Can a business approach link sanitation and curative health care?

More than 50% of health ailments (in developing countries) arise due to poor sanitation. Out-of-pocket costs for health care can comprise upwards of 60% of total household expenditures for the uninsured. The bottom-line: It is expensive to be uninsured. Linking sanitation and health can therefore make economic sense for entrepreneurs and governments alike.

Sanitation and health
Savings from good health make economic sense for both households and the public sector, reducing out of pocket health expenditures. Marketing for scale at the sanitation-health nexus has potential to achieve this through public-private partnerships co-selling health insurance and improved sanitation. In our SIWI session last august called ‘Can a business approach link sanitation and curative health care?’, we focused on the Indian and East African contexts. Case studies were presented on experiences with tele-medicine in India and universal health coverage in Kenya and Uganda. These highlighted opportunities for digitization to reach the rural poor and achieve improved health outcomes.

Telemedicine in India

The Odisha case study from India shared experiences with a telemedicine pilot conducted over the period 2020/21 which found success despite COVID-19 disruptions. With approximately 84 Gram Panchayats (government administrative units) in Odisha state, tele-consultation not only provides people with access to timely medical resources, but also provides the organization with data on health, illness, and sanitation in the respective regions. This pilot focuses on the engagement of local youths who are trained, given tablets and other equipment to use. The youth act as links to make tele-consultation accessible for the people, connecting and recording data with the technical assistance organisations. Overall, the model comprises four major aspects including telemedicine and consultation of users, data collection and processing, training the youth and people involved and engaging with rural entrepreneurs.

Universal Health Coverage in Kenya

The Kenyan case study shared a universal health coverage agenda and government-led initiative aiming to ensure universal access to healthcare for all. The focus is on broadening and converting national hospital insurance fund into a National Health Insurance Fund and link this to sanitation. The strategy adopted involves the use of WASTE’s Diamond Model for a multi-stakeholder approach. For health impacts to come about, a relatively high coverage of improved latrines is required.

SIWI 2021 Sanitation


During the session the panel discussion and audience interest raised key issues such as (a) roadblocks in tele-consultation and how digitization can enhance access to healthcare and sanitation especially for the [rural] poor; (b) building trust with communities and local stakeholders is critical; and (c) a lot more innovation, liberalization of regulation and clearance of ‘sand boxes’ is required.

Altogether, conveners aimed to spark discussion and share experiences regarding the sanitation-health-economy nexus, focusing on digital solutions for demand and supply-side management of interventions as well as the economics of improved sanitation linked to health. The session called for innovation to rethink sanitation programming to include health interventions and sustainable scaling and cooperation, for collaborative, multi-stakeholder, and public-private partnership approaches to tackle these issues sustainably and efficiently.

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