Sanitation marketing: A systematic review and theoretical critique using the capability approach

Abstract

Sanitation is a human right that benefits health. As such, technical and behavioural interventions are widely implemented to increase the number of people using sanitation facilities. These include sanitation marketing interventions (SMIs), in which external support agencies (ESAs) use a hybrid of commercial and social marketing tools to increase supply of, and demand for, sanitation products and services. However, there is little critical discourse on SMIs, or independent rigorous analysis on whether they increase or reduce well-being. Most available information is from ESAs about their own SMI implementation. We systematically reviewed the grey and peer-reviewed literature on sanitation marketing, including qualitatively analysing and calculating descriptive statistics for the parameters measured, or intended to be measured, in publications reporting on 33 SMIs. Guided by the capability approach to development we identified that publications for most SMIs (n = 31, 94%) reported on commodities, whilst fewer reported on parameters related to impacts on well-being (i.e., functionings, n = 22, 67%, and capabilities, n = 20, 61%). When evaluating future SMIs, it may be useful to develop a list of contextualised well-being indicators for the particular SMI's location, taking into account local cultural norms, with this list ideally co-produced with local stakeholders. We identified two common practices in SMIs that can reduce well-being and widen well-being inequalities; namely, the promotion of conspicuous consumption and assaults on dignity, and we discuss the mechanisms by which such impacts occur. We recommend that ESAs understand sanitation marketing's potential to reduce well-being and design SMIs to minimize such detrimental impacts. Throughout the implementation phase ESAs should continuously monitor for well-being impacts and adapt practices to optimise well-being outcomes for all involved.

Health Risk Perceptions Are Associated with Domestic Use of Basic Water and Sanitation Services—Evidence from Rural Ethiopia

“…While many studies examine the technical and engineering aspects of WaSH, such as functionality [ 5 ], water system breakdowns [ 6 ], access to sanitation [ 2 ], and sustainability of services [ 7 ], sociological, emotional distress and psychological aspects have received less attention [ 4 , 8 , 9 , 10 ]. However, as stated by Mara [ 11 ], rural water supply, sanitation and hygiene do not only incorporate engineering, but also sociology.…”

Using a theory-driven creative process to design a peri-urban on-site sanitation quality improvement intervention

“…Some concern was also raised among the team about profit-motive-related interventions and their potential to displace tenants through higher rental fees, resulting only in more income for landlords, or in the potential for increased marginalization caused by negative messaging [61]. We hypothesized that simply constructing high-quality toilets would inevitably lead to the displacement of many tenants.…”

Strengthening the Human Right to Sanitation as an Instrument for Inclusive Development

“…Nonetheless, there is still a lot of investment in technocratic engineering sanitation solutions and a significant body of literature on promoting demand for predetermined sanitation goods and services (Barrington et al, 2016(Barrington et al, , 2017Evans et al, 2014;Jenkins & Scott, 2007). The environmental sciences and public health literature analyse the technological drivers of poor sanitation, such as sewerage connections without treatment (Baum et al, 2013) and the limits of monitoring progress towards sanitation targets based on a hierarchy of predefined technologies (Kvarnström et al, 2011).…”

“…However, where economic instruments are poorly targeted (WaterAid, 2015) or solely focused on full cost recovery, this may exclude people who are unable to afford the cost of sanitation services from accessing them, leading to negative externalities for the wider population and the environment (Barlow, 2009;Mader, 2012;Sovacool, 2013). Practices like promoting conspicuous consumption and assaulting the dignity of non-users which commonly occur in sanitation marketing also affect human wellbeing and exacerbate inequalities (Barrington et al, 2017).…”