Abstract
Unsafe sanitation is an increasing public health concern for rapidly expanding cities in low-income countries. Understanding household demand for improved sanitation infrastructure is critical for planning effective sanitation investments. In this study, we compared the stated and revealed willingness to pay (WTP) for high-quality, pour-flush latrines among households in low-income areas in the city of Nakuru, Kenya. We found that stated WTP for high-quality, pour-flush latrines was much lower than market prices: less than 5% of households were willing to pay the full costs, which we estimated between 87,100–82,900 Kenyan Shillings (KES), or 871–829 USD. In addition, we found large discrepancies between stated and revealed WTP. For example, 90% of households stated that they would be willing to pay a discounted amount of 10,000 KES (100 USD) for a high-quality, pour-flush latrine, but only 10% of households redeemed vouchers at this price point (paid via six installment payments). Households reported that financial constraints (i.e., lack of cash, other spending priorities) were the main barriers to voucher redemption, even at highly discounted prices. Our results emphasize the importance of financial interventions that address the sizable gaps between the costs of sanitation products and customer demand among low-income populations.
Highlights
Unsafe sanitation is an increasing public health concern in developing countries, in low-income areas [1,2,3,4]
We evaluated the household demand for high-quality, pour-flush latrines through a household survey and a real money voucher trial, which were both conducted from May to December 2019 (Figure 1)
We developed the study design and surveys based on our prior experience with conducting similar willingness to pay (WTP) studies in Kenya and Tanzania [7,8,11,22]
Summary
Unsafe sanitation is an increasing public health concern in developing countries, in low-income areas [1,2,3,4]. In addition to reducing health risks, access to improved sanitation provides further benefits of privacy, dignity, safety, and gender equity [5]. In low-income urban neighborhoods, households typically rely on unimproved onsite sanitation facilities (such as pit latrines without slabs or platforms) shared by multiple households or practice open defecation [6]. Only 36% of the urban population in Kenya has access to private, improved facilities [6]. Understanding household demand for improved sanitation infrastructure in these settings is one critical element of urban sanitation development efforts. Previous efforts have compared household demand and supply costs for improved sanitation products and services.
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