A digital innovation improves delivery of sanitation services in Uganda

Comfort Hajra Mukasa is a Ugandan Environmental health scientist and Water, Sanitation and Hygiene (WASH) Programme Manager at African Medical and Research Foundation (Amref) Health Africa in Uganda and a grantee of Grand Challenges Africa programme (GC Africa), which promotes Africa-led scientific innovations to help countries achieve the UN’s Sustainable Development Goals (SDGs) by awarding seed and full grants to develop innovative solutions. GC Africa is implemented through the Alliance for Accelerating Excellence in Science in Africa (AESA), a funding, agenda-setting, programme management initiative of the African Academy of Sciences (AAS), the African Union Development Agency (AUDA-NEPAD), founding and funding global partners, and through a resolution of the summit of African Union Heads of Governments. GC Africa is supported by the Bill & Melinda Gates Foundation, Swedish International Development Cooperation Agency (Sida), and the German Federal Ministry of Education and Research (BMBF).

Summary

Poor sanitation is the main reason why approximately 23,000 people, including 19,700 children under five, die each year from diarrhoea in Uganda. Comfort Hajra Mukasa and her team are developing a Sanitation Digital Solutions system (SaniDigS) that brings sanitation stakeholders and beneficiaries together by just a click of a button for better planning, coordination and improved service delivery.

Despite increased investment and engagement in sanitation, according to the World Bank’s water sanitation programme, almost half of Africa’s population, 564 million, do not have access to latrine or toilet. Consequently, mortality in the African Region due to unsafe water, sanitation and hygiene (WASH) services is four times the global rate. The second leading cause of mortality in children under five is diarrhoeal disease, killing 525,000 children every year, -- more than malaria, AIDS and measles combined -- heart-breaking when diarrhoea is both preventable and treatable. 

In Uganda, 22% of the rural population and 12.1% of urban/peri-urban populations still defecate in the open, respectively. Approximately 23,000 people, including 19,700 children under five, die each year from diarrhoea – nearly 90% of which is directly attributed to poor WASH. It is no wonder that Africa still grapples with 80% disease burden attributed to sanitation.

On a global scale, half of the people who drink water from unsafe sources live in Africa. In Sub-Saharan Africa, only 24% of the population have access to safe drinking water, and only 28% have basic latrine or toilet that are not shared with other households. Sadly, 28% of the people in Sub-Sahara Africa practice open defecation, which, coupled with limited access to a safe water source, creates a welcoming environment for the spread of sanitation-related and waterborne conditions like diarrhoea.

The UN’s Sustainable Development Goal (SDG) target 6.2 aims to achieve access by 2030 to adequate and equitable sanitation and hygiene for all, by eliminating open defecation while paying special attention to the physical safety of women and girls and other vulnerable individuals. Regrettably, access to safe drinking water and improved sanitation remains very low by global standards, despite the fact that sub-Saharan Africa receives the lion’s share of the Official Development Assistance (ODA) for water supply and sanitation.

Unfortunately, much of the international investment in sanitation in Africa is targeted more to donor needs than to community needs, and there is poor government tracking of private investment in sanitation. Many international efforts have been dedicated to achieving better sanitation standards, with some efforts focused on one approach to the exclusion of all others. This project sought a broader approach by building on “weyonje”, implemented by the Kampala Capital City Authority (KCCA.) The project called, One Stop Sanitation Digital Solution (SaniDigS) Centre, provides a comprehensive dashboard for government, service providers, entrepreneurs, sanitation services implementers, researchers, the private sector and the consumers of sanitation services for joint planning, daily engagement, better coordination and controlled service delivery informed by real-time data for inclusive sanitation service delivery.

The Centre, still under development, has brought together different sectors delivering sanitation services, while enabling the beneficiaries of sanitation to guide planning for sanitation based on their needs. Service providers have expressed their need for real time data collection and sharing for trend analysis and informed decision making. Data, including photographs of peri-urban settlements, captured to-date, confirm that sanitation services are still insufficient. Our belief is that this can in large part be attributed to the lack of coordination and communication among service deliverers.

Coordinating the various investments in sanitation in Africa will increase disease prevention, including a reduction in outbreaks such as cholera, dysentery, diarrhoea and other conditions, also enabling economic development. It is therefore a strategic tool in poverty alleviation.

SaniDigS has been used to map out current access to sanitation using programmed organizational data kits. Mapping is integrated with the promotion of appropriate sanitation technologies and accompanying services through home visits by the existing sanitation workforce. These kits upload data in real-time and are used to follow up at the household level. Sanitation promotion is enhanced by the interface of different stakeholders along the sanitation chain on one centralised dashboard. In this way, SaniDigS is improving multi-sectoral decision making, planning, and provision of safely managed sanitation services to peri-urban settlements.