Water Currents: Citywide Inclusive Sanitation


USAID is committed to exploring new ideas to achieving increased access to urban sanitation services.  The agency believes that sustainable sanitation requires that all stakeholders—from policymakers, the private sector, and utilities, to local NGOs, communities, and households—work together to achieve long-term solutions.
This issue of Water Currents includes articles, tools, and other resources related to Citywide Inclusive Sanitation (CWIS), an approach to urban sanitation that involves collaboration among many actors to ensure that everyone benefits from adequate sanitation service delivery outcomes. CWIS aims to help cities develop comprehensive approaches to sanitation improvement that encompass long-term planning, technical innovation, institutional reforms, and financial mobilization.
The concept of CWIS has been gaining traction among development practitioners. At World Water Week 2018 in Stockholm, the World Bank and other partners released an official Call to Action for all stakeholders to “embrace a radical shift in urban sanitation practices deemed necessary to achieve citywide inclusive sanitation.” This issue of Currents was compiled with help from the World Bank and the Bill & Melinda Gates Foundation.

CWIS Resources

Citywide Inclusive Sanitation (CWIS) Initiative – The CWIS Initiative is made up of a growing group of institutions that are partnering on CWIS, including the Bill & Melinda Gates Foundation, Emory University, Plan International, the University of Leeds, WaterAid, and the World Bank. The website provides background about the initiative, as well as CWIS-related news, events, and resources.

Water, Sanitation & Hygiene (WSH)/Bill & Melinda Gates Foundation – The WSH team’s Urban Sanitation Markets focus area has been structuring its urban sanitation investments around CWIS principles, following a year of detailed assessments. The team made city-level grants based on CWIS principles to cities in Senegal, Uganda, and Zambia in Africa, and Bangladesh and India in South Asia. The team funded two grants for the development of a CWIS Metrics Dashboard; and Gender Mainstreaming technical assistance to support learning and practice across these cities.

Global Water Security & Sanitation Partnership (GWSP) – GWSP is a multi-donor trust fund headed by the World Bank. Launched in 2017, GWSP works with others to advance five priority themes where action is critically needed—sustainability, financing, institutions, inclusion, and resilience. GWSP also provides funding for the World Bank’s CWIS activities.

World Bank Sanitation Strategy – CWIS is an important part of the World Bank’s sanitation strategy. With funding support from GWSP, the World Bank’s CWIS team works with cities around the world to support bank operational lending. Several countries are also using CWIS tools and mobilizing support from the bank’s CWIS core team and consultants to help formulate their thinking on urban sanitation using a CWIS approach.

Citywide Inclusive Sanitation (CWIS)/Eawag – Eawag’s CWIS project in India is developing a methodology for urban sanitation planning in developing countries. It bridges top-down and bottom-up planning techniques, with a holistic inclusion of sociocultural, institutional, economic, spatial, and temporal factors.

Container Based Sanitation Alliance (CBSA) – A global coalition of container-based sanitation practitioners formed CBSA in November 2016. They include Clean Team (Ghana), Loowatt (Madagascar), Sanivation and Sanergy (Kenya), SOIL (Haiti), and x-runner (Peru). Groups affiliated with CBSA include Sanitation First (India), MoSan, Re.source, Non-Water Sanitation, and Water and Sanitation for the Urban Poor.
Faecal Sludge Management (FSM) Toolbox – The FSM toolbox was developed to better organize existing FSM knowledge into a user-friendly platform. This site consists of various tools, documents, templates, guidance manuals, plans, programs, etc. that are carefully curated to best suit the needs of those working in FSM.

SaniPath – This Rapid Assessment Tool for assessing exposure to fecal contamination in urban, low-income settings is under development by the Center for Global Safe Water at Emory University with funding from the Bill & Melinda Gates Foundation. It guides users in collecting much needed data on exposure to fecal contamination in low income, urban neighborhoods, and synthesizes these data for community, government, and service providers’ decision-making.

SFD (Shit Flow Diagram) Promotion Initiative – The SFD Promotion Initiative is developing and promoting standardized tools for excreta flow analysis to inform urban sanitation programming. SFD is a visualization tool that summarizes complex information into an easy-to-understand diagram that shows how excreta is, or is not, contained along the sanitation value chain.

IRC Faecal Waste Flow Calculator – This tool is being developed to determine fecal waste volumes along the entire sanitation service chain, allowing city planners, service authorities, or any other users to determine where the biggest losses are and where to target interventions. Less easily quantifiable issues such as the existence of policies and legislation, availability and transparency of plans and budgets, and presence and adherence to environmental and safety standards are captured with the use of scorecards.

Research and Guidance 
Faecal Sludge and Septage Treatment: A Guide for Low- and Middle-Income Countries. Practical Action, August 2018. Co-funded by the Bill & Melinda Gates Foundation and the World Bank, this guide discusses the urban contexts that influence treatment requirements and overall septage treatment processes. It also examines the options and design approaches at each stage of treatment.

Shared and Public Toilets: Championing Delivery Models that Work. The World Bank, August 2018. This document provides background and guidance on how to design and implement shared, communal, and public sanitation facilities, with a focus on operation and management models that support long-term service provision. Drawing on experiences from across the globe, it reflects lessons learned from design and implementation experiences—both positive and negative—in a range of countries.

Compendium of Sanitation Systems and Technologies. Eawag, 2016. The second, revised edition of the compendium presents a huge range of information on sanitation systems and technologies, serving as a guidance document for engineers and planners in low- and middle-income countries. Part 1 describes different system configurations for a variety of contexts. Part 2 describes the main advantages, disadvantages, applications, and appropriateness of different technologies.

Sanitation Safety Planning (SSP): Manual for Safe Use and Disposal of Wastewater, Greywater and Excreta. World Health Organization (WHO), 2015. SSP is a step-by-step, risk-based approach to assist in the implementation of the “WHO Guidelines for Safe Use of Wastewater, Excreta and Greywater in Agriculture and Aquaculture.” The approach can be applied to all sanitary systems to ensure they are managed to meet health objectives. SSP assists users to systematically identify and manage health risk along the sanitation chain, and guide investment based on actual risks, to promote health benefits and minimize adverse health impacts.

A Tale of Clean Cities: Insights for Planning Urban Sanitation from Ghana, India and the Philippines. WaterAid. A Tale of Clean Cities is a WaterAid-commissioned research project to learn from the experience of cities in developing countries that are making good progress in planning and providing citywide sanitation services. This collection includes reports and case studies from San Fernando, the Philippines; Visakhapatnam, India; and Kumasi, Ghana.
Articles and Videos 
Not All Toilets Look the Same: A Peek into Citywide Inclusive Sanitation on World Toilet Day. The World Bank, November 2017. This blog post showcases a series of videos highlighting good practices in CWIS from around the world.

Seven Myths about Urban Sanitation Debunked. The World Bank, August 2017. City managers and sector experts across the world have worked hard to achieve effective urban sanitation, often with limited success. This is typically due to a set of enduring myths debunked in this video. From the importance of toilets, to the funding needed for waste management, it is critical to know the facts about urban sanitation and waste management.

Addressing the Urban Sanitation Crisis: Time for a Radical Shift. Water Blog, November 2016. Business as usual will fail to deliver the kind of sanitation that underpins urban transformation. A radical shift in mindsets and practices toward urban sanitation is required that impacts political priorities, funding, planning, design, management, and governance.

Scheduled Desludging Service (LLTT) for Safely-Managed Sanitation. USAID/Indonesia IUWASH PLUS, October 2018. Regular desludging, called LLTT in Indonesia, is a service mechanism for routine desludging of on-site septage systems with agreed payment methods. The LLTT system creates cost savings in transportation of waste while giving customers attractive payment options as compared to the typical on-call services.


Water Currents
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USAID Bureau for Economic Growth, Education and Environment (E3) Water Office
Population Focus