Container-based sanitation in urban Haiti: how can it improve human rights as a component of citywide inclusive sanitation?

Abstract

Health, sanitation, and livelihoods are interrelated human rights and essential components of community wellbeing. Despite the United Nations recognizing the human right to sanitation, one-third of the world's population lack access to improved sanitation. Furthermore, in many low- and middle-income countries, urban latrines are excavated manually without physical or regulatory protections. Container-based sanitation (CBS) has promise as a component of Citywide Inclusive Sanitation (CWIS) in densely populated, low-resource environments. Before investing in CBS, however, governments and funders require evidence of user acceptance, public demand, and labor aspects of service delivery. To provide this evidence base, we completed 633 interviews with active and former users of EkoLakay, a CBS service in Cap Haïtien, Haiti, creating a profile of the user base and their motivations for subscribing. We also compiled and analyzed secondary data to determine the impacts of widespread CBS expansion in northern Haiti. Results reveal that CBS presently serves a geographical subset of Haiti's most resource-insecure residents, and that CBS significantly reduces handling of untreated excreta in Haiti's Nord Department, while doubling livelihood opportunities through safe and dignified jobs. Given its cost-effectiveness, this provides an opportunity to achieve widespread sanitation coverage by integrating and cross-subsidizing CBS within a CWIS strategy.

Characterizing customer attrition mitigation strategies in container-based sanitation (CBS) organizations: the challenge of the public-private continuum

“…Further, dissatisfaction was not identified as a meaningful driver of attrition from CBS services which aligns with other studies that have found low dissatisfaction with CBS in serviced areas (World Bank, 2019;Tidwell et al, 2022). This low dissatisfaction may be due to CBS organizations' practice of collaboratively designing their sanitation systems based on feedback from their customers (e.g., Mijthab et al, 2021;VanRiper, 2021). Indeed, previous literature suggests that CBS services can satisfy subscriber's wants and needs for sanitation (Russel et al, 2019).…”

“…Whereas, SEs generate enough revenue to sustain their operations independently through their business model or through a mix of revenue generating activities and grants (Luke and Chu, 2013;Doherty et al, 2014). CBS organizations often provide sanitation services in locations where a government utility currently does not provide services (Mijthab et al, 2021;VanRiper et al, 2022c) and where individual sanitation users may struggle to afford subsidized costs of safely managed sanitation services (VanRiper et al, 2022a). Therefore, gathering reliable income solely from external sources (e.g., government funds or grants) or full funding from internal subscribers is difficult (World Bank, 2019).…”

“…Container-based sanitation was first recognized by the Joint Monitoring Program (JMP) as an improved sanitation solution in 2018 (UNICEF and WHO, 2018), and has been expanding globally since 2009 (World Bank, 2019). CBS organizations provide toilets that store excreta in a removable receptacle and then collect and transport the containerized excreta for treatment at regular intervals (World Bank, 2019;VanRiper et al, 2022c). Many CBS organizations operate as subscription-based services.…”

“…Most collect containerized excreta from the point of use. Some CBS business models require households to drop off their full container at a collection site (World Bank, 2019) or dispose of collected urine while the organization picks up the solid waste (World Bank, 2019;VanRiper et al, 2022c). CBS services providing household-scale toilets meet safely managed sanitation standards set by JMP (Russel et al, 2019).…”