This article is based on discussions and materials from the [http://www.susana.org/en/resources/thematic-discussion-series SuSanA thematic discussion] on the topic of [http://www.susana.org/en/resources/thematic-discussion-series/253-sanitation-ladder 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 [http://www.forum.susana.org 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''.<br/>
===Background===
=== 1. Background<br/> ===
==== Development of the sanitation ladder<br/> ====
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.<br/>
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. These steps are 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 ====
[[File:Ladder.jpg|thumb|right|180px|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).<br/>
==== Role Development of the functional sanitation ladder in WASH monitoring<br/> ==== [[File:LadderFunctionbasedladder.jpgpng|thumb|right|180px|Figure 12: TechnologyProposed function-focused based sanitation ladder (JMPKvarnström et al., 20082011)]]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).<br/> === 2. Development of the functional sanitation ladder<br/> ===
[[File:Functionbasedladder.png|thumb|right|180px|Figure 2: Proposed function-based sanitation ladder (Kvarnström et al., 2011)]]In 2011, the paper [http://www.susana.org/en/resources/library/details/2143 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):<br/>
*'''Health functions:'''
**1) Excreta containment
**2) Safe access and availability
**4) pathogen reduction in treatment
*'''Environmental functions:'''
**5) nutrient reuse
**6) eutrophication risk reduction
*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<br/> ====
{| cellspacing="10" cellpadding="110" border="1" style="width: 100%"
|-
| style="width: 516px" | '''PROS'''
| style="width: 534px" | '''CONS'''
|-
| style="width: 516px" |
*(ladder) Simple to understand
*(ladder) Linear concept: appeals to aspirations to move up “social ladder”<br/>
*Can be applied towards international monitoring processes such as<br/> the Sustainable Development Goals (SDGs)<br/>
*It has been applied in practice to support monitoring of sanitation interventions carried out by different development partners<br/>
| style="width: 534px" |
*(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)<br/>
*(ladder) Spontaneous advancement rare in a community, often due to: affordability, lack of awareness of next steps, satisfaction with current step
*Possible negative reactions with “flush toilet” no longer the ultimate goal<br/>
*Various organisations have moved forward with the ladder concept, but operationalisation remains problematic
|}
=== 3. Adaptations of the functional sanitation ladder<br/> ===
{| cellspacing="10" cellpadding="110" border="1" style="width: 100%"
|-
| style="width: 284px" | [http://forum.susana.org/forum/categories/185-thematic-discussion-the-sanitation-ladder-next-steps/11966-tds-week-1-theme-evolution-and-further-development-of-the-sanitation-ladder?limit=12&start=12#12011 SKAT's service level approach to the ladder]| style="width: 783px" | A country-specific service-level approach used by Skat (a Swiss funded water and sanitation organisation) in Moldova.
|-
| style="width: 284px" | [http://www.welthungerhilfe.de/en/about-us/media-centre/artikel/mediathek/orientation-framework-wash.html Welthungerhilfe 6-Rung Functional Ladder]<br/>| style="width: 783px" | 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<br/>
|-
| style="width: 284px" | [http://www.ircwash.org/resources/assessing-sanitation-service-levels IRC’s WASHCost Project Working paper “Assessing sanitation service levels"]<br/> | style="width: 783px" | Outlines a costing perspective for different sanitation and hygiene service levels where different ladder rungs can be translated to different service levels.<br/>
|-
| style="width: 284px" | [http://forum.susana.org/forum/categories/185-thematic-discussion-the-sanitation-ladder-next-steps/12185-tds-week-3-theme-the-way-forwardadaptation-of-the-sanitation-ladder-to-the-post-2015-period#12513 SARAR Transformacion Spanish draft version of the functional sanitation ladder]<br/>| style="width: 783px" | A Spanish draft of the functional sanitation ladder.<br/>
|}
<br/>
=== 4. Criticisms and recommendations for further development of the functional sanitation ladder<br/> ===
*expand Expand on the lower rungs of the ladder to better incorporate basic sanitation and the needs of developing countries<br/>*review 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<br/>*in In rung two, clarify what “accessibility” means, as well as “safe”<br/>*ensure Ensure the indicators for the rungs can be regularly (such as annually) updated*consider 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<br/>
*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 Further incorporate equity, equality and human rights into the functional sanitation ladder
<br/> === 5. Acknolwedgements<br/> Acknowledgements===
The Sanitation Ladder: Next Steps - Synthesis of thematic discussion on SuSanA Discussion Forum. March 2015. [http://www.susana.org/en/ susana.org]
Summary of the Webinar Follow-up to The Sanitation Ladder: Next Steps Thematic Discussion. April 2015. [http://www.susana.org/en/ susana.org]
[[Category:SuSanA_working_group_04_-_Sanitation_systems,_technology_options,_hygiene_and_health]]