Many see the provision of sanitation services as a technical challenge calling for the skills of engineers to design, build, and operate facilities. However, the need for sanitation is about individual well-being and public health, which in turn has broad economic benefits. For those benefits to accrue, the construction and delivery of sanitation infrastructure are not sufficient; it must be used hygienically and considered in broader water, sanitation, and hygiene (WASH) context.

However, the responsibilities for promotion of hygienic use is usually beyond the mandate of those building the infrastructure and given to health departments, households, and institutions.

Good hygiene is receiving more attention than ever during the coronavirus disease (COVID-19) pandemic, especially handwashing with soap for infection prevention and control. There are also many longer-term health benefits of hygienic sanitation use, such as reducing waterborne diseases, anti-microbial resistance, and reducing stunting and neglected tropical disease. Although shifting human behavior is difficult, it is important for sanitation programs to address hygiene behaviors holistically to ensure the health benefits of investments are enjoyed by beneficiaries.

Given the complex institutional arrangements surrounding sanitation and hygiene promotion, is there a case for reviewing the roles and responsibilities of institutions involved in delivering sanitation services and ensuring hygiene promotion for their proper use? Where should the roles of health departments, utilities, and public works start and finish with regard to sustainability and use of sanitation facilities? And likewise, where should the responsibilities for sustained and hygienic use of sanitation facilities lie? What innovative approaches can institutions take to improve hygiene practices? What measures are in place to measure progress in improving hygiene and ensuring sustained use of sanitation infrastructure?

This workshop explored these questions and the challenge of how sanitation service providers and health departments together ensure a holistic approach to WASH for improved health outcomes. Participants were expected to learn from sector specialists and participate in an interactive session to share their views and experiences.