Imagine you are a child and the only toilet in your school is out of order—and has been since the start of the school year. Sadly, this is the reality for at least 539 million school children around the world. Almost half of these children have no toilet in school at all. For the other half, a toilet may exist but have become unusable through a lack of basic maintenance. These children suffer the impact of Toilet Loss daily.
Toilet Loss is the economic and societal cost of neglected toilets.
Economist Impact, supported by Unilever, is launching novel research that measures the scale, scope and cost of Toilet Loss and develops an investment pathway to ensure every child has access to a clean and safe basic school toilet. The research covers four geographically diverse countries: Ecuador, India, Nigeria and the Philippines.
Key findings include:
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Across the four countries considered in this study, 1.2m school toilets constructed since 2015 have been “lost” through lack of maintenance, equivalent to a loss of US$1.9bn. These losses have been most extreme in India and Nigeria, where 0.6m and 0.4m constructed toilets have respectively been lost. In Nigeria and Ecuador, the losses amount to nearly 20% of all investment in school sanitation since 2015—in other words, for every US$5 invested in school toilets, US$1 has been lost.
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Prioritising operation and maintenance (O&M) is critical to preventing Toilet Loss. If toilet construction had been supported by O&M, the countries in this study could be 10% closer to full coverage of basic toilets across schools. While constructing new school toilets is necessary to reach full school sanitation coverage, construction without O&M results in a significant and rapid loss of the newly built toilets. In Ecuador, US$120m has been lost from building new school toilets that have not been maintained. If this money had been put towards maintaining existing toilets instead, access to basic school toilets in the country could be 69% instead of 59%.
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Increased O&M spending could have avoided large healthcare expenditure, reduced family income and lost economic output of over US$10bn across the countries studied in 2015-21. India and Nigeria suffered the greatest losses, of US$5.1bn and US$4.4bn respectively. The greatest contributor to these losses is healthcare expenditure to treat infections in children—in India, healthcare expenditure constitutes two-thirds of the total loss. Losses in the longer term could be substantially higher than estimated, as learning losses drive wider economic impacts as children grow older, from reduced access to skilled labour and decreased overall productivity.
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Globally, at least 20m more basic service toilets are needed across schools to reach 100% coverage by 2030. Meeting this target requires a six-fold acceleration in the progress made since 2015. Between 2015 and 2021, the number of basic service toilets in schools increased from 36m to 38m. By 2030, 58m toilets will be needed across schools. To achieve this goal, our analysis estimates that:
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12m more toilets need to be newly constructed and subsequently maintained;
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an additional 8m existing toilets need to be rehabilitated and receive subsequent regular O&M; and,
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the remaining 38m need continued O&M.
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An additional cent in every dollar of education spending per child each year will allow most countries to achieve full basic sanitation coverage in schools through investment in the construction and O&M of school toilets by 2030. Additional estimated annual spending of US$2-11 per child is needed to achieve 100% coverage of basic school toilets across the four countries studied. Nigeria is the only country among those studied where more substantial increases in spending—equivalent to 23% of current education spending per child—will be needed for full basic coverage. This level of investment is a result of lower baseline education spending in Nigeria and much larger gaps in basic toilet coverage in schools. Across all countries, additional investment will be needed beyond those estimated to achieve advanced service levels in schools, particularly in terms of sanitation software such as training, and the implementation of monitoring and evaluation systems.
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In a budget constrained environment, prioritising O&M investment to maintain existing school toilets is the most cost-effective strategy—in Nigeria, this strategy delivers social returns of US$2.6 for every US$1 invested. Achieving the SDG targets will ultimately require investing in both construction and O&M, but, in a fiscally constrained environment, countries may not have the capacity to substantially increase their investment in school sanitation. Investing first in maintaining existing toilets is the most cost-effective and feasible strategy, delivering the highest social returns for every dollar invested. In the longer term, as more funding is unlocked, greater investment can be directed towards building and maintaining new toilets to close the access gap.
Based on the insights of experts interviewed, published research and learning from countries leading the way towards sanitation for all children, we identify a three-point plan as a baseline for developing local strategies to close gaps in sanitation access in schools:
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Accelerate future planning: no school toilet built without a plan and budget for operations and maintenance
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Better monitoring: collecting systematic data against clear guidelines to measure and monitor the availability of and access to basic sanitation services in schools
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Clear governance: clarifying roles and responsibilities for all stakeholders providing sanitation services in schools
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