Challenges Facing Sanitation Workers in Africa: A Four-Country Study
2.1. Country and City Selection
2.3. Data Collection
2.4. Data Analysis
- The study compares data from four countries in Africa. The study, therefore, provides an overview of common challenges faced by sanitation workers in various African countries but does not provide a continent-wide picture. Other countries may face unique challenges that were not identified in this study.
- There are limited in-country primary data sources on sanitation workers (e.g., number of workers, profiles, income, vaccination, the number of incidents of discrimination, deaths, and illnesses) and resources (e.g., research papers, reports). The results are, therefore, based mainly on qualitative data collected through in-person discussions, with limited triangulation.
- The types of sanitation workers included varied by country. The Burkina Faso and Nigeria assessments focused on manual and mechanical emptiers, while the Tanzania and Zambia assessments also included toilet cleaners and treatment plant operators. The data on toilet cleaners and treatment plant operators are, therefore, more limited.
- The study used rapid assessments to gain an overview of the sanitation workforce in each city. More comprehensive assessments including all types of sanitation workers would be required to quantify the extent of the challenges and draw more representative conclusions.
- Health and safety (illnesses, injuries and fatalities, personal protective equipment (PPE), healthcare services);
- Financial security;
- Legal protection (regulation and formalisation);
- Dignity (stigma and discrimination, infrastructure, equipment, inclusivity).
3.1. Health and Safety
3.1.1. Illnesses, Injuries, and Fatalities
3.1.2. Personal Protective Equipment (PPE)
- Tanzania: Promote adherence to health and safety requirements at the Local Government Authority (LGA) level, improve enforcement, and strengthen on-the-job training;
- Zambia: Deliver training programmes to sensitise sanitation workers on guidelines and health and safety policies, including the use of PPE;
- Nigeria: Revisit the health and safety guidelines for sanitation workers to ensure the use of PPE;
- Burkina Faso: Provide PPE to emptiers, make it mandatory to wear PPE when delivering sanitation services; provide training programmes and certificates.
3.1.3. Healthcare Services
3.2. Financial Security
3.3. Legal Protection
- The Tanzania assessment identified the need to advocate for the recognition of sanitation workers to all concerned authorities (Ministry of Health, Community Development, Gender, Elderly, and Children; the President’s Office—Regional Administration and Local Government; and the Ministry of Water), to develop the capacity of LGAs to register sanitation service providers, and to develop a suitable model for formalising sanitation workers;
- The Zambia assessment identified the need to improve contracts with employers to ensure adherence to the country’s labour laws;
- The Nigeria assessment identified the need to reform policy to include the legal rights of sanitation workers and to register and license organisations representing sanitation workers;
- The Burkina Faso assessment identified the need to license emptiers after completion of training and to define rules and bylaws to create associations in all communes across the country. It recommended financial and technical support be provided to these associations.
3.4.1. Stigma and Discrimination
- Nigeria: Provide support to sanitation workers, including the provision of tools, equipment and vehicles;
- Tanzania: Promote new innovative desludging equipment;
- Zambia: Company owners invest capital in equipment for mechanical and manual emptiers.
3.4.4. Gender and Inclusion
4.2.1. Health and Safety
- Develop or improve health and safety guidelines for sanitation workers in accordance with the ILO and WHO guidelines on sanitation and health ;
- Improve inspections and enforcement processes of health and safety guidelines to ensure adherence;
- Develop the capacity of sanitation workers on health and safety guidelines to ensure compliance;
- Provide training programmes and certificates to ensure the safe provision of sanitation services;
- Coordinate efforts between the ministries responsible for sanitation and ministries of health to improve healthcare services for sanitation workers, including medical check-ups and vaccinations;
- Develop a system to ensure regular medical check-ups and vaccinations for sanitation workers, including registration with primary healthcare facilities and subsidies;
- Institutionalise the use of health booklets for sanitation workers (e.g., vaccinations, PPE) and use these tools as part of the registration process;
- Promote innovative desludging equipment to overcome challenges with manual emptying.
- Sanitation workers reported the inconvenience and increased occupational risks of using impractical PPE. Not addressing these issues could limit the effectiveness of PPE initiatives. For example, in Bolivia, mechanical emptiers did not wear PPE even when it was provided to them ;
- Treatment plant operators said they were using worn-out PPE and needed more systematic replacements. This suggests there is a need to improve the management of PPE in utilities;
- There is a need to address the occupational risks associated with household behaviours such as, ‘non-compliance of septic tank construction to design standards, irregular cleaning, improper disposal of inappropriate items in toilets’  (p. 1).
4.2.2. Financial Security
- Recognise all sanitation workers to ensure protection under labour laws and improve contract modalities;
- Recognise and create associations in all towns and cities, and provide financial support to these associations;
- Develop an appropriate economic support model for sanitation workers to ensure effective and sustainable operations;
- Facilitate links between sanitation workers and financial institutions that are often reluctant to provide loans and grants.
4.2.3. Legal Protection
- Advocate for the recognition and rights of sanitation workers to all concerned authorities at all levels;
- Reform or develop the legal framework for sanitation workers and associations, including enforcement processes;
- Develop or strengthen the registration process (e.g., health and safety, training) to include all sanitation workers and associations;
- Provide financial and technical support to create sanitation worker associations in all cities and towns across the country;
- Develop the capacity of local government to register sanitation service providers;
- Ensure employers adhere to national labour laws to improve contracts with sanitation workers.
- Create public awareness of the role sanitation workers play in protecting public health and the environment;
- Implement a behaviour change campaign on the rights and dignity of sanitation workers targeting government, health workers, NGOs, community-based organisations, and religious organisations;
- Identify sanitation champions who could share their stories on media platforms such as television and radio shows;
- Identify land for FSTPs and invest in infrastructure to allow sanitation workers to effectively conduct their work;
- Promote new innovative desludging equipment.
4.3. Next Steps
4.3.1. Increase Knowledge, Improve Knowledge Management
4.3.2. National Action Plans and Implementing Solutions
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
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|Treatment plant operators||x||x|
|Region||West Africa||West Africa||East Africa||Southern Africa|
|Date of data collection||23 March–2 April|
|October 2021||27 September–|
1 October 2021
Bobo Dioulasso, Ouagadougou
|Kano City||Arusha, Dar es|
|Key informant interviews||52||33||19||6|
|Focus group discussions||2||2||0||3|
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Philippe, S.; Hueso, A.; Kafuria, G.; Sow, J.; Kambou, H.B.; Akosu, W.; Beensi, L. Challenges Facing Sanitation Workers in Africa: A Four-Country Study. Water 2022, 14, 3733. https://doi.org/10.3390/w14223733
Philippe S, Hueso A, Kafuria G, Sow J, Kambou HB, Akosu W, Beensi L. Challenges Facing Sanitation Workers in Africa: A Four-Country Study. Water. 2022; 14(22):3733. https://doi.org/10.3390/w14223733Chicago/Turabian Style
Philippe, Sterenn, Andrés Hueso, Gloria Kafuria, Jules Sow, Hermann B. Kambou, Wandoo Akosu, and Lloyd Beensi. 2022. "Challenges Facing Sanitation Workers in Africa: A Four-Country Study" Water 14, no. 22: 3733. https://doi.org/10.3390/w14223733