rehabilitated GSD facilities diminished quickly, reverting to the conditions of existing facilities, indicating lower sustainability compared to sanitation delivered from the private sector. Barriers in financial aspects related to the ongoing implementation of PSSD emerged, particularly among public schools, and few were able to pay for continued service. Our study demonstrates that the engagement of the private sector may lead to improvements in affordable, safely managed sanitation for schools and their students. Yet, to reach a sustained scale, additional guidance is needed on how to develop these partnerships, streamline procurement and contracting processes, and incorporate appropriate financing mechanisms.https://www.mdpi.com/1660-4601/17/15/5298sanitationschoolinformal settlementssanitation service deliveryprivate sector provision
collection DOAJ
language English
format Article
sources DOAJ
author Jedidiah S. Snyder
Graeme Prentice-Mott
Charles Boera
Alex Mwaki
Kelly T. Alexander
Matthew C. Freeman
spellingShingle Jedidiah S. Snyder
Graeme Prentice-Mott
Charles Boera
Alex Mwaki
Kelly T. Alexander
Matthew C. Freeman
The Sustainability and Scalability of Private Sector Sanitation Delivery in Urban Informal Settlement Schools: A Mixed Methods Follow Up of a Randomized Trial in Nairobi, Kenya
International Journal of Environmental Research and Public Health
sanitation
school
informal settlements
sanitation service delivery
private sector provision
author_facet Jedidiah S. Snyder
Graeme Prentice-Mott
Charles Boera
Alex Mwaki
Kelly T. Alexander
Matthew C. Freeman
author_sort Jedidiah S. Snyder
title The Sustainability and Scalability of Private Sector Sanitation Delivery in Urban Informal Settlement Schools: A Mixed Methods Follow Up of a Randomized Trial in Nairobi, Kenya
title_short The Sustainability and Scalability of Private Sector Sanitation Delivery in Urban Informal Settlement Schools: A Mixed Methods Follow Up of a Randomized Trial in Nairobi, Kenya
title_full The Sustainability and Scalability of Private Sector Sanitation Delivery in Urban Informal Settlement Schools: A Mixed Methods Follow Up of a Randomized Trial in Nairobi, Kenya
title_fullStr The Sustainability and Scalability of Private Sector Sanitation Delivery in Urban Informal Settlement Schools: A Mixed Methods Follow Up of a Randomized Trial in Nairobi, Kenya
title_full_unstemmed The Sustainability and Scalability of Private Sector Sanitation Delivery in Urban Informal Settlement Schools: A Mixed Methods Follow Up of a Randomized Trial in Nairobi, Kenya
title_sort sustainability and scalability of private sector sanitation delivery in urban informal settlement schools: a mixed methods follow up of a randomized trial in nairobi, kenya
publisher MDPI AG
series International Journal of Environmental Research and Public Health
issn 1661-7827
1660-4601
publishDate 2020-07-01
description There are considerable challenges to achieving the Sustainable Development Goals’ target of universal access to basic sanitation in schools. Schools require safe, clean, and sex-segregated facilities for a large number of students. Robust and affordable solutions are needed to address the economic, spatial, social, institutional, and political factors which contribute to poor sanitary conditions in informal settlements. In 2015, we undertook a randomized controlled trial to assess the feasibility of private sector sanitation delivery (PSSD) in 20 primary schools, in informal settlements of Nairobi, Kenya. Our preliminary evaluation after one year of service delivery suggested that PSSD of urine-diverting dry latrines with routine waste collection and maintenance provided a feasible, lower-cost alternative to the government standard delivery (GSD) of cistern-flush toilets or ventilated improved pit latrines. We conducted a mixed-methods follow-up study to assess sanitation delivery over 3–4 years and investigate prevailing drivers and barriers that may influence the scalability of PSSD. The conditions of newly constructed and rehabilitated GSD facilities diminished quickly, reverting to the conditions of existing facilities, indicating lower sustainability compared to sanitation delivered from the private sector. Barriers in financial aspects related to the ongoing implementation of PSSD emerged, particularly among public schools, and few were able to pay for continued service. Our study demonstrates that the engagement of the private sector may lead to improvements in affordable, safely managed sanitation for schools and their students. Yet, to reach a sustained scale, additional guidance is needed on how to develop these partnerships, streamline procurement and contracting processes, and incorporate appropriate financing mechanisms.
topic sanitation
school
informal settlements
sanitation service delivery
private sector provision
url https://www.mdpi.com/1660-4601/17/15/5298
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