This report summarizes findings from a pilot study in Nepal to develop methods for monitoring safe management of on-site sanitation (SMOSS). The SMOSS project is an initiative led by WHO/UNICEF JMP with funding from the Bill and Melinda Gates Foundation. It was designed to respond to the needs identified at national level through a phased approach, including the analysis of the legal and institutional framework, the definition and piloting of a set of indicators and tools for data collection, as well as the development of an action plan for the institutionalization of a national system for monitoring SMOSS services. The study was carried out with the support of the World Health Organization Country Office, in partnership with the National Agency for Public Health as the technical implementation institution. The activities were carried out in collaboration with the Ministry of Health, the Ministry of Environment, the Ministry of Infrastructure and Regional Development, the Congress of Local Authorities of Moldova (CALM), the National Bureau of Statistics, as well as other relevant actors in the field of public health and sanitation services.
- More than 80% of households in rural areas are not connected to a centralized sewerage system, using individual improvised sanitation systems (permeable septic tanks, latrines), which do not comply with minimum sanitary standards. This reality points to insufficient critical infrastructure, with a direct impact on health and the environment.
- About 46% of households use drinking water from decentralized sources, such as springs, public and individual wells. At the same time, for 84.6% of respondents (n=280) the source of drinking water is located at a distance of up to 50 meters from the individual effluent collection facility, these practices amplify the risk of contamination of drinking water, which represents a danger to the health of consumers, especially vulnerable groups.
- According to the results obtained, based on the risk assessment matrix, over 55% of households are classified in the "medium" or "high" health risk category. Early education institutions are characterized by a more favorable health situation, 96% of them being classified in the category of "low" health risk.
- More than 35% of early childhood education institutions use sanitary facilities that are not adapted to children. It is important to mention that over 80% do not provide separate toilets for girls and boys, as well as 23% do not have separate toilets for staff and children.
- The assessment of the challenges of local public authorities in health management reflects the main difficulties, such as insufficient financial resources (100%), low community awareness of appropriate sanitation practices (30.8%) and insufficient qualified personnel in LPAs (23.1%).
- The share of operators of effluent emptying and transport services that encounter difficulties regarding the availability of human resources is 40%. Another challenge identified refers to the distance of more than 12 km to the effluent disposal plants, reported by 60% of operators.
- Rural sanitation infrastructure is not monitored, indicators on the use of individual sanitation systems are not integrated into official statistics. The lack of data limits the country's ability to assess progress on universal access to safe health services, according to the Sustainable Development Goals (SDGs 6.2 and 6.3).