Attachment 11_AID-696-A-16-00008 Sludge Management and Emptying Services.pdf

Submission Date: March 30, 2018

Cooperative Agreement Number: AID-696-A-16-00008

Submitted to: AOR, Nicole Mukunzi

Submitted by: Eveline Viegas, Chief of Party

SNV USA

Queen’s Land House, KG 563 Street, BP 1049 Kigali - Rwanda Tel: +250 781 849 876 Email: eviegas@snvworld.org

ISUKU IWACU

Sludge Management and Emptying Services Assessment May 2018

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Sludge Management and Emptying Services Assessment

FINAL REPORT

By

Aime Tsinda

For

SNV through ISUKU IWACU Project

May 2018

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Table of content

Table of content

Acknowledgments

List of tables

List of figures

Acronyms and Abbreviations

Executive Summary

1. Setting the Scene

1.1. Introduction

1.2. Background

1.3. Objectives

1.4. Organisation of the Report

2. State-art and Context

2.1. Introduction

2.2. State-art

2.2.1. Sanitation Demand

2.2.2. Sanitation Supply

2.2.3. Sanitation services and service providers

2.2.4. Faecal Sludge and Sanitation Service Chain

2.3. Context

2.3.1. Socio-economic context

2.3.2. Institutional arrangement for sanitation and faecal sludge management

2.3.3. Policy and Legal Framework for sanitation and faecal sludge management

3. Methodology

3.1. Desktop Research

3.2. Key Informant Interviews (KII) and focus group discussions (FGDs)

3.3. Survey

3.3.1. Population

3.3.2. Sampling Design

3.3.3. Training and Piloting

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3.3.4. Mapping of the sampled households

3.3.5. Field Work Organization

3.3.6. The Quantitative Data Analysis and Tabulation Plan

3.3.7. Qualitative Data Analysis

3.4. The Quality of the Data – Quality Assurance

4. Findings

4.1. Socio-Economic Characteristics of Survey Respondents

4.2. Distribution of the existing sanitation facilities in the sampled areas of study Districts

4.3. Satisfaction and dissasfaction with the current sanitation facilities

4.4. Characterizing household demand for sanitation improvements

4.4.1. Households at the different stages of demand for sanitation improvements

4.4.2. Demand and household social-economic status

4.4.3. Demand and willingness to pay

4.4.4. Demand and preferred sanitation facility

4.4.5. Education on sanitation improvements and stage of demand

4.4.6. Pit emptying, re-emptying times

4.4.7. Motivations to demand for sanitation improvements

4.5. Sanitation information communication mechanisms

4.5.1. Education and sensitisation media in study areas

4.5.2. Communication mechanisms

4.6. Availability and accessibility of sanitation products and services

4.6.1. Availability of manual emptiers and mechanical pit-emptying service providers/vacuum trucks 57

4.6.2. Availability and accessibility of masons and pit diggers

4.6.3. Availability and accessibility of retailers and wholesellers

4.6.4. Availability and accessibility of revolving funds, SACCOs and MFIs

4.6.5. Self-community help through umuganda

4.6.6. Role of Government and NGOs/CBOs

4.7. Willingess to pay and affordability for sanitation related products and services

4.8. Barriers and Challenges to the Promotion of Sanitation Value Chains

4.9. Schematic model to stimulate demand and promote supply markets for sustainable sanitation improvements

5. Conclusions and recommendations

5.1. Conclusion

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5.1.1. Existing sanitation situation in study areas

5.1.2. Stimulating for demand for sanitation improvements in study districts

5.1.3. Promoting sanitation related products and services in study districts

5.2. Comparative analysis

5.3. Areas for further assessment

5.4. Recommendations

References

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Acknowledgments

Special thanks to all the stakeholders, local and national government officials for their time and invaluable support during the assessment of faecal sludge management.

We would especially like to thank all the supply chain actors (households in the villages, suppliers including masons, pit diggers, pit emptiers, wholesalers and manufactures, SACCOs, MFIs, NGOs, etc...) for their time and cooperation in participating in this assessment.

We also extend our sincere gratitude to SNV through ISUKU Iwacu Project for all support we get during this assessment. We also thank the assessment research team for the work well done.

A number of experts provided comments on the draft of this report and we particularly thank Professor Pamela Abbott from the University of Aberdeen, UK.

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List of tables

Table 1. Roles and responsibilities of key institutions related to sanitation and faecal sludge management in Rwanda Table 2. Analysis of key policies, laws and plans relevant to faecal sludge management in Rwanda Table 3: Sampling of the number of households and villages in all study districts Table 4. Socio-economic characteristics of the surveyed respondents (%) Table 5. Distribution of improved sanitation systems (a) and shared usage according to JMP definition (b) in the study districts Table 6. Satisfaction and dissatisfaction of respondents with the existing sanitation facilities in all study areas Table 7. Sanitation facility distance from motor (access) route per the Districts Table 8. Distance of disposal sites from the households Table 9. Proportion of households at the different stages of demand for sanitation improvement by the study districts Table 10. Comparison of households in the demand stages with respondents's level of education Table 11. Proportions of respondents willing to pay for installing private sanitation and the stages of demand across the districts Table 12. Stage of demand and preferred sanitation technology across the districts Table 13. Pit or toilet re-emptying times across the districts Table 14. Frequency of toilet re-emptying in years across the districts Table 15. Model for stimulating demand and promoting supply markets for sanitation improvements in study areas

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List of figures

Figure 1. Household demand model adapted from Jenkins and Scott (2007) Figure 2. Rwanda and its neighbouring countries Figure 3. Variation of demand with satisfaction between the Districts Figure 4. Reasons of dissatisfaction with the current sanitation facilities Figure 5. Stage of demand for sanitation improvement occupancy status of household across the study districts Figure 6. Stage of demand for sanitation improvements by Ubudehe category of households Figure 7. Proportion of households by the sex of head of household at stages of demand for sanitation improvement across study districts Figure 8. Proportion of households by location at stages of demand for sanitation improvement across study districts Figure 9. Comparison of households along the demand process with education on sanitation improvements Figure 10.Areas of Education across the Districts Figure 11. Relative importance of factors that motivate households to install own sanitation facilities by district Figure 12. Communication channels across districts Figure 13. Availability and accessibility of manual emptiers in study districts Figure 14. Availability and accessibility of mechanical pit-emptying service providers/vacuum truck in study districts Figure 15. Availability and accessibility of both skilled and assistant masons in study districts Figure 16. Availability and accessibility of pit diggers in study districts Figure 17. Channels of getting information related to sanitation service providers in all study districts ... 61 Figure 18. Availability and accessibility of retailers in study districts Figure 19. Availability and accessibility of wholesellers in study districts Figure 20. Availability and accessibility of revolving funds/tontines in study districts Figure 21. Availaibility and accessibility of SACCOs in study districts Figure 22. Availability and accessibility of MFIs in study districts

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Acronyms and Abbreviations CBOs Community-Based Organisations

CDF Common Development Fund, Rwanda

CHWs Community Health Workers

CLTS Community-Led Total Sanitation

DPs Development Partners

EDPRS Economic Development and Poverty Reduction Strategy, Rwanda

EICV Integrated Household Living Conditions Survey, Rwanda

FDI Foreign Direct Investment

FGDs Focus Group Discussions

FS Faecal Sludge

HAMS Hygiene et Assainissement en Milieu Scolaire, Rwanda

HSPI Hygiene and Sanitation Presidential Initiative, Rwanda

GDP Gross Domestic Product

GNI Gross National Income

GNP Gross National Product

JMP Joint Monitoring Programme

MAPET Manual Pit Latrine Emptying Technology

MDGs Millennium Development Goals

MDI Multi-Dimensional indicators (MDI) of Poverty

MFIs Microfinance Institutions

MINALOC Ministry of Local Government

MINECOFIN Ministry of Finance and Economic Planning

MININFRA Ministry of Infrastructure, Rwanda

MoE Ministry of Environment

MoH Ministry of Health

NGOs Non-Governmental Organisations http://www.google.ca/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0CC0QFjAA&url=http%3A%2F%2Fwww.statistics.gov.rw%2Fsurvey%2Fintegrated-household-living-conditions-survey-eicv&ei=okSAU5v-JY3jO6SmgYgF&usg=AFQjCNGJmxVE8fmyhZHX_RX1PrprCGEUvw&cad=rja http://en.wikipedia.org/wiki/Gross_national_product

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NISR National Institute of Statistics of Rwanda

NST National Strategy for Transformation

ODF Open Defecation Free

REMA Rwanda Environment Management Authority

RWF Rwandan Francs

SACCO Savings and Credit Cooperatives

SNV Netherlands Development Organisation

SPSS Statistical Package for the Social Sciences

SSIPs Small-Scale Independent Providers

UN United Nations

UNDP United Nations Development Programme

UN-Habitat United Nations Human Settlements Programme

UNICEF United Nation’s Children Education Fund

VIP Ventilated Improved Pit

VUP Vision 2020 Umurenge Programme

WASAC Water and Sanitation Corporation

WSP Water and Sanitation Program http://www.google.ca/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&sqi=2&ved=0CCoQFjAA&url=http%3A%2F%2Fwww.undp.org%2F&ei=FEuAU8jiHuqm0QWolYDwCQ&usg=AFQjCNEULm1nTZluj9MieuoBxcpsA_IH1g&cad=rja

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Executive Summary

Effective management of the excreta or faecal sludge (FS) emptying, transport and disposal mechanisms from the on-plot latrines in both urban and rural areas is critical for the sustainability of sanitation. Since 2016, a USAID-funded Iwacu Project directly supports and contributes to the Government of Rwanda efforts to improve access to sanitation in Rwanda.The overall goal of the “Isuku Iwacu Activity” is to increase local ownership and capacity to deliver sustainable, high quality sanitation and hygiene services to decrease childhood stunting.

To accomplish this goal, Isuku Iwacu Project will improve access to and encourage correct, consistent use of household sanitation and hygiene facilities by (i) directly supporting and contributing to the government led efforts to improve access to sanitation in Rwanda, and (ii) promoting districtwide, private sector-driven household sanitation and hygiene interventions and on district- and national-level capacity development. In March 2018, Isuku Iwacu Project commissioned a study to assess sludge management and emptying services. The assessment characterized both the demand side (households’ needs and preferences) and supply side (service providers) and any other factors or actions shaping the status of sludge management and latrine emptying services. A comparative case study in seven districts of Eastern (Rwamagana, Kayonzza and Ngoma) and Sourthern (Muhanga, Ruhango, Nyanza and Huye) provinces. The assessment involved policy analysis, household stratified probability survey (n=1000) complemented with focus group discussions (FGDs) and interviews. These data have been analysed in the context of two main themes – sanitation demand and sanitation markets.

Existing situation: Almost all households (99%) reported having access to sanitation facilities. The most common sanitation facilities used by households are open pit latrine without slab (82% of households);

followed by pit latrine with a slab (13.6%), flush (Flush toilet connected to sewerage system, pour flush connected to septic tank) (2.8%) and other few both improved categories (VIP, UDTT or Eco-san, composting toilet) and unimproved categories (Bucket, shared/public toilets, pour flush to elsewhere not to piped sewer system...).

According to the JMP definition, few households have access to improved sanitation. A sanitation facility is considered improved if it is a flush or pour- flush toilet connected to a piped sewer system /septic tank/pit latrine, VIPs, pit latrine with slab, a composting toilet and other special cases (e.g. urine diverting dry toilet);

but under the JMP definition, these facilities cannot be shared. Overall, out of the total 1000 households, only 152 (16 %) are considered to have access to improved sanitation facility. These results show that there is a need in all seven case study Districts to improve access to sanitation because most residents do not have hygienic sanitation facilities.

Sanitation Demand: A five or six progressive decision-stage sanitation demand model revealed that Kayonza had the highest level of “no preference” (68.5%) while Ngoma had the highest level of preference (17.0%). Overall, all districts have high level of “intent” with the district of Muhanga taking the lead (93.1%), followed by the district of Rwamagana (90.6%). The district of Nyanza had more proportion of “choice” (33.3%) while the districts of Ngoma, Rwamagana, Muhanga and Nyanza had similar proportion of “installed and improved”, but the district of Ruhango had higher proportions of “installed but unimproved” (66.7%).

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The more disadvantaged households with respect to ubudehe categories 1 and 2, and households with no education were less likely to be on the demand process with varied proportions across the districts. Some of the households who expressed to be willing to pay were not ready to install better systems in the next 12 months because they had not yet on the process to demand for improvement. The low demand for sanitation improvements was associated to a few barriers including poverty and low willingness to invest in sanitation for most people.

Sanitation markets: It was clear that both skilled and assistant masons and pit diggers, retailers, revolving funds and SACCOs are much available and accessible in all study districts, while MFIs, the wholesellers, manual emptiers and mechanical pit emptying service providers/vaccum trucks are less accessible or not available in most of the study districts- except for few districts.

There is evidence of fairly demand for products and services provided at the right price, with more than half of households being prepared to pay for the construction materials, the installation of improved sanitation facilities and maintenance and cleaning services, although those in Kayonza and Muhanga were noticeably less willing to pay for construction materials, installation of improved sanitation facilities and maintainance and cleaning services.

However, in all districts, the households showed a relatively low level of willingness to pay for emptying, transport and treatment and disposal of sludge. This may be because the services have not been available and thus there is less understanding of the benefits of using them.

When asked about the price of the sanitation-related products and services during the survey, most of the households (more than 70%) said that the construction materials, construction for sanitation facility and sanitation related maintainance products and services are very expensive. However, most households showed a relatively low level of awareness of the price for emptying, transport and treatment and disposal of sludge. Again, this may be because these services are very limited in study districts and so there is less understanding of the cost.

Although the cost or poverty is a key barrier, it is evident that the main barrier is willingness to invest in sanitation for most people. Investing in sanitation is not a priority for most of households across all districts.

The state and other stakeholders are expected, to stimulate demand by making citizens aware of the importance of investing in sanitation.

Based on the above analysis and the main challenges discussed, the Government of Rwanda in collaboration with other stakeholders (including SNV through Isuku Iwacu Project) should consider the following key policy recommendations:

The demand challenge is characterised by households in the districts of Kayonza and Muhanga where demand for household sanitation was limited by sanitation facilities which are poorly built and not safe.

The solution here to stimulate demand for improved sanitation at a household requires addressing the combination of these issues, although improving access more generally can be achieved through catalyzing sanitation supply.

It was found that the differences in sanitation coverage, barriers, motivations and level of demand for sanitation improvements within and between districts may relate to the geo-physical and socio-economic characteristics of the areas/districts. These call for the need to tailor programmes to meet the local demand

11 | P a g e for sanitation improvements, specific for each community. Appropriate interventions (a combination of education on sanitation construction regulations, subsidies on construction materials, support to develop the emptying services, etc) should be carried out for the category of households at each stage of demand through engagement of key stakeholders to facilitate their demand progression to actualization.

Stimulating demand for sanitation improvements will enhance acceptability and usage of the facility to result in increased access and minimize waste of resources.

Appropriate information for stimulating demand is of paramount importance in the study areas.

However, this an only yield sustainable adoption when it is timely, rightfully and continuously communicated to the right people who need them most. The information may be aimed to educate, create awareness or sensitize on sanitation issues and when appropriately done, is expected to improve the impact of any sanitation intervention. Both formal and informal education systems that attempt to impart knowledge, awareness or behavioural change to better hygienic sanitation practices at households will increase the level of access to improved sanitation in the study areas.

The market challenge is characterised by households in districts of Ngoma, Kayonza, and Muhanga where the main challenges include the lack of availability and accessibility of service providers (e.g. manual emptiers, etc.) and less willing to pay for construction materials, installation of improved sanitation facilities and maintainance and cleaning services. While this is described as a market challenge, the solution is not necessarily a market solution: Access may be improved by a combination of education on improving sanitation and hygyiene, support to develop the emptying services, etc.

However, the findings have also revealed that there is lack of marketing skills among service providers who do not promote their products and services. In other words, most households are not aware of the available sanitation products and services. Other gaps that need to be filled include: developing more appropriate latrine options for low-income households, assisting service providers with generating demand, and creating the enabling environment to maximise the effectiveness of the service providers. The majority of service providers mentioned that their potential customers are households who are financially better off;

thus few households in the study areas can afford to pay these services and this affects the ability of households to adopt desired improvements.

Despite these gaps, there exist within the study areas various systems of finance that help households to afford some sanitation products and services. In all seven districts, households indicated that instalment payments arrangements would increase their ability to pay for sanitation products and services.

Service providers were sometimes prepared to extend credit to customers that they knew and trusted, and other residents borrowed through savings and loans clubs.

Formal loans from MFIs and SACCOs are generally used for starting-up businesses rather than investing in home improvements, including sanitation. Also, residents that take out small loans with formal financial institutions to start small businesses are able to invest in improved sanitation from the profits they generate.

A few households in the case study areas reported that they made use of microfinance credits and used them for investments in sanitation improvements, but the opportunity of access to microfinance options was still limited in all study areas (to a greater or lesser extent).

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In addition, in all case study areas sanitation is often a low priority compared with other pressing needs.

Poverty can also make it difficult for the poor to save and to get credit to invest in sanitation. In fact most poor people do save but their saving is mainly for risk mitigation (unexpected emergency such as illness) or anticipated expenditure such as costs associated with children’s schooling.

One way to increase affordability would be to reduce costs, but the service providers have few options for doing so. With current technologies, inputs are dominated by materials whose prices are not within the control of sanitation enterprises. There is therefore a limited scope to reduce price, except by skimping on materials, with a consequent impact on durability and safety. Another way to offset labour costs in the majority of the cases is the construction of the pit latrine being undertaken by family members.

However, in the absence of any major technical advance in designing low-cost products, the price of sanitation products and services will not change much. Furthermore, there may be other cost reductions made through technical innovation that would be acceptable to users once research was promoted.

Research and development towards users-acceptable lower-cost designs should be encouraged, and if any of these are marketable, the suppliers are there to make them available.

While cost reduction is an important strategy to improve sanitation for the poor living in both rural and urban areas, it cannot be achieved without the involvement of the masons and emptiers.There is a need for training masons and emptiers to bring to the market acceptable minimum standards and design information. However, the issue is not so much the inability to afford the cost but the unavailability of good quality products that are acceptable to potential consumers. What is necessary is the development of appropriate products, at the right price, available (place) and known through promotion. However, stimulating the supply of and demand for sanitation services requires determined effort of different players including state, NGOs, CBOs, private sector (private enterprises and small-scale service providers) and residents.

The state and other stakeholders are expected, to stimulate demand by making citizens aware of the importance of investing in sanitation and developing appropriate emptying services and sanitation products. This also involves engaging key stakeholders including the beneficiary households, to identify the specific local conditions in each area as well as the barriers and probable motivations and develop appropriate and acceptable solutions for each category of households in the process to improve to adequate sustainable sanitation.

From our assessment it is evident that a single strategy is highly unlikely to improve levels of access to improved sanitation in study areas. One strategy recommended is to to use participation and engagement throughout the process of improving sanitation to understand the barriers and motivations for sanitation in the context of the community. Understanding this context is key to understanding whether strategies from other locations are transferable.

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1. Setting the Scene

1.1. Introduction

The World Health Organization (WHO)/UNICEF Joint Monitoring Programme (2015) estimates that 32% of the world's population does not use a safe sanitation facility and 9% a safe water source [1]. In Rwanda, about 83% of households use improved sanitation facilities. Rural areas are more adversely affected with access to improved sanitation facilities at 81% whereas access in urban areas is at 93 % [2]. Moreover, although more than 90% Rwandans in rural areas own toilets, only 46% meet the required hygiene and structural standards [3].

Diseases related to unsafe water, sanitation and hygiene (WaSH) products and services are major causes of mortality and morbidity [4]. In seeking progress, WaSH practitioners across the globe facilitate interventions to provide improved products and services and encourage preferred WaSH behaviours. Many of these approaches focus on stimulating demand for WaSH products and services by motivating changes to personal behaviours [5]. Recent studies describe a mismatch between supply and demand in the existing sanitation markets [6-8].

1.2. Background

Isuku USAID-funded Iwacu Project directly supports and contributes to the Government of Rwanda efforts to improve access to sanitation in Rwanda as highlighted in various government policies1.This project is being implemented by a consortium of Non-Governmental Organisations headed by SNV and including World Vision International and Water for People.

1.3. Objectives

The overall goal of the “Isuku Iwacu Activity” is to increase local ownership and capacity to deliver sustainable, high quality sanitation and hygiene services to decrease childhood stunting.

To accomplish this goal, Isuku Iwacu Project will improve access to and encourage correct, consistent use of household sanitation and hygiene facilities by (i) directly supporting and contributing to the government led efforts to improve access to sanitation in Rwanda, and (ii) promoting districtwide, private sector-driven household sanitation and hygiene interventions and on district- and national-level capacity development.

Therefore, SNV through Isuku Iwacu Project conducted a sludge management and emptying services assessment for Isuku Iwacu Activity. This was done through sludge management value chain from generation up to final treatment and disposal to understand the sludge management and emptying service market mix, i.e. demand and supply. Specifically, the assessment characterized both the demand side

1 Relevant policies include the Vision 2020, the draft document of Vision 2050, the National Strategy for Transformation/Seven Year Government Programme (7YGP) (2017-2024), the Water and Sanitation Sector Strategic Plan (2018-2024), etc.

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(households’ needs and preferences) and supply side (service providers) and any other factors or actions shaping the status of sludge management and latrine emptying services.

1.4. Organisation of the Report

This report contains five sections. Section 1 sets the scene for the assignement by providing background and objectives outlined the specific focus and organisation of the report. Section 2 presents the state of the art, provides the country context, an overview of the sanitation situation in Rwanda, analyses the policy and legal framework of faecal sludge management, and describes the institutions arrangement of the WSS sector. The study methodology and methods are discussed in section 3. Section 4 presents the findings of the assessment. Section 5 presents the conclusions and recommendations of the report.

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2. State-art and Context

2.1. Introduction

Demand and supply are two important aspects of the sanitation marketing literature. The supply includes the availability of finance for purchasing, servicing, building and maintaining sanitation facilities and the availability of the necessary goods and services - the extent to which there is a sanitation market. Finance is also necessary for service providers to invest in establishing and operating businesses. To operate efficiently markets including financial markets require that there is adequate demand for the product or service and that there are private sector or other providers, such as non-profit or social marketing organizations, prepared and able to meet the demand.

2.2. State-art

2.2.1. Sanitation Demand

Efforts to improve access to sanitation have mainly focused on hardware interventions [9, 10]. This can be linked to the general understanding of progress as reported by the Joint Monitoring Programme (JMP) on sanitation which considers the number of facilities installed [1]. Hardware intervention may be necessary as direct support to the economically most vulnerable households/communities who may not afford adequate sanitation from a human rights perspective. Provision of sanitation hardware without considering the local demand may result in the facilities either being abandoned/misused or never used at all [11, 12] which amounts to a wastage of resources. Integrated approaches identify the software attributes necessary for any sanitation hardware interventions, through the involvement of all stakeholders [13, 14] and has proved useful in identifying strategies for scaling-up sustainable access to improved sanitation [15] in low-income countries.

Many reasons have been put across to explain the slow progress in improving sanitation achieving and include demographic, technological, financial, regulatory, institutional, and political reasons (Isunju et al., 2011; Kariuki, 2011) but the one aspect that still comes out clearly is the conventional supply-led model that has failed to generate demand for improved sanitation among targeted households [16-18].

Lessons learnt worldwide show that the provision of facilities does not guarantee proper usage, and efforts should not only reduce the huge number who remain without access to a toilet but also the huge number who do not use facilities hygienically even when they are available [19, 20]. Understanding the local demand will guide in identifying appropriate software attributes to go with the hardware to increase acceptability and usage.

The attributes may involve: empower users with knowledge, enable a change in behaviour, create demand for services, facilitate establishment of supply chains, and improve the planning and implementation of hygiene and sanitation projects to go with appropriate hardware [21-28]. Hence, the importance to understand the households demand status and identify the barriers and catalysts at the different stages in

16 | P a g e the sanitation demand decision process model, in order to develop appropriate intervention strategies [28, 29].

Furthermore, a greater understanding of the drivers of dissatisfaction with sanitation may enable interventions to be better targeted at stimulating demand for improvement A systematic review of satisfaction with existing sanitation suggests that users of shared communal/public toilets are more satisfied than users of pit latrines, whether shared or not, and the most satisfied are those that have private improved sanitation [30] A recent research in informal settlements in Kisumu and Kampala has found that residents prefer shared improved toilets to communal/public ones [20, 31]. Cleanliness is the major factor influencing the acceptability of toilets [32]. Other factors include sharing with too many people, distance to the toilet, accessibility day and night and privacy. Affordability is a major factor for communal/public toilet users.

The same study found that 51% of respondents were dissatisfied with their sanitation but provide no information on how satisfaction varies by type of toilet. A study in Accra, Ghana found that 81% of users of public toilets were dissatisfied.

All these show that household demand for improved sustainable sanitation is complex and is defined in a variety of ways drawing on psychological [29], economic theory [33] and engineering [34] aspects. It is influenced by a number of factors that include, among others, demographic characteristics, availability, reliability, cost and convenience and household attitudes [34], household awareness and understanding, technical, competing priorities, tenancy and geophysical settings [16, 34].

Figure 1. Household demand model adapted from Jenkins and Scott (2007)

Drawing from the works of Jenkins and Scott and Parry- Jones, household demand for sanitation improvement is considered as a decision behavioral process based on psychological, economic and engineering theories and defined as a process of an informed expression of willingness, and ability, to adapt to a new or better sanitation and appropriate sanitation services of preference [8].

Behavior change can create demand for sanitation improvement, and numerous models have been suggested to assess behavior change [14, 35, 36] and demand [29, 37] for sanitation improvements. This study has adapted the three progressive decision stages model developed by Jenkins and Scott (2007) and, extended to a five-stage model to include those who have not considered installing an improved sanitation system (No preference) and the actualised category of installed (Figure 1).

In the model “Preference” indicates that the household has considered installing a household sanitation facility (toilet), but do not intend to install within a year; “Intent” indicates they have a low to medium likelihood of installing within a year; and “Choice” indicates a high likelihood of installing within a year and “Installed” is respondents who have indicated that they have already installed a household sanitation facility. Preference, intent and choice are further grouped into “Demand”.

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2.2.2. Sanitation Supply

Although demand is important in sanitation, a key component of sanitation market is supply. Initially four, and more recently seven, factors relating to supply are discussed in the sanitation market literature as being key to having a functioning market [38]. These factors are product, price, place, promotion, policy, partnership and people.

According to Peal, Evans, and Van Der Voorden [19], the product can be an item (e.g. a latrine) or a service (e.g. pit emptying) or even a change in sanitation practices like adopting hand washing or stopping open defecation. Sy et al (2014) argue that the potential market for improved on-site sanitation is huge. For installing latrines, markets include the sale of materials and components and the manufacture of prefabricated cement products used to build latrines. It also includes associated services and products, financial services, repairs, pit emptying and sewage disposal [39].

However, the price of sanitation products might be the greatest barrier for those most urgently in need of

it. Consequently, market-based solutions to sanitation need to ensure the development of affordable options and various price ranges [40]. The financial burden on the user can be reduced by:

• Cutting transaction costs-transporting materials;

• Spending time and money on permits or connection fees;

• Spreading the capital cost out over time-savings;

• Implementing credit programs for home improvement that allow households to structure payments to match their income stream;

• And constructing the latrine in stages over time to avoid having to come up with a lump sum.

However, there is insufficient private sector involvement in the sanitation sector because of lack of a commercial market and low potential for income generation [10, 41-43]. Promotion of sanitation might include something which helps to get the customers' attention and convince them to buy the product or make use of the service [29]. However, often the key users of the services, particularly women who are traditionally involved in the health of a household, are not aware of the services available [8, 44, 45].

In the case of sanitation supply, a fifth P, Policy, was suggested, which alludes to the important influence that legislation/policies might have on the context in which sanitation market is implemented [46]. While agreeing with the importance of policy, USAID suggests a sixth P, Partnership [47]. However, to stimulate the production of appropriate and affordable products, it is important to keep the production numbers independent from the subsidies. Consequently, approaching People, a seventh P, is required.

However, markets are imperfect; they do not always deliver the goods and services people need and some consumers cannot afford to buy goods and services they need. This leads to the need for market-based solutions which go beyond improving supply and require a partnership between a range of actors including government, development partners, NGOs, CBOs, landlords and residents [48, 49].

2.2.3. Sanitation services and service providers

The sanitation service is a set of activities involved in the improvement of sanitation along the sanitation chain right from the provision of resources for the installation/operation of sanitation systems to safe

18 | P a g e disposal/reuse. Such services may include, among others, construction and/or operation of sanitation facilities, emptying, transportation, treatment, disposal/reuse and education/sensitisation on hygienic practices. Appropriate processes are different for formal and informal areas but in all cases the systems must be adapted to meet the needs of the user [13] and ensure that the waste does not get into human contact to avoid transmission of diseases. How this is achieved along the sanitation chain is equally important. The services that are needed include construction/installation of sanitation facilities, supply of sanitation products, and repair/maintenance of facilities, emptying services, transportation/treatment/safe disposal of waste and education/sensitisation of the community on hygienic practices.

There is insufficient private sector involvement in the sanitation sector because of lack of a commercial market, low creditworthiness and low potential for income generation [41, 50]. On the other hand, key users of the services, and particularly women who are traditionally involved in the health of a household, are not aware of the services available [46]. Noticing the mismatch, Murray and Ray suggest that sanitation intervention should then refocus on the “back-end users” (like individual households) rather than “front-end users” (like suppliers of sanitary products), so that demand for sanitation services will trigger the supply, operation and maintenance of sanitation systems [9].

This involves influencing human behaviour in a business approach by understanding consumers’ needs, desires, habits and circumstances as urged by Curtis et al. [51] for the facility to be acceptable and meet the needs of the users rather than what fits them. However, a focus on only one side of the demand–supply market by either increasing the demand for sanitation services or availability of the services may create a mismatch that is likely to undermine sustainability of the sanitation services. How to assess the demand to be met before supplying any sanitation services is important because facilities supplied without considering the local demand have not been properly used [19].

Therefore, the community or individual household should be considered both as potential consumers and suppliers of sanitation services on the demand–supply market and their involvement and consideration in the sector can positively impact service delivery in informal settlements that mostly use on-site sanitation [52]. The targeted community or individual households for any sanitation service should be consulted to ensure that the appropriate services are extended. Hence, the “front-end users” and “back-end users” should all be involved in a collective approach together with other key stakeholders in assessing the local demand for sanitation to ensure sustainability of sanitation services [15].

2.2.4. Faecal Sludge and Sanitation Service Chain

Faecal sludge comprises a mix of solid and liquid waste contents of pits and vaults accumulated in OSS installations, such as pit latrines and septic tanks. These liquids are normally several times more concentrated in suspended and dissolved solids than wastewater [53, 54]. FSM deals with OSS systems, while wastewater management is concerned with sewered sanitation. Faecal sludge may be treated in separate treatment works or co-treated with sludge produced in wastewater treatment plants [55]. OSS is a system of sanitation whose storage facilities are contained within a plot occupied by a dwelling and its immediate surroundings. For some systems, such as double-pit or vault latrines, faecal matter treatment is conducted on-site and by extended in-pit consolidation and storage. With other systems, such as septic tanks and single-pit latrines, the sludge must be collected and treated off-site [56].

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A sanitation service focuses on sustainable sanitation services for all and at scale, by providing access to sanitary latrines, ensuring continuous hygienic use, adopting maintenance and emptying when full, disposing of faecal sludge safely and/or using it for productive purposes. There are two steps in the sanitation service chain for an OSS system. The first step is user interface (from International Water Association, IWA is a toilet, which is achieved by OSS installations. The focus of this report is on the next steps, which are storage (containment), collection (emptying), transport, treatment and reuse/disposal of faecal sludge, collectively known as faecal sludge management, or FSM.

2.3. Context

2.3.1. Socio-economic context

Rwanda is one of the African’s most densely populated countries. Approximately 12 million people live in an area of 26 338 square kilometers, resulting in a population density of 456 inhabitants per square kilometer. Figure 2 shows the map of Rwanda and its neighbouring countries.

Figure 2. Rwanda and its neighbouring countries

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The infant mortality (deaths of children under one year) dropped from 50 to 32 per 1,000 live births between 2010 and 2015 [57]. Under-5 mortality declined from 76 to 50 per 1,000 live births over the same period [58]. The maternal mortality rate declined from 476 deaths per 100,000 live births in 2010 to 210 per 100,000 live births in 2015 [57]. This is consistent with improving access to sanitation. Between 2010/11 and 2013/14, households having access to improved sanitation increased from 74.5% to 83.4% [2].

However, rural areas are more adversely affected with access to improved sanitation facilities at 81% whereas access in urban areas is at 93 % [2]. Moreover, although more than 90% Rwandans in rural areas own toilets, only 46% meet the required hygiene and structural standards [3]. There is also still limited knowledge on behavioural changes regarding sanitation and hygiene.

2.3.2. Institutional arrangement for sanitation and faecal sludge management

The institutional sanitation framework in Rwanda cuts across various Ministries. There are also departments formed under the ministries to discharge the responsibilities of sanitation services and faecal sludge management. The division of stakeholders’ responsibilities regarding sanitation and faecal sludge management are summarised in Table 1.

Table 1. Roles and responsibilities of key institutions related to sanitation and faecal sludge management in Rwanda

Key institutions Roles and Responsibilities

MININFRA Responsible for the development of policies and regulations regarding sanitation, water, urbanisation (including informal settlements) and housing.

MoH Responsible for the development of policies and regulations regarding hospital and hazard waste management and overseeing of the implementation of environmental health related programmes that mitigate water borne diseases. MoH has the lead in household sanitation and hygiene promotion.

MINALOC Responsible for good governance in all local administration levels including environment governance at local level and various community management programmes: Umuganda, Ubudehe, and Imihigo.

MINEDUC Responsible for school sanitation programmes including both implementation in schools and consideration in curricula as well as funding the construction of school latrines and overseeing the implementation of environmental education programmes.

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MINECOFIN Responsible for mobilising funds, coordinating the national budgeting, plannin and allocating them to sectors with a strong role in related aspects of the WS services Subsector sector.

WASAC

Responsible for urban sewerage systems and sludge emptying services, coordination of programmes related to sanitation infrastructure, and funding of the construction of sanitation, water facilities and waste management.

REMA

Responsible for setting up environment standards and regulations, monitoring, inspecting and ensuring compliance with environmental awareness, enforcing environmental regulations and raising awareness about domestic and industrial solid waste management.

RURA

Responsible for ensuring that services are provided according to required standards and that there are good conditions for fair completion in provision of public services.

RSB

Responsible for inspection of sanitation systems of hotels and other businesses along with MoH.

Districts Responsible for implementation of policy and participation in policy making process; complying with the set standards and regulation

DPs), Non- Government Organisations (NGOs), Private sector

Responsible for technical support, providing advice on sanitation policy and funding.

2.3.3. Policy and Legal Framework for sanitation and faecal sludge management

The Water and Sanitation sector in Rwanda is being guided by National Strategy for Transformation and Prosperity (NST 2018/19-2023/24) and the Vision 2050 which is about ensuring high standards of living for all Rwandans; improve quality of life, modern infrastructure, transformation for prosperity. It is also governed by several policies, strategies and plans. Analysis of policy and legal framework is given in Table 2.

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Table 2. Analysis of key policies, laws and plans relevant to faecal sludge management in Rwanda

Policies, laws and plans

Content and reference

Vision 2050 aspirations

Ensures high standards of living for all Rwandans and is aimed to shift Rwandan’s from the current livelihood to the society everyone wants with modern infrastructure and adequate sanitation

Vision 2020 States that all Rwandans will have access to safe drinking water in 2020; at least 80% of the Rwandan population will have easy access to adequate waste management systems and will have mastered individual and community hygiene practices

EDPRS2 Universal access to both safe water and improved sanitation

NST1/7YGP Aims to increase the proportion of the population/households accessing improved source of water from 84.8% (EICV 4) to 100% and the proportion with improved sanitation services/ facilities from 83% (EICV 4) to 100%. It is also aims to increase the proportion of schools with latrines complying with health norms will reach a target of 100% and the proportion for rural households will increase to 100%, any statistical information on the health centres.

Constitution of 2003 revised in

Provides for environmental protection which states that “each citizen has the right to a clean and healthy and satisfying environment”; Everyone is entitled to protect, conserve and promote the environment.

decree from

Stipulates that the disposal of excreta is prohibited on roads and public places in urban areas and towns outside areas planned by public departments for this purpose

A decree from

Enforced the construction of latrines in every house

National Water and Sanitation Policy

Stresses the importance for urban areas to have sanitation master plans which will identify zones for on-site sanitation and collective, off-site sewerage. This policy focuses on simplified, affordable solutions for collective sanitation and outlines solutions for septic tank emptying services and sludge disposal

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Health Policy In line with the health policy, CHWs were established to provide basic preventive services including sensitising community members on hygiene and various diseases at monthly village meetings. Through this policy, environmental health interventions were also strengthened from the national to the village levels. Hygiene inspections were decentralized to empower districts

Environmental Health Policy

Formalised the shift in the government’s strategy to improve health indicators from curative to preventive approaches. Through this policy, the Environmental Health Desk of the Ministry of Health launched a ‘hygiene behaviour change approach’ known as a ‘Community Based Environmental Health Promotion Program (CBEHPP) to build on the community-based approaches tested under Participatory Hygiene and Sanitation Transformation (PHAST) and Hygiene et Assainissement en Milieu Scolaire (HAMS). It is also under this policy that the Hygiene and Sanitation Presidential Initiative (HSPI) was launched, which promotes hygiene and sanitation in homes, schools, offices, restaurants, and other public places.

Urban Housing Policy

Recognizes the need to ensure that people have access to potable water and adequate sanitation facilities

Decentralisation policy

Promotes transparency and accountability for local service delivery through citizen participation in planning. Through this policy, local government is held accountable through the Imihigo (performance contracts) which are agreed between the districts and the President of the Republic with the districts being held accountable for their performance at an annual public event chaired by the President. Imihigo are set based on what households promise to achieve.

Community Development Policy

Anchored on the ubudehe process and relies on cooperation and harmonisation between formal and informal communities, the private sector, civil society, NGOs, central and decentralised government institutions. Through this policy, cooperation and coordination was enhanced through the Joint Action Development Forum

(JADF).

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3. Methodology

This assessment was conducted…