Use of Basic and Safely Managed Sanitation Facilities

Fecal pathogens can enter the human body in multiple ways, causing intestinal infections, inflammation of the gut, or micronutrient deficiencies through reduced micronutrient absorption. Using basic and safely managed sanitation facilities is an important way to stop the transmission by removing fecal matter from the environment, which prevents pathogens from entering waterways, household courtyard soil, and contaminating surfaces. Access to basic and safely managed sanitation infrastructure should be accompanied by effective behavior change strategies to address social and cultural barriers for use; ensure sustained use; and ensure the adequate disposal of adult, infant, and animal feces.

Using “basic and safely managed” sanitation facilities for regular waste disposal removes the waste from human contact and controls flies. While various types of facilities fall into this category, the main focus is to ensure that the way waste is collected and stored does not allow pathogens to easily contaminate the surrounding environment.

Basic sanitation facilities include the following (UN-Water 2016):

• flush toilet
• piped sewer system
• septic tank
• flush/pour flush to pit latrine
• ventilated improved pit latrine (VIP)
• pit latrine with slab
• composting toilet.

Note that these “basic” sources used to be known as “improved” sources.

Safely managed services include sanitation facilities that are not shared, where excreta is safely disposed of in situ or treated off-site, and where handwashing facilities with soap and water are available. Sanitation facilities are often seen as a ladder, with households progressing from open defecation (the lowest rung), to unimproved facilities, to use of basic facilities by all households in a community, to—finally—all households having and using basic and safely managed facilities.

Measurement and data sources

Ideally, collecting information on the use of basic and safely managed sanitation facilities would be through structured observations of facility use, but most available data rely on observing the presence or reported use of sanitation facilities.

Surveys generally report the percentage of households that have access to a basic, unshared toilet facility. Respondents usually show or are asked to describe the type of facility their household has access to or uses, with answers categorized into various options that are relevant for the target population (see the basic sanitation facility options in the list above). The indicator can be disaggregated by service level: no or unimproved services, basic (or improved) services, and safely managed services.

Surveys that collect information on the use of basic and safely managed sanitation facilities include—

• Demographic and Health Surveys
• Multiple Indicator Cluster Surveys
• National Micronutrient Surveys
• Knowledge, Practice, and Coverage Surveys
• other research or evaluation activities.

The WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation maintains a database of information on the coverage of water, sanitation, and hygiene programs.

Additional data sources for the use of basic facilities may be available, including from businesses that sell latrines.

Methodological issues

• Collecting data by observing household hygiene practices is expensive, can be impractical, and may change the behavior of the people being observed.
• The definition of “basic” is generally understood, but classification of facilities could vary slightly between survey instruments, so make sure you understand what is included under “basic.”
• “Safely managed” does not include households sharing facilities, but some surveys may differ on how the final results are reported for the survey.