Main take away: Sanitation is NOT nr 1 priority

Improved health is the main reason for improving sanitation and improved health is only attained if EVERYBODY in the community has an improved toilet. However, usually, improved sanitation is NOT number one priority for a household, a community, neither for governments nor donors. Hence, actions are needed to prioritise, multiple parties need to align their actions, incentives are needed and in-depth knowledge and insight need to be developed to be able to develop the right 'trigger' for wanting a toilet.

The Netherlands focus on 'numbers', is highly influenced by world players such as UNICEF, notably the work of Peter Morgan in Zimbabwe. Ghandi's movement to liberate India's scavengers is a source of inspiration as well as the progress by Sulabh and the CLTS movement started by Kamal Kar. The photos below show the work in the 1980 in India. The video shows how CLTS gets momentum in Africa. The commemorating of World Toilet Day on 19 November is a great step to attract attentions, see video 1 and video 2 of WTD in Nakuru 

The progress of the approach in the Netherlands between 1989 and 2011 is well documented by the IOB as well as the approach after 2011. An important action to focus more on sustainability is the introduction of sustainability clauses and pacts (page 21) although implementation has its challenges, see letter ministry. 

NGOs are important change agents, amongst others PLAN, AMREF, NLRC, SIMAVI, SNV, IRC and the WASH Alliance. The approach of the WASH Alliance is illustrated in this video. 

Projects in Indonesia by IWACO (OTA-33) and by IWACO/HASKONING (STS) or by the Indian organisation PRED paid attention to sanitation, see photo of a mission in India.