Scaling Market-Based Sanitation: Desk Review on Market-Based Rural Sanitation Development Programs

Inadequate access to sanitation remains a significant problem globally and is linked to the transmission of numerous communicable diseases with a disproportionately large effect on children. The scale of investment required to deliver sanitation goods and services to those who lack access is beyond the capacity of public finance alone. The private sector has already proven itself a key player in the financing, construction, and operation of municipal water supply and wastewater systems in both developed and developing world settings, and has a significant role to play in the provision of onsite sanitation.

This desk review describes the current state of knowledge in market-based sanitation (MBS) and establishes a framework to analyze, design, and improve MBS interventions. It is based on a survey of approximately 600 documents on MBS, in-depth research into 13 MBS intervention case studies across the global south, and interviews with sector experts and program personnel.

Experts increasingly view MBS as a promising approach for scaling the delivery of onsite sanitation to households that are not connected to centralized wastewater collection and conveyance systems. Successful MBS interventions in Southeast Asia and Bangladesh demonstrate the promise of this approach, yet those successes have proven difficult to replicate in other regions, particularly sub-Saharan Africa and India, where the need is greatest. The challenges to scaling MBS include appropriate product and business model choices, the viability of sanitation enterprises, and the difficulty of unlocking public and private financing for sanitation.

Given this backdrop, this desk review offers a framework that: (1) draws upon and contributes to existing evidence across the three crucial areas highlighted; (2) helps funders and implementers to design, analyze, and improve MBS interventions; and (3) offers guidance for stakeholders and governments interested in using sanitation markets to expand sanitation coverage and reduce open defecation. In addition, this review highlights the larger contextual parameters that determine the applicability of MBS as an approach within a given market.