Note: This is Part 1 of a two-part blog series on findings from a national Rural Household and Institutional Survey in Uganda. Part 1 focuses on the consumer research findings. Part 2 will cover the enterprise perspective.
Uganda has committed to reaching Sustainable Development Goal (SDG) 6.2: “By 2030, achieve access to adequate and equitable sanitation and hygiene for all and end open defecation.” It is encouraging that 94 percent of Uganda’s population has access to some form of sanitation facility.1 This puts Uganda at an advantage vis-à-vis many other sub-Saharan countries in that most households have adopted fixed-point defecation. However, access to basic sanitation remains low in Uganda—just 19 percent overall and 17 percent in rural areas—and has not been rising at the pace needed to reach the SDG target (see Figure 1 below).
Figure 1: Trends of Basic Sanitation Coverage in Uganda
(sum of basic and safely managed sanitation JMP data)
Recent sanitation interventions in Uganda have focused primarily on reducing open defecation. Far fewer efforts have been made to develop well-functioning markets to fulfill an increased demand for sanitation services with high-quality products and services.
It is within this context and consistent with USAID’s recently released Private-Sector Engagement Policy that the USAID Uganda Sanitation for Health Activity (USHA) is supporting the Uganda Ministry of Health and other stakeholders to develop a National Sanitation Market Strategy (NSMS) aimed at increasing access to and use of basic sanitation services through market interventions. USHA is working in 25 districts across Uganda to increase household access to sanitation and water services; ensure that key hygiene behaviors are adopted at home, school, and health facilities; and strengthen district governance for sustainable services. To inform the NSMS over the last year, USHA has carried out both secondary and primary research to better understand the current sanitation market in Uganda with a focus on identifying drivers for, and barriers to, accelerating uptake.
Beginning in mid-2018, USHA collaborated with the Uganda Bureau of Statistics (UBOS) to use national data sets and GIS mapping to develop a sampling frame targeting 1,185 households from 99 enumeration areas2 across 10 districts that captured the diversity of sanitation-related contexts in terms of affluence, market access, and market infrastructure. Key to household data collection was re-constructing the customer buying process, which required documenting the customer’s journey toward achieving a desired behavior (in this case building an improved toilet) into distinct stages, each ending with a key customer decision. The research team, led by USHA partner FSG, studied customer behavior at each stage of the buying process to identify key leverage points that increase the chances of purchase and usage, and key drop-off points that act as hindrances to uptake.
In early February 2019, USHA convened a subcommittee of the National Sanitation Working Group consisting of stakeholders from the Ministry of Health, Ministry of Water and Environment, private sector actors, and NGOs to discuss the research findings. Once the NSMS is finalized, all data from the study will be placed in the public domain for use by government agencies and development partners working in Uganda.
USHA used the household survey results to segment the potential Uganda sanitation market (i.e., households that do not use basic facilities) into 11 distinct and identifiable groups based on statistically significant differences in their attitudes, beliefs, preferences, and behavior (Figure 2). It is important to note that defining market segments that are both internally homogenous and externally heterogeneous based on variables that are both appropriate (i.e., statistically significant) and executable (i.e., can be used to actionably identify different segments) allows for:
Figure 2: Segmentation of the Addressable Sanitation Market in Uganda
Each of the 11 segments has a distinct customer profile created based on an understanding of their buying process, where they live, their demographics, income characteristics, willingness and ability to pay, as well as their “asks” and expectations in terms of toilet features to fit their needs. Figure 3 includes a narrative customer profile for segment C.
Figure 3: Example of the Customer Profile for Segment C
Considering the size and relative ease of conversion3 of the 11 segments, our research suggests E, B, C, and K are priority segments for market-based sanitation efforts in Uganda (Figure 4). Other segments, particularly those in the rural north and west far from a main road (segments D, I, J) will likely be most difficult to reach using purely market mechanisms, likely requiring extensive community-led total sanitation or social behavior change-type interventions to increase latent demand for basic sanitation and eventually targeted subsidies to the neediest households in these areas to achieve universal coverage.
Figure 4: Prioritizing Uganda's Addressable Sanitation Market
For next steps, USHA will continue working through the National Sanitation Working Group to socialize the study results and work with the subcommittee to consolidate an initial draft of the NSMS by late April 2019. In parallel, USHA has begun using the research findings to identify toilet product packages and delivery models focusing on segments B, C, and E, corresponding to the project’s initial intervention districts. We hope to begin market testing in April or May and will keep you posted on our progress.
By Jonathan Annis, Project Manager for USAID’s Uganda Sanitation for Health Activity
 Joint Monitoring Programme (JMP) Data website. Summary of unimproved, limited, basic, and safely managed sanitation from 2015 data.
 UBOS has divided the country into a number of enumeration areas, each of which is categorized as being either urban or rural; households are considered to be urban or rural based on which enumeration area they live in.
 A function of a customer’s ability to pay, willingness to pay, home ownership, the extent to which a customer has considered using “improved” toilet features in the past, and the degree of geographic suitability of the customer’s residential area, with respect to building toilets (suitability includes flood risk and soil type).