ABSTRACT
The larger study from which this chapter is drawn was commissioned by Waste Enterprisers and sponsored by the Bill and Melinda Gates Foundation. Its original purpose was to investigate ‘public toilet’ sites in Accra, Ghana, articulating the maintenance and management practices of site operators in order to identify sanitation delivery challenges and potential strategies for future interventions aimed at expanding sanitation access in Accra. One of the assumptions tested was that toilet operators will forgo important maintenance tasks because of the cost, and that those decisions will directly impact on the availability of sanitation in the city. This fear was supported by the literature. When cost structure, management, lack of public participation or the socio-political context of toilet provision results in inadequate maintenance of sanitation facilities, serious problems emerge in community health, environmental degradation and constrained sanitation access (Burra 2003; Nance and Ortolano 2007; Schouten and Mathenge 2010).
