Water supply and sanitation in development

by John M. Kalbermatten

Today's water supply and sanitation technologies are less the result of scientific than of historical development Attempts to improve the health and productivity of people in industrializing countries in the second half of the 19th century concentrated on making an adequate supply of safe water reasonably accessible and on removing excrete from human contact The most effective means of accomplishing this were disputed until the early 20th century, with waterborne sewerage and the requirement for in-house water taps becoming the unquestioned choice only in the 1920s and 1930s. Since then ever more complex and expensive measures have been added to overcome environmental damage caused by an ever-increasing load of pollutants discharged into water courses. This itself is the result of ever increasing water demand powered by modern conveniences (washing machines etc.) which no longer has any relationship with personal health. The simple truth Is that 20-50 lifers per capita of safe water, reasonably accessible, and a sanitary means of disposing of exreta, if they are complemented by appropriate personal hygiene practices, provide the same health benefits as luxurious cistern-flush toilets and multiple-tap house connections.

Of course, not unlike high-quality products or high-convenience service in the private sector, high-convenience water supply and sanitation services tend to be expensive, ranging upwards from 100 dollars per capita for water supply two to three times that for waterborne sewerage. In contrast, facilities designed to serve basic needs can easily be ten times less expensive. Not unlike the situation in the private sector, luxury service tends to be restricted to those who can afford it or have the political power to ensure their access to it. Statistics collected and periodically published by WHO support this conclusion; observations during visits to developing countries easily confirm it. According to WHO, the following service level (coverage) existed in 1980) and 1983).

These figures present an optimistic picture because they do not reveal the often unsatisfactory service, such as interrupted water supply in cities, broken-down handpumps in rural areas, etc., caused by ineffecitve operation and maintenance. They also show that the more prosperous urban population is better served than the poorer rural inhabitants. Visits to urban centers confirm that among the urban population it is the well-to-do who are served and the fringe area and slum residents who lack service.

The figures cited above show that the International Drinking Water Supply and Sanitation Decade, initiated by the United Nations General Assembly in November 1980, has not yet resulted in the hoped-for massive improvements in service to Iower-income groups. Given the economic problems of the early 1980s, keeping pace with population is probably a substantial achievement. More important, however, is the fact that the Decade has focused attention on the sector and has fed to a re-examination of policies and priorities. More and more governments and development agencies are changing from the conventional approach to the implemention of projects better suited to provide water supply and sanitation services to all population groups by using appropriate technologies.

Economic justification

The examination of existing practices which leads to a different approach starts with the recognition that successful development requires healthy, productive people That, in turn, requires the satisfaction of certain basic needs. Among them are education, adequate nutrition, primary health care, water supply and sanitation. Without an adequate supply of safe water, sanitary disposal of waste and good personal hygiene practices, gastro-enteric disease morbidity and mortality rates are high. It is estimated that these diseases are the principal reason why 15 million children below the age of 5 die in developing countries every year. In addition, the loss of productivity caused by water and sanitation-related illnesses and time wasted in carrying water from distant sources is significant. Furthermore, industry and commerce could not operate without adequate water supply and waste disposal. Projects serving the latter and well-to-do residents can be easily justified with appropriate economic and financial rates of return.

Recent work by the World Bank indicates that adequate economic rates of return can also be calculated for projects serving the poor in urban fringe and rural areas, provided technical solutions are appropriate to the circumstances; prices paid for water are used as the value consumers assign to the benefit of water supply and consumer surplus is estimated and included in calculations of benefit or economic rate of return. The analysis is complex, time consuming, suffers from a lack of data and is therefore justified only for major projects. Investment programs financing many small communities, such as rural water supply, should demonstrate economic justification by examining one or several "typical" communities. It is, after all, more important to provide benefits which can be qualified rather than to develop further refinements in benefit quantification, if the Decade is to succeed. The real obstacle to progress is not a question of economic justification but rather the difficulty of translating economic facts into financing means.

Financing

Having justified a project economically, financial resources must be mobilized. The poor in rural areas, in particular, may fully appreciate the benefits of water supply and sanitation yet still not be able to finance the investment. This calls for the use of technologies which provide the appropriate standard of service, maximize the use of labor and materials which can be provided by the user, and can be maintained locally. Although such projects require some initial financial assistance, the long-range objectives should be to have the sewed community assume complete responsibility for the system. Success of projects ranging from the Malawi gravity water schemes to latrine programs in India demonstrate that motivated individuals and communities can indeed manage such projects. Experience also shows that facilities provided from "outside" without the community's or user's involvement soon fall into disrepair.

Urban areas generally have a stronger economic base and water and sanitation systems for the poor can be financed through sector-internal cross-subsidies: funds generated by the application of increasing block tariffs under which an amount of water adequate for basic needs is sold at a "lifeline" tariff affordable by the poor and financial viability is maintained by charging for large quantities of water (luxury consumption) at higher rates, usually at long-term marginal costs. This practice has been widely adopted in developing countries and is socially more equitable than the declining block tariff popular in developed countries. The former has the further advantage of encouraging water conservation. Sanitation facilities in both rural and urban areas can be financed similarly. A second conclusion, therefore, is that financial self-reliance in the long term, with some initial financial support in rural areas, is feasible and essential for the long-term solution to water supply and sanitation problems. Outsider priorities, whether government's or donor's, change while facilities must be maintained on a continuous basis. The many malfunctioning or totally useless facilities constructed with subsidies and without community commitment demonstrate that such projects are doomed to failure while community participation in financing and operation results in projects providing benefits on a long-term basis.

Table 1: Water Supply and Sanitation Coverage ¹)

¹) Not including figures from the EEC and the People’s Republic of China

Costs

Economic justification and financial feasibility of a project depend, among other things, on project cost. The cost, in turn, is determined by the technology selected. For example, a stand pipe water supply system can cost as little as US $ 10 per capita while the multiple tap house connection system is likely to cost in excess of US $ 100 per capita. Similarly, a pourflush toilet will cost US $ 20 per capita while waterborne sewerage will cost upwards of US $ 200 per capita. Between these extremes in cost and service convenience, there are intermediate steps which can be utilized. The range of technical alternatives and their costs is shown in Table 2. Which technology or service standard is most appropriate depends on socio-economic and environmental health conditions and user perception. Religion, traditions and customs can play as important a role as cost and the user's income in the selection of the appropriate technology. Urban communities in developing countries are generally not as homogeneous as cities in developed technology. Planners must analyze demands of different areas and consumer groups and select the technology most appropriate to serve them. Rural communities are more likely to be served by a single technology or service standards because they are more homogeneous.

In both situations, however, conditions will change in time and it is to be hoped that project beneficiaries will improve their economic wellbeing. This, in turn, will create a demand for more conveniences- in the case of water supply and sanitation a call for higher service standards. The original design must therefore provide for the most economic upgrading of services as time goes by. Designing projects which provide service at standards the user finds acceptable and affordable is complicated and requires skills and knowledge not necessary in the conventional single technology/standard approach. Engineering must be supplemented with hygiene education and behavioral sciences and planners must equip themselves for a multidisciplinary task.

A third conclusion is clear: to serve all, as opposed to just those who can afford high standards, projects must use technologies appropriate for each consumer group to be served and they must be selected and implemented with the users' full participation.

Health aspects

One of the problems preventing accurate quantification of the health benefits of water supply and sanitation investments is the fact that while water supply and sanitation are indispensable, they are not the sole requirement for good health. Poor personal hygiene and domestic sanitation practices can negate the full benefits of improved water and sanitation, while awareness of the value of good personal hygiene can reduce some of the adverse impacts of unsafe water or the lack of sanitation.

The health impact of water supply and sanitation projects is thus intimately linked to adequate hygiene education: it is impossible to separate the effect of one from the other. Many studies exist which have attempted to quantify the impact on health of water supply and/or sanitation. Some report significant improvements, others claim no effect. Amazingly, contradictory claims are sometimes made for the same project. What these studies do have in common is a demonstration that awareness of benefits of safe water and adequate sanitation is the principal factor determining the impact of water supply and sanitation. The obvious fourth conclusion is that no investments should be made in the sector without provision of adequate hygiene education, either by the project itself or by another agency such as the Ministry of Health of the country concerned.

Implementation strategies

Ultimate success of a project requires effective implementation and efficient operation and maintenance. These tasks are performed by agencies or the users themselves with varying degrees of outside assistance. In either case, motivated people determine success or failure, and users of the service and those providing it should share common objectives arrieved at through a program of information and consultation.

In urban areas with large and complex projects, project implementation and operation is usually delegated to water supply and sanitation organizations. They may be municipal departments, semi-independent authorities or even private companies. Any of these organizational arrangements will work, provided the entity has clearly defined objectives, authority to take the actions necessary to achieve them, and sufficient independence to decide on financial policies and manage funds without outside interference. Among the various actions for which the enterprise should have full authority are: organizational structure and management, selection of staff, consultants and contractors and the fixing of salaries and fees, policies for fixing and collecting tariffs, appropriate borrowing capacity, planning and implementation of system expansion, operation and maintenance. For projects serving low-income consumers in urban fringe areas, the enterprise will also need to employ competent personnel to undertake community participation programs and provide hygiene education, or organize the provision of these services by others.

Organizations assisting rural communities should have similar authority. GeneralIy they are less concerned with actual operations than with the provision of technical assistance and support because centralized operation of many systems would be inefficient and costly. The principal task for such an agency is to help a community plan and implement the project, train local users in operation and maintenance, provide hygiene education and assistance in tasks not within the community's competence to undertake, for example the provision of spare parts. Both urban and rural water supply and sanitation organizations need to select technologies appropriate to the local situation and, particularly in rural areas, base the selection on the community's ability to maintain the facilities. Women's roles need to be specifically considered because they are both the providers of primary health care to the family and suffer most from the absence of an adequate water supply and sanitation. Assigning to women the responsibility for maintaining rural systems, after appropriate training, could conceivably be the most effective measure for overcoming the consistent lack of proper maintenance of such systems. A fifth conclusion, therefore, is the need for user involvement and, particularly in rural areas, the full participation of the community in the selection and subsequent operation of the technology.

Governments and development agencies can ensure success in the sector by establishing policies which clearly stipulate that all population groups must be served, which encourage community participation and hygiene education, and provide for financial self-reliance. They should insist that their staff and contractors be capable of designing and implementing projects which are based on appropriate technologies and community participation. Finally, they should allocate funds to sector agencies on the basis of how well the objective of service to all is met.

once these principles become the the norm - and exceptions must be justified by project planners and implementers - progress will accelerate, and not only will service to all become a reality, as stipulated in the Decade resolution by the member nations of the United Nations, but services will be maintained for the long term.

Abstract

In this article the author reaches the conclusion that water and sanitation projects are economically justified and that this can be demonstrated. Furthermore, such projects are financially feasible in all but extreme conditions of poverty. To be successful, the projects must use appropriate technology so that all - the poor as well as the rich - will benefit. In addition, it is important to provide for hygiene education of users if low income groups are to derive full benefit from water supply and sanitation investments. The success or failure of such projects also depends on their being the responsibility of institutions which have adequate authority to operate successfully. And finally, in rural and urban fringe areas, participation of the community in all areas of project development, implementation and operation must be assured.

Resume

Dans son article, I'auteur en arrive a la conclusion que les projects de distribution d'eau et d'cuation des eaux ont leur justification nomique, ce qui peut d'ailleurs e dntrEt, poursuit-il, ils ne vent financiment irrisables qu'en cas de pauvretbsolue. Afin de se solder par une rsite, de tels projets devraient e con,cus selon le principe de la technologie appropride sorte que tous, riches ou pauvres, puissent en profiler. Selon l'auteur, il est important d'assurer lement l'cation a l'hygi des bficiaires, car ce n'est qu'a cette condition que les groupes de population aux faibles revenue pourraient alors en profiler vtablement, surtout sur le plan sanitaire. La responsabilites institutions auxquelles incombe la risation de tels projets contribue lement a leur succou a leur ec. Enfin, il faut assurer la participation de la population des phphes rurales et urbaines a tous les niveaux du projet - au cours de la conception et de la risation.

Extracto

En su trabajo el autor llega a la conclusion de que los proyectos que se ocupan del abastecimiento de agua potable y la evacuacie les aguas residuales estjustificados econamente, como puede tambien demostrarse. Unicamente, prosigue, resultan impracticables desde el punto de vista econo en los caves de absoluta pobreza. Para que tengan to, deben ser proyectos con tecnolog adaptadas, a fin de que todos, pobres y ricos, puedan beneficiarse de ellos. Tambien es importante, dice el autor, la educaci la higiene de los beneficiarios, pues solo en este cave los grupos de poblacion escasos ingresos tendran un beneficio real, sobre todo en el aspecto sanitario.

El to o el fracaso de un proyecto de estas caractericas depende asimismo del sentido de la responsabilidad de les instituciones encargadas de su realizaciY finalmente, en les zonas marginales rurales y urbanas debe asegurarse la participacie la poblacin todos los campos del proyecto, tanto durante la preparaciomo en la puesta en practica.

Table2: Alternative Sanitation Technologies. Financial Requirements for Investment and Recurrent Cost per Household ¹) (1978 U.S. Dollars)

^a) Including hosehold plumbing as well as all other on-site system costs.

^b) Assuming thet investment cost is financed by Ioans at 8 percent over 5 years for the low-cost systems,10 years for the medium-cost systems, and 20 years for the high-cost systems.

^c) Assuming average annual income per capita of $180 and use by 6 persons per household in some of the case studies.

^d) Based on location of the toilet itself in the house.

^e) Based on costs per capita scaled up to household costs to account for multiple-household use in some of the case studies.

¹) From “Water Supply and Waste Disposal, Poverty and Basic Needs Series”, World Bank, Washington, D.C., September 1980.