Reaching the Sustainable Development Goal (SDG) for sanitation (6.2) of “Access to safely managed sanitation for all” is estimated to cost about USD $1 Trillion from 2015-2030. Most of this expenditure is for urban areas, where investments will largely go towards infrastructure. Little user contribution to sanitation costs is expected, and many existing toilets are not of sufficient quality to be connected to any sewerage lines constructed. Formative research has identified several promising possibilities for peri-urban sanitation quality improvement interventions, and observational evidence suggests that latent tenant demand communicated to landlords could lead to substantial gains in sanitation quality. However, the lack of rigorous evidence prevents the implementation of such demand-creation interventions on a large scale, and so a trial is both necessary and has the opportunity to have a major impact on meeting the sanitation SDG. We designed the SanDem trial to test the hypothesis that we could create demand for peri-urban sanitation and increase sanitation quality with no intervention on the supply side.
Trial Protocol (Forthcoming)