Sanitation refers to public health conditions related to clean drinking

water and treatment and disposal of human

excreta and sewage.[1] Preventing human contact with feces is part of
sanitation, as is hand washing with soap. Sanitation systems aim to
protect human health by providing a clean environment that will stop
the transmission of disease, especially through the fecal–oral
route.[2] For example, diarrhea, a main cause
of malnutrition and stunted growth in children, can be reduced through
adequate sanitation.[3] There are many other diseases which are easily
transmitted in communities that have low levels of sanitation, such
as ascariasis (a type of intestinal worm infection
or helminthiasis), cholera, hepatitis, polio, schistosomiasis,
and trachoma, to name just a few.
A range of sanitation technologies and approaches exists. Some
examples are community-led total sanitation, container-based
sanitation, ecological sanitation, emergency sanitation, environmental
sanitation, onsite sanitation and sustainable sanitation. A sanitation
system includes the capture, storage, transport, treatment and
disposal or reuse of human excreta and wastewater.[4] Reuse activities
within the sanitation system may focus on the nutrients, water, energy
or organic matter contained in excreta and wastewater. This is
referred to as the "sanitation value chain" or "sanitation
economy".[5][6] The people responsible for cleaning, maintaining,
operating, or emptying a sanitation technology at any step of the
sanitation chain are called "sanitation workers".[7]: 2
Several sanitation "levels" are being used to compare sanitation
service levels within countries or across countries.[8] The sanitation
ladder defined by the Joint Monitoring Programme in 2016 starts
at open defecation and moves upwards using the terms "unimproved",
"limited", "basic", with the highest level being "safely managed".[8] This
is particularly applicable to developing countries.
The Human right to water and sanitation was recognized by the United
Nations General Assembly in 2010. Sanitation is a global
development priority and the subject of Sustainable Development
Goal 6.[9] The estimate in 2017 by JMP states that 4.5 billion people
currently do not have safely managed sanitation.[9] Lack of access to
sanitation has an impact not only on public health but also on
human dignity and personal safety.

Definitions
[edit]
Animated video to underline the importance of sanitation (here with a focus on toilets) on public

health in developing countries Urban

improved sanitation facilities versus rural improved sanitation facilities, 2015.[10]

There are some variations on the use of the term "sanitation" between
countries and organizations. The World Health Organization defines
the term "sanitation" as follows:
"Sanitation generally refers to the provision of facilities and services
for the safe disposal of human urine and faeces. The word 'sanitation'
also refers to the maintenance of hygienic conditions, through services
such as garbage collection and wastewater disposal."[11]
Sanitation includes all four of these technical and non-technical
systems: Excreta management systems, wastewater management
systems (included here are wastewater treatment plants), solid waste
management systems as well as drainage systems for rainwater, also
called stormwater drainage.[citation needed] However, many in
the WASH sector only include excreta management in their definition
of sanitation.
Another example of what is included in sanitation is found in the
handbook by Sphere on "Humanitarian Charter and Minimum
Standards in Humanitarian Response" which describes minimum
standards in four "key response sectors" in humanitarian
response situations. One of them is "Water Supply, Sanitation and
Hygiene Promotion" (WASH) and it includes the following
areas: Hygiene promotion, water supply, excreta management, vector
control, solid waste management and WASH in disease
outbreaks and healthcare settings.[12]: 91
Hygiene promotion is seen by many as an integral part of sanitation.
The Water Supply and Sanitation Collaborative Council defines
sanitation as "The collection, transport, treatment and disposal
or reuse of human excreta, domestic wastewater and solid waste, and
associated hygiene promotion."[13]
Despite the fact that sanitation includes wastewater treatment, the two
terms are often used side by side as "sanitation and wastewater
management".
Another definition is in the DFID guidance manual on water supply
and sanitation programmes from 1998:[14]
"For the purposes of this manual, the word 'sanitation' alone is taken
to mean the safe management of human excreta. It therefore includes
both the 'hardware' (e.g. latrines and sewers) and the 'software'
(regulation, hygiene promotion) needed to reduce faecal-oral disease
transmission. It encompasses too the re-use and ultimate disposal of
human excreta. The term environmental sanitation is used to cover
the wider concept of controlling all the factors in the physical
environment which may have deleterious impacts on human health
and well-being. In developing countries, it normally includes drainage,
solid waste management, and vector control, in addition to the
activities covered by the definition of sanitation."
Sanitation can include personal sanitation and public hygiene.
Personal sanitation work can include handling menstrual waste,
cleaning household toilets, and managing household garbage. Public
sanitation work can involve garbage collection, transfer and treatment
(municipal solid waste management), cleaning drains, streets,
schools, trains, public spaces, community toilets and public
toilets, sewers, operating sewage treatment plants, etc.[15]: 4 Workers
who provide these services for other people are called sanitation
workers.

Purposes
[edit]

Access to safe drinking water and sanitation

(2016)

The overall purposes of sanitation are to provide a healthy living

environment for everyone, to protect the natural resources (such
as surface water, groundwater, soil), and to provide safety, security
and dignity for people when they defecate or urinate.[citation needed]
The Human Right to Water and Sanitation was recognized by
the United Nations (UN) General Assembly in 2010.[16][17][18] It has been
recognized in international law through human rights treaties,
declarations and other standards. It is derived from the human right to
an adequate standard of living.[19]
Effective sanitation systems provide barriers between excreta and
humans in such a way as to break the disease transmission cycle (for
example in the case of fecal-borne diseases).[20] This aspect is
visualised with the F-diagram where all major routes of fecal-oral
disease transmission begin with the letter F: feces, fingers, flies, fields,
fluids, food.[21]
Sanitation infrastructure has to be adapted to several specific contexts
including consumers' expectations and local resources available. [citation
needed]

Sanitation technologies may involve centralized civil

engineering structures like sewer systems, sewage treatment, surface
runoff treatment and solid waste landfills. These structures are
designed to treat wastewater and municipal solid waste. Sanitation
technologies may also take the form of relatively simple onsite
sanitation systems. This can in some cases consist of a simple pit
latrine or other type of non-flush toilet for the excreta management
part.
Providing sanitation to people requires attention to the entire system,
not just focusing on technical aspects such as the toilet, fecal sludge
management or the wastewater treatment plant.[22] The "sanitation
chain" involves the experience of the user, excreta and wastewater
collection methods, transporting and treatment of waste, and reuse or
disposal. All need to be thoroughly considered.[22]
Economic impacts
[edit]

The benefits to society of managing human excreta are considerable,

for public health as well as for the environment. As a rough estimate:
For every US$1 spent on sanitation, the return to society is
US$5.50.[23]: 2
For developing countries, the economic costs of inadequate sanitation
is a huge concern. For example, according to a World Bank study,
economic losses due to inadequate sanitation to The Indian economy
are equivalent to 6.4% of its GDP.[24] Most of these are due to
premature mortality, time lost in accessing, loss of productivity,
additional costs for healthcare among others.[24] Inadequate sanitation
also leads to loss from potential tourism revenue.[24] This study also
found that impacts are disproportionately higher for the poor, women
and children. Availability of toilet at home on the other hand, positively
contributes to economic well-being of women as it leads to an
increase in literacy and participation in labor force.[25]
Types and concepts (for excreta management)
[edit]

Percentage of population served by different types

of sanitation systems[26]Example of sanitation infrastructure: Shower, double-vault urine-diverting dry
toilet (UDDT) and waterless urinal in Lima, Peru

The term sanitation is connected with various descriptors or adjectives

to signify certain types of sanitation systems (which may deal only
with human excreta management or with the entire sanitation system,
i.e. also greywater, stormwater and solid waste management) – in
alphabetical order:
Basic sanitation
[edit]

In 2017, JMP defined a new term: "basic sanitation service". This is

defined as the use of improved sanitation facilities that are not shared
with other households. A lower level of service is now called "limited
sanitation service" which refers to use of improved sanitation facilities
that are shared between two or more households.[9]
Container-based sanitation
[edit]

This section is an excerpt from Container-based sanitation.[edit]

Container-based sanitation (abbreviated as CBS) refers to a sanitation
system where toilets collect human excreta in sealable, removable
containers (also called cartridges) that are transported to treatment
facilities.[27] This type of sanitation involves a commercial service which
provides certain types of portable toilets, and delivers empty
containers when picking up full ones. The service transports and
safely disposes of or reuses collected excreta. The cost of collection
of excreta is usually borne by the users. With suitable development,
support and functioning partnerships, CBS can be used to provide
low-income urban populations with safe collection, transport and
treatment of excrement at a lower cost than installing and
maintaining sewers.[28] In most cases, CBS is based on the use
of urine-diverting dry toilets.
Community-based sanitation
[edit]

Community-based sanitation is related to decentralized wastewater

treatment (DEWATS).[citation needed]
Community-led total sanitation
[edit]

This section is an excerpt from Community-led total sanitation.[edit]

Community-led total sanitation (CLTS) is used mainly in developing
countries to improve sanitation and hygiene practices in a community.
It focuses on spontaneous and long-lasting behavioral change of an
entire community. The aim of CLTS is to achieve behavior
change with a 'trigger' that is meant to lead to spontaneous and long-
term abandonment of open defecation practices, thereby improving
community sanitation and overall health. The term "triggering" is
central to the CLTS process. It refers to ways of igniting community
interest in ending open defecation, usually by building simple toilets,
such as pit latrines. CLTS effect is two-fold: it involves actions leading
to increased self-respect and pride in one's community, and it also
involves shame and disgust about one's own open defecation
behaviors.[29] CLTS takes an approach to rural sanitation that works
without hardware subsidies and that facilitates communities to
recognize the problem of open defecation and take collective action to
become "open defecation free" and clean up.
Dry sanitation
[edit]
The term "dry sanitation" is not in widespread use and is not very well
defined. It usually refers to a system that uses a type of dry toilet and
no sewers to transport excreta. Often when people speak of "dry
sanitation" they mean a sanitation system that uses urine-diverting dry
toilet (UDDTs).[30][31]
Ecological sanitation
[edit]

This section is an excerpt from Ecological sanitation.[edit]

Ecological sanitation, commonly abbreviated as ecosan (also spelled
eco-san or EcoSan), is an approach to sanitation provision which aims
to safely reuse excreta in agriculture.[32] It is an approach, rather than a
technology or a device which is characterized by a desire to "close the
loop", mainly for the nutrients and organic matter between sanitation
and agriculture in a safe manner. One of the aims is to minimise the
use of non-renewable resources. When properly designed and
operated, ecosan systems provide a hygienically safe system to
convert human excreta into nutrients to be returned to the soil, and
water to be returned to the land. Ecosan is also called resource-
oriented sanitation.