Click below to download our latest white paper about the 3SI project for rural sanitation in Bihar, India. 

& Hygiene

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Watch how PSI partnered with Unilever’s Domestos Toilet Academy to address critical barriers to toilet ownership and increase access quality sanitation in Bihar, India.


Diarrheal disease linked to unsafe water, sanitation and hygiene is still a leading cause of childhood death in most developing countries, leading to more than 500,000 deaths of children under 1 each year. In sub-Saharan Africa alone, the World Bank estimates that more than $5 billion is lost each year due to death, healthcare costs and losses in productivity.

PSI works to improve the health, safety and economic opportunity of low-income families in the developing world by increasing access to affordable water, sanitation and hygiene (WASH) products and services that customers want to use. We leverage the expertise and resources of the public and private sectors to maximize the health impact of our WASH programming.

How we

Asset 17


Asset 26

Market Development



Asset 9


The Three Pillars of our Work in
Water, Sanitation and Hygiene


We work to activate and shape sanitation markets.

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We use consumer-centered design to create quality sanitation products.

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We strengthen systems to create an enabling environment for sanitation.

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Here's how our WASH interventions have provided 672,000 years of healthy life for our clients:

Since 1996, we’ve distributed more than

1.6 billion

household water treatment products

Since 2012, PSI has facilitated the sale of


hygienic toilets through private sector actors

We’ve facilitated hygienic toilet sales in



We’ve safely managed more than

27 million

liters of fecal sludge in 3 countries

Our WASH Solutions

Because providing sanitation for low-income consumers is rarely viewed as a profitable business opportunity, people who want a toilet often can’t get one. PSI engages the private sector to demonstrate the market opportunity and supports businesses to introduce profitable sanitation products and services into their offering. Through demand aggregation and introduction of better products, PSI also works to engage higher capacity, larger business that can bring sanitation to scale. And through helping businesses formalize and improve business practices, we help entrepreneurs grow and reach more customers.

Microfinance institutions rarely develop loan products for families to purchase toilets, as they do not contribute to an income generating activity. Moreover, loans are also usually unavailable for service providers, who are largely small, informal businesses. This lack of access to finance inhibits growth of the supply and demand side of markets. PSI works with customers and entrepreneurs to qualify for loans and with microfinance institutions to develop sanitation loan products.

In some places, even people who have toilets in their homes do not use them. This is particularly true for men, who are often comfortable defecating in the open. PSI develops and executes behavior change campaigns to increase use of toilets by all members of the family.

In most places, the majority of rural consumers have either built their own toilets using local materials or been given a subsidized toilet through a donor or government-funded project. As a result, they are not aware of or have never been offered a desirable toilet that they can afford to buy. Through direct door-to-door sales, PSI increases awareness of new and better toilet solutions and connects them directly to service providers.

While the private sector provides a huge percentage of sanitation services, from toilet solutions to septic tank emptying, the companies are usually informal and not acknowledged by the government as a critical part of the sanitation economy. As a result, there are often policies in place that make it difficult for sanitation entrepreneurs to succeed, such as expensive fees to use treatment facilities. PSI advocates with governments to remove these barriers and proactively engage the private sector as critical partners in solving the sanitation crisis.

PSI has drawn on its global expertise in social franchising and marketing to develop a unique public toilet franchise in Ethiopia. This business offers safer, more convenient and more hygienic toilet and shower facilities than provided by other public toilet operators, including the government. These public toilets provide a critical service to people living in urban areas, without access to household toilets.

Featured Projects

USAID Transform WASH and USAID Growth through Nutrition Activity

Donor: USAID

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Supporting Sustainable Sanitation – Pathways to Scale

Donor: Bill & Melinda Gates Foundation

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Hygienic Toilets for All: A Market Entry Program in Ghana

Donor: USAID and Lixil

Project Lead: PSI

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WASH Experts

Jennifer Marcy

Senior Technical Advisor, WASH PSI

John Sauer

Senior Technical Advisor, WASH PSI


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