Multi-level sanitation governance: understanding and overcoming challenges in the sanitation sector in sub-Saharan Africa

Nelson Ekane, Stacey Noel, Björn Nykvist, Nina Weitz, Marianne Kjellén

Research output: Contribution to journalArticleAcademicpeer-review


The provision of sanitation facilities - a basic necessity for human health, well-being, dignity, and development - remains a mammoth challenge for developing countries where the vast majority of the 2.5 billion people without improved sanitation facilities reside. Sub-Saharan Africa (SSA) is one of the regions where decent, dignified, and functional toilet facilities remain largely inaccessible. Most of the countries in SSA will miss the Millennium Development Goal (MDG) for sanitation. There are sharp contradictions in the region between formal and informal sanitation institutions. There is also a disconnect between actors at the macro, meso, and micro governance levels. This paper shows how multi-level governance analysis, path dependency, and institutional inertia can be used to improve understanding of some challenges in the sanitation sector in SSA, and discusses approaches that can contribute to improving the sanitation situation in a sustainable way. In addition, the paper asserts that demand-driven strategies and private sector involvement in the sanitation sector is paramount for establishing new sanitation paradigms and sociotechnical regimes. We conclude that a good understanding of actors at all levels - their various roles, interactions, and the way they interpret and respond to policies - is key to accelerating progress in sustainable sanitation coverage in SSA.
Original languageEnglish
Pages (from-to)242-256
Number of pages15
Issue number3
Publication statusPublished - 2014


  • Sanitation
  • Hygiene
  • Functionality
  • Multi-level governance
  • Institutions
  • Institutional inertia
  • Path dependency
  • Coordination
  • Socio-technical regimes
  • Demand-driven


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