L’assainissement dans les pays en développement: Practical Paths to Health, Dignity and Resilience

Sanitation — or in French, l’assainissement — is more than toilets and pipes. It’s a foundation for health, education, gender equality, economic opportunity and environmental protection. In developing countries, turning sanitation from a distant dream into everyday reality requires more than engineering: it needs political will, cultural understanding, reliable finance, community ownership and technologies that match local conditions. In this article I will walk you through why sanitation matters, what gets in the way, the practical options available, how to plan and finance programs, and how communities and leaders can work together to build long-term solutions. I speak plainly and show real steps so you can both understand the problem and imagine realistic solutions.

Why sanitation matters — the human and societal stakes

We often underestimate how central sanitation is to daily life. Without adequate sanitation systems, human waste contaminates water, food, soil and housing. That contamination leads to diarrhoeal diseases, parasitic infections, stunting in children, lost school days, and lost productivity for families and communities. Sanitation is tied directly to the Sustainable Development Goals — most notably SDG 6 (clean water and sanitation) — but it also affects SDG 3 (health), SDG 4 (education), SDG 5 (gender equality) and SDG 13 (climate action).

Beyond the statistics, there’s dignity. Women and girls face particular safety and privacy risks when sanitation facilities are missing, poorly designed, or not maintained. Handwashing with soap and safe waste disposal protect entire communities from epidemics, from cholera to many waterborne illnesses. Investment in sanitation yields returns in improved health outcomes, increased school attendance, and economic gains for households and nations. The challenge is turning knowledge into action where resources and systems are weak.

Health, environment, and economic impacts

Poor sanitation contributes to a vicious cycle: disease reduces earning power, increases healthcare spending, and keeps children out of school, which undermines human capital. Environmentally, untreated waste can degrade rivers, coastal zones, and groundwater, harming ecosystems and livelihoods dependent on fisheries or agriculture. Conversely, safe sanitation protects water sources, improves agricultural safety (when treated properly), and supports tourism and local economies. The returns are not just health-based; they are social and economic, making sanitation an investment with broad impacts.

Common barriers in developing countries

Understanding why sanitation lags in many developing countries requires looking beyond a single cause. The barriers are systemic and interlinked: limited infrastructure, weak institutions, insufficient financing, cultural taboos, rapid urbanization, and climatic threats like flooding. Each barrier requires a different response.

Infrastructure and technical challenges

In many rural areas, building centralized sewerage systems is impractical due to low population density and high costs. In fast-growing urban informal settlements, overcrowding and lack of land make conventional systems impossible. Many countries also struggle with fecal sludge management — collecting, transporting, treating and safely disposing of excreta from pit latrines and septic tanks. Even where toilets exist, emptying and treatment systems are often missing, creating a ticking public health time bomb.

Governance, policy and finance

Even where technologies exist, weak governance and fragmented responsibilities cause failures. Ministries, municipalities and utilities may not coordinate, budgets might be inadequate, and policies may not support scaling or maintenance. Financing is a major sticking point: governments often cannot fund large infrastructure, and households lack the means to invest in durable solutions. Aid and nonprofit partners help, but sustainable systems need domestic funding models and private sector participation.

Social and cultural barriers

Behavior change is crucial. Open defecation may continue due to beliefs, lack of privacy, or simply because sanitation programs ignore community preferences. Gender norms can prevent women from using public facilities. Projects that ignore social context risk low uptake and eventual abandonment. Successful programs combine hardware (latrines, drains) with software (education, social marketing) and community participation.

Practical sanitation technologies and approaches

There is no one-size-fits-all sanitation solution. Choices depend on population density, soil and groundwater conditions, climate risks, available finance, and social preferences. Below is an overview of commonly used options and when they make sense.

On-site sanitation: pit latrines, ventilated improved pits and septic tanks

On-site sanitation systems are often the most practical in rural areas and many peri-urban contexts. Pit latrines are low-cost and straightforward to construct, while ventilated improved pit (VIP) latrines reduce odors and flies. Septic tanks serve households or clusters but require safe emptying and disposal of septage. The advantage of on-site systems is simplicity and low capital cost; the challenge is long-term fecal sludge management.

Containment plus fecal sludge management (FSM)

Containment systems must be paired with regular emptying, transport and treatment. FSM programs establish services to empty pits and septic tanks, trucks or smaller vehicles to transport fecal sludge, and treatment sites for safe disposal or re-use. Successful FSM systems are often entrepreneurial — private providers offering emptying services under municipal regulation, with transfer stations and treatment plants managed by public or private entities.

Decentralized and small-bore sewer systems

In dense urban settlements where full sewerage is too expensive, decentralized systems such as small-bore sewers or clustered treatment plants work well. These systems reduce the need for deep trenching and gravity sewers, lowering costs while improving public health outcomes. They require careful planning, maintenance mechanisms and often a combination of user fees and subsidies.

Centralized sewerage and wastewater treatment

In cities with adequate planning and finance, centralized sewerage connected to treatment facilities provides the highest level of service. However, construction and rehabilitation costs are high, and such systems must be resilient to climate stresses. Central systems make sense where density, institutional capacity and funding allow long-term operation.

Nature-based and low-energy solutions

Constructed wetlands, waste stabilization ponds, and ecological sanitation (EcoSan) can provide safe and affordable treatment in appropriate contexts. These systems often use natural processes and lower energy but need land and proper design to avoid contamination. When designed well, they offer low-operational-cost solutions and opportunities for safe reuse in agriculture.

Designing programs that work: community-centered and phased approaches

Sanitation projects succeed when they are rooted in local realities. A phased approach — starting with community engagement, then improving access, followed by strengthening services and financing — reduces risk and builds ownership. Community-Led Total Sanitation (CLTS) is one example that focuses on behavior change to eliminate open defecation, while complementary investments in hardware and services create sustainable outcomes.

Community engagement and behavior change

Behavior change strategies should be respectful and participatory. Communities should be involved in selecting technologies, locating facilities and managing maintenance. Social marketing, school-based programs, and local champions can shift norms. Incentives and accountability mechanisms, such as community monitoring or public recognition for open-defecation-free status, often reinforce change.

Inclusive design: gender and vulnerable groups

Sanitation must serve women, girls, people with disabilities, and marginalized groups. That means separate, safe facilities for women, locks and lighting for privacy and safety, handwashing stations, menstrual hygiene provisions, and designs that enable wheelchair access. Inclusion improves uptake and ensures that investments benefit entire communities.

Phasing and scalable pilots

Start small, learn, adapt, then scale. A pilot project in a neighborhood or a cluster of villages allows teams to test technologies, financing arrangements and governance models. Monitoring data informs adjustments before scaling city- or region-wide. Scalable designs often use modular technologies and adaptable institutional frameworks.

Financing and business models

Financing is the hinge on which sanitation projects turn. Finding the right mix of household contributions, municipal budgets, donor funds, microfinance, and private investment is essential. Business models that create revenue streams — for example, fee-based emptying services, sale of treated biosolids as fertilizer, or connection fees for sewerage — can make systems more sustainable.

Household and community financing

Subsidies and grants are often necessary for the poorest households, but microloans and payment plans enable many families to construct better latrines. Community savings groups can finance shared facilities, and local artisans can be trained to provide affordable, quality installations. Transparent pricing and trustworthy service providers encourage uptake.

Municipal and national budgets

Municipalities bear primary responsibility for service delivery in many countries but often have limited revenue. Earmarking municipal finance for sanitation, improving tariff structures for water and sanitation utilities, and accessing national transfers can increase resources. Sound financial planning and clear roles for operations, maintenance and capital investments are critical.

Market-based models and private sector engagement

The private sector can provide products and services at scale — from latrine components to emptying trucks and treatment plants. Public-private partnerships can combine the public sector’s regulatory role with private efficiency. Contracts should include performance incentives and clear service standards to protect users.

Data, monitoring and governance for long-term success

Good data and transparent governance underpin effective sanitation programs. Monitoring access, usage, service levels, fecal sludge flows and environmental impacts allows managers to adjust strategies. Digital tools, GIS mapping, and community reporting systems can make monitoring more accurate and timely. Governance frameworks should clarify responsibilities across agencies and levels of government.

Key indicators to track

Trackable indicators include the proportion of the population with access to safely managed sanitation, frequency of pit or tank emptying, operation of treatment plants, incidence of sanitation-related diseases, and financial sustainability metrics like cost recovery ratios. Regular audits and citizen feedback help keep services accountable.

Climate resilience and sanitation

Climate change makes sanitation planning more urgent. Flooding can spread untreated waste, coastal erosion can damage infrastructure, and water scarcity affects hygiene. Sanitation systems must be designed for resilience: elevating latrines in flood-prone areas, protecting treatment plants, and integrating sanitation with water management and disaster planning. Ecosystem-based solutions and decentralized systems often prove more adaptable to changing climates.

Designing for floods and droughts

In flood-prone settings, sealed, elevated containment units and robust emptying services prevent overflow. During droughts, water-saving technologies, urine-diverting dry toilets, and handwashing stations with minimal water use help maintain hygiene. Planning for extremes ensures continuity of services during shocks.

Innovation and promising technologies

New tools are making sanitation cheaper, more effective and more culturally appropriate. Low-cost sensor networks monitor fill levels of pits and septic tanks enabling smarter emptying schedules. Mobile payments facilitate fee collection and improve transparency. Small-scale treatment units can be deployed quickly, and modular sewers reduce installation time.

Examples of innovations

• Smart fecal sludge management platforms for scheduling and payment.
• urine-diverting dry toilets and container-based sanitation in dense areas.
• Constructed wetlands for low-energy treatment and reuse.
• Mobile apps for community reporting and monitoring service delivery.

These innovations work best when they are paired with local entrepreneurship and institutional support. Piloting new technologies while measuring outcomes is the best way to scale what works.

Institutional roles and partnerships

No single actor can deliver sanitation at scale. Success requires collaboration between governments, municipalities, utilities, NGOs, private companies, community groups and international donors. Clear roles, transparent contracts, and mechanisms for community input are essential to coordinate action and avoid duplication.

Stakeholder roles

National governments often set policy and standards and provide subsidies. Local governments implement services and manage public infrastructure. Utilities operate treatment plants and sewers. Private firms provide construction, emptying and treatment services. NGOs work on behavior change and community mobilization. Donors provide finance and technical assistance. Each actor brings skills and resources, and their collaboration defines program success.

Case studies and lessons from the field

Examples from countries that have made progress provide practical lessons. In Rwanda, strong political leadership and community mobilization substantially reduced open defecation through CLTS and enforcement mechanisms. In Burkina Faso, NGO-led programs combined sanitation marketing and microfinance to increase household latrine ownership. In parts of India, FSM businesses have grown to serve dense urban areas by coupling technology with local enterprise. Each case shows the importance of local leadership, adaptable designs, and robust financing.

Comparing sanitation technologies: a simple table

Technology	Typical context	Advantages	Limitations
Pit Latrine / VIP	Rural, low-cost settings	Low capital cost, simple construction	Requires emptying/relocation, groundwater risk if shallow
Septic Tank	Peri-urban, household clusters	Better containment, works with low water use	Needs proper emptying and septage treatment
Decentralized Treatment	Dense peri-urban, small towns	Modular, lower cost than full sewerage	Requires local management and O&M capacity
Central Sewerage	Planned urban centers	High level of service, centralized treatment	Expensive, vulnerable to system failures without maintenance
Container-based Sanitation	Informal dense settlements	Rapid roll-out, suited to areas lacking infrastructure	Requires reliable collection and safe disposal

Practical checklist for local planners

For city managers, NGO leaders, and community organizers, here is a practical checklist to guide sanitation planning. It focuses on steps that can be taken now to build momentum and avoid common pitfalls.

1. Assess current sanitation conditions, mapping facilities and fecal sludge flows.
2. Engage communities early to understand needs, preferences and constraints.
3. Choose technologies suited to local density, groundwater and climate risks.
4. Plan for fecal sludge management from day one — not an afterthought.
5. Develop financing plans combining user fees, municipal budgets, and external support where needed.
6. Design inclusive facilities that meet the needs of women, girls and people with disabilities.
7. Create monitoring systems with clear indicators and community feedback loops.
8. Start with pilots, learn, adapt, and scale successful models.
9. Invest in local entrepreneurship and build capacity for operation and maintenance.
10. Plan for climate resilience and integrate sanitation with broader water and disaster planning.

Risks to anticipate and how to mitigate them

Projects can fail for predictable reasons: lack of maintenance, unclear roles, insufficient financing, or poor community buy-in. Mitigation strategies include establishing user associations for maintenance, clear contracts with private providers, contingency funds for repairs, training for local technicians, and continuous engagement to preserve behavior change. Transparency and accountability — from published performance data to community oversight — reduce risks and build trust.

Dealing with political and institutional change

Sanitation projects often outlast political cycles. Institutionalizing practices — through legislation, municipal standards and funding lines — helps continuity. Building multiple champions across government, civil society and communities ensures that progress survives leadership changes.

How individuals and communities can act now

Not every solution requires large budgets. Community-level actions can make immediate differences: organizing cleanup campaigns, promoting household handwashing, building shared latrines with maintenance plans, training local masons in improved latrine design, and forming groups to negotiate with local authorities for services. Households can adopt simple measures like upgrading existing pit covers or arranging scheduled emptying to reduce risks.

Simple steps for households

• Install a basic, covered latrine to reduce contamination and flies.
• Practice and promote handwashing with soap after using the toilet and before eating.
• Keep a record of when pits or tanks need emptying and budget for it.
• Support community monitoring and report broken or overflowing systems promptly.
• Engage local leaders to prioritize sanitation in planning and budgets.

Scaling up: national strategies and international support

National governments play a pivotal role by setting policies, standards, and budget priorities. Effective national strategies combine targets for universal access, investment plans, capacity building, regulatory frameworks for private providers, and strong monitoring systems. International partners support technical assistance, financing, and knowledge-sharing. The best partnerships respect local leadership and aim for sustainable, country-led solutions rather than short-term projects.

Principles for sustainable national programs

Programs should be equitable, evidence-based, and financeable. They must prioritize the poorest and most vulnerable, use data to guide investments, and include realistic budgets for operation and maintenance. Climate resilience, inclusion, and market development for sanitation products should be core elements.

Measuring success: what good sanitation looks like

Success is more than numbers of toilets built. It’s about safely managed sanitation services that reliably separate people from their waste and treat it so that health and the environment are protected. Regular use, maintenance, safe emptying and treatment, affordability, gender-sensitive design and institutional sustainability are all measures of good sanitation.

Indicators of well-functioning sanitation systems

• Consistent use of toilets by all household members.
• Regular desludging of containment systems and safe transport of sludge.
• Operational treatment facilities preventing environmental contamination.
• Affordable services and transparent pricing.
• Inclusion of women, girls and people with disabilities in design and operation.
• Monitoring data used to improve services over time.

Final thoughts and a call to action

Sanitation in developing countries is a solvable problem, but it requires integrated thinking. Technical solutions are necessary but not sufficient. Long-term success depends on governance, finance, inclusion, behavior change and climate-resilient design. The time to act is now: every investment in sanitation pays dividends in health, dignity and economic opportunity. Whether you are a policymaker, a local leader, a funder, an entrepreneur, or a community member, you have a role to play. Start with small, achievable actions, scale what works, and keep the focus on sustainably managed services that protect people and ecosystems.

Conclusion

Improving l’assainissement dans les pays en développement is both a moral imperative and a smart investment: it saves lives, uplifts communities, and builds resilience to future shocks. The path forward combines appropriate technologies, inclusive design, strong institutions, sustainable finance, and community engagement. By prioritizing safe containment, reliable fecal sludge management, behavior change and decentralized solutions where centralized systems are not feasible, countries can make rapid, lasting progress. The challenge is complex but manageable — with political commitment, local leadership and smart partnerships, universal access to safe sanitation can become a reality, changing millions of lives for the better.