The Functional Sanitation Ladder

This article is based on discussions and materials from the SuSanA thematic discussion on the topic of The Sanitation Ladder: Next Steps, which addressed the role of the functional sanitation ladder in the WASH-related post-2015 landscape. The 3-week discussion took place on the SuSanA discussion forum and was led by three thematic experts, Patrick Bracken, Elisabeth Kvarnström, and Ricard Gine with weekly topics of Evolution and further development of the sanitation ladder; The post-2015 agenda & emerging monitoring challenges in the sanitation sector; and The way forward - adaptation of the sanitation ladder to the post-2015 period.

Background

Development of the sanitation ladder

The sanitation ladder was originally a tool that developed from participatory approaches such as Participatory Rural Appraisal (PRA) and Participatory Hygiene and Sanitation Transformation (PHAST). The ladder aimed at providing community members with a visual guide to different sanitation options, providing information on a range of factors (e.g. cost, convenience, upgradeability etc.) in order to facilitate household and communal sanitation planning and decision making. These ladders are still in use in some areas. The ladders which developed in this way are centred on particular latrine/ toilet technologies, appropriate to the given context, with advancement up the ladder generally accompanied by a more complex technology, theoretically providing improved service. While serving as a basis for communal decision-making, these ladders tend to have an aspirational character - that households or communities, once on the ladder, would seek to move up the ladder, according to their means.

Generally, a set of agreed criteria are used to identify suitable sanitation options. One of the better-known examples of these types of ladder is the Lao PDR Sanitation Ladder, with its 6 steps:

1. improved traditional practice
2. conventional pit latrine
3. lid or cover latrine
4. ventilated Improved Pit Latrine
5. pour flush latrine
6. septic tank toilet.

Role of the sanitation ladder in WASH monitoring

Figure 1: Technology-focused sanitation ladder (JMP, 2008)

While the ladder concept was developed to help communities decide on the sanitation service appropriate to them, it has also been used to describe the state of existing sanitation services, and subsequently for monitoring sanitation systems. In 2008, the JMP (WHO/ UNICEF Joint Monitoring Programme for Water Supply and Sanitation) adopted a version of the sanitation ladder for monitoring purposes for progress towards the MDGs, based on technological definitions of unimproved, shared and improved sanitation technologies (see Figure 1).

Development of the functional sanitation ladder

Figure 2: Proposed function-based sanitation ladder (Kvarnström et al., 2011)

In 2011, the paper The Sanitation Ladder – a need for a revamp? by Kvarnström et al raised questions regarding the use of a technocentric sanitation ladder for monitoring or promoting sanitation systems in order to achieve global sanitation targets. Kvarnström et al’s paper criticized the focus on a technology-based sanitation ladder, and proposed the use of a “functions-based” sanitation ladder, with the aim that the outcome and impact of a functioning sanitation system should be the focus of sanitation monitoring and thus be technically neutral. See figure 2 for the functional sanitation ladder, which includes the following functions, in ascending order (which each have their own indicators):

Health functions:

• • 1) Excreta containment
  • 2) Safe access and availability
  • 3) greywater management
  • 4) pathogen reduction in treatment

Environmental functions:

• • 5) nutrient reuse
  • 6) eutrophication risk reduction
  • 7) integrated resource management

Applicability of the functional sanitation ladder

The use of the ladder is primarily associated with a role in monitoring (nation-wide and global), but can be considered to have additional roles in advocacy, influencing policy, and as a resource for implementation. For example, a municipality may use the new ladder to: monitor, assess the status quo, compare to other neighbourhoods/ cities in an objective fashion, identify gaps, and based on this, lobby for funds and propose new sanitation interventions.

In the context of using the functional sanitation ladder in the post-2015 Sustainable Development Goal (SDG) monitoring, the ladder steps most closely relate to the following proposed SDG targets:

• Target 6.1 by 2030, achieve universal and equitable access to safe and affordable drinking water for all
• Target 6.2 by 2030, achieve access to adequate and equitable sanitation and hygiene for all, and end open defecation, paying special attention to the needs of women and girls and those in vulnerable situations

Pros and cons of the functional sanitation ladder

PROS

CONS

(ladder) Simple to understand (ladder) Linear concept: appeals to aspirations to move up “social ladder” Priority setting: only those systems that satisfy the requirements of the previous rungs go through, with the primary priorities as: containing excreta and assuring privacy, access, and acceptability Can cover dimensions to ensure the realisation of the multi-dimensional benefits of sanitation and service expectations Recognizes the context, and that a one-size fits all technological approach can be limiting to new technologies and different contexts Eases the framework for upscaling of new sanitation technologies As the ladder concept is accepted and well-known, the functional ladder can impact existing monitoring and inspire shift to a function-focus Concentrates on the function of entire systems, not just user interfaces Can be applied towards international monitoring processes such as  the Sustainable Development Goals (SDGs) It has been applied in practice to support monitoring of sanitation interventions carried out by different development partners

(ladder) Linear concept: reality often not linear - the ladder does not reflect multiple dimensions; and different functions are not always viewed in a culturally euro-centric concept of “climbing up” (alternate suggestions might include a score-card system, service level approach or multi-part core monitoring indicator) (ladder) Spontaneous advancement rare in a community, often due to: affordability, lack of awareness of next steps, satisfaction with current step Can fade out local priorities and stakeholder preferences Perspective that for some, if they aim to start at the bottom of the ladder, they may possibly miss out on opportunities to start higher up the ladder More complicated to understand for policy-makers, vs. technology-based More information required for assessment and analysis, vs. technology-based Top rungs (related to other SDGs) are more academic than pragmatic, while lower rungs don’t discrminate among people with poor access to sanitation Possible negative reactions with “flush toilet” no longer the ultimate goal Various organisations have moved forward with the ladder concept, but operationalisation remains problematic

Adaptations of the functional sanitation ladder

SKAT's service level approach to the ladder	A country-specific service-level approach used by Skat (a Swiss funded water and sanitation organisation) in Moldova.
Welthungerhilfe 6-Rung Functional Ladder	Used a 6 rung function-based ladder to monitor progress in the sanitation and hygiene status of partner communities to specifically consider their project environments
IRC’s WASHCost Project Working paper “Assessing sanitation service levels"	Outlines a costing perspective for different sanitation and hygiene service levels where different ladder rungs can be translated to different service levels.
SARAR Transformacion Spanish draft version of the functional sanitation ladder	A Spanish draft of the functional sanitation ladder.

Criticisms and recommendations for further development of the functional sanitation ladder

• Expand on the lower rungs of the ladder to better incorporate basic sanitation and the needs of developing countries
  
• Review the indicators to ensure that they, and the outcomes of the information that they produce, relate to SDG targets 6.1-6.3 and are relevant for decision-makers
  
• In rung two, clarify what “accessibility” means, as well as “safe”
  
• Ensure the indicators for the rungs can be regularly (such as annually) updated
• Consider the development of add-ons/ supportive documents ex. for cost increases with each rung of the ladder, or for case studies and good practice databases
  
• Population-based surveys and national censuses may not provide adequate data and other sources to collect data may be necessary (with a possible cost increase); a shift to more qualitative data may also be necessary.
• How to approach the different assessment levels, i.e. in areas with varying levels of sanitation service, system boundaries may be set at different levels, for example, the individual project level or city level.
• Further incorporate equity, equality and human rights into the functional sanitation ladder

Acknowledgements

The Sanitation Ladder: Next Steps - Synthesis of thematic discussion on SuSanA Discussion Forum. March 2015. susana.org

Background Information for “The Sanitation Ladder: Next Steps” Thematic Discussion. February 2015. susana.org

Summary of the Webinar Follow-up to The Sanitation Ladder: Next Steps Thematic Discussion. April 2015. susana.org