Why is sanitation safety planning needed?

Sanitation safety planning (SSP) supports the implementation of the World Health Organization (WHO)
Guidelines on sanitation and health (WHO, 2018) at the local authority level. SSP is the approach
recommended by WHO for incremental improvement leading to safely managed sanitation services for
all.

The underlying purpose of sanitation systems is to protect public health. However, sanitation
interventions do not always sustainably improve health to the extent anticipated. This is primarily
because the combination of technologies, behaviour change and management approaches used in these
interventions does not systematically interrupt transmission of locally relevant diseases. The burden of
these diseases often falls on the poorest in society and areas most affected by a changing climate. Too
often, there is insufficient analysis of local risks and ongoing management of the system needed to
sustain safe services.

Large, but ultimately cost-effective, investments are needed to achieve safely managed sanitation
services. Other health targets – such as for cholera and other diarrhoeal diseases, neglected tropical
diseases, and antimicrobial resistance – depend on such services. Similarly, targets on decent work and
the circular economy rely on management of hazards from sanitation systems for workers and the
environment.

It can be challenging, especially in urban areas, to achieve safely managed services using a single
intervention. Therefore, investment is needed in incremental improvements where they can have the
greatest impact for the most people, along with sound management of existing services to reduce risk
and prevent backsliding.

What is sanitation safety planning?

SSP is a risk-based management tool for sanitation systems that:

helps with systematically identifying and prioritizing health risks along the sanitation chain – that is,
toilet, containment–storage/treatment, conveyance, treatment, and end use or disposal;

guides management and investments in sanitation systems according to risk;

identifies operational monitoring priorities and regulatory oversight mechanisms that target the highest
risks; and

provides assurance to authorities and the public on the safety of sanitationrelated products and
services.

Key updates in this edition of Sanitation safety planning include:

simplification of the SSP process;

reorientation to support recommendations on local-level risk assessment and management in the WHO
Guidelines on sanitation and health, covering all steps of the sanitation chain, with or without safe end
use; and

inclusion of climate risks.

This edition provides more in-depth information to strengthen climate resilience, including identification
of climate-related risks (such as those caused by water scarcity, sea level rise and extreme weather
events), and associated management and monitoring options (Kohlitz, 2019). Proactive management is
central to SSP. Considering climate impacts improves the preparedness of local authorities for an
uncertain future. These principles also apply to other future shocks and emergencies, such as disasters,
epidemics and pandemics.

SSP provides a coordinating structure to bring together actors along the sanitation service chain to
identify risks, and agree on improvements and regular monitoring. The approach ensures that controls
and investments target the greatest health risks and emphasizes incremental improvement over time.
SSP is applicable in both high- and low-resource settings. It can be used at the planning stage for new
schemes, and to improve the performance of existing systems. The methodology and tools in this SSP
manual can be applied to all sanitation systems (e.g. sewered, non-sewered, decentralized systems).
Ideally, SSP covers all service types within an administrative area.

SSP underscores the role of the health sector in sanitation and helps bring a human health perspective
to sanitation, supporting the roles of the local government, housing, sanitary engineering and
agriculture sectors.

SSP complements the water safety planning (WSP) approach. Both SSP and WSP are based on the
Stockholm Framework for preventive risk assessment and management of water-related diseases. Both
methodologies use the methods and procedures of hazard analysis and critical control points (HACCP).