Identifying Constraints to Increasing Sanitation Coverage

Sanitation Demand andSupply in Cambodia Analysis of the sanitation supply chain and household sanitation demand shows that growth in coverage can be stimulated by making sanitation products and services more available, attractiveand affordable while at the same time overcoming the prevalent high-end facility preference.

The Water and Sanitation Program is aninternational partnership for improving waterand sanitation sector policies, practices, andcapacities to serve poor people

October 2008

Field Note

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Developing market strategies that supply the required information, productsand service and that focus on demand creation among consumers maycontribute to increased sanitation coverage in Cambodia.

1 Economic impacts of sanitation in Cambodia. Kov P, Sok H, Roth S, Chhoeun K, Hutton G. World Bank, Water and SanitationProgram. 2008. Download from: http://www.wsp.org/pubs/index.asp

Background and Rationale

Only about 17% of Cambodian rural poorhouseholds have access to improved sanitation facilities - latrines which effectively separate human excreta fromhuman contact (see box 1 for the definition of improved sanitation). At current rates of latrine construction andpopulation growth, Cambodia’s sanitationsector Millennium Development Goal for2015 (30% coverage) will not be reachedfor more than 30 years, and full coveragenot reached for more than 100 years. Thisshortfall will have serious consequencesin terms of health, environment, waterresources, economic opportunity, andhuman dignity—consequences that willbe felt by women. The recent Economicsof Sanitation Initiative (ESI) report1 by theWater and Sanitation Program (WSP)highlights that the economic loss due topoor sanitation in Cambodia totals $448million per year: $187 million in healthcosts, $149 million in water access costs,$38.2 million in time loss, and $73.7million in tourism loss.

Executive Summary

This field note summarizes research from two studies undertaken

in rural and peri-urban areas of Cambodia; one on the demand for

latrines among consumers, and the other on the supply of latrines

by the private sector. It provides discussion on the opportunity to

increase latrine purchase and installation via market forces, and

outlines the recommended interventions on both the demand and

supply dimensions of the market to achieve this.

There is a strong demand for latrines among the Cambodian

population, yet this demand remains mostly unrealized. While there

is a functioning market for latrines, it is constrained by a strong

preference for unaffordable top-end designs on the consumer side,

and a limited ability to supply lower cost or upgradable latrines on

the supply side.

These weaknesses can be addressed. It has been demonstrated

through Community Led Total Sanitation (CLTS) efforts that the

high-end design preference can be overcome and consumers will

construct cheaper latrines if adequately motivated to do so.

The supply side needs to be strengthened to provide for the

cheapest and mid-range end of the market. The components of

cheaper designs are available. However, cheaper design options

are not ‘ packaged’ in a way that is obvious or easily accessible

to consumers, nor with clear pricing information, nor in a way

that maps out an upgrade path starting with a lower cost initial

investment.

Developing market strategies that supply the required packaged

information, products and services and that equally focus on

demand creation to persuade consumers to consider alternate

and more affordable options, may help turn stated demand into

an actual acquisition and contribute to increased sanitation

coverage in the country.

Sanitation Demand and Supply in Cambodia

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The private sector continues to providethe majority of latrines installed in thecountry. This private sector ischaracterized by a fragmented network of businesses including importers oflatrine components and constructionmaterials; local manufacturers, wholesalers, and retailers of latrine components/construction materials; and masons that provide constructionservices. In most cases, latrines or latrinecomponents form only a small part of thetotal product or service offering fromthese suppliers. Latrines are not an off-the-shelf product, rather they aremade from a range of components andmaterials brought together at the installation site, and either constructed into a latrine by a local mason, or self-built by the purchasing family.

There is much hope for a demand-drivenapproach to increasing sanitation coverage in Cambodia. Such anapproach requires interventions thataddress both the supply and demand forlatrines. On the demand side, social marketing strategies that increase thedemand for latrines. On the supply side,

product and service offerings that aremore tailored to the consumers needs,thereby making latrine purchase moreattractive and affordable.

This two-pronged strategy – facilitatingsupply and stimulating market demand –needs to be designed with a clear and in-depth understanding of both the supplyand demand sides of the market. For thispurpose, two reports commissioned by theWorld Bank’s Water and Sanitation Program(WSP) in Cambodia – one on the demandfor latrines, and the other on the supply of

latrines in rural and peri-urban areas ofCambodia – provide the necessary insightsand information to (a) verify whether thereis opportunity to increase latrine purchaseand installation via market forces, and (b)to outline the required interventions onboth the demand and supply dimensionsof the market to achieve this.

This field note summarizes the researchfrom these two field studies, and providesdiscussion and analysis specifically toinform the design of, and priority focusareas for, downstream market facilitation.

This field note utilizes the Cambodian definitions of improved and unimproved sanitation

options, which are based on those used by the JMP (Joint Monitoring Programme of

UNICEF/WHO):

. Improved sanitation options: . Unimproved sanitation options:

Flush or pour flush to sewerage Any public or shared latrine

Flush or pour flush to septic tank or pit Flush or pour flush to elsewhere

Pit latrine with slab Open pit latrine without slab

Ventilated Improved Pit latrine Latrine overhanging water

Other options

Box 1. IMPROVED AND UNIMPROVED SANITATION OPTIONS

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The private sector is responding to an unsubsidized demand for latrines andproviding by far the majority of latrine installations in Cambodia.

Survey Methodology

The demand and supply surveys wereundertaken in both rural and urban settings. The rural areas surveyed werein Kandal, Siem Reap, and Svay Riengprovinces, and the urban locations werePhnom Penh, Siem Reap and Svay Riengtowns (see Figure 1 for a map of the project areas). This survey areaencompassed a range of socio-economicand environmental conditions that arebroadly representative of rural and urbanareas in Cambodia. In addition theyinclude areas with high, medium, and lowaccess to sanitation. Two villages whichhad been involved in Community LedTotal Sanitation (CLTS) programs were purposefully included because of theinterest in complementarities betweenCLTS programs and market strategies.

The demand survey covered a total of 41 villages and 939 households whichincluded both latrine owners and non-owners. In addition, six focus groupdiscussions were conducted with a totalof 44 participants including women andmen, latrine owners and non-owners.

The supply study consisted of 131 interviews and four focus groups, withrepresentation from the entire latrine supply chain - masons, concrete ring and slab producers, hardware retailers,and construction material importers/wholesalers. In addition to these privatesector interviews, international andnational organizations active inCambodia’s sanitation sector were alsointerviewed.

The research techniques were designedto yield both qualitative and quantitativeassessments of the supply and demandof latrines in order to ascertain whetherand how the market can be stimulated toencourage increased latrine purchases.

Discussion ofFindings

Supply Side: The Private Sector LatrineSupply Chain

The private sector is responding to anunsubsidized demand for latrines andproviding by far the majority of latrineinstallations in Cambodia. This privatesector is characterized by a fragmentedset of independent businesses, eachsupplying one or other of the ‘ingredients’of a latrine construction, or the on-siteconstruction service itself.

Latrine construction requires a range ofconstruction materials which, dependingon design, could include cement, bricks,sand, gravel, plastic pipes, wood, tinroofing, etc. These materials are notunique to latrines, and their availability isdriven by a much larger demand for non-latrine construction activities. Separateconverging supply chains – connectingmanufacturers, importers, wholesalers,and retailers – for each of the constructionmaterials bring them together at the consumer level. The various actors inthese supply chains do not considerthemselves as suppliers of latrine components, but rather suppliers to thegeneral construction trade.

Figure 1. Map of the project area

[This map is for illustrative purposes and does not imply theexpression of any opinion on the part of the authors or publishers ofthis report concerning the legal status of any country or territory orconcerning the delimitation of frontiers or boundaries.]

Sanitation Demand and Supply in Cambodia

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In addition to construction material producers and suppliers, and closer tothe consumer, exist two other businessesthat provide services for latrineconstruction. These are (1) masons, whoprovide construction services, and (2)prefabricated concrete producers, whomake concrete components for theconstruction trade – concrete rings thatare used for well linings, water tanks, orsoakaway pits, reinforced concrete slabs,etc. These two business types – masonsand prefabricated concrete producers –derive proportionally more of their incomespecifically from latrine construction thanany other businesses – in rural areasapproximately 30% and 40% respectively.

However, neither of these businessservices are essential to a latrineconstruction nor are prefabricated concretecomponents required for simpler latrinedesigns. Additionally, when consumersdo contract mason services, they do notnecessarily outsource the entire job, butemploy a mix of skilled and unskilledmasonry combined with their own labor.

The schematic of the supply chaindepicted in Figure 2 outlines the supplystructure for latrines in Cambodia, and forthe material supply considers in particularthe flow of latrine pans/bowls since this isthe one component that is unique tolatrine construction.

It is easy to see from this schematic thatthe latrine supply is structured across anumber of businesses and serviceproviders, all or none of whom could beinvolved in a particular latrine constructionproject.

This fragmentation arises due to the factthat the construction of a latrine requiresa variety of hardware and human inputs.This characteristic, and the fact thatlatrines only account for a relatively small

amount of each of the businesses’ activity,results in a supply system that has limitedability to innovate, package, or priceproducts/services that could yield moreattractive, simpler, and clearer purchaseoptions for consumers.

There is little evidence of any kind of promotional activities on the part of anyof the supply chain actors. Rather thanreach out to find and attract new customers, the supply system remainspassive, simply reacting to consumerdecisions to build a latrine. This is notsurprising: The naturally competitive supply chains for construction commoditiesresult in tight profit margins and proactivemarketing is expensive either in cash

terms or time-input. Masons, who wouldpossibly be best placed to market theirservices verbally and therefore at relativelylow cost, suffer from a lack of trust amongconsumers that discredits them asproviders of reliable or credible information.

In addition to this lack of trust in masonsthere is a problem of quality. By definition,an improved latrine can be a simple construction. However, factors such asthe latrine design and construction quality, and the latrine placement in relationship to water sources or food storage and preparation areas can seriously affect consumer benefits interms of health and environment, or simply value for money.

NGOs

Masons

Concrete Producers

Large Construction Companies

Small Retailers Large Retailers

50%

30% 20%

75%

25%

70%

10%

20%

30% 40% 30%

Consumers

Importers of Latrine Pans/Bowls(Vietnam, Thailand, and China)

Figure 2. Schematic latrine supply chain in Cambodia

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The private sector is often cited as providing poor quality, and neither they,nor consumers are equipped with the knowledge or skills to ensure latrineconstructions do indeed yield improved sanitation.

The private sector is often cited as providing poor quality, and neither they,nor consumers are equipped with theknowledge or skills to ensure latrine constructions do indeed yield improvedsanitation.

Whilst the supply chains for latrines havethe aforementioned limitations, it is clearthat there is a self-sustaining private supply network that is making all latrinecomponents and construction servicesavailable to willing consumers.

In addition to the commercial enterprises,projects promoting sanitation throughconstruction also play a role in the latrinesupply market. The approach is projectspecific, and ranges from assistance withfinancing to complete and fully subsidizedlatrine installations. The chosen approachmay or may not be supportive of the localsuppliers depending on whether theorganization contracts local services, orprovides centrally contracted latrine construction bypassing local suppliersand service providers. The latter practice

– ordinarily driven and justified by costsavings and control over procurementand construction quality – can be detrimental to, rather than supportive of,the business of local suppliers and contractors.

More detail of each of the types of supplyenterprises is provided below, and assistance that could help them play theirrole and reap the benefits of increasedlatrine installations via market interventionsare discussed at the end of this field note.

Sanitation Demand and Supply in Cambodia

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Importers and wholesalers:

Importers and wholesalers are enterprisesthat import construction materials (e.g.cement, ceramic pans, PVC tubing, galvanized steel sheet, tiles, etc.) fromoutside Cambodia for wholesale in thecountry. They sell to retailers, constructionprojects, and may also sell small amountsdirectly to consumers. Latrine componentsare generally a minor part of their productrange.

Nearly all construction materials used inCambodia currently come from China,Thailand and Vietnam: cement, steel,ceramic floor and wall tiles, roof tiles,latrine accessories, insulation products,paint, gypsum board, PVC pipe, etc.

The importers and wholesalers are farremoved from the end-consumers, andtrade their products – essentially construction commodities – with limitedunderstanding or interest in their end use.The supply study concluded a range ofconstraints impeding these businesses:limited market information, their characteristically passive sales approach,limited coordination in downstream supplychains, working-capital limitations, etc.However, interventions that would addressthese issues would have minimal trickle-down effect to reduce the cost of latrines,otherwise benefit latrine purchasers, orstimulate greater latrine sales.

Retailers

Retailers are typically family-ownedshops in urban or rural markets that sellconstruction materials including latrinecomponents. There is usually more thanone in each local market, creating a competitive retail environment, especiallyin the provincial town markets. About60% of the rural retailers’ latrine-pansales occur in the dry season, coinciding

with the post-harvest cash and laboravailability among the local population.

Sales figures for latrine pans averageabout seven units per month for ruralretailers and some 30 units per month forurban retailers. Latrines only account fora small part of these retailers total salesactivity - latrine-pan sales represent only3-5% of their total sales, though they alsosell other construction materials requiredfor a latrine. About 50% of their latrine-pansales are direct to households, about 30% to concrete ring and slab producerswho embed them in concrete and re-retailthem, and about 20% to NGO sanitationprograms. Retailers reported that ceramiclatrine pans are heavy to transport and

are easily broken during transportation orstorage.

No examples were found of retailers havingservice contracts with masons to installlatrines for retail customers. However,when retailers acted as suppliers on contracts tendered by CommuneCouncils, NGOs, or government and private contractors, some of them subcontracted or partnered with masonsto execute the contract services. It maybe possible to extend this ‘bundling’ of services – retailer and mason roles - toretail customers, especially if these customers could themselves group toderive multiple latrine constructions undera single contract.

How can we use importer and wholesaler information for marketing purposes?

The importers/wholesalers are critical to the overall availability of construction materials in

Cambodia, and they do provide (1) a conduit to making available cheaper latrine

components such as PVC latrine pans that are not presently available in the country and

which may be marketable, and (2) a ‘wholesale’ information channel to access large numbers of

retailers throughout the country should downstream interventions need to achieve this.

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The prices of concrete latrine components varied significantly from area toarea - some areas retailing at double the price of other areas.

How can we use retailer informationfor marketing purposes?

Whilst latrines make up only a small part of

the retailers total trade, they are a key

point in the supply chain due to the fact

that most people that construct a latrine

(except perhaps for the simplest pit

latrines) will procure materials from one of

these shops. They are therefore perfectly

placed as a point-of-sale source of

information for consumers, which could

include technical advice, distribution of

non-technical promotional information, or

contact with qualified installers. Bundling

retail services with construction services

could offer cost savings and better quality

management, but would probably require

consumer grouping to make the

proposition attractive to suppliers and

contractors.

Prefabricated concrete producers

Prefabricated concrete producers manufacture and sell such products asconcrete rings for wells, water tanks andlatrines, and slabs for use in latrine construction. Some of the largerproducers situated closer to urban areasalso sell tiled concrete slabs withembedded ceramic pans. Producers’latrine related sales are proportionatelythe highest among all supply chainmembers, with about 40% of productused for latrines in rural locations and65% in urban locations.

A relatively low capital requirement forentry (about $300) and simple skillrequirements has permitted many micro-enterprises to set up concrete production. As many as 6-8 concrete producers may be located in a provincialtown and 2-3 in a rural district center.

The prices of concrete latrinecomponents varied significantly from area to area – some areas retailing atdouble the price of other areas, duemainly to the regional variation in thecosts of inputs – well-graded sand andgravel varies in cost proportionally to itsaccessibility.

Concrete producers in urban areas are typically full-time businesses with less pronounced seasonality of demand(about 60% dry season versus 40% wet season). In rural areas, sales aremore seasonally variable, with the dryseason accounting for about 80% ofannual sales. This leads to a seasonalturnover of labor and a less experienced workforce, which may also affect quality.

Sanitation Demand and Supply in Cambodia

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Masons

Masons are construction workers whobuild latrines as a part of their generalconstruction services. They range from:(1) skilled masons with advanced masonry and construction skills, and whotypically lead a construction team, earning $5 - $10 per day, (2) Simplemasons that have basic skills and wouldtypically work under the supervision of askilled mason, earning $3 - $4 per day,and (3) laborers who are unskilled workers providing simple manual taskslike digging, mixing, carrying materialsetc., earning $1.50 - $2 per day.

The cost of hired labor for latrine construction can be divided into twoparts: for the substructure which includesdigging the pit and installing the concreterings, slab, and pan – ranging from $25to $50; and for the superstructureincluding the shelter walls, roof, and door– ranging from $50 to $150. These ratesare prohibitively expensive for much ofCambodia’s population, and manyhouseholds therefore opt to constructlatrines on their own, or with only partiallyhired assistance. Thus households tendto manage the construction themselves,and also procure their own construction materials – in only 20% of the surveyedhouseholds did the masons purchasematerials on their behalf.

There is a large demand for masons inurban areas, enticing rural masons to

urban centers to earn more. Ruraldemand for masons’ latrine-building services is mostly in the dry season(about 75%), whereas demand for theservices in urban areas is less seasonally dependent with the dry seasonaccounting for about 60% of latrineconstructions.

Similar to the prefabricated concrete producers, the percentage of income thatmasons derive specifically from latrineconstructions is relatively high,accounting for about 30% of the annualincome in rural areas. This fact couldmotivate masons to actively participate in promotional activities. However, thedemand survey revealed a significantlack of trust in masons among consumersand within the supply chain, with retailersciting masons as a common source ofbad debt.

At present, masons’ knowledge of latrine design is very low due to a lack

of any formal training, and hence theirability to communicate latrine designinformation and choices to consumersis limited. Even with the right designinformation, the quality of construction is generally poor, due to both cost-cuttingas well as the level of technical ability.

How can we use mason informationfor marketing purposes?

Whilst masons are impeded by a lack of

trust among their consumers, and many

consumers do not employ masons for

their latrine installations, they are

nevertheless a significant player in the

supply of latrines, and therefore well

positioned to provide information on

design and construction options to

consumers. This would require training of

masons to improve their design/construction

skills and knowledge, whilst simultaneously

easing their low credibility through

co-branding with, or endorsement by,

more trusted information providers.

How can we use concrete producer information for marketing purposes?

Producers’ income is highly dependent on latrine sales, giving them a strong incentive to develop increased demand, and positioning them as a

good source of information for consumers.

Concrete rings and slabs made by producers are all of the same basic type, and there have been limited attempts to innovate simpler and

cheaper approaches (ferrocement, bamboo-reinforced concrete, etc.) under Cambodian conditions. Design innovations could be introduced

via these producers, hence increasing the range of design choices available to consumers.

Demand Side: Latrine Consumers

The demand study provides valuableinformation about latrine owners and non-owners from a variety of angles: their attitudes toward latrine construction– current and desired latrine types,designs, and pricing; perceivedadvantages and disadvantages ofownership; perceptions of and interactionwith the supply businesses; the purchasedecision-making process; healthawareness with regard to latrines; theranking of latrines as a purchase priority;common sources of health information, etc.

This information – both qualitative andquantitative in nature - is interesting initself, but also critical for the design ofsocial marketing strategies that seek toincrease unsubsidized demand forlatrines. The major findings of the researchare presented below, and alongside this,comments and considerations as to itsrelevance toward downstream marketingstrategies.

Income and latrine ownership

The demand survey categorizedconsumers into five categories (quintiles)of income. Not surprisingly, there is acorrelation between increased latrineownership and increased income. Thatsaid, there are poor families who own alatrine, and wealthy families that do not.Latrine ownership ranged from 8% to33% from the poorest to wealthiestquintiles in rural areas, and from 28% to84% in urban areas.

The majority (83%) of these householdshad managed to pay for their latrineswithout any external project assistance:however the 17% that received subsidizedlatrines (with varying degrees of subsidy)are a significant part of the market.Subsidies, depending on their scale andhow they are delivered, can generate await-for-the-free-latrine mentality thatcompetes with market initiatives targetinglower-cost unsubsidized installations.Furthermore, there seemed to be littlecorrelation between the income groupings

and those that had received subsidizedlatrines. Seventeen percent of the wealthiestfamilies had accessed a subsidized latrine,indicating that sanitation projects werenot successfully prioritizing the poorestfamilies when awarding subsidies.

The demand survey sought to ascertainthe reasons why non-owners did not owna latrine - respondents were not promptedwith any pre-formatted responses andthey could cite as many reasons as theyliked. Ninety-five percent of them gave“too expensive/don’t have enough money”as one of the reasons for not owning alatrine. In a separate survey question,only 4% of these households reportedbeing satisfied living without a latrine.Furthermore, 77% of rural non-latrineowners said that they had considered orwere currently considering purchasing orconstructing a latrine.

These figures indicate a strong demand –beyond a mere interest in the idea ofownership to the extent of actuallyconsidering purchase – however ademand that is suppressed frommaterializing into purchases by the actualor perceived price of latrine construction.

How can we use income andownership information for marketingpurposes?

Whilst demand is strong, there is a needfor cheaper latrine options due to a lack ofaffordability. Emphasis needs to be placedon the word ‘options’ because manywealthier families who might not beinterested in lowest-cost technologies alsodo not own a latrine. Marketing activitieswould need to target wealthy as well aspoorer consumers. Policy influence andoutreach to NGOs and other developmentorganizations may be an importantcomponent of marketing activities assubsidized installations may compete withmarket initiatives.

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By far the majority of latrines were of a near identical high-end, high-costdesign, and interestingly this was the case across all income groupings.

Sanitation Demand and Supply in Cambodia

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Latrine preferences

Among households interviewed duringthe field studies that already had alatrine, the most popular design in bothrural and urban areas comprises of: anoffset tank - most commonly constructedas a soakaway pit with concrete rings –(80% of rural and 72% of urban latrinessurveyed); a pour-flush slab (87% of ruraland 97% urban latrines); concrete/brickwalls (66% of rural and 67% of urbanlatrines), and a galvanized steel roof(76% of rural and 74 % of urban latrines).

Thus, by far the majority of latrinessurveyed were of a near identical high-end, high-cost design, and interestinglythis was the case across all incomegroupings. This is surprising given thatcost was cited as the most prohibitivefactor for latrine ownership, and the costof this type of latrine ($150 upward) ismore than ten times the cost of thesimplest designs ($5 - $10 using un-costed family labor and locallyharvested materials).

So there exists a strong consumerpreference for expensive designsconsisting of an offset tank, a pour flushpan, and solid walls and roof. Thispreference undoubtedly has a strongbearing on the uptake of latrineconstructions. There was no mention ofupgrading latrines to more robustconstructions over time as a way ofeasing the financial burden of latrineconstruction, even though this is relativelyeasy for the latrine pan, and extremelyeasy for the above-ground structure.

The focus group discussions confirmedthese survey findings, and yielded someconsumer reasoning; designs that areshort of the perceived ‘ideal latrine’ areconsidered unattractive, not likely to lasta long time/would have to be re-built.

The stark exception was in the twovillages that had been a part of CLTSprograms. In these villages – where astrong and urgent ‘call-to-action’ towardlatrine ownership was generated throughcommunity peer pressure, and in theabsence of any financial subsidies –villagers abandoned their preference forhigh-end designs, and constructedsimple latrines that satisfied their

immediate commitments toward latrineownership. In these villages more than80% of families opted for a simple unlineddug pit and an open-hole wooden slab,and more than 70% of families opted fora thatch or salvaged material shelter.Only 20% of those surveyed constructedthe high-end design that was found to bethe preference in all other (non-CLTS)areas – both rural and urban.

Figure 3. Sample latrine design options

Slab & Pans:

Pits/Tanks:

Latrines have essentially three components and can be constructed with anycombination of the options for: (1) an above-the-ground shelter mainly for privacy,(2) a latrine slab which incorporates the latrine pan or hole, and (3) the below-the-ground structure into which the waste is passed.

The design, materials, and cost of each of these components ranges from verysimple and cheap (using local materials such as bamboo and wood for the above-ground shelter and latrine slab and a simple dug hole for the below-the-groundstructure), to robust and expensive (using materials such as steel reinforcedconcrete, ceramic latrine pans, ceramic tiles, and steel or concrete roof).

Shelters:

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If a household at national poverty line were able to save the cash equivalentof 5% of its annual income ($45) toward latrine purchase, there would beenough to pay for a basic yet upgradable latrine in only one year.

The study results across all surveyedlocations depict a near all-or-nothingscenario – either latrines are of thepreferred expensive ‘ideal’ design, orthey are the cheapest possible design.There is not much in between these twoextremes – well-constructed undergroundstructures with simple but upgradeableabove-ground structures and latrine slabs– yet such designs would cost about halfas much as the ‘ideal’ latrines, and couldbe upgraded to the ‘ideal’ design as andwhen resources became available.

Cost perceptions and affordability

The research questioned latrine ownersand non-owners about the latrine costsfor various designs. Latrine owners, withthe benefit of experience, were able toaccurately estimate the installed costs oflatrines. Non-owners underestimatedcosts, indicating that the real cost to them– if they decided to purchase – would behigher than their expectations, thusincreasing the challenge of encouraginglatrine purchase. This is contrary toexperiences in neighboring Vietnamwhere market research found non-ownerstypically over-estimated costs, in somecases significantly, laying the foundationfor consumer marketing strategies thatfocused on actual price communication.

As noted earlier, the vast majority ofpeople who do not own a latrine haveconsidered construction in the past,though they have a strong preference fora robust and expensive design ($150upward). When asked at what price theywould be motivated to purchase, 10% ofthem said they could afford $100, and50% said they could afford a $20 latrine.These percentages were similar for bothrural and urban non-latrine owners, whichsupports another research observation

that cash income distribution is similar forboth rural and urban non-latrine owners.

Table 1 shows the wide variation in theactual cost of a latrine installed inCambodia. It considers the below-groundcomponent and slab/pan only, detailingthe costs for various configurations, andwhether family labor, hired unskilled labor,or hired skilled labor is used to constructthe latrine. The commonly perceived‘ideal’ latrine is highlighted.

Table 1. The cost of various latrine configurations (slab/pan and below-ground component only)

Family labor Hired unskilled labor

($2.50/day)

Hired skilled labor

($7.50/day)

Simple dug pit with wooden platform $3.50 $6.00 $11.00

Two ring lined pit and concrete slab $15.50 $23.00 $43.00

Four ring lined pit with concrete slab and ceramic pan *

$29.00 $41.50 $76.50

Double lined pits and concrete slab, ceramic pan,and water tank

$42.00 $59.50 $109.50

How can we use latrine preferencesinformation for marketing purposes?

To accelerate latrine adoption amonga price-sensitive consumer base willrequire overcoming the prevalentdemand for high-cost latrines.Community marketing initiatives aspioneered by CLTS approaches haveachieved this, and these methodscan play a role in consumermarketing tactics at the communitylevel. The ‘all-or-nothing’ designs thatare prevalent indicate limited, orpoorly communicated designinformation with regard to mid-pricedupgradeable design options whichneeds to be overcome.

* Commonly perceived ‘ideal’ latrine configuration.

Sanitation Demand and Supply in Cambodia

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A latrine design that consisted of anoffset tank and a very simple thatchedabove-ground shelter could cost as littleas $35, assuming that un-costed familylabor is used to do the construction. Such a design would be ‘half’ of the ideal latrine; everything below groundwould be the perceived ‘ideal’, whilst the cheaper above-ground portion would be perceived as less durable (yet would offer the same privacy andhygiene benefits and could be upgraded over time). The challenge inpromoting such a design lies inpersuading consumers to put the bulk oftheir investment below ground where itcannot be seen, whilst utilizing a cheapabove- ground structure which can beseen.

A five-person household at the nationalpoverty line (NPL) earns about $900 peryear, some of which is cash income. Ifsuch an NPL household were able tosave the cash equivalent of 5% of itsannual income ($45) toward latrinepurchase, there would be enough to payfor this type of basic yet upgradeable unitin only one year. This simple illustrativeanalysis suggests that, even with currenttechnology at current prices, a goodquality latrine substructure may not bebeyond the financial means of poorerhouseholds, even without subsidy. It isrecognized that this is a very simplisticcalculation, and does not include suchchallenges as savings and cash-flow thatwould hamper their ability to readily makesuch investments.

How can we use cost perceptionsand affordability information formarketing purposes?

The price sensitivity of consumersand their need for time to save for alatrine indicates that, at least for aportion of the market, the latrineacquisition process will have to benurtured over a longer time frame –perhaps six months, and/or inconjunction with credit availability. Inthe absence of credit, upgradeableand/or simpler designs that utilizelocal materials and family labor canease the savings requirements, andencourage consumers to invest earlierthan they would have otherwise. Withthe right technologies families on orclose to the National Poverty Line area relevant target market forunsubsidized latrine constructions.

Perceptions of consumers toward

latrines - Advantages and

disadvantages

The research delved into the perceivedadvantages and disadvantages oflatrines among owners and non-owners,of both rural and peri-urban families.Respondents were not prompted, andcould name several advantages/dis-advantages of latrine ownership. Thefindings, averaged across the whole ofthe surveyed population are depicted inFigure 4. This shows a range of perceivedbenefits with improved hygiene/clean-liness, comfort, and health cited by morethan 50% of respondents, and convenience,safety, privacy and prestige cited by a minority.

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Only 17% of the surveyed respondents identified any disadvantages tolatrine ownership.

Only 17% of the surveyed respondentsidentified any disadvantages to latrineownership. These were: bad smells (7%),maintenance and cost of maintenance(less than 5%), and attracts flies (2%):

The findings were almost identicalbetween rural and urban respondents;however latrine owners – perhaps notsurprisingly – rated both the advantagesand disadvantages of latrine ownershipslightly higher than non-owners. Latrineowners are more aware of the benefits ofownership (probably why they were moremotivated to purchase), but are also moreattuned to the disadvantages (from theirexperiences). Encouragingly, theresearch confirmed a broad satisfactionamong latrine owners with their latrines.

Respondents in the two CLTS villagesalso voiced satisfaction with their latrines.However, they ranked latrinedisadvantages slightly higher than thetotal sample average, almost certainlydue to the prevalence of cheaper andless sophisticated designs adopted inthese villages.

Stated reasons for purchasing or

not purchasing a latrine

Not surprisingly, the reasons given bylatrine owners for purchasing their latrines mirrored almost exactly theperceived advantages of ownership.Reasons for not having purchased alatrine among non-owners were asfollows:

1. Too expensive/don’t have enough money (95% of all respondents);

2. Other priorities come first (19% of rural and 30% of peri-urban);

3. Satisfied with current practice/don’t see the need (4% of all respondents);

4. Have access to someone else’s latrine already (1% of all respondents);

5. Lack information on where to purchase (1% of all respondents).

These figures inform of two clear andconcise reasons for not purchasing: cost (as given by almost all respondents),and a low prioritization of latrine purchase(given by a minority of respondents,though more prevalent among peri-urbanhouseholds). These findings reinforce thecurrent strength of demand for latrines, ademand that remains predominantlyuntapped due to the prohibitive cost ofpurchase and expenditure priority.

How can we use information aboutreasons not to purchase for marketingpurposes?

By far the most critical constraint to purchase that needs to be targeted is cost. However, even with the cash in hand, a highproportion of the market (especiallyurban) has alternate purchasepriorities. The ranking of latrines as a purchase priority should thereforebe directly addressed throughcommunications efforts.

How can we use consumer perceptions information for marketing purposes?

Promotion of latrines can be undertaken in the knowledge that there is a great dealof satisfaction in latrines among existing consumers. There are no significantdisadvantages against which a consumer marketing initiative may be constrained,or would need to overcome. The perceived advantages of latrine ownership arebroad and due to their nature – health, comfort, safety, convenience – will berelatively easy to link to the dreams and aspirations of a wide-ranging targetdemographic for the purpose of marketing materials development.

Figure 4. Perceived advantages of latrine ownership

Sanitation Demand and Supply in Cambodia

15

Opportunities forMarket Facilitation

Overview

The studies verify that there is a strongdemand for latrine ownership – 77% ofrespondents indicated that they hadconsidered or were consideringconstructing a latrine. Yet there arechallenges to be overcome to translatethis demand into increased ownership.

On the demand side, the major issues are:

1. A prevalent perception of an ‘ideal’ yet prohibitively expensive latrine design.

2. A lack of urgency toward investment in latrines even though consumers readily recognize a wide range of advantages, and almost no disadvantages of latrine ownership.

On the supply side:

1. No readily available or clear information on design options, or pricing that would help consumers make decisions.

2. A lack of trust among potential consumers toward the very businesses which supply latrine components or construction services, and who are most

optimally placed to interact with customers concerning latrine purchase decisions.

3. A lack of affordable designs that areaccepted by discerning customersas durable and investment-worthy.

4. Poor quality construction and latrineplacement in relation to water pointsthat compromises the hygienic benefits of new latrine constructions.

These challenges need to be addressed,and solutions delivered into the market.Whilst it may not be possible to overcomesuch issues completely, progress on eachof them can be made that will result inincreased latrine construction and use inCambodia.

16

The two-pronged strategies of consumer marketing initiative should beovercoming the perception of an ‘ideal’ design, and encouraging latrinepurchases that can be upgraded over time.

Demand-side Initiatives:Consumer Marketing

The objectives of consumer marketinginitiatives should be to:

• Overcome the perception of an ‘ideal’ design, and encourage users to choose options that can be upgraded toward the ‘ideal’ designs, but with lower entry-level costs.

• Encourage latrine purchases that can be upgraded over time.

1. Overcoming the perception of an

‘ ideal’ design

The perception of an ideal design seemsto be deep-rooted, and whilst it ischallenging to overcome, it is perhapsthe most critical block to increased latrinepurchase. Further qualitative consumerresearch into this perception should beundertaken prior to designing strategiesto address it. For the moment, we canconsider what we already know or canspeculate from the existing research,which would feed the design and direction of that future research.

The focus group discussions indicated aperception that local materials such asthatch or bamboo are consideredunattractive, and would not last a longtime/would have to be re-built periodically.Whilst these things are true, it has beenshown in the CLTS villages that consumerswill put these concerns aside when thereis adequate urgency for them to invest.

In order to ascertain consumer ability topay, the focus group participants wereasked at what price they would purchasetheir ‘ideal’ latrine (actual cost of $150upward). The majority said they would doso at $100 but not immediately - they

would need time to save and most ofthem thought a year of saving would berequired. Almost all respondents saidthey would purchase at $50, some ofthem still require time to save but justthree or four months. All respondentswould purchase at $25.

Thus real life experiences show that thisperception whilst very prevalent is notinsurmountable if (1) there is adequatepressure/urgency on the families to installa latrine, and (2) if the cost can belowered. Lowering the cost is mostreadily achieved via upgradeability - toalign with the perception of betterdesigns, yet to map out a path forconstruction and upgrade toward thatideal over a longer period that eases thefinancial requirements to achieve this.

Lower entry-cost upgradeable designsshould be promoted as the‘wiser/smarter’ investment option. All communications materials, no matterwhat their underlying message is (forexample health benefits) should depictlatrine designs that are constructed fromsimple and cheap materials to ensurethat these communications efforts do notleave the idea in consumer minds thatthese benefits are only achievable with‘top-end’ high-cost options.

It should be noted that all the perceivedbenefits of latrine ownership – improvedhygiene cleanliness, comfort, health,safety, convenience, privacy, with thepossible exception of ‘prestige’ whichwas ranked the lowest, can be realizedfrom the most basic latrine constructions.

Sanitation Demand and Supply in Cambodia

17

2. Encouraging latrine purchase

The majority of consumers are alreadyinterested in latrine ownership. However,they need to be persuaded towardactually taking the decision to invest – aninvestment that could be in the form ofcash in the case of top-end designs, orpredominantly labor and reclaimedmaterials for the simplest designs.Stimulating this investment can beachieved in several ways, and futureexperiences will inform as to what themost effective mix of media and activitiesis that yields the best results.

It has been shown, and perhaps notsurprisingly, that community peerpressure – as provided through CLTSapproaches – is a very powerful motivator

toward latrine construction. Stoppingopen defecation is beneficial to the whole community, but it takes thecollective action of all individuals toachieve it. From the outset, thismethodology can be employed as aproven demand-side marketing strategywithin broader and more holistic marketfacilitation initiatives.

In addition, and to support suchcommunity-based strategies, there areother communication initiatives that would help persuade consumers towardlatrine investment. These should beassessed from experience for cost vs.impact in a continual process ofrefinement as to what marketing effortsresult in the greatest return on institutionalexpenditure.

What is being communicated,

and to whom?

Effective communications materials needto provide the most motivating messagesfor their audiences. These willencompass the most prevalent concernsand perceived benefits of latrineownership, and tie these to the mostpowerful motivators for the targetpopulation. These motivators are beyondthe scope of the existing research, butwill likely be things such as increasedwealth, health, pride, school success, etc.

Different target audiences – men, women,children, the elderly etc. – will respond todifferent motivators, and these will needto be ascertained for the target for aparticular campaign or communication

18

Promotional materials should speak directly to the ranking of latrines withrespect to other priorities, and attempt to reposition the latrine acquisition inthe consumers’ minds.

material. It is noted from the research thata latrine purchase decision involves bothmen and women, in slightly differentroles, and with different interests. Whilstmen and women could therefore betargeted separately, it is also important toencourage household discussionbetween men and women on the subjectof latrine ownership.

Communication materials should seek toreposition latrines higher up the rankingof desired purchases to instill a greaterurgency toward latrine construction.Whilst almost all non-owners would like alatrine, they would also like to own otherthings – 10% of rural households own aDVD player and 63% a television - hencethe latrine acquisition is competing forsavings against other expenditures: 19%of rural and 30% of peri-urban familiesstated that other purchase prioritieswould come first. Promotional materialsshould therefore speak directly to theranking of latrines with respect to otherresearched priorities, and attempt toreposition the latrine acquisition in theconsumer’s minds.

Getting the messages to the

consumers

There are a plethora of potential channelsto deliver marketing information, and thatinformation can be conveyed throughthese channels via printed communi-cations materials, verbal messages andadvice, or a combination of these. Thesurvey assessed which informationsources were considered mosttrustworthy or reliable for sanitationadvice. The responses, ordered bypercentage ranking of ‘very goodinformation resource’ are detailed inFigure 5. Health professionals ranked thehighest, whilst profit driven privatebusinesses – market traders and masonsranked the lowest.

All of these are possible channels forcommunications messages, and naturallyreach out to either men, or women, orchildren, or a combination of them. Thedelivery of communication materials ormessages to consumers via thesechannels, along with their ownendorsement and additional advice, willprovide credibility to the messages.

On the surface it may seem futile totarget children who are obviously notdecision makers for latrine purchases.However, teachers’ advice is held inrelatively high regard, and visiting healthprofessionals can add further credibilityto their messages. Schoolchildren couldfor example be encouraged to take homematerials and do ‘homework’ that isspecifically designed to stimulatediscussion and reflection on latrineownership and usage with and betweentheir parents.

Health stations and physicians areranked the highest of all credible

information resources. Healthprofessionals can provide assistance byproactively taking messages into thecommunity, or at minimum simplydistributing leaflets and giving advice topeople who visit the health station withsanitation related health issues.

This is an opportune moment to getsomeone to reflect upon the fact thatthere could be a relationship betweentheir health problem and their domestichygiene and sanitation, and to promotepreventive health measures such aslatrine ownership and sanitary behavior.

Figure 5. Consumer perceptions of the quality of various information sources

Sanitation Demand and Supply in Cambodia

19

Supply-side Initiatives

The objectives of supply-side initiativesshould be to strengthen capacity toensure that:

• The private sector optimally plays a role in information exchange, demand creation, and sales closure.

• Affordable, hygienic, and upgradeable latrines are available through the market in order that all consumers, no matter how poor become potential beneficiaries of the services.

1. The private sector role in

information provision, demand

creation, and sales closure

Almost all consumers that construct alatrine will interact with hardwaresuppliers, prefabricated concrete ringproducers, and/or masons. Even when

masons are hired, by far the majority ofconsumers purchase their own materials.Whilst interaction between thesesuppliers and customers will be fargreater once a decision to build a latrinehas been made, interested customers willalso interact with them to understandprices, and options prior to taking apurchase decision.

In addition to consumer marketingmaterials (which appeal mostly towomen), these suppliers can be an outletfor more technical information on designand pricing options. Clear pricing, evenclear estimates of pricing, along withvisual materials to support designdiscussions will play a role in helpingthese suppliers to retain interest amongtheir potential consumers.

Design information also needs to beprovided to customers to support theirown construction efforts. Manyconsumers construct their own latrines,but very few of them will have any design

information on which to base theirconstructions. Thus, for hardware shopsand prefabricated concrete suppliers, inaddition to providing their products, theycan provide guidelines for self-built andmid-cost upgradeable latrine projects.

A limitation of the private sector insupplying this information for the simplestself-built designs is that it conflicts withtheir interest in selling products to endconsumers. Hence whilst the cheapest,or ‘zero cash-cost’ latrines may notrealistically be communicated throughthese channels, there is still a largemarket gap of middle-range options thatsuppliers would be prepared to providethrough their self interest in sales ofcomponents.

Another limitation of these suppliers asinformation sources is their lack ofcredibility among consumers. Pre-printedinformation made available through them– posters or take-away leaflets – shouldtherefore be endorsed by a credible thirdparty. It may also be possible to co-brandtrained suppliers in allegiance with acredible institutional marketing effort,essentially ‘certifying’ them as suppliersof quality technical information.

At the other end of the supply networksare the importers and wholesalers ofmaterials. Positioned at the apex of thesupply chains, these businesses couldassist in broader and less targeteddissemination of design information orother materials used at the retail point-of-sale for their products. In addition to theirpotential as an information channel, theyalso offer the perfect avenue for thebroad dissemination of imported orlocally fabricated technology innovationsthat provide better cheaper or higherquality latrine components.

20

Cost reductions of a latrine can be made by material compromise, and viathe concept of upgradeability.

2. Affordable, hygienic, and

upgradeable latrines are

available through the market.

In the absence of any major technicaladvance in creative low-cost design, theprice of latrines is not going to changemuch – it is linked to the commoditycosts of construction materials and labor.However, as previously noted, costreductions can be made by materialcompromises, and via the concept ofupgradeability. The suppliers need to bearmed with materials to communicatethese things in a simple, clear, andmotivating way.

Such materials will provide theinformation that will enable andencourage consumers to progress up thesanitation ladder through successive

upgrades, and via the provision of middlecost-designs that fill the gap between thesimplest home-built lowest-cost designsand the perceived ideal designs, providealternate entry level designs.

Whilst the greatest cost reductions willundoubtedly be made by consumercompromises in material selection andbelow-ground design, there may also beother cost reductions made throughtechnical innovation that would beacceptable to consumers. For example,using plastic latrine pans, bambooreinforced ferrocement, or on-sitefabrication of latrine slabs. Research anddevelopment toward consumer-acceptable lower-cost designs should beencouraged, and if any of these aremarketable, the suppliers are there tomake them available.

Such research could extend to tacklingthe retailer-identified problems of latrinepan damage during transportation andstorage (which adds to the cost oflatrines) by for example, the markettesting in Cambodia of plastic latrinepans that have been successfullymarketed in some other Asian countries.

Whilst cost reduction is an importantstrategy, it must be achieved withoutcompromising the health/hygiene benefitsof latrine ownership. There is a need formason training (and indeed directconsumer training given that manyconsumers will self-construct) to bring tothe marketplace acceptable minimumstandards and design information, eitherfor current latrine designs, or for newinnovations that are introduced into themarket.

Sanitation Demand and Supply in Cambodia

21

Encouraging interaction between

suppliers and consumers

As previously mentioned, mostconsumers will interact with hardwaresuppliers, prefabricated concreteproducers, and masons. However thisinteraction is mainly at the last stage ofmaking a purchase decision, or once thedecision has already been made. Yetinteraction with suppliers, especially ifthey can additionally convey good designand pricing information will provideencouragement earlier in the decision-making process.

Hence it is important that any marketinginitiative that delivers on consumer andsupplier fronts also focuses on gettingthese two parties to talk to each other.This can be achieved via endorsement oftrained suppliers within consumermarketing efforts, and encouragingwomen (who are more responsive to theconsumer messages) to get theirhusbands (who are more interested in thetechnical aspects) to go to meetsuppliers. They will be especiallyinterested in doing so if they know that

design information to support self-buildconstructions is available through them.

Consumer-supplier interaction willinevitably be instigated by a third party: a market development facilitator. Thisfacilitator could achieve this interactionby various means, ranging frommarketing communications, or viapersonal interaction at the communitylevel. No matter how this is achieved, thisfacilitation role should extend to directlyproviding design information toconsumers for the very simplest ‘no-cost,self-built’ latrine designs, to complementthe mid and high-cost design informationthat they should be able to receive fromprivate sector suppliers.

Dissemination of market

interventions

To derive the greatest and most cost-efficient impact, solutions to these issueswould be provided into the market in aparallel and coordinated fashion. It isimportant to also note however, that anyof them, even in total isolation of theothers, would still have a beneficial

impact. This fact opens up the options fordelivery of these solutions into the marketfrom village-wide high-intensity holisticefforts, to partial delivery of suitablesolutions in support of and via on-goingor planned large-scale sanitationinitiatives, to nationwide multimediadelivery of key messages that are criticaland relevant to broad audiences.

Thus market initiatives do not have to belimited to isolated self-contained activities,but additionally offer complementarities toother programs that are focused on oneor other aspect of the market, but whichcould benefit from extended marketinfluence. Likewise, there are otherinitiatives that have found ways toachieve the same goals as marketingstrategies, and market-based initiativescan learn from these. CLTS is oneobvious example, whereby demandcreation is achieved through communitymotivation, and these may prove to bethe most cost-effective supply-sideinitiatives possible. Likewise, the CLTSapproach may benefit from extension tosupply-side techniques that would ensurethat consumers who decided to invest

Increasingdemand for latrines

and improvedsanitation

Strengtheningsupply capacity and ensuring appropriate

and affordable technologies are

available

Increasing Interactionbetween consumers and

suppliers

22

A high level of subsidy for latrine construction has the effect of depressingthe market for privately purchased latrines.

were indeed armed with useful designinformation, and quality local services toprovide the constructions.

Another example would be thepublication of a booklet on latrineupgrading by the Ministry of RuralDevelopment (MRD) to support thepreviously published ‘Informed ChoiceManual on Rural Household LatrineSelection’. The booklet gives details oncost, quantities, and techniques forlatrine construction. The objective is touse the manual to support constructionby trained masons or by communitymembers, and could readily plug intosupply-side marketing interventions. It would therefore be wise to designmarket interventions that can capitalize

on existing available materials, and alsorecognize other initiatives as potentialavenues for implementation, or channelsto move information. This vastly increasesthe potential outlets for market solutions,be they on the demand or supply side ofthe equation.

Perhaps one of the most importantcontributions of a marketing effort wouldbe to persuade – to the extent possible –all other programs that produce visualmaterials depicting latrines, whethertelevised, on brochures, on posters, orleaflets, to utilize images of simple andaffordable designs such that consumerscan associate these designs with thesame benefits – health for example – ashigher-priced yet unaffordable designs.

Likewise efforts could be channeledtoward the influence of policies ofgovernment and aid agencies, as thesecan have a significant impact—positiveor negative—on latrine demand. A highlevel of subsidy for latrine constructionhas the effect of depressing the marketfor privately purchased latrines.

Minimum design standards for sanitarylatrines could improve the quality oflatrines but, if rigorously enforced, couldreduce overall demand by discouraginghouseholds from starting with simpledesigns and upgrading over time.

Sanitation Demand and Supply in Cambodia

23

Conclusions

The private sector continues to providethe majority of latrines installed inCambodia. It is a self-sustaining networkresponding to an unsubsidized demandfor latrines. However, the fragmentation ofthis network and the fact that latrines onlyaccount for a relatively small amount ofeach of the businesses’ activity, results in a supply system that has limited abilityto innovate, package, or price products/services that could yield more attractivepurchase options for consumers.

There is a strong existing demand forlatrines: 77% of rural non-latrine ownerssaid that they had considered or werecurrently considering constructing alatrine. However, this demand is notbeing realized due to cost: 95% ofrespondents who did not own latrinesgave “too expensive/don’t have enoughmoney” as the reason for not havingpurchased a latrine.

Whilst cost is prohibitive, this statement ismade by consumers that have a strongpreference for the most expensivepossible latrine designs, costing in the

region of $150. Indeed, by far themajority of existing latrines that weresurveyed (across all income groupings)were of a similar high-end, high-costdesign. However, simple self-built latrinesusing locally fabricated materials cancost as little as $5 - $10, easily within therange of affordability of even the pooresthouseholds.

Whilst the preference for the mostexpensive designs is strong, theresearched CLTS program villagesdemonstrated that this preference is notinsurmountable. In these villages, morethan 80% of families opted for a simpleunlined dug pit and an open-holewooden slab, and more than 70% offamilies opted for a thatch or salvagedmaterial shelter, satisfying their immediatecommitments toward latrine ownership ata very much lower cost.

Hence on the one hand there are existingdemand-creation methodologies able toencourage the cheapest latrineinstallations, yet a supply market that isskewed toward providing for theprevailing market preference for higher-end designs. The supply market needs tobe strengthened in between these two

extremes. Whilst all the components ofcheaper latrine configurations areavailable, such configurations – lower-entry cost and upgradeable – are notpackaged and presented in a way that isobvious, accessible, or attractive toconsumers.

The suppliers and constructors can beuseful conduits for design informationand associated products. However, thereare two limitations to their use asinformation providers: (1) for the verysimplest self-built designs, thisinformation competes with their ownprofit-motivated interests, and (2) theresearch identified a prevalent lack oftrust in these businesses among potentialconsumers. The lack of trust can (at leastpartially) be overcome through consumermarketing initiatives that endorse andraise the credibility of the suppliers, eitherco-branding/associating them withtrustworthy campaigns or byendorsement of the suppliers by credibleinformation providers; the research foundhealth stations and physicians to be themost credible information sources.

The very cheap self-built designs thatwere prevalent in the CLTS villages arenot likely to be proactively promoted bythe suppliers. In fact, it may be the casethat the suppliers advise the marketagainst these designs. Hence thisinformation – for the very cheapestdesigns in support of consumers’ ownconstruction efforts – needs to beprovided by a third-party marketfacilitator via consumer marketinginitiatives.

In addition to technical informationprovision, the facilitator’s marketing/com-munication strategies will need toaddress prevalent consumer-sideconstraints: The strong perception of an‘ideal’ yet prohibitively expensive latrine

design; and a lack of urgency towardinvestment in latrines by consumers eventhough the demand is strong. It is notenough to make lower cost orupgradeable designs available throughlatrine suppliers, consumers need tohave the knowledge of this availabilitybrought directly to them, and in aattractive and motivating way.

The perceived advantages of latrineownership are broad and due to theirnature – health, comfort, safety, andconvenience – are relatively easy to linkto the dreams and aspirations of a wide-ranging target demographic for thepurpose of motivational marketingmaterials development.

Lower entry-cost upgradeable designsshould be promoted as the ‘wiser/smarter’investment option, and all communications

materials, no matter what their underlyingmessage (for example health benefits)should depict latrine designs that areconstructed from simple and cheapmaterials to ensure that they do not leavein the minds of their target audience thatthese benefits are only achievable with‘top-end’ high-cost options. It should benoted that all the perceived benefits oflatrine ownership – improved hygienecleanliness, comfort, health, safety,convenience, privacy, with the possibleexception of ‘prestige’ which was rankedthe lowest – can be realized from themost basic latrine constructions.

To derive the greatest and most cost-efficient impact, demand- and supply-sideinitiatives should be delivered in paralleland in a coordinated fashion. However,any of them, even in total isolation ofeach other, would still have a beneficialimpact on latrine uptake. This fact opensup the options for delivery of marketsolutions from: village-wide high-intensityholistic efforts, to partial delivery ofsuitable solutions in support of and viaon-going or planned large-scalesanitation initiatives, to nationwidemultimedia delivery of key messages thatare relevant to broad audiences.

Thus market initiatives do not have to belimited to isolated self-contained activities,but additionally offer complementarities toother programs that are focused on oneor other aspect of the market, but whichcould benefit from extended marketinfluence.

Cambodia Country Office111E1 Norodom Boulevard Mail: 113 Norodom Blvd.Phnom Penh, Cambodia

Phone: (+855-23) 217 304 ext.103Fax: (+855-23) 210 373E-mail: wspeap@worldbank.orgWeb site: www.wsp.org

October 2008

WSP MISSION: To help the poor gain sustained access toimproved water and sanitation services.

WSP FUNDING PARTNERS: The governments of Australia, Austria,Belgium, Canada, Denmark, France,Ireland, Luxembourg, the Netherlands,Norway, Sweden, Switzerland, the UnitedKingdom, the United States of America,the United Nations DevelopmentProgramme, The World Bank, and the Billand Melinda Gates Foundation.

ACKNOWLEDGMENTS:This Field Note was prepared by Dan Salteron the basis of two reports prepared bythe NGO International DevelopmentEnterprises (IDE) for WSP: “DemandAssessment for Sanitary Latrines in Ruraland Urban Areas of Cambodia” byMichael Roberts and Anthea Long, and“Supply Chain Assessment for SanitaryLatrines in Rural and Peri-Urban Areas ofCambodia” by Michael Roberts, AaronTanner, and Andrew McNaughton.

REVIEWED BY:Lyn McLennan, Rain Water Cambodia;Andrew Oliver-Smith, Danish Red Cross;Jan Willem Rosenboom, Guy Hutton, andPhyrum Kov, Water and SanitationProgram – East Asia and the Pacific(WSP-EAP).

Cover photo by: Tang Chhin SothyOther picture credits: Michael Roberts, Judy Hagan,Tang Chhin Sothy, Declan O’Leary, Jan Willem Rosenboom,Phyrum KovCreated by: Graphic RootsPrinted at: Graphic Roots

The findings, interpretations, and conclusions expressed are entirely those of the author and should not be attributed in any manner toThe World Bank, to its affiliated organizations, or to members of its Board of Executive Directors or the companies they represent.

ABOUT THE SERIES:

WSP Field Notes describe andanalyze projects and activities inwater and sanitation that providelessons for sector leaders,administrators, and individualstackling the water and sanitationchallenges in urban and ruralareas. The criteria for selection ofstories included in this series arelarge-scale impact, demonstrablesustainability, good cost recovery,replicable conditions, andleadership.