Sustainable Sanitation and Hygiene Delivery in West Africa : paper prepared for the West Africa Regional Sanitation and Hygiene Symposium, 3-5 Nov 2009, Accra, Ghana.

The need for adequate sanitation and improved hygiene behaviours has become more widespread in recent years, and have been included in the Millennium Development Goals (MDG) ;it is therefore necessary that the sector pursues the MDGs and full coverage with vigour. This is however not the first time the world body has embarked on a vigorous campaign to improve sanitation. The “water and sanitation decade” of the 1980s had the bold aim of meeting all needs. At the end of the decade Africa was the only region which fared worst at the end of the decade. This time the target is longer (i.e. 15 years) and the goals are less ambitious. However, there remain huge problems in the achievement of these goals. Therefore the conduct of this symposium is timely; in it, participants will share their experiences of good and indifferent practices and outcomes, and through discussions, help to create an environment in which greater progress can be made. It is the purpose of this paper to stimulate some of the debate. Its aim is to raise some of the issues across the range of topics which need to be confronted in the sanitation and hygiene sector in West Africa. It cannot be fully comprehensive, this is not the objective – but it is the aim to raise questions throughout that may form part of a list of issues for participants at the symposium to consider. So, in each section, one or some key questions are posed for that purpose. The relevant text can, therefore, be seen in each case as the context for generating inputs to the symposium. This paper discusses the various definitions of sanitation by different insititutions and countries. It also reiterates the importance of sanitation and hygiene delivery. There is a major section on the overview of sanitation in West Africa which highlighted several issues including institutional arrangement, technologies and approaches in sanitation and hygiene delivery, challenges in the sanitation sector and cost-effectiveness analysis using Disability Adjusted Life Years (DALY) implications. Several issues are also elaborated in the section on the way forward. The paper concludes with some key issues such as disparity in definitions, sanitation planning and financing sanitation which need to be critically looked at by all stakeholders. (authors abstract)