Despite decades of effort, progress in safely managed sanitation─a public sector mandate─is stalling due to limited public funding and poor governance, among other reasons. As a result, public health has suffered and environmental degradation has continued. Social enterprises that use innovative business models to provide on-site sanitation services, also known as sanitation enterprises, are considered an emerging solution. However, sanitation enterprises have not yet successfully replaced public provision at scale. This work explores the barriers that sanitation enterprises encounter in lower- and middle-income countries. Q-Method, a mixed-methods approach that assesses social perspectives on an issue, is used to evaluate major barriers and groups of dominant perception for 19 sanitation enterprises operating across 20 countries. A total of 25 mutually exclusive, collectively exhaustive barriers are identified, ranging from affording capital expenses to navigating political corruption. The results show that most of the identified barriers fall into the financial barrier category, with reaching economies of scale being the greatest obstacle for sanitation enterprises. On the basis of these results, the premise of independent profitability underlying the sanitation enterprise value proposition should be reevaluated. Four enterprise types are proposed and can explain half of the variance among the sanitation enterprises studied. The context of a sanitation enterprise, including its countries of operation, size, customer base, sources of revenue, and section of the sanitation value chain, influences the barriers that the enterprise encounters. This research underscores the crucial role of context in influencing barriers for sanitation enterprises, emphasizing the need for investment and for policy makers to take these contextual dimensions into account.

Urban sanitation is a basic service essential for public and environmental health. Incorporating various advances over the past two decades, the urban sanitation agenda has evolved towards the paradigm shift of Citywide Inclusive Sanitation (CWIS). Overall, CWIS aims at providing equitable and sustainable sanitation services and is closely linked to Sustainable Development Goal (SDGs) 6 on clean water and sanitation and directly and indirectly benefits several other SDGs. Since its inception in 2016, CWIS has evolved through various research and implementation experiences, resulting in four conceptual frameworks that redefine sanitation as a service delivery process, emphasizing the entire sanitation value chain and the coexistence of sewered and non-sewered technologies. This discussion paper draws on 77 journal articles and grey literature explicitly linked to CWIS, reviews the state of the art on the topic by comparing the four prominent CWIS frameworks and by identifying key advances, current gaps, and emerging issues to inform ways forward towards a more unified CWIS framework.

Sanitation in India has received national attention for over a decade, especially with the Swachh Bharat Mission (SBM) making it a political priority. However, due to the lack of appropriate sanitation planning practices, there have been little long-term gains made in urban sanitation beyond the ending of open defaecation. In this paper, we analyse the key barriers to sanitation planning, in India, in the context of the emerging paradigm of Citywide Inclusive Sanitation (CWIS). A mixed method approach of shit flow diagrams, social network analysis, policy analysis, interviews and workshops at the national, state (2) and city (4) levels was conducted. Eight factors were identified as important barriers for planning including inadequate planning capacities, lack of ownership of city sanitation plans among city governments, poor community involvement, absence of a uniform planning framework, unreliable political and financial support, overlapping jurisdictions, and scheme-based funding. The paper also proposes the CWIS Planning Framework which offers a perspective at overcoming these barriers with the recommendation of bridging top-down and bottom-up planning approaches. While there is increasingly more clarity on what CWIS means, there is little understanding on how to plan for it. Therefore, this framework provides the theoretical basis for planning with the CWIS approach.

The water, sanitation, and solid waste sectors are closely related and have many interactions between their respective service chains in low-and middle-income countries. Currently, these interactions mostly lead to cross-contamination, and opportunities for co-benefits are seldom realized. This review presents the key advancements within each of these three development sectors in the past two decades. We identify numerous similarities such as decentralization, resource recovery, community involved planning, and digitalization. Despite the potential for synergies and the opportunities to maximize positive interactions, there have been few attempts to break the existing sectoral silos in order to integrate these three service chains. We argue that, with the right enabling environment, an integrated approach to holistically planning and implementing water supply, sanitation, and solid waste management can create positive interactions resulting in co-benefits among complementary development goals.

Social network analysis (SNA) is a versatile and increasingly popular methodological tool to understand structures of relationships between actors involved in governance situations. Given the complexity of the set of stakeholders involved in the governance of Water, Sanitation and Hygiene (WASH) and the diversity of their interests, this article proposes SNA to the WASH sector. The use of SNA as an appropriate diagnostic tool for planning Citywide Inclusive Sanitation is explored. Missing data is a major problem for SNA in the studies of governance situations, especially in low- and middle-income countries. Therefore, a novel validation methodology for incomplete SNA data, relying on information from internal and external experts is proposed. SNA and the validation method is then applied to study the governance of decentralized wastewater treatment in four cities of India. The results corroborate key differences between mega and secondary cities in terms of institutions, community engagement and overall sanitation situation including aspects of decentralized wastewater treatment plants, based on the city types.

Although the number of urban dwellers in the Global South with access to improved sanitation increased significantly over the last three decades, progress has been outpaced by rapid urban growth. The number of people in urban areas lacking improved sanitation has steadily increased and today over 1.8 billion urban dwellers do not use safely managed services. Progress has not only been slow, but also uneven between different segments of the population. The focus of ministries, urban authorities and financing agencies has been mostly on incremental expansion of sewers, benefitting non-poor segments of the population, and in most places, utilities have failed to provide citywide services mainly because they have stayed within the sewer paradigm. [...]

Citywide Inclusive Sanitation (CWIS) is gaining traction as an integrated approach that can achieve multiple United Nations Sustainable Development Goals (SDGs). Abishek S. Narayan and Christoph Lüthi at the Department of Sanitation, Water and Solid Waste for Development (Sandec) at the Swiss Federal Institute of Aquatic Science and Technology (Eawag) in Zurich, Switzerland, explain the concept and its implementation through current projects.

Introduction – In addition to underground drainage and large‐scale sewage treatment plants (STPs) and the management of faecal sludge and septage from non‐sewered on‐site systems, small‐scale sanitation (SSS) systems are becoming increasingly important. Such systems consist of small‐scale sewerage networks and STPs, allowing for incremental, modular and flexible implementation. Therefore, they have significant potential for cost‐effective local wastewater treatment and reuse. In order to improve public health, relieve water stress and protect the environment in urban India, SSS systems have a key role to play.
Since a policy drive for small sewage treatment plants (SSTPs) in India beginning in 2006, there has been a remarkable growth in the number of installations in the country’s rapidly expanding urban areas, especially in big cities. However, it is known that many of the existing systems are underperforming or have failed for various reasons.
Thus far, SSS sector developments in India have not been informed by a systematic assessment of lessons learned, and there has been very little research on the enabling conditions and implications for the successful long‐term operation and management of SSS systems at scale. The main goal of the "Technology, Implementation and Operation" component of the 4S Project is to evaluate present experience with SSS systems and to develop evidence‐based policy recommendations for their successful design, implementation, operation and maintenance at scale.