To integrate or not to integrate basic WASH services - that is the question
Published on: 18/04/2024
This guest blog is written by Abishek S Narayan and Marisa Boller, researchers at EAWAG.
The provision of basic water and waste services, i.e., water supply, sanitation, solid waste and stormwater management, is essential for ensuring public and environmental health. These services are closely linked which creates both opportunities and challenges for delivering them. Negative interlinkages can occur when solid waste enters pit latrines or faecal matter contaminates drinking water. On the other hand, there are opportunities for positive interlinkages or synergies, such as the reuse of treated wastewater or the processing of faecal and organic waste together. Despite these known synergies, institutional arrangements remain fragmented, and sectors continue to operate in siloes. This raises the question: Should planning, implementation and management of these basic services be integrated? At the All Systems Connect Symposium 2023 in The Hague, six eminent speakers from academia, government, non-governmental organisations (NGOs) and the private sector debated this issue. This article presents the key arguments that were made for and against integration.
From a user perspective, there is a need for integration of services, since they interact directly at the household level – be it in taps, toilets or trash cans. Menstrual hygiene is an example where the three services need to work together in order to prioritise user convenience. Conversely, inadequately managed services can hinder service quality and lead to increased costs: for example, users need household water treatment units before using water from bore wells contaminated with faecal matter. Stormwater drains can also fill up due to the dumping of solid waste or faecal sludge, leading to flooding and further public health risks. To prevent such negative incidents and ensure effective management of these services, service integration plays an essential role.
Integrating water and waste services from the service provider perspective could improve governance, accountability and cost-efficiency. Often, since the same level of government is responsible for providing basic services, integrating these sectors can enhance their coordination and accountability, resulting in more efficient service delivery. The costs of unified planning, monitoring and fee collection could also be lower than through separate services. Further, it could encourage systems leadership towards the development of long-term sustainability.
Finally, taking an integrated approach could also open up opportunities for reaping multiple benefits. Opportunities for positive interactions include the reuse of treated wastewater, recovery of nutrients and energy, as well as co-treatment of faecal sludge and organic waste. Such synergies could ultimately lead to improved circularity and cost-effectiveness, benefitting both users and service providers.
Integration could lead to a loss of specialisation and service quality that has been achieved through several decades of research and experience. Each sector requires specific expertise and knowledge to ensure its efficiency and effectiveness. Moreover, there is a risk of neglecting certain sectors when bundling everything together. For instance, sanitation may receive far less budget in a unified service approach, leading to suboptimal outcomes, as seen in the latest GLAAS report from WHO and UNICEF.
Integration of water and waste services would further increase the complexity of planning and managing these services. Each service chain has its own set of complex steps in containment, collection, treatment and end use. Fully integrating these services may challenge the limits of current technical, financial and infrastructural management.
There is also a lack of operational capacity for integrating these services. Each service is often handled by specialists with little operational knowledge of other sectors. Training and developing technical capacities of integrated services would be an arduous task. Additionally, there is limited knowledge in the field of integration in terms of successful attempts and best practices, that could be passed on. These challenges would result in limited political will for such integration experiments in reality.
Summary of the main arguments for and against integration of basic services
Supporters of integration argue that siloed approaches have not been able to achieve basic services for all in the past several decades. The separate water, sanitation, and solid waste sectors have not been successful in achieving sustainable service delivery. Such approaches resulted in duplicated efforts, missed opportunities to harness synergies, and led to inconsistent policies. In Uganda, for example, solid waste is typically managed by the city authorities, while water and sanitation services are managed by a national utility, resulting in inefficient service provision and inadequate waste disposal practices contaminating water sources due to lack of coordination.
While siloed approaches have failed in the past, opponents of integration point out that this does not mean that integration is the solution. In fact, there have been cases where integrating basic services has not been successful: for example, slum upgrading projects in Kenya, where planning for infrastructures is integrated, but the implementation faces many challenges, resulting in a continued lack of basic services for the people.
An audience vote at the end revealed that integration was not favoured, albeit only by a slight majority. A key criticism was the lack of a clear scientific definition of the term integration itself – is it only at the user end or is it at the service provider end? And what form would integration take in different contexts? Indeed, integration should be seen as a continuum, with varying degrees of integration ranging from complete siloes to full service integration from planning to operational management.
A consensus between both sides was that coordination between different services is certainly needed due their inherent links. The level of integration then becomes the major question. The best way forward may be to choose the appropriate level of integration based on the specific context and needs of each community, considering the benefits and drawbacks of each approach.
While integration poses challenges such as increased complexity, successful integration can be fostered by strong political will and institutional frameworks. Further research could provide insights into what the optimal level of integration is for different contexts. Practical examples will enhance our understanding of integration in reality and its benefits and challenges. This experience can then be used for building political will.
The debate over integration remains unresolved until we have clear definitions, usable guidelines and real-life examples. Until then, collaboration between researchers, practitioners, and government representatives is essential to bring evidence to the forefront and to address the unresolved debate over integration.
We would like to thank the speakers who participated in the conference session titled 'The integration debate' at All Systems Connect, 2023. We acknowledge Eng. Joseph Oriono Eyatu, Dr. Angela Huston, Antoinette Kome, Jane Nabunnya, Dr. Darren Saywell, and George Wainaina for their valuable contributions to the engaging session. It is important to note that this debate was a role play conducted during the conference session, and the views expressed by the speakers were part of a simulated exercise, not necessarily reflecting their personal or professional opinions.
A different version of this article was published earlier in PLOS Water: https://doi.org/10.1371/journal.pwat.0000180
Abishek S Narayan and Marisa Boller are researchers at the Swiss Federal Institute of Aquatic Science and Technology (Eawag) and are part of the WABES project testing integrated planning of water, sanitation and solid waste. More details available at: www.sandec.ch/wabes
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