The monitoring safely managed on-site sanitation (M-SMOSS) pilot in Malawi tested methods to assess sanitation across the service chain that could be integrated into ongoing national monitoring. The pilot was conducted by the National Statistics Office in collaboration with UNICEF, WHO, sector ministries and other stakeholders, and included household surveys, service provider and service authority surveys in three cities and three districts. Using a stratified multi-stage sampling design, the survey interviewed 2,160 households, 40 service providers, and 4 service authorities. Data collection employed structured questionnaires adapted from JMP-SMOSS templates, translated into Chichewa and Tumbuka, and administered via Computer-Assisted Personal Interviewing (CAPI). Rigorous training, piloting, and ethical safeguards ensured data quality and respondent protection.
- Access to Basic Sanitation: While over 89.3% of households use improved sanitation facilities, only 50.8% have access to basic sanitation due to widespread toilet sharing—especially in urban areas, where 48% of households share toilets. Open defecation persists in rural areas (11.4%) and among the poorest households. Access to toilets is highly unequal, with 78% of the wealthiest households having their own, compared to just 18% of the poorest.
- Waste Containment: Over 99% of septic tanks and pit systems show safe containment, with limited structural issues and unsafe discharges observed.
- Emptying and Transportation: Sludge emptying is rare—only 10% of septic tank users and 3% of pit latrine users have ever emptied their systems, a total of 3.8% of all improved OSS. In rural areas, services are unavailable, leading households abandoning full pits and reconstructing new toilets or resorting to open defecation. Urban barriers to seeking pit emptying services include high costs, limited access, and a shortage of trained service providers. Public awareness is low, with only 21.2% of households aware of available pit emptying services.
- Treatment and Disposal: Less than half (39%) of emptied waste is safely treated, with only 48% of emptied sludge delivered to treatment and half of the treatment plants not providing adequate treatment. Rural areas lack treatment facilities entirely, while many treatment plants in urban areas are dilapidated, overstretched and not designed for fecal sludge. Weak monitoring and regulation make it difficult to track waste treatment outcomes.
- Service Providers: Almost all emptying is done by service providers (both formal and informal) , and over 13 percent of excreta emptied by service providers was reported by households to be disposed unsafely to the environment. The emptying and transport service provider ecosystem is underdeveloped and unevenly distributed, with limited services for many rural and poor urban populations. The sector remains largely informal and under-resourced, facing numerous operational and safety challenges that hinder effective service delivery. More than 60% of service providers have no formal training in safe emptying practices. Additionally, half of them do not use basic protective gear such as gloves or boots, leaving them exposed to health risks. Most service providers operate with minimal oversight and regulations.
- Service Authorities: Service authorities face systemic challenges including limited financing, inadequate staffing/limited skills, lack of tools, and weak legal mandates. Monitoring and data tracking systems for service quality and coverage remain underdeveloped.