SANITATION AND DEVELOPMENT:

INADEQUATE SANITATION
FACILITIES AND SERVICES IN
MODERN GHANA

AUTHORS:
Institute of Demography, National
Gabriella Leelee Enchill
Research University Higher School of Mitela Rahman
Economics, Moscow, Russia. Adenrele Sikirat Adegbenro
OUTLINE
1. Abstract
10. Partners and Interested Parties
2. Introduction
11. Source of Funding
3. Problem Statement
12. The Role of Public and Private Sectors
4. Scope of the Problem
13. Possible Risk
5. Purpose of the Study
14. Comparative Perspective
6. Poor Sanitation and Development
15. Sanitation Facilities and Services: Ways of
7. Poor Sanitation Amid Coronavirus Implementation

8. Availability of Adequate Sanitation Facilities and 16. Recommended Actions and Solutions
Services
17. Summary and Conclusion
9. Beneficiaries of Sanitation Facilities and Services
Abstract
 Safe water and sanitation are prerequisites of health, human growth, and development.

 Based on the data retrieved from contents, literature and scientific articles/documents being
reviewed, it was developed that, strategies can be developed to present a combined and
partnered method of strategies needed for the implementation of sanitation initiatives

 This article targets to contribute to the achievement of the access to sustained sanitation
for all Ghanaians, which is a goal that the Government of Ghana, and Ministry of Sanitation
and Water Resources want to achieve in relation to Sustainable Development Goal 6.

 The aims were on revealing the inadequacy of sanitation facilities and services being
experienced in Ghana, and how poor sanitation is having effects on the population and the
economy.

 Here, assumptions of how implementation of sanitation initiatives especially at the

community level are being suggested.
Introduction
Population (millions) without proper
 Safe water and sanitation are prerequisites of health, sanitation for 2004 & 2015
human growth, and development. Globally, 2004 = 2.6 billion and 2015 = 2.4
billion
Note: Inner circle is for 2004 and Outter circle
 Globally, the commitment showcased by governments is for 2015
to attain the SDGs in their various countries and
across the world, is a fight worth fighting for. 106
98 Southern Asia
121
176 125
Eastern Asia
 The situation in sub-Saharan Africa is even more 183
disturbing, as only 28% of the people have access to Sub-Saharan
955 953
basic sanitation (WHO/UNICEF, 2017). Africa

Southeastern
463 Asia
 In Ghana, there is 89% access to water coverage and
Latin America
15% coverage of improved sanitation (World Vision & 695 and
UNICEF, 2015). the Carribean

 This shows how imperative it is for more attention to 761

Other regions
be on improving sanitation facilities and services 337

including public education and awareness creation. Source: Developed for this study with data from
WHO/UNICEF Joint Monitoring Programme
Scope of the Problem
Water & Sanitation Coverage Trend in Ghana  In 2018, Ghana successfully achieved
Water Sanitation 80% access to water coverage but only
90 20% coverage of access to sanitation
WATER & SANITATION COVERAGE (%)

has been achieved (Ghana Statistical

80
Service, 2019).
70

60  Sanitation does not have much attention

when it is being compared to other
50
issues that are having immediate
40 solutions, such as politics, water
30 coverage, education and others.
20
 The inadequacy of sanitation facilities
10
and services is not the only problem
0 here, but the diseases it comes with,
are the most deadly and costly.

Source: Developed for this study with data from GSS, 2018
Scope of the Problem
 There is a growing concern about the
voluntary/intentional disposal of solid
waste and faeces.

 This is where fewer households

especially in the rural areas have toilet
facilities and even lack the best way to
dispose waste.

 Ghana has to ensure the availability

and sustainable management of water
and sanitation for all.

 If Ghana is able to achieve SDG 6, it

will be a win-win achievement, where
all citizens in the country will benefit,
and so as the country.
Source: Developed for this study with the use of STAT compiler
Sanitation Profile for Urban and Rural Areas
S A N I TAT I O N FA C I L I T I E S A N D S E RV I C E I N  Not much progress has been
GHANA (2018)
made in achieving the sanitation
Rural Urban Total target made by the Ministry of
60%
56%
Water and Sanitation in achieving
“water and sanitation for all
Sanitation Facilties and Service Levels

50%
45% Ghanaians by 2030”.
40%
35%
 Per UNICEF study (2015), only
31%
30% one rural household out of ten
25%
22% were using improved household
21%
20% 17% 18% toilets while three in every ten of
13%
11%
them practiced open defecation.
10% 8%

 The sanitation gap between rural

0% and urban areas tends to widen.
Basic Limited Unimproved Open Defecation

Trend/Types of Sanitation Facilities and Service

Source: Developed for this study with data from GSS (2018)
Reasons why most Ghanaians do not incorporate toilet facilities in their house

Source: Water and Sanitation for the Urban Poor, WSUP Ghana
Sanitation Profile for Urban and Rural Areas
 By region, data from Ghana Health Service (2014) discovered that,
 Greater Accra is the richest region, with 52% of the population in the highest wealth quintile,
compared with only 2% each of the population in the Northern and Upper East regions.

 More than 7 in 10 of the population in the Northern (72%) and Upper East regions (79%) and 6
in 10 of the population in the Upper West region (60%) is in the lowest wealth quintile.

 This explains rural-urban migration being referred to as, North-South emigration is rampant.

 This shows the inequality gap between urban and rural communities in Ghana, upon which the
rural communities’ members massively migrate to urban communities to get the opportunity to
utilize certain social amenities which are mostly found in urban areas.

 However, as this situation has reached a level of complexity, there is the need for joint forces in
combating this harmful pratice because it is now or too late for this problem to be dealt with.
Purpose of the Study
 As the Ministry of Sanitation and Water Resources of Ghana has created basic sanitation guidelines
to achieve equitable and adequate access to sanitation services and hygiene for all Ghanaians by
2030,
 we hope, our research, findings and suggestions for this target, provide greater depth of
knowledge for this targeted phenomenon, by contributing to its effective achievement.

 This paper will also help other researches to become more observant and absorbed when it comes
to sanitation-related issues in Ghana by getting a clearer picture behind poor sanitation issues in the
country.

 The findings/recommended actions and solutions including necessary mechanisms that can be
developed for the achievement of total coverage of sustainable sanitation in Ghana, could be
strategized by the Ministry of Sanitation and Water Resources, NGOs, CBOs and any party such as
project/program facilitators.

 This will enable these parties to provide targeted support and contributions to the advancement of
sanitation initiatives in order to achieve total and sustainable sanitation coverage in modern Ghana.
Poor Sanitation and Development
 How will a country fully develop when its citizens are unhealthy or live in an unhealthy
environment, as population growth is normally not integrated into development plans?

 Poor sanitation and hygiene practices reduce productivity and increase health care cost,
trapping communities in poverty, (WHO, 2017).

 According to Economic Impacts of Poor Sanitation in Africa (2012), in Ghana,

▪ 74% of economic costs come from the annual premature 19,000 deaths from
diarrhoeal disease, with 5,100 children under the age of 5

▪ with nearly 90% of caused by poor water, sanitation and hygiene

▪ health-related costs accounted for nearly 19% of the total economic costs

▪ as well as time and productivity losses being accounted for about 7%.
 Ghana will not be able to grow sustainably without addressing the cost involve in poor
sanitation and other issues which comes with poor sanitation (Awunyo-Akaba, 2016).
Poor Sanitation Amid Coronavirus
 During the first week of April, 2021; per coronavirus update in Ghana, according to Ghana
health service; confirmed cases were 91,545; new cases were 42; active cases were 1,379;
recoveries were 89,400; vaccines administered were 742,349; deaths were 766
 Among the 16 regions, Greater Accra had 50,527; Ashanti had 15,439 were highest.

 Globally, 1 in 4 health facilities lacks basic water services, within which 1 in 10 of the facilities
has no sanitation service, and 1 in 3 lacks hand hygiene facilities at points of care (Sanitation
and Water for All, 2021); which will be worse within healthcare facilities in Ghana.

 Even before the onset of coronavirus, the efforts needed for solving poor sanitation in the
country was insufficient, and these are expected to decline.

 This shows how worse the situation of sanitation-related issue will be, if nothing is done now.

 Sanitation is the first precaution that comes in mind when COVID19 pops up.
 As stated by Catarina de Albuquerque (2021), “the human rights to water and sanitation
will be achievable only if governments seize this moment to reduce health risks,
strengthen health systems, and prevent future pandemics”.
Availability of Adequate Sanitation Facilities and Services
 Adequate drinking water, proper sanitation, and hygiene are essential requirements to
ensure human health and better economic development.

 Currently, the importance of water and adequate sanitation is recognized at both local and
global levels. In spite of concerted efforts by governmental and non-governmental
organizations, water and adequate sanitation is still a challenge.

 A World Bank report estimates that, for sub-Saharan Africa, approximately 0.9% of the
region’s GDP must be spent annually to meet the sanitation MDG which is now SDG target,
aimed to halve the proportion of people without access to improved sanitation.

 Adequate sanitation facilities and services will seek to benefit all people.

 If the stakeholders commit to reach out to all the communities who are in need of this project,
based on community engagement,
 this will enable a sustainable availability and utilization of adequate sanitation facilities
and services in the country.
Beneficiaries of Adequate Sanitation Facilities and Services
 Hence, the safety of humanity is at stake here.
 Availability of adequate sanitation facilities and services in Ghana will benefit all humankind
especially the citizens, the country and neighboring countries too.

Partners and Interested Parties

 Combating sanitation-related issues in Ghana which has reached a level of complexity, could be
quite difficult and expensive.
 Looking at the situation on grounds in the country, there is limited private sector interest in
sanitation.
 Though, there are some international organizations who are on a good course to combat poor
sanitation in Ghana.
 But more non-profit organizations especially the local ones and even community-based
organizations are needed to assist this initiative.
 NGOs like; the World Bank’s Water and Sanitation Program, WHO/UNICEF, Melinda Gate
Foundation, WaterAid Ghana, etc.
Source of Funding
 The implementation of sanitation
initiatives such as the construction of
sanitary facilities within the Ghanaian
communities can be financed by the;
 Community members
 Government of Ghana
 International Organization
 Joint Partnerships
The Role of Public and Private
 As stated by Malumba, et al. (2014), “public and
private sectors can partner to deliver affordable,
sustainable, high-quality water and sanitation
services, linked to financial sustainability of
providers and authorities.”
 It should not be an individual goal but a goal for
the entire team and the members to coordinate
and implement

Possible Risk
 This led us to use SWOT analysis, and the possible risk discovered under the weakness
were; Poor leadership and representation
 Inability to finace project
 Unwillingness to attend the poor condition of sanitary facilities
 Indigenous cultural values being practiced.

 To prevent any aftermath complications, there should be inclusiveness.

Comparative Perspective: What Can Ghana Learn?
1) Availability and utilization of sanitation
facilities in Ethiopia:
 Ghana can learn the positive procedures and
techniques Ethiopia has put in place to achieve
nation-wide sanitation coverage, this includes;
a) the use of available local
materials/people
b) accurate division and assigning of
roles to workers/actors/facilitators
c) training local actors
2) Singapore - The Right to Water and
Sanitation:
 One of the basic factors contributing to
Singapore’s progression was the focus
on public health, based on a “clean and
green” strategy.
 Ghana can partner with Singapore
based NGO, World Toilet Organiztion,
to assist the country in curbing the
country’s poor sanitation issues.

3) Ghana - Netherlands Water Sanitation and Hygiene Programme (GNWP):

 GNWP was initiated by the Dutch Embassy and National Government of Ghana, due to poor
sanitation in Ghana.
 The main approach was to achieve behavioral change in order to reduce the practice of
open defecation and increase the use of in-house toilet.
 This programme then provides an evidence that, Ghana sanitation can be improved and
achieved, if proper measures are being put in place.
Sanitation Facilities and Services: Ways of Implementation
 Improving sanitation conditions does not mean the application of Western-style
technology but ingenious and cheap technology or ideas can be developed and utilized
(Schiller, 2020).

 The communities and the people that are affected by any sanitation-related crisis must
be the center of any response.

 Here, there are 10 stages to approach the implementation of such initiatives, which
include,
1st - Community Entry: This is the initial stage, through a community forum, where by a
cluster of community leaders and members to gather the necessary information about the
community needed for the purpose of executing the sanitation project.

2nd - Intervention Planning and Design: This is by understanding and analyzing the
information, opinions and concerns relayed by the community, that are needed to develop
the appropriate planning and designing of various activities for the implementation of the
intervention.
3rd - Community Need Assessment: This is the assessment of finding an appropriate way of
executing the suggested solutions for the community’s concerned sanitation needs, in terms of
the kind of sanitation project the community may need/want, and how suitable it will be for them.

4th - Community Profiling: The profiling should be done by writing or summarizing a

comprehensive report on the impacts of the project, suggestions, challenges and potentials of
the selected community.

5th - Infrastructure Building: Sanitation infrastructure building for the provision of sanitation
services has to be done by making it a local asset for targeted/affected communities, through
collective actions contributed by the local people, as well as the assistance of external supports.

6th - Education and Awareness: Enlightenment means empowerment in the sense that
effective communication and sharing sanitation information with the local people, as well as
using feedback to help in the adaptation of the intervention is the key.

7th - Community Ownership: At the completion of the implementation process, it must be the
community that own the system, as well as making the decisions on when to call for support and
exercises control over access to the system, facility or service.
Sanitation Facilities and Services: Ways of Implementation

 Resources being used will lead to achieving the

results, then, to the achievement of expected short-
term and long-term effects .
Recommended Actions and Solutions
 The situation in sub Saharan Africa is even more disturbing as only 28% of the people have
access to basic sanitation (WHO/UNICEF, 2017).

 There is the need to find measures and act toward the attainment of good sanitation and
health practices. This include;
1. Public sanitation education and awareness.

2. Sanitation being recognized as a necessity.

3. Planning an equitable and sustainable sanitation services.

4. Rural-urban migration should be seen as a factor for poor sanitation.

5. Multi-stakeholders partnership must be encouraged.

6. Plannning and the execution of reduce, reuse and recycle programs.

7. Policy initiatives for total sanitation coverage.

Summary and Conclusion
 According to Water & Sanitation Programme (2011), in Ghana, water supply and sanitation
infrastructure is insufficient, especially in rural areas. This is an evidence that there is wide
disparities between regions within the country, and the urban and rural areas.

 People affected by this crisis are more susceptible to illness and death from disease like
diarrhea, and also, in this era, being unhygenic can lead to the high morbidity of coronavirus.

 Effective engagement links communities and response teams to maximize community

influence to reduce public health risks, provide appropriate, accessible services, improve
programme quality and establish accountability.

 For Ghana to fully achieve a total sanitation coverage, the country has to especially achieve
infrastructure building, sanitation education, monitoring, feedback and improvements, leading
to community ownership.

 By achieving the required sanitation coverage would require a fundamental change in current
efforts. Like, in relation to shifting attentions to other aspect that influence poor sanitation
practices such as rural-urban drift, and rapid population growth in Ghana.
References
Awunyo-Akaba, Y., Awunyo-Akaba, J., Gyapong, M., Senah, K., Konradsen, F., Rheinlander, T., (2016). Sanitation investments
in Ghana: An ethnographic investigation of the role of tenure security, land ownership and livelihoods. BMC Public Health 16,
Article number: 594.

Catarina de Albuquerque, (2021). Achieving human rights to water and sanitation amid COVID-19. Sanitation and Water for All.
[accessed on 16/04/2021].

Ghana Statistical Service, GSS, (2019). Ghana Health Survey: Malaria Indicator Survey Final Report. Accra, Ghana, and
Rockville, Maryland, USA: GSS and ICF. Published on July, 2020.

Mulumba, N., J., Nothomb, C., Potter, a., Snel, M., (2014). Striking the balance: what is the role of the public sector in sanitation
as a service and as a business? Practical Action Publishing. Vol. 33, No. 3 (July 2014), pp. 195-210(16pages).

Schiller B., (2020). This Infographic Explains How Much Poor Sanitation Costs The World $260 billion A Year. [accessed on
07/02/2021].

Water and Sanitation Program, WSP, (2011). Water Supply and Sanitation in Ghana: Turning finance into services for 2015 and
beyond. An AMCOW Country Status Overview.

World Health Organization, and United Nations Children’s Fund, (2017). 2.1 billion People lack safe drinking water at home, more
than twice as many lack safe sanitation. [accessed on 10/12/2020].

World Vision, and UNICEF (2015). Water, Sanitation and Hygiene. Joint Monitoring Programme. [accessed on 24/12/2020].
Thank
You !