Water and sanitation service levels in urban informal settlements: a case study of Portee-Rokupa in Freetown, Sierra Leone

The Joint Monitoring Programme (JMP) is a global mechanism for monitoring global progress on water and sanitation, and classifies access to water and sanitation into five service levels ranging from safely managed to either surface water or open defaecation (WHO/UNICEF 2017). While recent JMP data show that half of the urban population in sub-Saharan Africa (SSA) has access to safely managed drinking water and only a quarter has access to safely managed sanitation, wide variations exist between and within most countries (WHO/UNICEF 2021). Moreover, water and sanitation coverage estimates might not be reflective of the situation in most of the informal settlements where the data are less available, and because their concerns are rarely considered during conventional urban planning, policy making and financing (UN 2021). Additionally, even where services exist within informal settlements, they mainly benefit the wealthy who are able to pay for the services than the poor households (Armah et al. 2018; Asante-Wusu & Yeboah 2020).

Over a billion urban dwellers live in informal settlements, commonly known as slums, with more than 237 million people in SSA (UN-Habitat 2020; UN 2021). The fast-increasing populations and growth of slums with already constrained access to safe water, sanitation and other basic services are likely to widen the gap of meeting the universal water and sanitation targets (Santos et al. 2017; Sinharoy et al. 2019; Motta-Veiga 2021). The COVID-19 pandemic has created greater urgency for national governments and all service sectors to prioritize water services in informal settlements as it is critical for an efficient hygiene infrastructure (Corburn et al. 2020; Wilkinson 2020). Measures curbing the spread of COVID-19 disrupted the water supply and its access, and thus in high-density communities, the limited sources of water increased the risk of exposure to COVID-19 for dwellers seeking water due to congestion at the water sources (Barbier & Burgess 2020).

A quadrupling of investment is needed to achieve safely managed sanitation services (UN 2021; WHO/UNICEF 2021). Critical investment areas identified by the UN to stimulate accelerated water and sanitation coverage include financing, data and information, capacity development, governance and innovation (UNICEF/WHO 2020; UN-Water 2020).

In Sierra Leone, the 2021 JMP report shows that only 11% of the country's population uses water sources that are free of contamination and only 14% have access to safely managed sanitation services (WHO/UNICEF 2021). In urban areas, the situation is only marginally better, with 13% of the population having access to improved water sources that are free from contamination and 20% having access to safely managed sanitation. The water sources and sanitation facilities are mainly off-grid (non-piped) systems (WHO/UNICEF 2021). However, such estimates may not be representative of informal settlements due to their ever increasing formation and residents (Lynch et al. 2020; Conteh et al. 2021; Oviedo et al. 2021).

The focus of this study was to ascertain access to safe water and sanitation service levels in Portee-Rokupa, an informal urban settlement in Sierra Leone's city of Freetown. The findings from this study contribute to the increasing need for evidence-driven planning and investments in improved and safely managed water and sanitation services.

A cross-sectional study design was used. Quantitative and qualitative household data were collected using semi-structured questionnaires. Data collected were related to socio-demographic characteristics of the respondents, the household water sources and sanitation situation.

Using Cochran's sampling formula (Z²pq/e²) (Cochran, 1963), we estimated 385 household respondents to be interviewed. A proportion (p) of 0.5 coverage was assumed at a desired 95% confidence interval. Systematic random sampling was used, starting from the centre of the settlement that was determined with a guide who was a local leader in the community. At the household level, mainly the household heads or next in-charge when it came to decision-making around water services were interviewed. As such, most of the respondents were either household heads or their spouses.

Household data were collected between August and September 2021 by trained enumerators. The training included mastery of the data collection tools, creating a conducive face-to-face interview environment, asking questions and response noting. A series of roleplays and field exercises was done prior to actual data collection. Due to COVID-19 travel restrictions, a mixed face-to-face and virtual training approach were used. Semi-structured questionnaires with open- and close-ended questions were used for data collection. The questionnaire was pre-tested and piloted prior to the survey to ensure it would capture the required data. Collected data were reviewed daily to ensure completeness and quality.

The Statistical Package for the Social Sciences (SPSS) software, version 27 was used for quantitative data analysis; and thematic analysis was used for qualitative data. Frequencies, proportions, mean scores and linear regression results are provided for the quantitative analysis. Only variables with statistically significant Pearson correlation values (P-value <0.05) at the bi-variate analysis level were included in the linear regression models to test for associations within water and sanitation service levels and their influencing factors. Qualitative results for the thematic analysis on the threats and disruptions related to the access to domestic water and sanitation services are presented in the Supplementary Material.

Ethical approval for the study was obtained from the University of Bristol's Faculty of Engineering Research Ethics Committee (FREC). Participation in the study was voluntary and study participants provided written informed consent.

A total of 385 participants were interviewed, of which 66% were household heads. As indicated in Table 1, over a half (55%) of the respondents were female while majority of household heads (77%) were male. Most respondents had up to secondary education (44%), followed by 22% having tertiary/higher education. Education was a statistically significant factor influencing sanitation service levels in Portee-Rokupa (Table 3). Respondents with no formal education were less likely to have sanitation facilities that provided at least a basic service level than respondents with tertiary or higher education. 42% of households' income ranged between Sierra Leone Leones (SLL) 500,001 and 1,000,000 (US$46.93–70.39), followed by SLL 100,000 and 500,000 (US$9.39–46.93) (38.5%).

Sachet water is the main drinking water source as reported by most respondents (84%). This finding concurs with previous studies in West Africa that have reported the dominance of sachet water as the main drinking source as opposed to piped or non-piped water sources (Stoler et al. 2012; Stoler et al. 2015; Asante-Wusu & Yeboah 2020). A study on sachet drinking water in Ghana has indicated that sachet water was one of the coping strategies for urban water shortages (Asibey et al. 2019), and it was becoming the most important drinking water source in Accra, and in many low-income neighbourhoods (Stoler et al. 2012). In this study, there was a strong conviction by majority of the respondents (96%) that sachet water was safe to drink. This belief on the safety of packaged water relates with those in a qualitative study similarly conducted in Sierra Leone on consumer perceptions and purchasing power of packaged water products (Jalloh et al. 2018). Jalloh et al. (2018) stated that there was a widespread belief that most packaged water products were safe. However, as shown in the Supplementary Material (Table S1), some respondents mentioned that sachet water emitted odours when stored for a long time. Previous studies regarding the microbiological and chemical quality of packaged sachet water and household-stored drinking water in Freetown detected Escherichia coli in samples collected from packaged water manufacturing facilities (Fisher et al. 2015).

The average cost of 20 packets of sachet water was SLL 4,000, with general costs ranging between SLL 3,000 and 5,000 (US$0.27–0.46). Over half (57%) of the respondents were paying SLL 3,500 (US$0.32), followed by over one-third (35%) paying SLL 4,000 (US$0.36). Over half of the respondents (52%) mentioned that the cost for sachet water was affordable. Each 0.5 l of sachet at retail price was reported to cost SLL 500 (US$0.05). This cost is slightly more than US$0.04 that was reported in a study on the roles and attitudes of urbanites towards water insecurity conducted in Ghana (Asibey et al. 2019).

There were also limitations reported by respondents regarding access to sachet water. Only 25% of the respondents reported that sachet water locations (selling shops) have never run out of water, whereas close to half of the respondents (49%) reported that the locations were not close to their homes. This finding differs from what was found in a study conducted in Ghana where sachet water was reported to be 100% available (Jimmy et al. 2013). These variations could be due to the production and supply chains in the two countries and the related effect of seasons.

Only 22% of the respondents used improved water sources with a basic service level while 19% used unimproved water sources (Figure 2(b)). Access to basic water services in this study were over three times less than what is reported by WHO/UNICEF-JMP and the Government of Sierra Leone's Ministry of Water Resources and the Ministry of Health and Sanitation (MoWR/MoHS 2017; WHO/UNICEF 2021). These differences could be due to disparities in reporting national statistics where data from informal settlements are often missed or non-existent, leading to over-estimation when it comes to coverage statistics (Adams 2018b). However, the differences in coverage could also be due to the variations in the target populations, community versus national statistics. In a study on household water insecurities in Lilongwe in Malawi, the author reported that national statistics over-estimated and failed to show the disparities in urban informal settlements (Adams 2018b).

Moreover, disparities in water service levels, for example, within SSA are apparent in the recent WHO/UNICEF-JMP report on the progress on drinking water, sanitation and hygiene (WHO/UNICEF 2021). These disparities in access to water services between countries, within state borders and between areas make the Sustainable Developmental Goal (SDG) universal access to safe water unattainable by 2030, unless they are specifically addressed (UN 2021). The disparities in access are also evident from the findings of this study. As shown in Figure 2(a), there are coverage and source-type variations in the two wards that make up Portee-Rokupa, which is also seen in Figure 2(b) on service levels. This variation explains why the wards were the statistically significant factors influencing water service levels as illustrated in Table 2. Residents in Rokupa were two times more likely to use unimproved services than those in Portee.

Furthermore, most of the water sources were seasonal (having water only during rainy season) as was reported by over two-thirds of the respondents (76%). This points to why irregularity of the water sources is one of the statistically significant factor affecting domestic water service levels (Table 2). The irregularity of water sources is reported in some studies as the reason for the people to use multiple alternative unimproved water sources (Adams 2018b; Gebremichael et al. 2021).

In terms of the cost for water services, the majority (89%) of respondents were paying SLL 500 (US$0.05) per 20-l water container. Households (32%) were mainly spending between SLL 51,000–100,000 (US$4.65–9.11) as monthly expenses on water, followed by SLL 150,000 (US$13.67) (25%), SLL 100,001–150,000 (US$9.11–13.67) (24%) and those spending less than SLL 51,000 (US$4.65) (19%). However, only 34% of the respondents reported that the monthly expenses were affordable.

Table 2 shows statistically significant factors influencing access to domestic water service levels. These include round-trip water collection time—inclusive of distance and waiting time (β=0.69, p<0.01), ward (β=0.14, p<0.01), irregular water availability at the source (β=0.10, p<0.01), and inability to have own household source (β=0.08, p<0.05). The regression model accounted for 65% (R²=0.65) of the variance in households' main domestic water service levels.

As illustrated in Table 3, the type of toilet had a statistically significant relationship with the sanitation service level. The users of buckets or hanging toilets were less likely to have a limited or basic sanitation service. Following WHO/UNICEF-JMP classification criteria (WHO/UNICEF 2017), non-shared improved facilities (pit latrines, flush and pour-flush to septic or pits) were classified as basic and limited if improved but not shared or shared by more than one household. Flushing toilets to elsewhere, hanging toilets and buckets were classified as providing an unimproved service.

The investment cost for building sanitation facilities depended on the type of toilets. Hanging toilets were the least expensive as was reported by 69% of respondents, costing less than SLL 500,000 (US$46.93). Flush or pour-flush toilets to septic tanks were the most expensive, costing more than SLL 2,000,000 (US$187.73) as was reported by 67% of respondents. As shown in Table 3, toilet construction expenses had a statistically significant relationship with sanitation service levels. Toilet facilities that cost less than SLL 500,000 were less likely to provide a basic service than facilities that cost more than SLL 2,000,000.

Sanitation facilities were mainly under a shared user arrangement with neighbouring households (73%), and the main reason for the limited sanitation service (Figure 3(b)). Table 3 shows that sanitation facility user arrangement is a significant factor influencing service levels. Privately managed improved toilet users are more likely to have access to basic sanitation services than the users of shared improved toilets. Only 19% of the toilet facilities in this study provided a basic sanitation service (Figure 3(b)). The sanitation service levels in this study are lower than the WHO/UNICEF's-JMP urban estimates for Sierra Leone, where 25% of the urban population reported using at least basic services (WHO/UNICEF 2021). Moreover, compared to Portee ward, it is evident in Figure 3(b) that Rokupa has nearly twice the highest number of facilities categorized as an unimproved service. The type of ward has a statistically significant influence on sanitation service levels as indicated in Table 3.

Threats were reported affecting the use of the sanitation facilities. These mainly included poor hygiene due to sharing of the facilities, danger of using the facilities at night and poor condition of the superstructures (Supplementary Material, Table S3). Two threats that had statistically significant relationship with sanitation service levels were flooding of toilet areas during heavy rain events and the need to use toilets before dark, due to lack of light in the facilities and security risks. The lack of light in the toilets accessible to slum residents has been reported in previous studies as one of the challenges affecting their use at night (Tsinda et al. 2013; Tumwebaze et al. 2013; Meili et al. 2021). In a study of indicators for sanitation quality in low-income urban settlements, it was revealed that the number of households that shared a facility and proper lighting for use at night were predictive factors for sanitation quality (Meili et al. 2021).

Achieving universal access to safely managed water and sanitation services, and making cities inclusive of human settlements, safe, resilient and sustainable by 2030 are fundamental targets in the SDGs. However, these may not be achieved especially in the context of urban informal settlements where coverage is way lower than the general urban reported progresses. These findings of the study signify the need for greater prioritization, widescale investments and promotion of water and sanitation service options that provide incremental but more sustainable access towards safely managed services:

Regarding water service levels, this study shows that non-piped (off-grid) services are still largely prevalent in low-income urban informal settlements. It is important to ensure the quality of services from non-piped sources and possible upgrade options to grid systems that are not hampered by climatic or seasonal changes. Sachet water which is the main source for drinking purpose provides new dynamics in overall understanding of water service levels as a distinction between drinking and non-drinking water sources becomes prominent and so are the factors influencing the access. Ensuring that regulations and policies are in place for all producers of sachet water and monitoring the mechanisms for quality adherence are important for consumer safety. However, with still existing water service disruptions in marginalized urban informal settlements, compliance with such regulations might be challenging to implement.

Access to safely managed sanitation remains a significant challenge for low-income settlements like Portee-Rokupa. With no sewered connections in the community, residents of Portee-Rokupa depend on onsite technologies dominated by pit latrines and hanging toilets. Safely managed sanitation services require functional and accessible faecal sludge and wastewater systems. An associated enabling environment that stimulates investments in improved sanitation infrastructure is needed if residents are to move from unimproved sanitation conditions to safer forms of sanitation.

Additionally, achieving safely managed or basic sanitation services in the context of urban slum settlements may still be unattainable unless the issue of sharing is incrementally addressed in relation to cleanliness and safety of use (Meili et al. 2021). Measures directed towards good quality of superstructures, limited number of sharing households and good hygiene protocols are important.

Finally, data and information are one of the acceleration investment areas identified under the SDG6 global acceleration framework (UN-Water 2020). These findings add to a growing information base on the water and sanitation situation in low-income urban informal settlements to contribute to evidence-based decision-making that is crucial for targeted investments and triggers to enhance service levels and theirimprovements.

The authors gratefully acknowledge all Sierra Leone Urban Research Centre (SLURC) teams collaborating on the project, research assistants and community guides that were involved in the planning and implementation of the study. Special gratitude to Abdulai Turay for the support in the coordination of the data collection exercise.

This work was supported by the Economic and Social Research Council (grant number ES/T007656/1) on behalf of the Global Challenges Research Fund.

All relevant data are included in the paper or its Supplementary Information.

The authors declare there is no conflict.