City sanitation ladder: moving from household to citywide sanitation assessment

Monitoring sanitation has generally focused on basic access with its implicit links to health impacts. The new thinking on urban sanitation monitoring goes beyond the household level facilities to encompass wider dimensions of equity, public health and natural environment. This requires an assessment of the full value chain from the user interface to storage, conveyance, treatment and disposal or reuse. In developing country context, this also necessitates incorporating other sanitation dimensions beyond excreta management, especially management of greywater, storm water and solid waste as these are often interlinked on the ground. In this context, it is important to revisit the concept of the sanitation ladder, widely used by the Joint Monitoring Programme (JMP), which has focused on household access. This paper suggests a framework for outcome-based citywide assessment of the full sanitation value chain across different sanitation sub-sectors. The ladder is redefined using a city sanitation score to assess city level performance. The suggested outcome-based assessment for different components of the value chain also provides a basis for city level monitoring of overall sanitation performance.