Integrating urban household solid waste management with WASH: Implications from case studies of monitoring in sub-Saharan Africa

Water, Sanitation and Hygiene (WASH) are commonly grouped for service delivery planning, monitoring and policy, reflecting their many interconnecting impacts, but few studies articulate household-level WASH-solid waste interactions. We aim to assess mismanaged solid waste interactions with WASH that affect urban households and whether integrated waste-WASH indicators can be constructed to monitor these interactions. Via literature review, we identify three trade-offs and seven synergies between WASH and waste management for urban households. Trade-offs arise from consumption of water packaged in bottles or bags and disposable diapers (DDs), whilst synergies include opportunities for households with water services to wash separated waste or cloth diapers. One trade-off (packaged water consumption) has grown rapidly in southeast Asia and West Africa. Household surveys for Ghana and Kenya demonstrate that the urban population lacking waste collection services overlaps strongly with those lacking WASH services. In Kenya, 3.3 million people simultaneously lacked waste collection, hygiene, and basic sanitation services. Finally, we construct indicators from household survey micro-data to measure DD and packaged water consumption in households lacking waste services. Case studies show that from 2012-13 to 2016-17, packaged water consumption grew among Ghanaian households burning or dumping waste, whilst most urban Nigerian households consuming DD lack waste collection services. We conclude that household survey micro-data can be used to construct tradeoff measures to inform policy and target services towards populations simultaneously exposed to uncollected waste and lacking WASH services. However, such analyses require an institutional mechanism to coordinate cross-goal monitoring and greater survey data harmonisation. In countries where large populations lack both waste collection and WASH services or with growing DD or packaged water consumption, balanced evidence is needed on DD and packaged water's impacts from both WASH and solid waste management perspectives.