Global progress across sanitation service levels assessed against MDG

A new study in PLOS Water uses a novel metric to compare sanitation improvements across countries between 1990 and 2015, revealing insights that could help progress.

The United Nations (UN) pledged in 2004 to reduce the number of people without basic sanitation by half by 2015. While progress was made, it fell short of the Millennium Development Goal (MDG). Although the simple pass-fail metric used to track progress may miss meaningful gains like a household switching from open defecation to a shared latrine. Or it could curtail progress by rewarding minor changes. It was instead developed but not used for the MDG period.

The new Sanitation Ladder Score has now been applied to 190 countries, covering 99.8% of the global population. For most countries, the ladder score improved on the previous pass-fail metric. Forty-one countries improved their ladder score, while five countries deteriorated (Libya, Seychelles, Granada, Aruba, and French Polynesia).

The researchers studied data from Ghana, Ethiopia, Cambodia, Lao People's Democratic Republic, Nepal, and Poland. They believe the 1990-2015 ladder score could help countries achieve the UN's 2030 Sustainable Development Goals. Determining how to address sanitation deficits in urban and rural areas requires looking backwards at MDG progress.