Globally, a large proportion of people without access to sanitation live in rural areas (79%). Rural populations are dispersed, especially in most Sub-Saharan African countries, and are therefore difficult to access and expensive to reach with services. On one hand, a view exists that sanitation is not a huge 'felt' need for rural populations because their surroundings – fields, bushes and forests – enable open defecation, unlike in urban areas. On the other hand, supply-driven approaches, often subsidised by governments, have failed across many African and Asian countries. Obstacles to improving sanitation The ‘community-led total sanitation’ (CLTS) approach, created in Bangladesh around 2000, seemed to answer both of these problems. CLTS is intended to promote behaviour change to trigger demand for latrines, removing or reducing the need for external financial support. But concerns arose. People might choose sanitation options that were not necessarily 'improved'. Rural communities might not have sufficient information about appropriate toilets or the possible options. Communities might lack trained masons who could construct toilets of sufficient quality. An improved, appropriate toilet could also be expensive and out of reach of poor people. These factors could block attempts to scale up solutions that might have been successful at a pilot level. Answering the issues These were some of the considerations that encouraged the WaterAid Tanzania team to investigate viable options for a sanitation market combining some of the key elements of behaviour change, information, technical skills and financing options. In 2010, the team came up with the ‘Mutumba’ approach (Mutumba being the name of the village where this idea was generated). The team aimed to bring together some of the new ideas about promotion of sanitation and hygiene and combine them with participatory approaches and marketing principles. They therefore engaged with local NGO Sema and the local district authority in Nzega of Manyara region to set up a ‘sanicentre’ – a centre that would demonstrate the different options for toilets, explain appropriate conditions for each option, provide cost and financing options, and offer trained masons for construction to ensure quality. The centres would not provide subsidies. To encourage people to visit the centre, active behaviour change interventions would be established to raise awareness of the need for hygiene and improved sanitation. I visited this sanicentre in 2010 and was impressed by its professionalism and how interested in it the local district was. But I still wondered whether it was a replicable model. A model sanicentre An Iraqwi woman standing outside her improved toilet, Mbulu district, Tanzania, 2011. Credit: WaterAid In 2011 I had the opportunity to go back to Tanzania, to Mbulu district of Manyara region. With our team, I visited the Maratedu Ju Sani Centre. I could see that this too was a very professionally set up centre, demonstrating about 15 different toilet options. The staff running the centre clearly wanted toilets to be something that people would aspire to have and be proud of. About six options were most popular to local people based on cost and aesthetics, but also because they seemed to be appropriate for their environment and matched the way their houses were constructed. Some people were interested in the ‘EcoSan’ compostable options, which was encouraging. I was very pleased to hear that this centre had been attracting attention. Set up 18 months ago, the centre initially catered to a population of about 60,000, but had started attracting interest from areas further away as the word spread. However, what struck me most was that this sanicentre was set up by the local district authorities. The total cost was 26 million shillings, of which the district invested 20 million and the local community contributed 6 million. DMDD, WaterAid’s local partner, provided technical support and guidance, and WaterAid’s role was to facilitate links between the local community, district and partner. Initial outcomes are encouraging. Although only about 7% of Tanzania’s rural population has access to improved sanitation, in Mbulu district this is now 48.9%. If this outcome can be replicated by other districts, I’m optimistic about Tanzania’s prospect of achieving universal sanitation. Girish Menon is WaterAid’s Deputy Chief Executive and Director of International Programmes. You can read more of his blogs here and he tweets as @GirishMenonWA For global policy, practice and advocacy updates and discussion, follow @wateraid on Twitter.