The Sanitation Situation in our Target Zones – What We’ve Learned So Far

In October 2023, SOIL launched a baseline survey study to collect and compile data points on sanitation access and behavior in the zones targeted for expansion in our pilot with IDB Lab’s Outcomes for Change Fund in Haiti. 

Comparing collected data around toilet ownership and open defecation practices will help our team pinpoint the severity of sanitation access issues for individual households in these areas and ensure that we are supporting the most vulnerable residents in and around Cap-Haitien. The collected data will also help identify current sanitation practices and establish a baseline so our team can track progress towards improved sanitation coverage  and behavior change over time. 

In February, SOIL began a partnership with Aquaya, an established research consulting firm with significant expertise in launching targeted subsidy studies in several other countries, in order to further refine our data collection methodologies and help us design a follow-up exploratory study on the potential for deploying targeted subsidies to reduce the barriers to access experienced by the most vulnerable. We’re excited to share some of our findings: 

• Baseline values for sanitation coverage and open defecation across all target zones was verified.

Sanitation coverage (private toilet ownership) = 61%

Open defecation (OD) = 19% (exclusively among non-toilet owners)

Most of the households surveyed reported that they used a toilet, owned their home, and owned a private toilet, initially giving the illusion that the target population may be better off financially than originally thought and that subsidies may not be a necessity.  However, further analysis helped us understand what was really happening at the household level uncovering some major differences among the different communes but also within neighborhoods.

Among those that reported open defecations, we found this to be practiced exclusively by households who did not own a toilet. Unsurprisingly, satisfaction with the sanitation options available to them were lowest among households practicing OD (97%) or not owning a toilet (87%). 

While many of our findings confirmed our intuition about the sanitation situation on the ground, we made a few interesting discoveries that did not necessarily fit our prior beliefs such as:

• 24% of households who owned toilets also reported dissatisfaction with their toilet, thus representing another group that we may be able to bring on to the EkoLakay service. 
• Toilet ownership and open defecation were frequent among reported home-owners and non-homeowners alike thus debunking our assumptions of homeownership advantages. 

As anticipated, disparities in sanitation access and OD practice were more pronounced after factoring for wealth quintiles with the most vulnerable households most likely to lack access to a toilet . We found that a lack of toilet ownership was primarily attributable to cost with a caveat found in the wealthiest quintile where they mostly reported lack of home ownership as the primary reason for not having  a toilet.  The reported financial barriers substantiated our previous findings on cost being a main driver for Ekolakay attrition and underscores the value of future subsidy offerings, particularly among those in the bottom quintiles. 

Geospatial Analysis

In addition to our findings at the commune  level, we also marked the subzone for every household and their individual GPS coordinates to help us differentiate the sanitation situation within our target zones. Our analysis using the GPS coordinates afforded us the opportunity to gain previously unknown geographic insights related to our key study variables. For example, in Fort St Michel, the zone containing the poorest population within our target areas, open defecation was more concentrated in households near the water. This highlights the urgency for EkoLakay to expand service offerings within these locations to further mitigate the increased risk of water contamination and disease spread such as in the case of cholera. 

Fort St Michel

We also found that open defecation was higher among households whose neighbors practiced OD. While more can certainly be studied to better understand the nuances of OD and the impact of neighbors’ sanitation behavioral practices, this learning could be a potential asset down the line as we develop future strategies related to sanitation education and subsidy provision. 

For those living in lower density areas, this proved to be yet another surprise as we originally envisioned higher OD rates in denser areas (less space for toilet facilities). We now theorize that increased privacy and opportunities for finding open spaces in these lesser dense areas may be an even greater driving force behind OD thus necessitating a closer look at other similar geographic areas and their risk for high OD activities. 

The conclusion of our baseline survey study analysis has been critical in helping us chart a path forward with our ultimate goal of developing an appropriate targeted subsidy strategy. It provides us with the evidence to help focus our efforts by using equity based approaches. Based on Aquaya’s experience with targeted subsidy tool development in Ghana, our next steps seek to look beyond the Equity Tool and also identify vulnerability factors that are Haiti-specific and may help us further enhance our eligibility identification capabilities.

Our approach to identifying vulnerability factors will be further refined by our launch of stakeholder interviews in the coming months. The goal of these interviews will be to gain different expert perspectives around vulnerability factors and will pull from the experience of SOIL employees, our partners at DINEPA, OREPA and MSPP, as well as local community leaders. Feedback from the interviews will also serve to help us better understand policy, administrative and local considerations when launching a targeted subsidy program. These will take place in the form of interviews and workshops and we look forward to continuing to share more of our findings as they become available.