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Sanitation for Low-Income Regions: A Cross-Disciplinary Review

  • Hyun, Christopher
  • Burt, Zachary
  • Crider, Yoshika
  • Nelson, Kara L.
  • Prasad, C.S. Sharada
  • Rayasam, Swati D.G.
  • Tarpeh, William
  • Ray, Isha
Published Article
Annual Reviews
Publication Date
Oct 17, 2019
DOI: 10.1146/annurev-environ-101718-033327
Annual Reviews


Sanitation research focuses primarily on containing human waste and preventing disease; thus, it has traditionally been dominated by the fields of environmental engineering and public health. Over the past 20 years, however, the field has grown broader in scope and deeper in complexity, spanning diverse disciplinary perspectives. In this article, we review the current literature in the range of disciplines engaged with sanitation research in low- and middle-income countries (LMICs). We find that perspectives on what sanitation is, and what sanitation policy should prioritize, vary widely. We show how these diverse perspectives augment the conventional sanitation service chain, a framework describing the flow of waste from capture to disposal. We review how these perspectives can inform progress toward equitable sanitation for all [i.e., Sustainable Development Goal (SDG) 6]. Our key message is that both material and nonmaterial flows—and both technological and social functions—make up a sanitation “system.” The components of the sanitation service chain are embedded within the flows of finance, decision making, and labor that make material flows of waste possible. The functions of capture, storage, transport, treatment, reuse, and disposal are interlinked with those of ensuring equity and affordability. We find that a multilayered understanding of sanitation, with contributions from multiple disciplines, is necessary to facilitate inclusive and robust research toward the goal of sanitation for all.

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