ArticlePDF Available

The Role of the SaTo Pan Toilet Technologies in Advancing Progress in the Water, Sanitation and Hygiene (WASH) Sector

Authors:

Abstract and Figures

The United Nation’s (UN) 6th Sustainable Development Goal seeks to enable the availability and sustainable management of water and sanitation for all by 2030 (UN Sustainable Development Goals Platform). Lusaka, Zambia has thirteen peri-urban areas (PUAs), all with poor sanitation conditions (WHO / UNICEF). The SaToTM brand, created by the LIXIL Corporation, offers a suite of frontier sanitation technologies including various safe and affordable toilet products for use in lower-and middle-income countries (LMICs) in Africa and Asia. This study examines the potential market demand and environment for the SaToTM Pan Sit and Squat toilets in the Bauleni PUA. In Lusaka, landlords (LLs) hold the decision-making power regarding household-based infrastructure; therefore, this study measures LL interest in the SaToTM Pan Toilet technologies for the LL’s personal and familial use as well as for use by their tenants. 30 semi-structured interviews with conveniently sampled, adult LL residents of Bauleni were conducted to capture their demographic, sanitation, and toilet history status as well as their SaToTM Pan product interaction. Quantitative data was analyzed in Stata; qualitative data was analyzed via thematic content analysis. Results indicate that there is an overarching positive preference toward the SaToTM Pan Sit toilet compared to all other presented sanitation technology alternatives. Conducting a SaToTM Pan Sit toilet user trial and social marketing campaign pilot could potentially aid in efforts to effectively and affordably decrease the incidence of water, sanitation and hygiene (WASH)-related disease transmission in Zambia.
Content may be subject to copyright.
Journal of Science Policy & Governance TECHNOLOGY ASSESSMENT: SATOTM Toilet Tech
www.sciencepolicyjournal.org JSPG., Vol. 16, Issue 02, May 2020
The Role of the SaToTM Pan Toilet Technologies
in Advancing Progress in the Water, Sanitation
and Hygiene (WASH) Sector
Jasmine Burton1, James B. Tidwell2, Jenala Chipungu3,
Robert Aunger4
1London School of Hygiene and Tropical Medicine, Public Health, London, UK
2London School of Hygiene and Tropical Medicine, Behavioural Science, London ,UK
3Centre for Infectious Disease Research in Zambia, Social Behavioural Research, Lusaka, Zambia
4London School of Hygiene and Tropical Medicine, Evolutionary Public Health, London , UK
https://doi.org/10.38126/JSPG160203
Corresponding author: Jasmine Burton; jasminekburton@gmail.com
Keywords: WASH; WASH infrastructure; sanitation; toilets; toilet
Executive Summary: The United Nation’s (UN) 6th Sustainable Development Goal seeks to enable
the availability and sustainable management of water and sanitation for all by 2030 (UN Sustainable
Development Goals Platform). Lusaka, Zambia has thirteen peri-urban areas (PUAs), all with poor
sanitation conditions (WHO / UNICEF). The SaToTM brand, created by the LIXIL Corporation, offers
a suite of frontier sanitation technologies including various safe and affordable toilet products for
use in lower-and middle-income countries (LMICs) in Africa and Asia. This study examines the
potential market demand and environment for the SaToTM Pan Sit and Squat toilets in the Bauleni
PUA. In Lusaka, landlords (LLs) hold the decision-making power regarding household-based
infrastructure; therefore, this study measures LL interest in the SaToTM Pan Toilet technologies for
the LL’s personal and familial use as well as for use by their tenants. 30 semi-structured interviews
with conveniently sampled, adult LL residents of Bauleni were conducted to capture their
demographic, sanitation, and toilet history status as well as their SaToTM Pan product interaction.
Quantitative data was analyzed in Stata; qualitative data was analyzed via thematic content
analysis. Results indicate that there is an overarching positive preference toward the SaToTM Pan
Sit toilet compared to all other presented sanitation technology alternatives. Conducting a SaToTM
Pan Sit toilet user trial and social marketing campaign pilot could potentially aid in efforts to
effectively and affordably decrease the incidence of water, sanitation and hygiene (WASH)-related
disease transmission in Zambia.
I. Introduction
4.5 billion people lack safely managed sanitation
(WHO). In lower- and middle-income countries
(LMICs), people often share dry pit latrines, or basic
holes in the ground, that lead to health problems.
Lacking improved water, sanitation and hygiene
(WASH) infrastructure leads to the spread of WASH-
related diseases that “remain among the major causes
of death in children under five” (UN Sustainable
Development Goals Platform 2019). In 2015,
approximately “53% of the urban population in LMIC
still [relied] on on-site, unimproved sanitation, such
as unimproved pit latrine and open defecation”
(Roma and Biran 2016). As a result of this, the World
Bank reports that poor sanitation results in a 1.3 per
cent loss to Zambia’s national Gross Domestic
Product annually (“Water, Sanitation and Hygiene”
2020).
Therefore, safely managing fecal waste has become a
multisector priority. However, the provision of safe
and sustainable sanitation products and services in
peri-urban areas (PUAs) has proven to be incredibly
complex (Blackett and Hawkins 2016). This
Journal of Science Policy & Governance TECHNOLOGY ASSESSMENT: SATOTM Toilet Tech
www.sciencepolicyjournal.org JSPG., Vol. 16, Issue 02, May 2020
complexity is a result of a myriad of restrictions
including hardware constraints (such as toilet
technologies) and societal constraints (such as
behavior change, private sector support, policy
support, and legal enforcement). Numerous frontier
sanitation technologies have since been developed to
improve the user experience for both the latrine
users and for latrine emptying service providers
around the world. However, there are very few
market-ready solutions that have been proven at
scale (Roma and Biran 2016). There is a sense of
global urgency around the scale-up and accessibility
of frontier sanitation technologies.
i. Background of the sanitation landscape in Lusaka,
Zambia
Zambia’s capital, Lusaka, has over two million people
(Roma and Biran 2016; Central Statistical Office
Zambia 2014). Rapid urbanization resulted in the
development of thirteen PUAs across the city with
little formal infrastructural planning (Water and
Sanitation for the Urban Poor 2015; World Bank
2015). Approximately 56% of Zambia’s overall
population and 95% of the PUA population uses
unimproved sanitation facilities (Roma and Biran
2016; WHO/UNICEF 2019).
In 2015, the World Bank approved $65 million to be
utilized for the Lusaka Sanitation Project (LSP) to
“increase access to sanitation services in selected
areas of Lusaka and strengthen the Lusaka Water and
Sewerage Company (LWSC) capacity to manage
sanitation services” (World Bank 2015, Lusaka
Sanitation Project 2016). The project’s stated
objectives are to expand waterborne sewerage
systems to two PUAs, to develop a more standardized
response to on-site fecal sludge management (FSM)
challenges for non-sewered PUAs, and to provide
technical assistance to LWSC (“Re-Inventing the
Toilet: a New Era of Safe Non-Sewered Sanitation”,
n.d.). In September 2017, the project sought to target
216,000 people who were to receive 12,000 toilets,
10 decentralized wastewater treatment systems and
4 FSM systems sanitation facilities (Chipungu, J. 2016;
Lusaka Sanitation Landscape Report; World Bank).
The LSP is ongoing and is projected to close in
December 2020.
ii. SaTo TM toilets in Lusaka
This study selected two of the SaToTM Pan Toilet
technologies for assessment of general perceptions
because of their market readiness, widespread
availability, and public health relevance as an
improved pour-flush sanitation option by the World
Health Organization (WHO) and United Children’s
Fund (UNICEF)’s Joint Monitoring Program for Water
Supply and Sanitation standards (SSWM).
iii. SaToTM Pan Toilet products
The SaToTM brand, created by the LIXIL Corporation,
is a frontier technology that “offers safe, affordable,
and durable solutions for a better and more hygienic
toilet experience” throughout the LMICs in Africa and
Asia (SATO, American Standard). The original SaToTM
Pan is a “simple plastic pan with a counterweighted,
self-closing door that seals pit latrines to prevent the
passage of flying insects and thus spread of disease”
(SATO) (Figure 1). It operates as a pit latrine upgrade
and pour flush toilet. The wide flange SaToTM Pan
Toilet is an oblong squat pan that includes wings that
the user steps on while squatting. The SaToTM Pan sit
toilet is raised and allows the user to sit on the pan. It
is also intended to be easily installed using mud and
wood. They both act as pour flush toilets where water
must be poured inside after use (Figure 1) (USDP).
LIXIL currently manufactures toilet technologies in
Bangladesh, Uganda, and Kenya, and reports that
over 810,000 of the first SaToTM Pan Toilets have been
distributed and installed in Bangladesh, Uganda,
Figure 1: Various SaToTM Pan Toilet Products
Journal of Science Policy & Governance TECHNOLOGY ASSESSMENT: SATOTM Toilet Tech
www.sciencepolicyjournal.org JSPG., Vol. 16, Issue 02, May 2020
Haiti, Malawi, Nepal, Nigeria and the Philippines
(LIXIL). LIXIL also states that “by working with an
established local manufacturer, the $1.85 SaToTM Pan
cost made them attainable for a population surviving
on less than $1.00 per day” in Bangladesh (Research
and Development Magazine 2016). This SaToTM Pan
study in Zambia was not been endorsed or sponsored
by LIXIL.
iv. Study rationale
As of 2019, there is a global sanitation product
mapping that exists in unpublished data from the
London School of Hygiene and Tropical Medicine
(LSHTM). There are over 40 innovative toilet options
operating beyond pilot phase and prototype phase in
different regions around the world (Roma and Biran
2016). Each of these sanitation solutions have
different functionalities based on their target users
and the waste management services available. In the
southern Africa region, some frontier toilet
technologies that currently exist include the
Arumloo, EnviroSan, SavvyLoo, WeeStand and
SafiChoo (Figure 2). These models are largely being
tested in various pilots and or are scaling primarily in
South Africa specifically. There are therefore few
existing, commercially available options on the
Lusaka sanitation market beyond ceramic toilet
bowls and squat pans, which are expensive and
largely inaccessible to the PUA populations.
The overall objective of this study is to determine the
potential market demand for the frontier SaToTM Pan
Toilet technologies relative to existing toilet options
on the market and potential future toilet innovations
in the Bauleni PUA and Lusaka at large. Ultimately
this study seeks to contribute to the scope and impact
of other large-scale Lusaka sanitation projects
working to quell the negative health and economic
consequences of poor WASH infrastructure.
II. Methods
i. Study design
A series of semi-structured interviews were
conducted with adult landlord (LL) residents of the
Bauleni PUA to determine their personal interests
and perceptions of the SaToTM Pan Squat toilet versus
the SaToTM Pan Sit toilet for their personal/familial
use compared to for use by their tenants. The focus is
on LLs because they have the ultimate decision-
making and purchasing power when it comes to
household infrastructural renovations such as
changing a plot’s toilet (SHARE consortium 2016).
ii. Sampling criteria
30 purposively and conveniently sampled adult LLs
who reside in the Bauleni PUA were interviewed
based on who was available, met the inclusion
criteria, and consented to participation. With support
of the San-Dem Research Assistant from LSHTM, an
inclusion criterion was determined based on
previously collected demographic/geographic
information (SHARE Consortium 2016). Within the 6
zones of the PUA, a diverse cross-section of LLs were
identified who varied based on sex (male vs. female),
age (young vs. old), socioeconomic status (high vs.
low), and toilet status (shared with tenants vs.
separate from tenants) in order to develop baseline
understanding about the market interest and social
marketing opportunities for these toilet technologies.
iii. Interview guide components
The interview guide was comprised of question types
drawn from the formative research data collection
tools utilized for the other concurrent WASH projects
conducted by other research teams from the LSHTM
and the Centre for Infectious Disease Research in
Zambia (CIDRZ), the Behavior-Centered Design
(BCD) Toolkit, and questions previously used from
the 2016 SaToTM Pan trial pilot in Uganda and Kenya
(LIXIL 2016; Lusaka Water and Sewerage Company
2016). Basic demographic questions such as “How
many people live on your plot?” and “Who provides
the main income for [your] home?” were built upon
from the data collection tools utilized by San-Dem
(Tidwell 2017). The sanitation status portion of the
guide assessed the reported WASH status of each
interviewed LL’s plot. Toilet observation assessed the
current toilet status of the LL’s household in relation
to the plot. LLs were shown the SaToTM Pan Squat and
Sit toilet technologies and were asked to observe and
Figure 2: Various Toilet Innovations in the
Southern Africa Region (images available on toilet
company’s websites)
Journal of Science Policy & Governance TECHNOLOGY ASSESSMENT: SATOTM Toilet Tech
www.sciencepolicyjournal.org JSPG., Vol. 16, Issue 02, May 2020
describe them and then to choose between the
SaToTM Pan Squat toilet, the SaToTM Pan Sit toilet, and
their current toilet for their preferred choice for
themselves to use, their guests to use, and their
children to use. LLs were given 5 printed images of
different toilet technologies and asked to rank them:
a traditional ceramic sit toilet that is currently
available on the market, a ceramic squat toilet that is
currently available on the market, the SaToTM Pan Sit
toilet, the SaToTM Pan Squat toilet, and a white plastic
sit toilet that is not currently on the market but is
similar to the EnviroSan (Minh et al. 2013). This
activity captured LL perception of an array of
sanitation technologies to determine where the
SaToTM Pan Toilets technologies fit in comparison to
other competitive product options. LLs were asked to
indicate their own sanitation responsibilities in
response to provided statements using a sheet with
three smiley faces indicating “agreement,” “in-
between,” and “disagreement.”
iv. Data collection and analysis
Interview analysis methods included developing
abridged English transcripts and locating themes that
were in line with the study objectives. Demographic,
sanitation and toilet history data were tabulated and
converted into percentages in Stata version 14 to
determine the proportion of LLs with each
characteristic. The data from the BCD inspired-
technology showcase and interaction was analyzed
via the qualitative research methodology of thematic
content analysis (Aunger and Curtis 2015; Anderson
2007). Data collected from the Toilet Preference and
Ranking Activity portions of the interviews were
tabulated in Stata version 14 and the mode was
captured for the 3 questions related to the SaToTM Pan
Toilet technologies and their current toilet for
themselves to use, their guests to use and their
children to use (StataCorp 2015). The mode for each
segment of the ranking activity was captured to
determine which of the five toilets was preferred and
disdained the most frequently. For the LL
Perceptions of Tenants Activity, there were fourteen
questions asked that were subsequently answered
with the LL’s referring to the smiley face-Likert scale.
These data were tabulated to determine the
proportion of LLs that agreed, disagreed or were
neutral in response to tenant-related statements in
1
This taped prototype was used for the project as a result of shipping delays and short project timelines.
order to best determine the LLs existing perceptions
of their own compared to their tenants values for and
responsibility of a high-quality toilet.
III. Results
i. Demographic, sanitation status, and toilet history
15 of the surveyed LLs relied on water from their
neighbors with 14 of LLs having water on their plots
and 1 having to rely on a community well source.
Nearly half of LLs use dry pits with a few of them
having had a dry pit latrine that collapsed due to the
rainy season or to faulty construction alone. A quarter
of LLs use flushing toilets connected to a septic tank
and half of the LLs reported having only one toilet on
their plot. Nearly a third of LLs did not know how
much it cost them to construct their toilets while a
quarter of them reported that they paid between
1500-3000 ZMK where 10 ZMK ~ 1 USD (Coin Mill
Currency Conversion 2017). Over a third of the LLs
stated that they had between five-ten people using
their latrine while a quarter of the LLs had sixteen-
twenty people using their latrine each day.
ii. Technology showcase and interaction
Through thematic content analysis, results were
categorized, coded, and distilled into seventeen
qualitative themes as seen in Figure 3 (Aunger and
Curtis 2015; Anderson 2007). The SaToTM Pan Squat
toilet was largely spoken about negatively or thought
of as a child’s toilet, bath, or urinal, while the SaToTM
Pan Sit toilet was viewed more favorably.
The qualitative theme of improved user experience
had a high frequency and over 32 predominant
quotes across all of the transcripts with numerous
references to the SaToTM Pan Sit toilet; however, for
the product showcase portion of the interviews, none
of the interviewed LLs actually sat on the toilet
technology despite being invited to do so. Many LLs
wanted to purchase the products immediately,
particularly the SaToTM Pan Sit toilet, despite the fact
that there were prototype breakages held together by
duct tape.
1
The innovative counterweight seal of the
SaToTM Pan Toilet technologies proved to be of
interest but was not necessarily intuitively
understood to be a lid by all interviewees. There was
also an assumption that the two products fit together
to make one larger toilet product rather than being
Journal of Science Policy & Governance TECHNOLOGY ASSESSMENT: SATOTM Toilet Tech
www.sciencepolicyjournal.org JSPG., Vol. 16, Issue 02, May 2020
Figure 3 A compilation of the 17 Categorical Themes that emerged from the 30 interviews
Examples
“[The SaToTM Pan Sit] is a clean toilet.”
"The cheap is expensive."
"We would pay 300K for the SaToTM Pan squat toilet package for
ourselves because everything is included."
“Because the SaToTM Pan Sit is more comfortable because I have
problems with my legs, so usually when I use the squat toilet, I am usually
pained.” ;If you are tired you can sit easily on the SaToTM Pan Sit
“I don’t regard tenants to have lower class things. I put more into it so
that they can take care of it
"I prefer the SaToTM Pan sit if it was it was occupied by just me and my
family. I would use the SaToTM Squat if I was sharing with tenants.”
"Plumbers are dependent; I wouldn’t know what price unless I hear and
agree with them.”
“We had a tap on our plot, but water doesn’t come out.” [expressing
concern about needing water for the SaToTM Pan technologies]
"I don’t have money I can only have it if it is for free."
“I saw that the other was getting full so I decided to build another [by
digging a hole right next to it].”
“If the toilet is good the price of the house increases.”
"We like the SaToTM Pan sit toilet. But it needs a cover." [representing the
need for some education around the product’s features in this
community]
"The [tenants] don’t help- it is the responsibility of the landlord to fix the
toilet."
“Not installing the SaToTM Pan Squat toilet represents laziness. Look at it.
This is a do it yourself.”
“I don’t like the way that the SaToTM Squat looks.”
The SaToTM Squat looks like a tub or dish to bathe a child”
"The SaToTM Pan Sit is easy to install since it already has holes and just
need to make the holes bigger."
Journal of Science Policy & Governance TECHNOLOGY ASSESSMENT: SATOTM Toilet Tech
www.sciencepolicyjournal.org JSPG., Vol. 16, Issue 02, May 2020
two independent frontier sanitation technologies,
which was evidenced by the number of people who
tried to place them together or said statements like “I
see that this is something that you put on top of the
other toilet”.
The SaToTM Pan installation responses varied based
on the LLs technical knowledge. More technically
experienced respondents tended to be overly
analytical and critical about the installation needs
whereas laymen thought that it would be easy to
install with cement. There was an overarching
concern about cleanliness and hygiene. Many LLs
were renovating their toilets and expressed interest
in investing in something more long term and
expressed that plastic was only temporary. The
materiality responses varied with positive responses
such as “the rare part about it is that it is plastic. I
haven’t seen it with a toilet sitter” and “this plastic is
[strong] and different from the plastic that we use” as
well as negative responses such as “I don’t like the
SaToTM Pan, it’s too plastic” and "How durable can it
be since it’s plastic?”
Lastly, convenience was a frequent theme attributed
to these technologies and related to making the toilet
purchasing/installing process more accessible.
iii. Toilet preference
Overall, the preference rankings showed 16/30 LLs
found the SaToTM Pan Sit toilet technology to be the
preferred toilet for themselves, their children, and
their guests to use. The only interviewees that
preferred their current toilet to the SaToTM Pans were
the few that had fully flushing toilets connected to a
septic tank. Some respondents reported that they
would let their guests or children use the SaToTM Pan
Squat toilet or their current pit latrines because
children and guests are often messy or because the
SaToTM Pan Sit toilet technology would be special, to
Figure 4: These are the images of the toilets that were shown to the studies interviewees. The highlighted LL
responses showcase the least and most preferred options of the 5 toilets that were presented. (graph made by
Jasmine Burton; photos taken by Jasmine Burton)
Journal of Science Policy & Governance TECHNOLOGY ASSESSMENT: SATOTM Toilet Tech
www.sciencepolicyjournal.org JSPG., Vol. 16, Issue 02, May 2020
only be used by a nuclear family that cares for it.
These responses support the perceived notion that
the SaToTM Pan Squat toilet is better for managing
messier or unpredictable levels of cleanliness
whereas the SaToTM Pan Sit toilet is better for
personal use with predictable cleanliness.
iv. Toilet ranking
40% of the responses about the SaToTM Pan Sit toilet
were positively oriented as noted in Figure 4. The
SaToTM Pan Squat toilet technology was not identified
with recognizable frequency as a commonly ranked
toilet for any of the characteristics, either positive or
negative in connotation. The ceramic squat pan
currently on the market was rated the most
disgusting by nearly half of the respondents, the least
modern from nearly half of the respondents, the toilet
they were least willing to buy by over half of the
respondents, the least comfortable by half of the
respondents, the toilet that represents status the
least by half of the respondents, and the overall worst
toilet of the five options by half of the toilets (Figure
4). LLs most consistently stated that they would
install the SaToTM Pan Sit Toilet technology for
themselves and they would be most inclined to
provide the ceramic sit toilet for their tenants.
v. Landlord perceptions of tenants activity
Nearly all LLs agreed with statements (Figure 5). One
of the LLs said "there should be an agreement
between the landlord and tenants. It is not the job of
the tenant to improve the toilet".
The findings listed in Figure 5 indicate that there is a
general reported consensus that the LLs know and
recognize their role in providing improved sanitation
technologies for their tenants.
IV. Discussion
i. Implications
Cleanliness was one of the major themes to arise from
this study’s data, specifically regarding the LL’s
current sanitation situation and their perceptions of
the SaToTM Pan Toilet technologies. The LLs who
perceived the SaToTM Pan Toilets to be unhygienic,
due to either direct physical contact with the SaToTM
Pan Sit toilet or to the messy, splatter-prone
perception of the SaToTM Pan Squat toilet, stated that
they would not pay for the products for themselves,
their families or their tenants regardless of price.
The provision of specific or differentiated toilet
technology needs for LLs and tenants did not vary as
greatly; the concept of ‘shared sanitation’ is generally
not desirable, but because most people are focused
on leading clean, hygienic lives through affordable
WASH product and service offerings, cleanliness
appeared to be the LL’s primary concern. The cost of
the toilet technology was then their secondary
concern related to the SaToTM Pan Toilet
technologies. If these toilets technologies can be
proven to remain clean easy to clean while also being
affordable through further community-based trials,
the uptake and belief in the technology in Bauleni will
likely increase. However, a tension still exists for the
LLs that share toilets with their tenants, particularly
if they view their tenants as messy. The nuance of
these findings implies that a toilet technology
portfolio, inclusive of toilets with varying designs,
costs, and user experiences for the end user and
waste management provider, could meet the diverse
sanitation needs of resource-constrained PUAs
within Lusaka, while collectively working to reduce
the overall burden of WASH-related diseases in
Zambia.
ii. Strengths and limitations
This study’s strength is that it builds on and aligns
with existing WASH knowledge (both published and
unpublished) in Lusaka, Sub-Saharan Africa and in
the world at large. It acts as a baseline and formative
market-understanding for a specific pour-flush toilet
technology which could be instrumental for Lusaka as
its sanitation landscape prepares for large-scale
improvements and change. The sample size and
timeframe of this study catalyzed a series of
limitations that may impact the reliability of these
findings. Relying on the interviewees’ self-identifying
as LLs could have also produced some selection bias.
Social desirability bias was likely present as well
particularly in the toilet ranking activity.
Additionally, the SaToTM Pan Sit toilet broke en route
to Lusaka, which required the use of duct tape. Due to
the time constraints of this study, the researchers
were unable to procure another toilet sample.
Triangulating this data with that of other SaToTM Pan
markets studies may be beneficial in determining the
extent of these limitations.
Journal of Science Policy & Governance TECHNOLOGY ASSESSMENT: SATOTM Toilet Tech
www.sciencepolicyjournal.org JSPG., Vol. 16, Issue 02, May 2020
V. Conclusions
This study has shown that the SaToTM Pan Sit Toilet
technology is preferred over all other presented
alternatives, which represents a potential market
demand for this product to fill the supply-side void
for improved and affordable sanitation technologies.
The LL’s preference, interest and understanding of
the SaToTM Pan Squat toilet was quite negative or
indifferent especially related to the themes of
cleanliness, quality, and user experience.
LLs seem to collectively understand the value of
sanitation, that their tenants value clean and well-
maintained toilets, and that it is largely their
responsibility as LLs to invest in sanitation
infrastructure for their own financial benefit (i.e.
through increased rentals) and social benefit (i.e.
Figure 5: This graph showcases the landlord’s perceptions about their tenants
Journal of Science Policy & Governance TECHNOLOGY ASSESSMENT: SATOTM Toilet Tech
www.sciencepolicyjournal.org JSPG., Vol. 16, Issue 02, May 2020
wanting to protect their social capital and community
standing as responsible LLs). Lusaka represents an
opportunity to conduct user trials and perhaps a
market viability study in an effort to capture an
understanding of actual willingness-to-pay behaviors
of the PUA LLs.
Much of the WASH work done in Lusaka at this time
is being hallmarked as an incredible learning
opportunity for other large-scale sanitation
improvement projects in LMIC across Sub-Saharan
Africa. With SaToTM Pan Toilet technology trials and
leanings being conducted and collected in Kenya,
Uganda and Tanzania, these market research findings
could potentially be of value to LIXIL for design and
scaling strategy for the region. Additionally, the
investment and prioritization that Zambian
policymakers are making in WASH infrastructure,
behavior change, and education has enabled
technology innovation in this sector to grow and
thrive. SDG 6’s target 6.2 specifically calls for
universal access to improved sanitation and hygiene
while also ending open defecation by 2030 (UN
Sustainable Development Goals Knowledge Platform
2019). In 2018, UN Water released a report that
states that one in ten countries is currently on track
to achieve universal sanitation coverage by 2030.
“Substantial investment will be required, particularly
in rapidly growing urban areas, although solutions
will vary depending on the relative importance of
sewerage networks and on-site sanitation systems
(UN 2018). This means that building up and further
strengthening the capacity of authorities on the local
and national levels will increase in priority especially
in LMICs. Lusaka and Zambia at large are no
exception. It could be of interest to LSP and LWSC
authorities to have a set of toilet innovation products,
including technologies like the SaToTM Pan Toilet, to
develop a toolbox of toilet offerings that could be
afforded and effectively used by various people in
Lusaka.
According to UN Water, “achieving SDG 6 is essential
for progress on all other SDGs and vice versa.
Sustainable management of water and sanitation
underpins wider efforts to end poverty, advance
sustainable development and sustain peace and
stability” (UN Water 2018). Therefore, proven and
sustainable frontier technologies in the WASH sector,
particularly related to sanitation, have the potential
to have a profoundly positive and lasting impact as it
relates to global social inclusion, health equity,
gender parity, public private partnership models, and
the environmental movements.
References
American Standard. 2016. LIXIL Celebrates One Million
SaTo (“Safe Toilet”) Products in Use Globally.
Retrieved March 6, 2020, from American Standard
website
https://www.americanstandard-us.com/press-
room/press-releases/2016/05/31/lixil-
celebrates-one-million-sato-products-in-use-
globally
Anderson, R. 2007. Thematic Content Analysis (TCA)
Descriptive Presentation of Qualitative Data Using
Microsoft Word.
Aunger, R. and Curtis, V. A. 2015. Guide to Behaviour
Centred Design. Retrieved March 6, 2020, from
London School of Hygiene and Tropical Medicine
website:
https://blogs.lshtm.ac.uk/envhealthgroup/files/
2015/04/Guide-to-Behaviour-Centred-
Design.compressed-2.pdf
Blackett, I., and Hawkins, P. 2016. Faecal Sludge
Management Tools: Tools and Guidelines Water
Sanitation Program Technical Paper. World Bank
Group / Water and Sanitation Program.
http://documents.worldbank.org/curated/en/46
1321468338637425/pdf/106805-REVISED.pdf
Central Statistical Office (CSO) [Zambia], Ministry of
Health (MOH) [Zambia], and ICF International.
2014. Zambia Demographic and Health Survey
2013-2014. Rockville, Maryland, USA: Central
Statistical Office, Ministry of Health, and ICF
International.
Chipungu, J. 2016. Lusaka Sanitation Landscape Report.
(Unpublished).
Coin Mill Currency Conversion. 2017. United States Dollar
(USD) and Zambian Kwacha (ZMW) Currency
Exchange Rate Conversion Calculator.
LIXIL. 2016. Field Testing Protocol
Uganda/Kenya/UNICEF ESAR. (Unpublished).
Lusaka Water and Sewerage Company. 2016. Lusaka
Sanitation Program: Improving Sanitation in the
City of Lusaka. (Brochure).
“Re-Inventing the Toilet: a New Era of Safe Non-Sewered
Sanitation.” n.d. International Water Association,
iwa-network.org/news/re-inventing-the-toilet-a-
new-era-of-safe-non-sewered-sanitation/.
Research and Development. 2016. American Standard's
SaToTM: A Safe Toilet.
Journal of Science Policy & Governance TECHNOLOGY ASSESSMENT: SATOTM Toilet Tech
www.sciencepolicyjournal.org JSPG., Vol. 16, Issue 02, May 2020
Roma, E., and Biran, A. 2016. Faecal Sludge Management in
Urban and Peri-Urban Areas of Low and Middle
Income Countries: Bottlenecks and Viable
Solutions for Lusaka, Zambia (unpublished).
SATO. Smart, fresh toilets. Retrieved March 6, 2020 from
SATO website
http://www.sato.lixil.com/
SHARE Consortium. 2016. San-Dem. Retrieved March 6,
2020 from SHARE website:
https://www.shareresearch.org/project/san-
dem
SSWM. 2017. Pour-Flush Toilet. Retrieved March 6, 2020,
from SSWM website:
https://sswm.info/content/pour-flush-toilet
StataCorp. 2015. Stata Statistical Software: Release 14.
College Station, TX: StataCorp LP.
Tidwell, B. 2017. San-Dem Dataset. (Unpublished)
UN Water. 2018. Synthesis Report on Water and
Sanitation. Accessed March 6, 2020 from UN
website:
https://www.unwater.org/publications/highlig
hts-sdg-6-synthesis-report-2018-on-water-and-
sanitation-2/
https://doi.org/10.18356/e8fc060b-en
UN Sustainable Development Goals Knowledge Platform.
2019. Progress of Goal 6 in 2019. Retrieved March
6, 2020, from UN website:
https://sustainabledevelopment.un.org/sdg6
USDP. 2015. Improved or Unimproved Sanitation.
Retrieved March 6, 2020, from USDP website:
http://www.usdp.or.id/id/?p=4638
Water and Sanitation for the Urban Poor. 2015.
Introducing safe FSM services in low-income
urban areas: lessons from Lusaka. The Stone
Family Foundation, 1-11.
“Water, Sanitation and Hygiene.” Related UNICEF Sites, 29
Mar. 2020,
www.unicef.org/zambia/water-sanitation-and-
hygiene.
WHO / UNICEF. 2015. Lack of sanitation for 2.4 billion
people is undermining health improvements.
Retrieved March 6, 2020, from WHO website:
https://www.who.int/mediacentre/news/relea
ses/2015/jmp-report/en/
World Bank. 2015. FSM conditions in Lusaka, Zambia: A
Rapid Assessment. (Unpublished).
World Bank. 2015. Lusaka Sanitation Project. Retrieved
March 6, 2020, from UN website:
http://projects.worldbank.org/P149091/?lang
=en&tab=overview
Jasmine Burton
Jasmine Burton graduated with Highest Honors from the Georgia Institute of Technology’s (GT) School of
Design with a BSc in Industrial/Product Design. Prior to graduation, Burton founded Wish for WASH, LLC, a
social impact startup intended to bring innovation to sanitation after her senior design team was the first all-
female team to win the GT InVenture Prize Competition (the largest undergraduate invention competition in
the USA) for their invention - the SafiChoo toilet. This work was catalyzed in response to the 2.3 billion people
around the world today that lack safe and hygienic toilets, which is a statistic that disproportionately hinders
the livelihood of women, girls and other marginalized groups. Jasmine has since led Wish for WASH in
conducting iterative toilet innovation pilots and research in Kenya, Zambia, Uganda, Ethiopia and in an Atlanta-
based resettled refugee community with a human-centered design and gender equity lens. She continued to
pursue her passion for equitable and sustainable sanitation as a Rotary Global Grant Scholar and MSc in Public
Health student at the London School of Hygiene and Tropical Medicine. With 7+ years of diverse WASH (water,
sanitation and hygiene) experience in the research, communications, health and gender equity spaces within
the public, private, and social enterprise sectors across 10 countries, Jasmine identifies as a social impact
designer and storyteller who seeks to utilize design thinking and business acumen to accelerate universal
access to improved sanitation for all because #everybodypoops.
Acknowledgements
Jasmine Burton received London School of Hygiene and Tropical Medicine (LSHTM) technical support from
the San-Dem project Research Assistant and LSHTM PHD Candidate, Dr. James B Tidwell, as well as from the
TRANSFORM project Research Fellow, Dr. Katie Greenland. Dr Robert Aunger, Dr. Adam Biran, and Dr. Valerie
Curtis supported in the developed of my MSc project proposal and protocol; Dr. Aunger became Jasmine’s
direct project supervisor and aided in the refinement of my protocol, data collection tools, and written drafts.
While in Lusaka, Jasmine was provided with an office space at CIDRZ Headquarters after meeting with and
receiving support from the Zambian-facing LSHTM- CIDRZ TRANSFORM Principle Investigator (PI), Dr. Roma
Chilengi. Jenala Chipungu and Joyce Chilekwa, both of whom were CIDRZ Research Fellows, acted as Jasmine’s
Journal of Science Policy & Governance TECHNOLOGY ASSESSMENT: SATOTM Toilet Tech
www.sciencepolicyjournal.org JSPG., Vol. 16, Issue 02, May 2020
main in-country points of contact for training, logistics, and technical support. Financial support for this
fieldwork was obtained via the LSHTM Trust Fund, LSHTM MSc-based bursary, and Rotary International
Global Grant scholarships. During Jasmine’s time in Zambia, Dr. James B Tidwell supported her with
developing her sampling strategy within Bauleni. Jenala and Joyce aided in the selection of Jasmine’s two
Zambian project research assistants, Herbert and Ester, whom provided her with real-time interview
translations.
Disclaimer
SafiChoo is a modular toilet concept created by Wish for WASH, LLC which was founded by Jasmine Burton.
Article
Full-text available
Ensuring a sustainable urban water supply for developing/low-income countries requires an understanding of the factors affecting water consumption and technical evidence of individual consumption which can be used to design an improved water demand projection. This paper compared dry and rainy season water sources available for consumption and the end-use volume by each person in the different income groups. The study used a questionnaire survey to gather household data for a total of 398 households, which was analysed to develop the relationship between per capita water consumption characteristics: Socio-economic status, demographics, water use behaviour around indoor and outdoor water use activities. In the per capita water consumption patterns of Freetown, a seasonal variation was found: In the rainy season, per capita water consumption was found to be about 7% higher than the consumption for the full sample, whilst in the dry season, per capita water consumption was almost 14% lower than the full survey. The statistical analysis of the data shows that the average per capita water consumption for both households increases with income for informal slum-, low-, middle- and high-income households without piped connection (73, 78, 94 and 112 L/capita/day) and with connection (91, 97, 113 and 133 L/capita/day), respectively. The collected data have been used to develop 20 statistical models using the multiple linear stepwise regression method for selecting the best predictor variable from the data set. It can be seen from the values that the strongest significant relationships of per capita consumption are with the number of occupants (R = −0.728) in the household and time spent to fetch water for use (R = −0.711). Furthermore, the results reveal that the highest fraction of end use is showering (18%), then bathing (16%), followed by toilet use (14%). This is not in agreement with many developing countries where toilet use represents the largest component of indoor end use.
Lusaka Sanitation Program: Improving Sanitation in the City of Lusaka. (Brochure)
  • Lusaka Water
  • Sewerage Company
Lusaka Water and Sewerage Company. 2016. Lusaka Sanitation Program: Improving Sanitation in the City of Lusaka. (Brochure).
American Standard's SaToTM: A Safe Toilet
  • Development Research
Improved or Unimproved Sanitation
  • Usdp
Thematic Content Analysis (TCA) Descriptive Presentation of Qualitative Data Using Microsoft Word
  • R Anderson
Anderson, R. 2007. Thematic Content Analysis (TCA) Descriptive Presentation of Qualitative Data Using Microsoft Word.
LIXIL Celebrates One Million SaTo (“Safe Toilet”) Products in Use Globally
  • American Standard
Guide to Behaviour Centred Design
  • R Aunger
  • V A Curtis
Aunger, R. and Curtis, V. A. 2015. Guide to Behaviour Centred Design. Retrieved March 6, 2020, from London School of Hygiene and Tropical Medicine website: https://blogs.lshtm.ac.uk/envhealthgroup/files/ 2015/04/Guide-to-Behaviour-Centred-Design.compressed-2.pdf
Faecal Sludge Management Tools: Tools and Guidelines Water Sanitation Program Technical Paper
  • I Blackett
  • P Hawkins
Blackett, I., and Hawkins, P. 2016. Faecal Sludge Management Tools: Tools and Guidelines Water Sanitation Program Technical Paper. World Bank Group / Water and Sanitation Program. http://documents.worldbank.org/curated/en/46 1321468338637425/pdf/106805-REVISED.pdf
Lusaka Sanitation Landscape Report
  • J Chipungu
Chipungu, J. 2016. Lusaka Sanitation Landscape Report. (Unpublished).
Faecal Sludge Management in Urban and Peri-Urban Areas of Low and Middle Income Countries: Bottlenecks and Viable Solutions for Lusaka
  • E Roma
  • A Biran
Roma, E., and Biran, A. 2016. Faecal Sludge Management in Urban and Peri-Urban Areas of Low and Middle Income Countries: Bottlenecks and Viable Solutions for Lusaka, Zambia (unpublished).
  • U N Water