UGANDA LOSES UGX 389 BILLION ANNUALLY DUE TO POOR SANITATION

Published by: Water and Sanitation Program a March 2012 edition Poor sanitation costs Uganda 389 billion Uganda shillings each year, this is equivalent to US$177 million, according to desk study carried out by The Water and Sanitation Program (WSP). The sum is equivalent of US%5.5 per person in Uganda per year or 1.1% of the national GDP. 13.8 million Ugandans use unsanitary or shared latrines, 3.2 million have no latrine at all and defecate in the open, The poorest quintile is 13.5 times more likely to practice open defection than the richest. Open defecation costs Uganda USD41 million – yet eliminating the practice would require less than 650,000 latrines to be built and used. US$8.1 MILLION LOST EACH YEAR IN ACCESS TIME Each person practicing open defecation spends almost 2.5 days a year finding a private location to defecate leading to large economic losses. This cost falls disproportionately on women as caregivers who may spend additional time accompanying young children or sick or elderly relatives. This cost is likely to be an underestimation as those without toilets, particularly women, will be obliged to find a private location for urination as well. US$147 MILLION LOST EACH YEAR DUE TO PREMATURE DEATH Approximately 23,000 Ugandans, including 19,700 children under 5, die each year from Diarrhea – nearly 90% of which is directly attributed to poor water, sanitation and hygiene (WASH). In addition, poor sanitation is a contributing factor – through its impact on malnutrition rates – to other leading causes of child mortality including Malaria, ALRI and Measles. US$1.1 MILLION LOST EACH YEAR DUE TO PRODUCTIVITY LOSSES WHILST SICK OR ACCESSING HEALTHCARE This includes time absent from work or school due to diarrheal diseases, seeking treatment from a health clinic or hospital, and time spent caring for under – 5’s suffering from diarrhea or other sanitation – attributable diseases. US$21 MILLION SPENT EACH YEAR ON HEALTH CARE Diarrheal diseases directly, and indirectly via malnutrition (and its consequences for other diseases such as respiratory infections and Malaria) are all leading causes of morbidity, costs associated with health seeking behavior include consultation, medication, transport and in some cases hospitalization – which place a heavy burden on households and Government spending. THE ECONOMIC BURDEN OF POOR SANITATION FALLS MOST HEAVILY ON THE POOREST The costs of poor sanitation are inequitably distributed with the highest economic burden falling disproportionately on the poorest. The average cost associated with poor sanitation constitutes a much greater proportion of a poor person’s income than that of a wealthier person. Access to sanitation alone demonstrates inequalities; the poorest 20% of the population are 13.5 times more likely to practice open defecation than the wealthiest 20% of the population. For the poorest therefore, poverty is a double edged sword – not only are they more likely to have poor sanitation but they have to pay proportionately more for the negative effects it has. OPEN DEFECATION COSTS MORE THAN FIXED – POINT SANITATION In costs quantified by the study, open defecation costs more per person than any other type of unimproved sanitation; the additional costs are mainly due to the time taken to find a safe, private location for defecation. Costs associated with shared sanitation are likely to be higher if time taken to reach and queue at a public latrine as well as user-fees were added. Health costs cannot easily be assigned across latrine categories. Sanitation or lack thereof is a health issue – people are affected by their neighbours and communities sanitation status as well as their own, and the costs of open defecation are felt throughout the community. Open defecation also has considerable social costs. Loss of dignity and privacy or risk of physical attack and sexual violence may not be easily valued in monetary units, but these issues are the reality when sanitation facilities are not available. WHAT NEEDS TO BE DONE Allocate higher investments to sanitation Current sanitation investment in Uganda is between 0.1 – 0.5% GDP; which is lower than several estimates for what is required. Increased investments in sanitation and hygiene promotion are required not only to realize health and welfare benefits of sanitation but also to avert large economic losses. Address bottlenecks in the service delivery pathway Financing will be more efficiently used if shortcomings in budget, equity and markets are addressed. Target investments to the poorest Sanitation inequity should be addressed through specific strategies to address the sanitation needs of the poorest. Prioritize elimination of open defecation Open defecation not only has higher costs than any other sanitation practice, it has considerable adverse social impacts. Low cost and effective ways of stopping open defecation need to be scaled up. ESTIMATING THE ECONOMIC IMPACTS OF POOR SANITATION Traditionally, sanitation has not received the priority it deserves. It has not been widely recognized how good sanitation policies and practices can underpin socio-economic development and environmental protection. This study provides an estimation of economic impacts on populations without access to improved sanitation in order to provide information on the losses to society of the current sanitation situation. While not all these economic impacts can be immediately recovered from improved sanitation practices, it provides a perspective on the economic gains that are available to countries through a range of policies to mitigate these impacts over the longer term. Underlying data sets to estimate economic impacts are weak; the study therefore uses objectively verified data sources and conservative numbers to estimate economic impacts. Several impacts have been excluded due to lack of data.