Amref Health Africa

African Sanitation Revolution – Financial Inclusion Improves Sanitation & Health (FINISH) Highly Ranked


We will avert diarrheal deaths through implementing a sustainable sanitation model that provides improved sanitation services to 25,000,000 people across four Sub-Saharan African (SSA) countries.

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To learn more about – or provide significant funding to – this project, please contact Lever for Change.

Project Summary

Seventy percent of people in SSA have no access to a ‘basic’ or ‘safe’ toilet [1], which causes substantial health and economic impacts. For instance, poor sanitation and hygiene contribute to the diarrhoeal deaths of 289,000 children under the age of five each year [1]. Our project will help to rectify this erroneous situation by implementing a proven, sustainable sanitation model, FINISH, which will mobilise communities, governments, financiers and businesses, to construct 5,000,000 improved toilets that will serve 25,000,000 beneficiaries across Kenya, Uganda, Tanzania, and Ethiopia as well as two additional African countries. This will reduce diarrheal disease transmission by at least five percent in beneficiary communities, reduce medical expenditures related to diarrhoea, increase the privacy and dignity of women, generate over 2,250,000 tonnes of compost annually for agriculture, and create more than 273,000 jobs. Every dollar invested will leverage 4 dollar through commercial financing creating system change.

Problem Statement

Although diarrhoea is preventable, 289,000 children under the age of five die from diarrhoea every year [2]. There is an inequitable proportion of diarrhoea illness and death in low-income countries, which perpetuates a vicious cycle of disease, lost productivity, and poverty. A primary reason for this is because 673,000,000 people, most of which live in SSA, defecate in the open [3] even where toilets exist, key aspects of the sanitation value chain (containment, emptying, transport, treatment, and safe re-use or disposal) are normally missing. Part of the problem is national and local government’s underinvestment and ignorance of the importance of hygienically separating human excreta from human contact. Additionally, in SSA high poverty levels mean that most families cannot afford to build a toilet, and, in some communities, cultural biases remain a barrier to using toilets even when they are available. Poor women and girls are most affected by this situation because of the physical risk, loss of privacy and the indignity brought about by the lack of toilets. The majority of those affected do not appreciate that beyond acting as a means of disposing of waste, toilets provide a vital opportunity for harnessing the nutrients in urine and faeces for agriculture and energy production (green economy). In most contexts, the potential of this resource for climate change mitigation, employment creation, and solving food insecurity remains underexplored. With a little investment and training, a targeted sanitation intervention can create employment and sustainably break the vicious cycle of illness and poverty.

Solution Overview

Our project will avert diarrhoeal-related deaths among children under the age of five and break the vicious cycle of poverty and disease by implementing the proven and sustainable FINISH sanitation model. FINISH began in India and was brought to SSA with demonstrable results in scaling up the construction and use of toilets. The project will mobilise FINISH stakeholders (communities and governments, micro-finance institutions and sanitation entrepreneurs) to construct 5,000,000 improved toilets serving more than 25,000,000 direct beneficiaries in Kenya, Uganda, Tanzania, and Ethiopia. Women and the youth will be trained as artisans and marketers, effectively creating more than 265,000 jobs, increasing awareness and demand for safe, affordable, hygienic and durable toilets built by local artisans, and converting faecal matter into organic fertiliser and energy (bio-gas). The project will also establish a system to track the real-time reduction in diarrheal diseases, increased household incomes, businesses, as well as jobs created, and enable women to access credit for sanitation. Past performance data and evidence shows that, through the FINISH model, this project will reach more than 25,000,000 beneficiaries; reduce diarrheal disease transmission and minimise hours lost in seeking treatment; make savings in medical expenditure; increase the privacy, dignity and social status of women; and generate more than 2,250,000 tonnes of compost annually for agricultural use. For every dollar invested, the project will unlock four in sanitation – thereby creating an enormous economic impact. A market will also be created in the green economy to build a highly sustainable intervention.

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