Photo story – How consumers, communities and artisans benefit from market-based sanitation in Kisumu, Kenya

By Karl Hofmann, President and CEO, PSI

When the neighborhood is vying to host the Demonstration Toilet, you know you’re onto something.

PSI’s Board Chair Carolyn Brehm and I recently travelled to Kisumu in Western Kenya along with PSI/Kenya Country Rep Kipng’etich Mutai and PSI Malaria/WASH Director Tarryn Haslam to visit with the PSI staff starting up our new Western Kenya Sanitation Program and to see how the program is resonating with the community. For this USAID-funded activity, PSI works under overall project leadership of RTI and in partnership with AMREF, on market-based sanitation and menstrual health and hygiene initiatives in Kenya’s third-largest city and in eight counties in Kenya.


Photo – Carolyn Brehm (Board Member), Kipng’etich Mutai (PSI Kenya Country Rep), Tarryn Haslam (Director Malaria and WASH) arriving in Kisumu

Unlike the Nairobi area, which is struggling with near drought conditions, Western Kenya is green and vibrant as we fly in to the shores of Lake Victoria.

Kisumu County health leaders told us that latrine coverage in the county is high, but improved toilets are rarer.  Sanitation is among the challenges the county is addressing, where malaria and HIV incidence are above the national average, and contraceptive access is lagging.  Teenage pregnancy and high infant mortality are issues.  Nutrition challenges are adding to maternal and newborn morbidity.

Improved sanitation has a central role to play in this health needs mosaic, and through this program, PSI will use its lessons from market-based sanitation programs around the world to transform the sanitation landscape in Western Kenya.

First stop:  the vocational training center, where masons-in-training have learned new techniques for mass producing improved, lower-cost toilet components.  Experimenting with cement, rebar, bamboo and other materials, the masons show off with pride their components and discuss pricing strategies. The Rotary Training Center in Kisumu hosts 900 young men and women in various skills training programs, and the center’s director is proud to showcase this group’s work. Collaborating with existing training centers is part of the project’s sustainability strategy to ensure that high quality sanitation technical training is available over the long-term.

Photos – Vocational training for masons

Next, a visit to consumers who are using the new, improved toilets in their homes. 

Rose Adhiambo proudly welcomed us to her property in the outskirts of Kisumu, a mix of smallholder plots, cornfields, homes, and a few schools. This is a relatively prosperous peri-urban area, but Rose’s new outdoor toilet with its Lixil-made SATO pan receptacle, set into the masons’ new concrete slab to cover the latrine pit, gets lots of attention from the neighbors, who join us to discuss the toilet’s advantages: cleanliness, ease of use, lack of flies and smells.  Rose mentions she lets neighbors use it sometimes.

Photos – Rose Adhiambos home visit

Next, we visit Magdalina Amino Owak, who is one of the area’s elders who, at 80 years old (she proudly tells us), struggles with mobility. She too is pleased to show off her new, improved toilet featuring a raised seat that allows her all the advantages of Rose’s facility, plus a much easier entry and exit.  The county’s Community Health Volunteers are nearby, as they’ve been checking on Magdalina. 

Photos – Magdalina Amino Owaks accessible toilet


Photo – Kipng’etich Mutai checks out a sanitation facility

Looks like the improved sanitation facilities are a hit with the masons who have a new, desired product, and with consumers who are experiencing the benefits. 

By addressing both the supply and demand sides of the improved sanitation market gap, sustained progress is possible, but pricing, the input supply chain, communications, and the ability to iterate the offering are all key issues to address.  This new program will have to navigate these challenges and undoubtedly others, but early technical assistance has come from PSI’s Ethiopian team who have been implementing a similar USAID-funded program there for several years.  (The masons loved discussing what Mesfin Habtemariam from PSI/Ethiopia had taught them during his visit.) 

Critical to the success of any such program, the county health officials have a supportive mind-set.  “For this to have sustained impact, we know it has to happen outside the health department’s programs” and with private sector actors, we heard from them. 

I’m optimistic that Kisumu and its surrounding region will show leadership in market-based sanitation over the years ahead.  With new entrepreneurs, new artisans, new consumers and the community as a whole all benefiting.

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