The use of qualitative comparative analysis to identify pathways to successful and failed sanitation systems

Sanitation systems globally fail at high rates. Researchers and practitioners attribute the causes of both sanitation success and failure to numerous factors that include technical and non-technical issues. A comprehensive understanding of what leads to sanitation failure and how to achieve sanitation success is imperative to prioritize the use of limited resources. To determine which combinations of causal conditions led to successful and failed sanitation systems, we applied fuzzy-set qualitative comparative analysis to 20 cases in Karnataka and Tamil Nadu, India with small-scale sanitation systems. Two pathways led to successful sanitation systems, and four pathways led to failed sanitation systems. All successful systems required Sufficient O&M Funds, a Clear O&M Plan, and Technical Support in addition to either Addressed Sanitation Priorities and Community Participation in Planning or Behavior Change Education and Municipality Involved in Planning. All failed systems had Lack of Municipality in Planning, Unaddressed Sanitation Priorities, and No Technical Support. Most failed systems also had No Clear O&M Plan, Poor Construction Quality, Lack of Community Participation in Planning, and Insufficient O&M Funds. Two failed cases had unique pathways because Government Barriers permanently disrupted use and maintenance. Overall, implementing organizations who initiate sanitation projects in resource-limited communities should ensure that (1) communities have adequate technical and financial resources for maintenance; (2) community and municipality stakeholders are engaged in planning and know their maintenance responsibilities; and (3) appropriate technologies are selected that meet community needs and achieve community buy-in. (C) 2019 Elsevier B.V. All rights reserved.