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FEATURE STORY November 17, 2017

Not All Toilets Look the Same: A Peek into Citywide Inclusive Sanitation on World Toilet Day

World Bank Group


  • World Toilet Day – November 19 – is an apt time to recognize that proper sanitation is key to building thriving and healthy cities.
  • On World Toilet Day, we showcase a series of videos highlighting some good practices in ‘Citywide Inclusive Sanitation’ from around the world.
  • Citywide Inclusive Sanitation means everybody benefits from adequate sanitation, with human waste being safely managed at every point along the service chain.

As strange as it may seem, one of the first steps on the ladder of opportunity is a toilet. That’s because improved sanitation helps improve quality of life, offers healthier living environments leading to more attractive and competitive cities, and to economic and social gains for society more broadly. So, World Toilet Day is an apt time to recognize that proper sanitation is key to building thriving and healthy cities. 

This is particularly important because over half of the world’s population is now urban, representing some 3.9 billion people, and by the end of the next decade, 60% of humanity will live in cities. Today, nearly one billion people live in urban slums with poor or no sanitation. More than half of those living in urban areas do not have toilets which provide a full sanitation service —that is containment, collection, conveyance, treatment, and disposal/reuse. Additionally, 16% of urban dwellers do not even have a basic sanitation service.

The Sustainable Development Goals provide new impetus for cities to be inclusive, safe, and resilient, to ensure citizens’ health and wellbeing, and to provide access to sustainable water and sanitation services.

The World Bank has an essential role to play in this, by supporting our client countries in their efforts to provide their citizens with sanitation. However, we have also learned that there is no single, simple solution to the urban sanitation problem. We need locally relevant, innovative responses that consider the whole sanitation service chain. These solutions must put customers first and focus just as much on service management as on technology.

The following videos highlight some good practices in ‘Citywide Inclusive Sanitation’ from around the world, offering lessons and insights, and providing creative approaches as examples to other cities and to development professionals. Have a look, and spread the word with #InclusiveSanitation!



Brasilia, Brazil

This example from Brazil shows the power of innovation employed by an efficiently run water and sanitation utility. CAESB has rolled out the use of condominial sewers to all its customers in Brazil’s Federal District; poor and rich alike. The condominial approach is highly participatory and employs different design standards that allow sewers to be shallower and of shorter length, thus greatly reducing their cost when compared to conventional sewerage. Similarly, CAESB takes careful consideration of the capital and running costs of wastewater treatment alternatives as it designs and constructs these plants.

Cochabamba, Bolivia

The residents of Cochabamba are showing the power of community collaboration. In settlements around their ever-expanding city, people have come together to form Water Committees and Cooperatives in peripheral communities, through which they have helped build both decentralized sanitation and water systems, while charging a monthly fee to cover the running costs of the services.

Manila, the Philippines

The two private concessionaires that provide water and sanitation services to the mega metropolis of Manila have embraced a mix of sewers and onsite sanitation solutions to meet the obligations under their contracts. They demonstrate how it is possible for well-run utilities to service septic tanks along the whole sanitation chain, while also operating sewerage and wastewater treatment plants. Furthermore, they provide tailored solutions to their poorer customers, who would otherwise have to defecate and bathe in the street 

El Alto, Bolivia

What’s in a name? Quite a lot, actually, and the name Sumaj Huasi (meaning ‘healthy home’ in Quechua) gives a clue to the work of this foundation in El Alto. The Sumaj Huasi Foundation engages with poor households to provide a full sanitation service to them. This includes urine-diverting toilets, which are an integral part of a chain that results in the conversion of the family’s waste into fertilizer for growing crops. The toilets not only transform homes into healthy environments, but they are also beautified by the families as a proud addition to their houses.

Kenya and Haiti

When it comes to delivering services along the whole sanitation chain, these start-ups in Kenya and Haiti show how it can be done in the poorest of communities. The three ‘container based sanitation’ entrepreneurs charge a fee for providing in-home or public toilets and for the regular collection of their contents. The collected wastes are treated and transformed into fertilizer or fuel.

Citywide Inclusive Sanitation means everybody benefits from adequate sanitation, with human waste being safely managed at every point along the service chain. The cities show-cased in these videos each demonstrate experiences that have embraced such approaches to ensuring the poor are provided with sanitation services. 

The service providers presented here employ a diversity of technical solutions, encompassing, as appropriate, onsite services and sewerage and centralized and decentralized systems, to better respond to each unique situation. They have developed approaches to sanitation service delivery that focus on customer needs.

The videos are meant to provide other cities and service providers with inspiration on World Toilet Day, given the magnitude of the global sanitation challenge. The sanitation service chain may start with the toilet but, as you’ll see from the videos, it does not end there.