In Ghana, 15 percent of the population has access to improved sanitation. This is progress, albeit limited since 1990 — when sanitation coverage reached only one in 25 Ghanaians. The country faces a long road ahead as it works to eliminate open defecation, one of the greatest public health challenges associated with inadequate sanitation coverage. Today, roughly one in five Ghanaians are estimated to engage in open defecation, which elevates transmission risk of diarrhea, intestinal infections, and other illnesses. But after enduring a series of cholera outbreaks during the past two years, the country is now tackling its sanitation challenges with renewed vigor, and intensifying efforts to scale-up sanitation improvements nationwide.
To support these sanitation improvement efforts, USAID has launched a five-year WASH for Health initiative. It works in coordination with local partners across the country to educate the public about the benefits of eliminating open defecation, fostering community involvement in identifying and implementing sustainable sanitation solutions, and promoting mutual accountability for maintaining sanitation-related behavior change.
Building Upon Success
One of Ghana’s major development accomplishments in recent decades is achieving an impressive 85 percent water supply coverage rate. This has laid the foundation for the country’s current efforts to transform its sanitation outlook. WASH for Health is now being implemented in 30 districts across the country and aims to provide 50,000 Ghanaians with improved sanitation, and help achieve open defecation free status for 640 communities. WASH for Health coordinates closely with other USAID programs in the country to promote school WASH, governance improvements at the district level, and community-led total sanitation (CLTS).
“CLTS focuses on totality of community and not individual people or households. The idea is that no one in a community is safe [from fecal consumption] unless
everyone stops open defecation.”
CLTS empowers local communities to take ownership of their sanitation improvements through adoption of good hygiene behaviors, elimination of open defecation, and use of local materials to construct or rehabilitate household latrines for cleaner, healthier communities. “CLTS focuses on totality of community and not individual people or households,” said Alberto Wilde, Ghana Country Director for lead implementer Global Communities. “The idea is that no one in a community is safe [from fecal consumption] unless everyone stops open defecation.”
The increased use of CLTS in Ghana is indicative of its success in more than 50 other countries (including nearby Liberia), as well as the inability of previous approaches to achieve improved sanitation coverage in rural districts. Ghanaian institutions and organizations are now increasingly embracing this approach, which provides a robust structure for implementing and facilitating coordination between community sanitation leaders and their counterparts in local and national government.
“The community seemed enlivened about sanitation.”
The decision of an individual or a community to adopt better hygiene practices is influenced by multiple factors, including existing cultural practices, availability and affordability of sanitation infrastructure, and any other perceived benefits. Through both public education campaigns and technical support, the WASH for Health project is providing the necessary incentives to ignite community change. “I was recently out in the field and was able to see a triggering event for CLTS, and it was great,” said Nora Maresh, USAID Ghana’s Mission Family Health Team Leader. “The community seemed enlivened about sanitation.”
Integrating Science and Innovation to Provide Lasting Sanitation Solutions
In areas where land availability is an issue, the WASH for Health project has promoted the Biofil latrine, developed locally by a Ghanaian company. This unique and ecological toilet system treats fecal matter on-site by separating liquids and solids. Wastewater is filtered and absorbed into the ground, while solid waste is treated in a “digester” chamber where it is broken down into compost. The fast-acting decomposition allows Biofil latrines to likely last up to 15 years before requiring to be emptied.
Another notable sanitation innovation introduced by the project is a locally manufactured plastic latrine slab. Previously unavailable in Ghana, the plastic latrine slabs are low-cost and durable. The reinforced plastic can withstand heavy weight while providing households with the affordability, cleanliness, and ease of use that they desire. Use of the plastic latrine slabs was approved by Ghana’s Ministry of Local Government and Rural Development for pilot activities, and according to USAID Ghana’s Mission WASH Project Management Specialist Emmanuel Odotei, has reduced construction costs from around $400 to roughly $70. (To hear Emmanuel Odotei discuss recent WASH innovations in Ghana with Global Waters Radio, click here.)
Working Together Toward a Common Goal
Despite recent sanitation successes and the introduction of promising technologies, roughly 85 percent of Ghanaians still lack access to improved sanitation. To address this large unmet need and more effectively deliver sanitation solutions at scale, USAID’s Mission in Ghana continues to work with local and international development partners Coca-Cola and Rotary International who together have contributed $2.6 million to WASH for Health.
Engaging with the private sector has played a significant role in strengthening the project, allowing staff and beneficiaries to leverage considerable financial and technological resources to more effectively address the country’s chronic sanitation challenges. With the help of USAID and its partners, Ghana is gaining momentum in its ambitious campaign to provide improved water and sanitation access to all of its citizens by 2030.
“This is very important because the ultimate goal is to improve the health status of the people we serve,” said Maresh, “and in our most recent analysis, this is being achieved.”
By Taylor Schaefer