Safely managed sanitation is about stopping the spread of faecal pathogens. Toilets alone don’t do that – but if they’re part of a system that is safe, sustainable and well managed they do. Even pit latrines can do this effectively in certain contexts. Terms like ‘safe’, ‘sustainable’ and ‘well managed’ are very much dependant on the context. When someone asks “is this safe?” and you say “depends”, no wonder it leads to confusion. 

Which is why UNICEF has been supporting governments to hold workshops on safely managed sanitation, to define what it is and how it plays out in their context. In workshops from Ethiopia to Cambodia, Tanzania to The Gambia, we’ve heard all the questions and misinterpretations you can think of. In this blog, we’re sharing 5 of the most common myths we hear, so we can all move past the problems of definition and get to the real work: to mitigate the biggest risks of exposure to human pathogens along the sanitation chain.

Myth 1: “We must end open defecation before we consider safely managed sanitation”

Anyone can go from not using a toilet to using a safely managed toilet. Perhaps this misconception stems from the JMP service ladder, which benchmarks and compares service levels across countries. When one climbs a ladder you must go from one step to the next. However, in reality, individuals can simply skip a rung or two, jumping ahead to safely managed sanitation.

A pit latrine made from a durable material that can be easily cleaned and with a tight-fitting lid can be considered safely managed. Where groundwater is used for drinking, more caution is necessary. The Sanitation and Health Guidelines provide all of the nuance to determine if something is safe enough in each situation.

Myth 2: If the JMP defines a toilet as safely managed then it’s safe

The JMP definition of safely managed sanitation does not determine if a sanitation system itself is safe. As a global monitoring tool, the JMP is tasked with collecting a select set of indicators from all countries. This reporting gives us an indication of where we stand on the SDG target for sanitation. 

While JMP levels of service are important for tracking global development, they cannot capture all risks (nor is that the JMP’s purpose). Authorities must carry out local risk assessments to identify and control the most dangerous health risks from sanitation. Tools like WHO's Sanitation Safety Planning help to do this and are great at helping authorities decide what to spend their money on first. 

Myth 3: Safely managed sanitation is not possible in rural areas

Some believe that safely managed sanitation requires connecting households to sewers, implying massive infrastructure and investment. This is not the case. The simplest of sanitation systems can stop the spread of pathogens. Since 2020, more people use on-site sanitation systems than sewers. The major challenge is now ensuring excreta is safely contained in the ground – and safely emptied only when it needs to be, with proper procedures, regulations, and training to protect the sanitation workforce.

Myth 4: Safely managed sanitation is too expensive

As noted, many believe that sewers are a pre-requisite for safely managed sanitation and therefore, that safely managed sanitation would be too expensive to provide for everyone. One person we spoke to was imagining sewers reaching into the remotest areas of the country. In fact, even a hole in the ground and a washable slab with a tight-fitting lid can be built for just a few dollars and be considered safely managed. 

Costs for safely managed sanitation through on-site systems (e.g. pit latrines, septic tanks, etc.). usually lie with households, sometimes subsidized by governments for the poorest. Transport costs can be shared between households and governments, and treatment costs usually paid for by government. Safely managed sanitation for all isn’t cheap, but it’s an essential investment for public health.

Myth 5: Climate resilient sanitation equals safely managed sanitation

Climate resilient sanitation and safely managed sanitation are closely linked, but not the same. Climate change can impact sanitation facilities and services through damage and disruption. Poorly managed sanitation contributes to greenhouse gas emissions mainly through methane production.

If safely managed sanitation is about trying to stop pathogens from spreading, we should be really concerned with things that can cause those pathogens to spread further. The impacts of climate change can massively increase the risks of pathogen exposure at every step of the sanitation chain. For example, flood waters can enter into latrines and spread pathogens all around a community when the water subsides. Droughts can prevent water from being used for handwashing and cleaning dirty latrines. Climate resilient sanitation is about being prepared for the additional risks associated with increasing global temperatures, and reducing the greenhouse gas emissions from sanitation that contribute to climate change. 

Conclusion

Safely managed sanitation is not just ‘possible’ for everyone. If we want to make a public health impact, it’s a necessity. We can no longer follow a linear progression from open defecation to limited to basic. Safely managed sanitation is about minimizing exposure to excreta at every step of the sanitation chain. Efforts to end open defecation must continue, but the goal should be for households to use improved toilets that minimize exposure to excreta. Local risk assessments are essential to determine what constitutes safely managed sanitation in each context, which should inform regulation, behaviour change programmes and investment decisions. While the JMP provides useful benchmarks, the real work happens at the local level.

What you can do

You can become an advocate for safely managed sanitation by educating yourself through resources like the Sanitation and Health Guidelines or WHO’s online video course. Spread the word about the importance of risk-based programming and understanding that safely managed sanitation is a local determination based on risk assessments.

You could also organise a safely managed sanitation workshop as a critical first step in bridging the knowledge gap. Central to rolling out any kind of global shift in direction has been getting people to understand each other and come to some agreement of what it means in their context. And from the looks on the faces below, you might actually have some fun as well.