UNIVERSITY OF GHANA, LEGON (UG) LEGON CENTRE FOR INTERNATIONAL AFFAIRS AND DIPLOMACY IMPLEMENTATION OF SDG 6.2: AN ANALYSIS OF GHANA’S EFFORTS TOWARDS SUSTAINABLE MANAGEMENT OF SANITATION BY: MERCY AGULA BAWA (10877477) THIS DISSERTATION IS SUBMITED TO THE UNIVERSITY OF GHANA, LEGON, IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE AWARD OF THE MASTER OF ARTS DEGREE IN INTERNATIONAL AFFAIRS JANUARY, 2022 DECLARATION I, Mercy Agula Bawa hereby declare that this thesis is my own work under the supervision of Dr Daniel Dramani Kipo – Sunyehzi of Legon Centre of International Affairs and Diplomacy (LECIAD), University of Ghana for the award of a Master of Arts (MA) degree in International Affairs and Diplomacy. To the best of my knowledge this work has not been presented by anyone for an academic award in this or any other university except where due acknowledgement has been made in the text. …………………………… ………………………………………… MERCY AGULA BAWA DR DANIEL DRAMANI KIPO-SUNYEHZI (STUDENT) (SUPERVISOR) 20/01/2022 20/01/2022 DATE:……………………………… DATE:……………………………………… DEDICATION I first dedicate this work to the Almighty God for his tender mercies, love, guidance and most importantly his abundant grace throughout the duration of my Master’s programme. I also dedicate this work to my late dad (Ignatus Awongoge Bawah) and my uncle (Prof. Ayaga Bawah). I say a special thank you for your support, sacrifices and encouragement. Finally, to the Bawa Agula’s family, friends and loved ones who supported me during my period of study, I am forever grateful. May God richly bless you. ACKNOWLEDGEMENT First and foremost, I would like to convey my sincere gratitude to the Almighty God for his mercies, blessings and guidance. To Dr. Daniel Dramani Kipo-Sunyehzi, my supervisor, for his advice and assistance. Without him, this lengthy dissertation would not have been conceivable. I appreciate your efforts and God bless you abundantly. I would also like to take this opportunity to say thank you to all my interviewees for their contributions towards the completion of this work. My profound gratitude also goes out to the staff of Ministry of Sanitation and Water Resource (MSWR), Ministry of Health (MH), Accra Metropolitan Assembly (AMA), Zoomlion Ghana Limited, United Nation Development Programme (UNDP), Accra Markets Limited, Kaneshie and to the market kings and Queens, stations masters, buyers and sellers of Kaneshie and Nima markets for their genuine contributions and insightful views. To my late dad, thank you for laying the foundation for me to attain a higher height, I will forever love you. To Prof. Ayaga Bawah (uncle), I am grateful for your support and motivation always. To my sweet mum, your immense support and prayers took me this far and to my siblings, thanks for always being there for me. I am also appreciative to my professors for the knowledge they shared with me over the course of the program. To my colleagues, Douglas Owusu and Bernard Agbemor, I am grateful for your support, advices and time throughout the program. To LECIAD class of 2020/2021year group, it is a pleasure to be part of this lovely family. My final gratitude goes out to my family and friends who helped me in various ways during this time. Not forgetting Mr Lawrence Sackey for his assistance by way of proofreading and giving me direction on how to analyse the primary data that I have gathered. LIST OF ACRONYMS AMA = Accra Metropolitan Assembly AP = Action Plan EPA = Environmental Protection Agency GAMA = Greater Accra Metropolitan Assembly (GAMA) NCCE = National Commission of Civic Education NSA = National Sanitation Authority NUPs = National Urban Policies ODF = Open Defecation Free OECD = Organisation for Economic Cooperation and Development SDG = Sustainable Development Goal SWM = Solid Waste Management UN = United Nations UNDP = United Nations Development Program UNICEF = United Nations Children’s Fund USF = Urban Sustainability Framework WHO = World Health Organisation TABLE OF CONTENTS CONTENT PAGES TITLE PAGE i DECLARATION ii DEDICATION iii ACKNOWLEDGEMENT iv LIST OF ACRONYMS v TABLE OF CONTENTS vi LIST OF TABLES viii LIST OF FIGURES ix ABSTRACT x CHAPTER ONE - INTRODUCTION 1 1.1 Background of the Study 1 1.2 Problem Statement 5 1.3 Objectives 6 1.4 Research Questions 6 1.5 Scope of the Study 7 1.6 Rationale 7 1.7 Conceptual Framework 7 1.8 Literature Review 10 1.9 Research Methodology 14 1.9.1 Research Design 14 1.9.2 Data Source 14 1.9.3 Sampling Method and Sample Size 14 1.9.4 Data Analysis 15 1.9.5 Ethical Issues 16 1.10 Arrangement of Chapters 17 CHAPTER TWO – AN OVERVIEW OF SUSTAINABLE DEVELOPMENT GOAL 6 21 2.0 Introduction 21 2.1 SDG 6 Situation 21 2.1.1. SDG 6: Ghanaian Perspective/Situation 27 2.1.2. Growth of Accra and the Sanitation Situation 30 2.2 Global Perspective on the Role of Governments in Sanitation 32 2.3 Consequences of poor sanitation 37 2.3.1 Health 37 2.3.2 Global Social Impacts 39 2.4 Ghana’s Preparedness Towards Achieving The SDGs Sanitation Target 40 2.4.1 Financing Approach 40 2.4.2 Institutional Reforms and Arrangement 42 2.5 Potential Barriers Towards Achieving the SDGs Target for Sanitation 43 2.5.1 Unclear Sanitation Service Delivery Guidelines 43 2.5.2 High Cost of Sanitation Technologies and Extensive Use of Public Latrine 43 2.5.3 Perception Towards Sanitation in Africa 45 2.6 Conclusion 46 CHAPTER THREE – RESEARCH AND DISCUSSION 54 3.1 Introduction 54 3.2 Socio Demographic Characteristics of the Participants 55 3.3 Thematic Summary on SDG 6.2 in Ghana 57 3.3.1 Sustainable Development Goal (SDG) 6.2 59 3.3.2 The Role of Citizenry and State Towards Achieving SDG 6.2 60 3.3.3 Assessing the Effectiveness of policies Implementation 62 3.3.4 Implementation challenges 63 3.4 Discussion of Result ……………………… 64 3.4.1 The role of citizenry and state towards achieving SDG 6.2 64 3.4.2 Assessing the effectiveness of policies implementation 65 3.4.3 Implementation Challenges 66 3.5 Conclusion 66 CHAPTER FOUR – SUMMARY, CONCLUSION, AND RECOMMENDATION 68 4.1 Introduction 68 4.2 Summary of Main Findings 68 4.2.1 The role of citizenry and state towards achieving SDG 6.2 68 4.2.2 Assessing the effectiveness of policies implementation 69 4.2.3 Implementation challenges 69 4.3 Conclusion 70 4.4 Recommendations 71 4.4.1 Recommendations to the Government 71 4.5 Direction for Further Studies 73 Bibliography 74 Appendix I 82 LIST OF TABLES Table 2.1: Demographic Characteristics of Accra, 1960-2020 32 Table 2.2: The role of government in sanitation, a case of Tanzanian 36 Table 3.1: Demographic Characteristics of the Participants 55 Table 3.2: Thematic Summary of SDG 6.2 57 LIST OF FIGURES Figure 2.1: Proportion of population using improved water source, 2000 and 2010 23 Figure 2.2: Proportion of the population with improved and unimproved water source by region 24 Figure 2.3: Proportion of the population with access to improved and unimproved sanitation by locality,2000 and 2010 24 Figure 2.4: Improved and unimproved toilet facilities 25 Figure 2.5: SDG 6.2; World data on sanitation management, disposed in situ, and open defecation 28 Figure 2.6: SDG 6.2; Data on sanitation management, disposed in situ, and open defecation in Ghana 29 Figure 2.7: Ghana’s average is comparison to West Africa and Global average 38 ABSTRACT Sustainable Development Goal (SDG) 6.2 focuses on attaining access to equitable and adequate sanitation and hygiene for all and end open defecation by 2030. This particular study is aimed at examining the roles of individual citizens and the state in achieving SDG 6.2 Furthermore, the study is also purposed on assessing the effectiveness in policy implementation and the challenges that befog the implementation of SDG 6.2 in Ghana. In pursuit of these objectives, a qualitative research design was employed, where qualitative data was sourced via the use of interview guide from 15 respondents from key institutions and organisations whose activities relate to SDG 6.2. It emerged from the findings that, citizens role in achieving SDG 6.2 consists of proper disposal of waste, end open defecation, keeping the immediate environment clean and hygienic, etc., whereas that of state’s are to provide dustbin for the citizenry, enforcement of sanitation laws, monitoring and evaluation of SDG 6.2 progress, prioritizing sanitation, engaging the private sector, and coordinating with other agencies such as AMA, Ministry of Health, NCCE, EPA, etc., that will help speed up the SDG agenda. Also, measures put in place thus far in attaining SDG 6.2 in the near future are inadequate, as there is poor awareness of SDG 6.2 in the public domain, insufficient number of dustbins for households, poor coordination among relevant agencies that will help expedite activities, Findings from the study revealed that, the challenges that confront the implementation of SDG 6.2 in Ghana are delay in rubbish collection, poor coordination among government agencies, low private sector participation, and budget constraints. The study recommend that the government has to create awareness through education, partner with a lot of the private sectors, the officers should be constantly monitoring and evaluating their policies and the work on the ground. Keywords: Sustainable Development Goals, Sanitation, Waste Management 1 x CHAPTER ONE INTRODUCTION 1.1 Background of study The United Nations, an international organisation which constitutes 193 member states, among other things is committed to the advancement of human agency, progress and the preservation of the environment (Morton et al., 2017). It is against this backdrop that member states met to draw up a plan representing a universal agreement towards a common developmental end. The sustainable development goals (SDGs) are a set of objectives within this universal agreement aimed at eliminating poverty, protecting and preserving all that makes earth habitable and ensuring that all people regardless of race or gender enjoy peace and prosperity both in the present moment and the future (United Nations, 2021). There are 17 sustainable development objectives in all, each with its own set of targets and indicators. For example, SDG 6, which seeks to achieve universal access to and sustainable management of water and sanitation by 2030, contains six indicators, one of which is for sufficient and equitable sanitation and hygiene for everyone, with development in Ghana being the subject of this research. It is important to note however that these goals are all intricately connected and failure to realize this would imply an approach which is likely to be non-aligned and ineffective. All member states of the UN, including Ghana, formally adopted the goals in 2015 and agreed to work together to address the challenges facing humanity in a sustainable manner subsequently contributing to the development of the human race (Morton et al., 2017). The concept of development in many ways is polysemous. Definitions of development are hugely influenced by the observer’s disciplinary background; be it economical, sociological, developmental or psychological and also through the theoretical lens of the observer. Scholars define development differently depending on the context in which it is employed. Hugo Slim, a British professor and policy advisor in International Relations, for instance states that, "development is simply change: not just any change, but a change for the better" (Slim, 1995). At the same time, development is about continuity, and change must have something in common with the group or civilization in question if it is to take root. It must have relevance for the people involved and reflect their values and abilities. As a result, development must be suitable from a cultural, social, economic, technological, and environmental standpoint (Slim, 1995). Sen (1995) also conceptualized development in terms of human welfare in his capability approach. According to Sen’s capability approach, the functionings and capabilities of people are what determines their level of development. Functionings here referring to an individual’s state of being and capabilities also referring to the potential to achieve embedded within people. The capacity approach provides a broad normative foundation for evaluating a variety of dimensions of people's well-being, particularly poverty and inequality. It also serves as a model for developing and evaluating proposals and strategies related to social change in a specific society. The capability approach's fundamental premise is an emphasis on people's ability to do and be (Robeyns, 2005). An imperative factor to consider when looking at development is its sustainability. Sustainable development is essentially characterised by the quality of permanence. The realisation of this quality of permanence is however premised upon ethical underpinnings which involve intra and inter-generational justice, as well as justice as regards non-personal entities in the environment. According to the Brundtland report from 1987, development must be a path of human growth that fulfils present demands while not risking future generations' capacity to satisfy their own needs (Rydz-Żbikowska, 2012). The point of sustainability therefore is to attain economic and social objectives without compromising the integrity of the natural environment and also ensuring continuous accessibility to the resources in the environment taking into consideration time and space (Fiedor et al., 2002). The adoption of the SDGs by UN member states was a huge shift from the idea of development being the responsibility of or requirement of particular countries using other countries as a metric, to that of a universal frame of reference. For instance, in contrast to the prior Millennium Development Goals (MDGs) which were largely laid out by ‘developed’ countries and such that they almost entirely involved targets for ‘developing’ countries, the Sustainable Development Goals (SDGs) are concerned with what collective effort all countries can put in to realize commonly set targets (Horner, 2019). The SDGs of the UN 2030 Agenda for Sustainable Development, embodies universal aspirations to achieve a future without poverty, more peaceful and continual good living, without leaving anyone behind. Sustainable Development Goals (SDGs) as adopted by the UN member states has 17 main goals for which plans of action have been and are being set by these member states to be able to achieve the agenda 2030 (United Nations Development Program, 2015). The SDGs, a global agreement among UN member states, have played a vital role in national development programs (United Nations Development Group, 2017). (Department for International Development, 2017). These aims include, but go well beyond, an environmental agenda. SDG 6, one of the 17 SDGs (SDG 6). SDG 6 comprises 8 aims and 11 indicators. The objectives clearly define the aims, and the indicators serve as a standard for measuring progress towards achieving the targets. According to the UN, millions of people, mostly children, die annually from diseases caused by poor sanitation and hygiene (United Nations Children Fund, 2020). Thus, SDG 6's second goal is vital. By 2030, everyone will have access to sufficient sanitation and hygiene, and open defecation will be abolished, with specific attention on women, girls, and those in vulnerable circumstances. Sanitation and hygiene are serious global risks: According to the World Health Organization and the United Nations Children's Fund, 2.3 billion people lacked adequate sanitation in 2015. Only 26% of probable faecal encounters are followed by hand washing, and one in four people on the world lacks access to such a facility (Wolf et al., 2018). Moreover, just 45% of the population resides in locations where basic sanitation services are supplied to 75% or more (Wolf et al., 2018). Water, sanitation, and hygiene are predicted to be responsible for 829000 deaths and 49.8 million disability-adjusted life years due to diarrheal illnesses (Pruss-Ustun et al., 2019). Because SDG 6.2 is particular to access to better sanitation and hygiene, its achievement or non-attainment has far reached ramifications. The proportion of the population using safely managed sanitation services, including a hand washing facility with soap and water, is used to assess SDG 6.2 progress (World Health Organisation, 2017d). According to Nansubuga et al. (2016), sanitation is still a problem in many African countries. They observe that although worldwide sanitation has improved, Africa's sanitation condition remains abysmal, with over 20% of the population still using open defecation. Given that the most effective public-health intervention available to the international community is adequate sanitation (Caruso & Freeman, 2020), the current study aims to explore the scope, nature and implementation of SDG 6.2-the sub-goal of SDG 6 which has to do with sanitation- in Ghana. SDG 6.2 seeks to eradicate sanitation issues such as bad waste management systems, and open defecation. Some critical barriers to adequate sanitation in the country and the effects of this inadequacy will be identified. 1.2 Problem statement While the SDGs, especially SDG 6 represent a push towards the realization of the future planned by the Brundtland Commission, questions arise about the feasibility of these goals (Mensah, 2019). According to UNICEF (2020) sanitation is severely under-prioritized, under invested and lacks leadership. Approximately 2.5 billion people, or more than 35 percent of the world's population, do not have access to improved sanitation (WHO, 2014). Poor sanitation has serious health and economic effects. The progress made toward universal sanitation is startlingly behind schedule and disproportionately uneven in coverage. This exacerbates inequalities and further marginalizes the most disadvantaged people (UNICEF, 2020) Surprisingly, this problem is most acute in Africa, where just 28% of individuals in Sub-Saharan Africa have access to basic sanitation (WHO, 2017). In Ghana, the situation is not much better, with almost 85 percent of the population lacking access to any form of sanitation (WHO, 2014). We live at a time when cities house more than half of the world's population (Cui, Fang, Liu, & Liu, 2019). Due to economic expansion, Ghana is one of the fastest urbanizing countries in Sub-Sahara Africa (SSA), putting a strain on infrastructure and sanitation (Somanje, Mohan, Lopes, & Mensah, 2020). Abdul-Aziz et al. (2021) conducted a cross-sectional study on the prevalence and correlates related with hygiene behaviours among in-school teenagers in Ghana, finding that hand hygiene was practiced by fewer than 65 percent of the participants. According to Seidu et al. (2021), Ghana is unlikely to achieve universal sanitation by 2030. According to a study conducted by Foggitt et al. (2019) on the experiences of shared sanitation in low-income communities, only 56% of home units had at least one toilet, and of those, 47% of persons living in these facilities were denied access to the toilet by the landlord. According to these reports, Ghana is lagging behind in achieving SDG 6.2. The government of Ghana however indicates that improving access to adequate sanitation facilities is a priority (Government Of Ghana, 2019). The government has put in measures, policies, programs and laws to help curb these sanitation issues nationally. Some of these policies and programmes including Community Led Total Sanitation Programme (CLTS), National Sanitation Strategy and Action Plan (NESSAP), Community Water and Sanitation Agency (CWSA) among others are working hand-in-hand to eradicate filth and water issues in the country. It is imperative however that the implementation of these policies are assessed in order to appreciate the progress or otherwise of the country towards achieving SDG 6.2 by 2030. It is upon this premise that the motivation to investigate this social phenomenon. (Sanitation) stems. This study seeks to assess the implementation of SDG 6.2 in Ghana. 1.3 Objectives The study seeks to achieve the following objectives: 1 To examine the roles of individual citizens and the state towards achieving SDG 6.2. 2 To assess the efficacy of implementation of policies geared towards SDG 6.2 3 To analyse the implementation challenges of SDG 6.2 in Ghana 1.4 Research Questions The study aims to find answers to the following research questions: 1. What roles do individual citizens and the state play towards achieving SDG 6.2? 2. How well is Ghana faring with regard to policies aimed at achieving SDG 6.2? 3. What are the implementation challenges of SDG6.2 in Ghana? 1.5 Scope of the Study The study is limited to SDG 6.2, which is sanitation. The study examines the policies set by government to push the country forward in achieving SDG 6.2. The study is also focuses on the sanitation aspect of the SDG 6, specifically Waste and Waste Management at markets and lorry stations in some Metropolitan and Municipal Assemblies in the Greater Accra Region of Ghana. The Kaneshie Market and Lorry Station, Odorkor market and lorry station and Nima Market and Lorry station are the targeted locations. These locations are very busy and attract a lot of waste, thus the need to thoroughly investigate into how the waste are managed in those locations. 1.6 Rationale The relevance of this study is to expand or add to the knowledge of how SDG 6 can be achieved in Ghana by analysing the implementation processes and policies using some selected lorry stations and markets in Greater Accra Metropolis as a case study. This research also is meant to create a contextually relevant awareness of the extent of the sanitation problem in Ghana, accompanying health-related issues. The study may also be relevant as it would make some recommendations that may hopefully help improve the effective implementation of policies that are geared towards achieving good sanitation in some selected markets and lorry stations in Accra and Ghana as a country. 1.7 Conceptual Framework Environmental security is the conceptual framework that this research is based on. Environmental security emphasizes the preservation of human life from risks such as lack of access to drinking water, air pollution, natural catastrophes, deforestation, and salinization, among others. Individuals and communities attain environmental security when they are able to prevent or adapt to environmental change so that their basic needs, rights, and values are not jeopardized (Bernett, 2010). According to Scott &Thapa, instability arises when people do not have enough food, water, shelter, or natural resources to live (2015). Natural resources and environmental processes are seen as catalysts for conflict and barriers to human well-being, as well as a way of decreasing or managing uncertainty, according to environmental security. Environmental security is widely recognized as the cornerstone of human security, and it is critical for the long-term survival, health, and well-being of households and communities. Environmental security is a subset of human security, which is a wider concern. According to the Human Development Report (1994), human security is split into seven (7) categories: community security, environmental security, political security, food security, health security, personal security, and economic security. Human security serves as the conceptual framework for this research. The Human Development Report (HDR) of the UNDP (United Nations Development Program) from 1994 emphasized the importance of human security. Poverty-free living encompasses all areas of employment, health, nutrition, and housing. The concept of freedom from need stresses actions that lead to fundamental human requirements such as food and shelter, as well as the need for long-term, sustainable progress (Tadjbakhsh, 2005). Cleanliness and water are included in the definition of freedom from want since the population's fundamental requirements for sanitation and water must be met in order for them to exist. Human security, according to the 1994 HDR, is defined as protection from chronic dangers like as hunger, sickness, and oppression, as well as protection from abrupt and detrimental interruptions to everyday life, whether at home, at work, or in the community (UNDP, 1994). These ideas come into play when human survival and well-being are on the line. Elliott (2015) emphasizes that the focus should be on attaining human security rather than simply discussing it. The question then becomes, "Do people and their communities experience more secure environmental conditions, and as a result, are they becoming increasingly free of want and fear, and more liberated to live in dignity?" When it comes to environmental challenges, it has been stated that it is uncertain if the notion or practice of human security has had a real impact on the ground. People now are less vulnerable to environmental dangers than they were twenty years ago, according to limited empirical evidence (Elliot, 2015Premature mortality from easily avoidable and difficult-to-prevent diseases, as well as health burdens associated to environmental degradation, continue to climb. Environmental disasters kill many more people than wars and political violence. Hunger and starvation, as well as a variety of other forms of suffering that can be ascribed to environmental conditions, suffocate the lives of many more people than the threat of more traditional forms of assault (Elliot, 2015). The popularization of human security by the United Nations Development Programme's Human Development Report in 1994 was a watershed moment in security studies. Individuals, rather than countries or states, have become the emphasis of security. The goal was that this new security idea will significantly influence the trajectory of security research. This, however, did not transpire as planned. States and international institutions frequently adopted the concept for their own objectives, relegating individual focus to the background. Some human security critics speculated that this development signaled the end of an ineffective, non-state-based security philosophy. Other critics, on the other hand, maintain that it still has promise, and they continue to provide empirical evidence that acknowledges the importance of non-state actors in providing security and influencing policies implemented by governments and international organizations (Gjorv, 2018). As a result, the concept of human security is still important to both state and non-state actors. Despite the intuitive appeal of the theory of environmental security, the theory has been broadly criticised for being too all-encompassing and for few realisable policy-making recommendations. This notwithstanding, the theory has provided the foundation upon which other related theories and policy recommendations can be developed. 1.8 Literature Review Literature review is to give the researcher insight into what he or she wants to investigate and to keep him or her abreast of what has been done already (Travers, 1978). It is also to help the researcher to familiarize with the existing and emerging issues of the topic. There has been quite a number scholarly works that, to varying extents, the precedents and implementation of the SDGs in Ghana. Water and sanitation were investigated and assessed by Bartram et al. (2018) for SDG 6 Means of Implementation. The state's crucial role, including government leadership and planning, the benefit of disaggregating financial and capacity-building aid, and the necessity for people to understand their rights to information, voice, and recourse are recommended improvements. These are measures that both providing and receiving countries may use. Anarfi et al. (2020) investigated how National Urban Policies (NUPs) embrace and develop sustainability as a concept in the context of urbanization. This research looked at how Ghanaian urban development incorporates and promotes sustainability. The UN-City Habitat's Prosperity Index and the World Bank's Urban Sustainability Framework were used to evaluate Ghana's NUP and accompanying Action Plan (AP) (USF). While Ghana's NUP and AP encourage urban sustainability, obstacles such as a threatened platform for inclusion and social sustainability, a lack of a poverty reduction plan, and no environmental performance objectives may hinder the advantages of sustainability (Anarfi et al., 2020). Ghana, a poor nation and UN member, has not been allowed to achieve the SDGs alone. This is because achieving SDG 6 (universal access to water and sanitation) is difficult for poor countries owing to issues including budgetary restrictions, lack of political will, and overpopulation. The World Bank has so greatly aided worldwide water and sanitation programs. Sulemana (2019) examined the World Bank's role in helping Ghana achieve SDG6 using GAMA as a case study. Qualitative research was used to acquire data from primary and secondary sources. The World Bank GAMA initiative was found to have improved people's lives by increasing access to water and sanitation, as well as secondary benefits such as economic, health, social, and environmental benefits. Sulemana (2019) highlighted implementation problems such as budgetary limits, land availability, and human resource shortages. The report advised broad stakeholder involvement and hiring financially capable contractors. The targeted areas must be thoroughly assessed, the implementation teams adequately resourced, and sanitation and building codes must be effectively enforced. Zeroing in on sanitation, Mara and Evans (2017) sought to understand the scope and nature of the challenge set by SDG 6.2 and recognises crucial barriers as well as opportunities that are presented as regards sanitation and hygiene. They mentioned that, “rapid population growth in regions that are less developed is a prominent impediment to achieving SDG 6.2. For instance, if the proportion of open defecators to the total population who have no improved sanitation in 2015 (an estimated 2.35 billion translating to 38%) is used as a premise for projection in 2030, the current rate of provision of safely managed toilets will not be feasible to reach the target of no open defecation by 2030 (WHO, 2017).” This makes the need for an accelerated progress obvious and for this to happen there has to be a clear comprehension of both factors that prevent and factors that facilitate the shift from open defecation to the use of latrines. Augsburg et al. (2015) found that cost was a major barrier to installing and using latrines in both India and Nigeria. This highlights the necessity of financial access. For example, subsidizing microfinance loans (Afrane & Adjei-Poku, 2013; Ledgerwood et al., 2013). Mara and Evans (2017) found three techniques that, when combined, are most likely to result in ODF communities in both rural and urban areas. According to the approaches provided, professional sanitation and hygiene practitioners should be taught to efficiently deal with sanitation issues. In urban slums, where space for individual families to have their own sanitation facility is often a barrier, another option was to realize that ‘safely managed shared sanitation' is the only realistic alternative. Finally, impoverished nations' political objectives must emphasize hygiene. As a consequence, huge investment in sanitation will occur (Mara & Evans, 2017). Appiah-Effah et al. (2019) conducted research to assess Ghana's sanitation condition post-MDGs (MDGs). The research looked at why Ghana could not fulfil the MDG sanitation objective, how equipped Ghana was to meet the SDG sanitation target, probable barriers and possibilities in the sanitation sector. The research employed an eight-step policy analysis procedure. This is due to a lack of financial commitment, ineffective policy implementation, negative attitudes and beliefs about cleanliness, and significant use of public and communal toilets. Thoughtful sanitation reforms and programs, such as a new Sanitation and Water Resource Ministry, the National Sanitation Authority (NSA), sanitation surcharges on property taxes, and the Greater Accra Municipal Assembly sanitation and water project have positioned Ghana to rapidly expand its coverage. Encouraging the private sector to contribute efficient and low-cost technologies, funding methods, and people and technical resources (Appiah-Effah et al., 2019). All attempts to achieve SDG 6.2 would be hampered by a lack of knowledge and understanding about sanitation concerns such as solid waste management (SWM) (Debrah et al. 2021). SWM is a multi-faceted problem with political, institutional, social, and environmental components that is growing in importance as cities grow. Debrah et al. (2021) claim that in developing nations, the knowledge gap between young and elderly contributes to environmental issues, waste management issues, and unsustainability. So, they performed a comprehensive study from 2010 to 2019 on environmental knowledge, awareness, attitudes, and practices in developing nations. Secondary and tertiary students were found to be ecologically aware and knowledgeable. Teachers, on the other hand, lacked actual training to teach SWM to students. The research related students' lack of environmental awareness to instructors' lack of practical skill in SWM for environmental sustainability. An association between teacher and student understanding of SWM was also identified, as was an association between age and SWM awareness. The lack of environmental education in most developing countries is due to instructors' inability to adapt to current environmental concerns for sustainable development and cleaner industries (CP). SWM education should be implemented into schools at all levels in developing countries to bridge the knowledge gap between young and old (Debrah et al., 2021). 1.9 Research Methodology 1.8.1 .1.1. .1.2. .1.3. .1.4. .1.5. .1.6. .1.7. 1.9.1 Research Design The study employed the qualitative research design, which allowed the researcher collect and analyse concepts, opinions, and experience from individuals and organisations of concern. The qualitative design helped the researcher with in-depth knowledge into the research problem and would hopefully help to propose ways to mitigate problem. 1.9.2 Data Source In this study data was gathered by means of interviews as is characteristic of qualitative research design method. The primary source of data was based on one-on-one interviews which were held with key stakeholders. The interviews were held with staff of the Metropolitan and Municipal Assemblies in Accra. Also, some interviews involved drivers and other persons operating in the lorry stations. Other selected locations and targeted persons for the study are the Community Water and Sanitation Agency, Market Leaders (Queens), and Lorry Park Managers. The Secondary sources of information came from the policies and concepts put in place by the government to tackle sanitation. 1.9.3 Sampling Method and Sample Size Purposive sampling is the deliberate choosing of a participant based on their attributes (Bernard, 2002). In this non-random technique, no underlying ideas or numbers of participants are required. Simply put, the researcher identifies what data is necessary and then seeks out persons who can provide it (Bernard, 2002). This strategy was used to find people who knew about the study's questions. Purposive sampling also helps pick particular areas like markets and truck stops with significant levels of garbage owing to economic activity. The snowballing sampling technique was also employed in order to allow research participants recruit other participants for the study (Data et al., 2020). The sample size for the study is 30. According to the researchers, ten qualitative sample sizes may be sufficient for surveying a homogeneous population (Boddy, 2016). Others claim that when employing a grounded theory approach to qualitative inquiry, researchers often use qualitative sample sizes of 20-30 to reach data saturation (Creswell, 1998). Given that participants in the study are going to constitute municipal officers, market queens and lorry park managers, an equal representation of these persons was considered ideal by the researcher. 1.9.4 Data Analysis Techniques used by a researcher to make gathered information as succinct as possible while making the interpretation optimally clear constitute data analysis (Le Compte, Schensul & Jean, 1999). Data collection and analysis is hoped to be done within the same day that the data is collected. This helped to ensure precision of interpreting nonverbal cues. At the end of each day of interview, all audiotapes of interview data gathered was transcribed verbatim manually by the researcher. This means that the recorded speech from the interview was converted to text. In instances where the participant asked not to be recorded or added some information after recording was done, the researcher wrote down the unrecorded part as soon as possible. A decision was made about the level of exactness desired and it was to include long significant pauses within responses by means of noting them down in alongside transcribed material (Czarniawska, 2014). After manually transcribing all audio recordings, the material was typed and then analyzed using thematic content analysis. Thematic analysis is a method of labelling qualitative data in order to find and analyze patterns in unstructured text (Nuendorf, 2018). The researcher went over the transcripts several times to look for repeating themes. The themes were assigned codes to distinguish them. The researcher organized the group codes into a hierarchy, putting the most often occurring themes and their subthemes first. The complete data set was coded using a carefully created thematic coding frame, with suitable labels applied. Along with appropriate quotes, pieces of analysed data were read several times to unpack or tease out what the participants said about the phenomenon being studied. This is to say that the data material was read repeatedly to obtain a sense of the whole (Larson, Sahlsten, Segesten and Plos, 2011). 1.9.5 Ethical Issues A good research should be well adjusted, well-planned, appropriately designed, and ethically approved (Jenn, 2006). Ethics refer to a set of specific rules prescribed by a particular group of people, usually professionals to guide their practice (Resnik, 2020). Ethics are needed to protect both the researcher and the participants from undesirable consequences which may result from the research such as legal issues, to ensure that no harm is caused by means of participating in the research and to make participants aware of what they are taking part of (Shamoo & Resnik, 2015). In this study, the consent of the persons or individuals, organisations or group of people needed was sought before scheduling and organising any interview and adding their opinions to the study. These ethical principles were adhered to in the study, informed consent of participants, voluntary participation, and privacy of participants and anonymity where the participants’ names were not mentioned in the study. Informed consent was sought to ensure that participants participated in the study of their own volition. To ensure confidentiality, the names of participants were not required and the information participants gave out was secured from falling into other hands beside the researcher. 1.10 Arrangement of Chapters The research is organized in four main chapters and these are as follows: Chapter 1……………………… Introduction Chapter 2………………………. Overview of SDG 6 Chapter 3………………………. Research findings based on three research questions/objectives Chapter 4………………………. Summary of Findings, Conclusions and Recommendations REFERENCES Anarfi, K., Shiel, C., & Hill, R. A. (2020). Assessing How Sustainability Is Promoted in Ghana’s National Urban Policyt and Action Plan. MDPI, Sustainability, 1-15. Bartram, J., Brocklehurst, C., Bradley, D., Muller, M., & Evans, B. (2018). Policy Review of the means of implementation targets and indicators for sustainable development goal for water and sanitation . NPJ | Clean Water, 1-5. Bernard, H. R. (2002). Research Methods in anthropology: Qualitative and Quantitative approaches. Walnut Creek: Alta Mira Press. Bernett, J. (2010). Environmental Security. The Routledge Handbook of New Security Studies., 123-131. Caruso, B. A., & Freeman, M. C. (2020). Shared sanitation and the spread of COVID-19: risks and next steps. The Lancet Planetary Health, 4(5), e173. Cui, X., Fang, C., Liu, H., & Liu, X. (2019). Assessing sustainability of urbanization by a coordinated development index for an Urbanization-Resources-Environment complex system: A case study of Jing-Jin-Ji region, China. Ecological Indicators, 96(1), 383-391. Czarniawska, B. (2014). Social science research: From field to desk. Sage. Datta, R., Yadav, A. K., Singh, A., Datta, K., & Bansal, A. (2020). The infodemics of COVID-19 amongst healthcare professionals in India. medical journal armed forces india, 76(3), 276-283. Debrah, J. K., Vidal, D. G., & Dinis, M. A. (2021). Raising Awareness on Solid Waste Management through Formal Education for Sustainability: A Developing Countries Evidence Review. MDPI, Recycling, 1-21. Elliott, L. (2015). Human security/environmental security. Contemporary Politics, 21(1), 11-24. Elo, S., & Kyngas, H. (2008, March 18). The qualitative content analysis process. Retrieved from Wiley Online Library: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2648.2007.04569.x Fonseca, C. P. (2014). The death of the communal handpump? Rural water and sanitation household costs. 1-378. Foggitt, E., Cawood, S., Evans, B., & Acheampong, P. (2019). Experiences of shared sanitation–towards a better understanding of access, exclusion and ‘toilet mobility’in low-income urban areas. Journal of Water, Sanitation and Hygiene for Development, 9(3), 581-590. Government Of Ghana. (2019). Ghana Voluntary National Review (VNR) on the Implementation of the 2030 Agenda for Sustainable Development. Accra: Government of Ghana. Jenn, C. (2006, August 31). Common Ethical Issues In Research And Publication. Retrieved from NCBI: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4453117/ Lariatu, S. (2019). The Contribution Of The World Bank In Achieving Sustainable Development Goal 6 In Ghana: A Case Study Of The Greater Accra Metropolitan Area . 1-119. Lindamood, D. (2017). Towards a more sustainable water future: water governance and Sustainable Development Goal 6 achivability in India. 183. Nansubuga, I., Banadda, N., Verstraete, W., & Rabaey, K. (2016). A review of sustainable sanitation systems in Africa. Reviews in environmental science and bio/technology, 15(3), 465-478. Neuendorf, K. A. (2018). Content analysis and thematic analysis. In Advanced research methods for applied psychology (pp. 211-223). Routledge. Otigara, A. R., Kay, M., & Uhlenbrook, S. (2018). A Review of SDG 6 Synthesis Report 2018 from Education, Training, and Research Perspective. MDPI, 22. Scott, C. A., & Thapa, B. (2015). Environmental security. New York: Oxford University Press. Slim, H. (1995, May). What is Development. Development In Practice, 5(2), 143-148. Seidu, A. A., Amu, H., Salihu, T., Hagan, J. E., Agbaglo, E., Amoah, A., ... & Ahinkorah, B. O. (2021). Prevalence and Factors Associated with Hygiene Behaviours among In-School Adolescents in Ghana. J, 4(2), 169-181 Somanje, A. N., Mohan, G., Lopes, J., & Mensah, A. (2020). Challenges and Potential Solutions for Sustainable Urban-Rural Linkages in a Ghanaian Context. MDPI, Sustainability, 1-19. Tadjbakhsh, S. (2005). Human Security: Concepts and Implications: with an Application to Post- intervention Challenges in Afghanistan. Fondation nationale des Sciences politiques. The Lancet. (2007). Access to toilets for all. The Lancet, 370. Uitermark, J. (2005). The genesis and evolution of urban policy: A confrontation of regulationist and governmentality approaches. Political Geography, 24(2), 137-163. UNDP. (1994). Human Development Report 1994: New dimensions of human security. New York: Oxford University Press. UNDP. (2015, September 28). Clean Water and Sanitation. Retrieved from UNDP: https://www.undp.org/sustainable-development-goals#clean-water-and-sanitation UNICEF REPORT (2021). State of the world's sanitation WHO/UNICEF. (2014). Progress on Drinking Water and Sanitation. World Health Organization CHAPTER TWO AN OVERVIEW OF SUSTAINABLE DEVELOPMENT GOAL 6 2.0 Introduction The previous chapter discussed the study's background, problem statement, goal, literature review, and research methodology. Here, the provides an overview of UNICEF global sanitation perspective, the consequences of poor sanitation, progress made towards universal access to sanitation, policy and funding issues, and the efforts made by several African countries towards achieving SDG 6. 2.1 SDG 6 Situation Sanitation is critical for human health, child development, and socioeconomic success. Furthermore, guaranteeing adequate sanitation is a human right—essential for upholding children's rights and achieving healthy physical, psychological, and social well-being—recognized by the United Nations General Assembly in 2015 as a unique right. In the same year, UN member states committed to working toward Agenda 2030 for sustainable development, which included SDG 6.2 - Reach universal access to adequate sanitation and hygiene for all by 2030, focusing on women, girls, and those in vulnerable situations. Prior to the introduction of SDG 6.2, efforts were made by the Ghanaian government to achieve Millennium Development Goal 7 (MDG 7). The MDG 7 emphasizes ensuring environmental sustainability with four targets which include the third target (MDG 7C): to halve the proportion of the population of Ghanaians without sustainable access to safe drinking water and basic sanitation. The specific target by Ghana Government towards achieving national target on improved sanitation in both urban and rural areas was 85% by the year 2015. This national target was higher than the 54% set by Ghana towards the UN´s goal and target. Fifteen years after the formulation of the MDGs, the UN following their conference on Sustainable Development dubbed Rio+20 in 2012, agreed to set new global goals called Sustainable Development Goals (SDGs) ending in 2030 to address key systemic barriers that the MDGs failed to tackle. These barriers include inequality, unsustainable consumption patterns, weak institutional capacity and environmental degradation (Bryant, Martienssen, & Burkhardt, 2016). A critical review by Bryant, Martienssen, & Burkhardt, (2016) revealed that, government could not achieve the national target 54% but rather achieve 26% in national sanitation. Some of the frantic efforts made by government are: establishment of a policy aimed at increasing the fraction of Ghanaians that have access to sanitation services and to encourage the practice of three key hygiene behaviours; hand washing with soap, safe excreta disposal and household water treatment and safe storage (National Population Council, 2014). Furthermore, National Water Policy (NWP) (2007) was developed and has as part of its key strategic issues to develop, utilize and implement basic principles to address the challenges confronting water and sanitation subsector in Ghana. In addition, there was a launch of the National Environmental Sanitation Strategy and Action Plan (NESSAP) (2010-2015). The NESSAP was developed to provide clear strategies and action plans that will guide the Metropolitan, Municipal, and District Assemblies (MMDAs) to execute their targets on improving sanitation within their catchment areas (National Population Council, 2014). Other related policies and strategies directed at improving access to improved sanitation facilities in the country were developed. These include: the Environmental Sanitation Policy of Ghana, which was produced in September 2010 with the overall goal of developing a clear and nationally accepted vision of environmental sanitation as an essential social service and a major element for improving health and quality of life of Ghanaians and to strengthen all efforts in dealing with the devastating challenges of poor sanitation in Ghana; Medium Term National Development Policy Framework (MTDPF, 2014-2017), which has environmental sanitation as a key component of national development policy frameworks; and finally, Sanitation and Water for All (SWA): A Global Framework for Action, which is an international directive espoused to augment the already existing national policies (National Population Council, 2014). The progress made in achieving MDG 7c specifically in water source and sanitation facility are presented in Figure 2.1, 2.2, 2.3, 2.4 Figure 2.1: Proportion of population using improved water source, 2000 and 2010 Figure 2.2: Proportion of the population with improved and unimproved water source by region Figure 2.3: Proportion of the population with access to improved and unimproved sanitation by locality, 2000 and 2010 Figure 2.4 Improved and unimproved toilet facilities Globally, UNICEF (2021) reports considerable gaps in coverage, resulting in disparities and worsening the marginalization of the most affected and vulnerable. With only 9 years until 2030, achieving SDG 6.2 would require quadrupling the current sanitation coverage rate. At the current pace of improvement, it will take close to a century before everyone has access to proper sanitation (WHO, 2020). Sanitation is underfunded, underfunded, and lacks ability and leadership (UNICEF, 2021). Notably, most nations have national policies and strategies supporting proper sanitation. However, the execution of these policies is hampered by a lack of people and financial resources (WHO, 2019). Donors often prioritize water over sanitation. Between 2010 and 2018, the OECD estimates that money allocated for sanitation were half of those allocated for drinking water. Aid for sanitation systems has never exceeded 15% of the entire budget for water and sanitation in 2020. (OECD, 2020). Government and donor funding for sanitation is woefully insufficient to deliver resilient, sustainable, and safe services that benefit the environment, health, and economy (UNICEF, 2020). According to Alshomali & Gulseven (2020), most undeveloped or developing nations are still dealing with internal challenges and have a poor governance structure, making Agenda 2030 challenging and postponing the goal of providing all people with access to appropriate and equitable sanitation and hygiene. Alshomali & Gulseven (2020) also said that financial resources are critical in the execution of water projects and sanitation improvements. The SDGs seek to save society, provide clean water to everyone, and end poverty and hunger globally. The goal is to protect rivers, lakes, seas, forests, and other living ecosystems while maintaining a water-based ecosystem. Nonetheless, most nations prioritize economic development above other issues. However, lack of access to water and sanitation contributes to major land issues and climate change (Alshomali & Gulseven, 2020). Though global sanitation has improved, the problem of inadequate sanitation endures, with deadly repercussions. Figure 2.1 shows worldwide sanitation statistics. The results reveal that safe sanitation management has improved over time, with substantial improvement in urban regions compared to national and rural areas. Global efforts have been made in in-situ disposal. Because germs die off over time, the phrase "safely discarded insitu" is used for non-emptying pit latrines or septic tanks (Willcock, Parker, Wilson, Brewer, Bundhoo, Cooper, & Hutchings, 2021). Globally, insitu disposal has increased at the national, urban, and rural levels. Also, open defecation has declined dramatically. However, the national and rural statistics on open defecation remain noteworthy and need worldwide attention (UNICEF, 2020). 2.1.1 SDG 6: GHANAIAN PERSPECTIVE/SITUATION The SDGs are a worldwide call to action to eradicate poverty, safeguard the environment and climate, and secure peace and prosperity for everyone (Mensah, 2019). The Sustainable Development Goals (2021) for Ghana state that everyone should have (i) access to clean and affordable drinking water by 2030. (ii)To end open defecation by 2030, all people should have access to adequate sanitation and hygiene, with a specific emphasis on women, girls, and those in vulnerable situations. (iii) Reducing pollution and limiting hazardous chemical and material releases by 2030; halving the amount of untreated wastewater; and increasing recycling and safe reuse internationally; (iv) To alleviate water scarcity and ensure sustainable freshwater withdrawals and supply by 2030, (v) Implement integrated water resource management at all levels by 2030, when appropriate. (vi) Mountain, forest, wetland, river, aquifer, and lake ecosystems shall be conserved and restored by 2020. Extend international cooperation and capacity-building support to developing nations in water and sanitation-related activities and projects by 2030. Goals (i) to (v) are presently the pressing goals for Ghana because as illustrated in Figure 2.2, no significant improvement has been made when it comes to open defecation. Data on open defecation in Ghana has remained virtually the same of the years both at the urban and rural areas, and theses poses as serious sanitation threats to the entire country ((UN Sustainable Development, 2021). Figure 2.5: SDG 6.2; World Data on Sanitation Management, Disposed in situ, and Open Defecation Legend Proportion of population using safely managed sanitation services > Open defecation> National-World Proportion of population using safely managed sanitation services > Safely managed service > Disposed in situ > National-World Proportion of population using safely managed sanitation services > Safely managed service > Overall > National-World Proportion of population using an improved sanitation facility > Total > National-World As shown in Figure 2.5, the proportion of global population using safely managed sanitation services (i.e. not emptying pit latrines or septic tanks and leaving faecal wastes in the ground, where pathogens die off over time) has increased significantly, as shown by the line graph. Also, from 2009 to 2020, the share of people using open defecation has decreased globally. Figure 2.6: SDG 6.2; Data on Sanitation Management, Disposed in situ, and Open Defecation in Ghana Legend Proportion of population using safely managed sanitation services > Open defecation > National-Ghana Proportion of population using safely managed sanitation services > Safely managed service > Disposed insitu > National-Ghana Proportion of population using safely managed sanitation services > Safely managed service > Overall > National-Ghana Proportion of population using an improved sanitation facility > Total > National-Ghana Specifically, on Ghana, as illustrated in Figure 2.6, the proportion of the population that is using safely managed sanitation services – disposed in situ, those using safely managed sanitation services, and those using improved sanitation facilities in Ghana has increased slightly over the years. These can be observed by with using the red, green, and blue line graph. However, when it comes to open defecation (as depicted with a yellow line graph), the numbers have not decreased substantially over the years. Hence the need to examine how best the phenomenon can be reduced further. 2.1.2 Growth of Accra and the Sanitation Situation The population of Accra, Ghana's capital has risen dramatically recently (see Table 2.1). Despite ongoing population and area increase, as indicated in Table 2.1, Accra's growth rate has slowed. Some urbanists claim Accra's stated population and area are overblown (Konadu-Agyemang 2001a, Grant and Yankson 2003, Crook and Ayee 2006, ISSER 2007, Owusu 2008b). Because areas like Mallam, Gbawe, Taifa, Achimota, Ofankor, Macarthy Hill, Madina, Hatso, and others have been completely incorporated into the city yet are not legally recognized as such. These are the city's newest growing regions. As seen in Table 2.1, Accra's population grew from 340,000 in 1960 to nearly 1.6 million in 2000. In 2000, Accra had approximately 20% of the national urban population, or one in every five city inhabitants (Appiah-Effah et al (2019). Accra's population should reach 2.5 million by 2020. (Kanhai, Fobil, Nartey, Spadaro, & Mudu, 2021). A daily stream of individuals, known as the floating population, isn't included in the census population figures for Accra (Table 2.1). Between 2.5 and 3 million individuals are expected to dwell in Accra but were not counted in 2007. In 2007, the ISSER published a report. Thus, Accra's population is predicted to double by 2020, to over 2.5 million. Moreover, population density has grown from 36 in 1960 to around 226 in 2020. (See Table 2.1 for specifics.) Contrast this with high-income areas where population densities range from 17–40 people per acre (Accra Metropolitan Assembly [AMA], 2006). As a result, although Accra's average density has risen, disparities in poverty-stricken areas like Nima and Sabon Zongo have widened. Due to poor earnings, many Accra citizens seeking a foothold in the city wind up in these already crowded and dense urban districts. Accra's sanitation is insufficient, with clogged sewers, irregular garbage disposal, and overflowing central trash bins (AMA, 2006; Ayee and Crook, 2003). Individual, family, and community ignorance and irresponsibility, lack of collective action, and the rapid proliferation of illegal temporary constructions all contribute to this predicament. Squatters, unregulated street hawking, inconsistent sanitation funding, and a lack of fee-based services in low-income regions all contribute (Oteng-Ababio, 2012). Due to these obstacles, most rubbish in Accra ends up in drainage systems, aquatic bodies, and open areas (Ayee and Crook 2003; Oteng-Ababio, 2012). Accra generates between 1500 and 1800 tons of waste every day. Every day, the city gathers 1200 tons of rubbish, leaving 300-600 tons uncollected (Ampofo, Soyelle, & Abanyie, 2016). Accra has been divided into six garbage collection zones by the AMA. Private waste collection businesses were allocated zones in return for payments, depending on particular contractual agreements. The city's two waste collection methods are central container and door-to-door. The central container rubbish collection technique is employed in low-income communities. This service is free, and residents may dispose of rubbish in designated bins. Accra has been divided into six garbage collection zones by the AMA. Private waste collection businesses were allocated zones in return for payments, depending on particular contractual agreements. The city's two waste collection methods are central container and door-to-door. The central container rubbish collection technique is employed in low-income communities. This service is free, and residents may dispose of rubbish in designated bins. Despite these efforts, Accra generates an enormous quantity of rubbish, and several waste management systems have failed to appropriately regulate the sanitary situation. Table 2.1: Demographic Characteristics of Accra, 1960-2020 1960 1970 1984 2000 2006 2007 2020 Population 338,396 636,667 969,195 1,658,937 1,915,983 1,960,462 2,514,005 Pop. Growth rate 6.32% 7.51% 4.3% 4.3% 4.3% 1.57% Pop. Density/ha 36.0 50.8 69.3 118.6 137.4 140.6 225.7 Source: Researcher’s compilation (2021) from ISSER (2007) and Ghana Statistical Service (2021) 2.2 Global Perspective on the Role of Governments in Sanitation Universal access to adequate sanitation and hygiene by 2030 is a major challenge in many parts of the world. Target 6.2 requires countries to end open defecation, provide basic toilets, and develop safe excreta management technology. Between 2000 and 2015, the proportion of people using basic sanitation increased from 59% to 68%. On the other hand, just one in ten countries with coverage below 95% is on course to achieve universal coverage by 2030. A safe sanitation service was also unavailable to 4.5 billion people in 2015. To achieve the 2030 goal, the state must play a strategic role (SDG 6, Synthesis Report, 2018). Realization of basic sanitation for all by 2030 highlights the need for a doubling of the current global progress rates and a quadrupling of the pace towards universal access to safely managed sanitation. The implication of this is a necessity for a dramatic acceleration of the current progress rates. Governments have an enormous and crucial role to play in the achievement of sanitation. The issue of sanitation is a public one and addressing it appropriately will be a public good and thus there is the need for public funding of sanitation, which will promote good heath amongst the populace. This is in addition to social and economic development that will ensue. Sanitation, when poor, can result in adverse external occurrences, posing public health hazards and crippling economic development. On the other hand, good sanitation comes along with some economic benefits as well as enhances human productivity. For sanitations benefits to be realized by everyone, it is important to have regulation throughout the sanitation chain (Rao, Otoo, Drechsel, & Hanjra, (2017). Within a generation, some nations have made significant gains in sanitation coverage, life transformation, environmental transformation, and economic transformation (Sachs, Schmidt-Traub, Mazzucato, Messner, Nakicenovic, & Rockström, 2019). Governments can substantially improve sanitation and put their countries on pace to fulfil SDG 6.2 with strong political leadership, enough resources, total government engagement, and a multi-stakeholder approach. Countries like Malaysia, Singapore, Thailand, and the Republic of Korea attained 100% sanitation coverage in the 1960s and 1970s, with dramatic and astounding results (Sachs, Schmidt-Traub, Mazzucato, Messner, Nakicenovic, & Rockström, 2019). This repulsive practice, which disproportionately affects rural and poor populations, has recently been reduced, if not eliminated, in India. Ethiopia and Cambodia have decreased open defecation by over 50% since 2000, while Cambodia, Lao PDR, Indonesia, and Nepal have increased usage of basic sanitation facilities and services by over 40%. The sanitation ladder is being climbed by individuals and communities worldwide by mobilizing communities, strengthening markets and service providers, deploying a variety of funding and financing mechanisms, building resilient sanitation services that make better use of scarce resources, recycling waste for economic and environmental benefits (UNICEF, 2020). Though the speed at which some countries are gearing towards achieving the SDG 6 target by 2030 is slow, general progress has been made thus far especially in developing economies in Sub-Sahara Africa, and this can be attributed to the immense played by government (Jiménez, Mtango, & Cairncross, 2014). In the case of Tanzania, Jiménez, Mtango, & Cairncross, (2014) posited that, the local government plays a phenomenal role in promoting sanitation by establishing the Implementation of National Sanitation Campaign where local government commitment towards sanitation was enhanced. Tanzania has a unique history when it comes to rural sanitation. During the 1970s, it was aggressively promoted through government public health programs, which coincided with the forcible resettlement of dispersed rural smallholders to "Ujamaa" settlements in rural areas. As a result, the "Mtu ni Afya" "campaign" was able to greatly boost coverage, although this cleanliness promotion had little effect on people's behavior. Despite their extensive use, the majority of Tanzanian latrines are filthy (Baker and Ensink, 2012). According to the UN Joint Monitoring Programme, just 7% of rural Tanzanians use improved sanitation, 4% share their facilities with others, 73% use unimproved, and 16% practice open defecation. Due of this dire condition, donors and governments have recently focused on cleanliness. Creating a sanitation policy is one of the main results (Government of Tanzanian [GoT], 2011). Despite being a draft, its contents are already influencing the country's sanitation promotion policy. The Environmental Health, Hygiene, and Sanitation Department of the Ministry of Health and Social Welfare is in charge of sanitation and hygiene in Tanzania. Schools are required to follow water and sanitation requirements set by the Ministry of Education and Vocational Training. The Tanzanian Prime Minister's Office for Regional Administration and Local Government distributes, monitors, and oversees local budgets (PMO-RALG). The Water Sector Development Plan (WSDP) is administered by the Ministry of Water (MoW) (Venugopal, & Yilmaz, 2010). While the district council plans, coordinates, implements, monitors, and evaluates sanitation and hygiene activities, each family provides its own sanitation facilities (Jimenez, Mtango, & Cairncross, 2014). The National Hygiene and Sanitation Campaign (NSC), launched in 2012, is the Sanitation Policy's operational program. With a budget of $20 million, it seeks to rehabilitate or create new latrines in 1.3 million homes (a 14% increase in coverage) and 700 schools by 2015. To begin with, it targeted 100,000 residences in 42 districts (2012-2013). (Chumbula, 2018) The Tanzanian government was responsible for planning, budgeting, coordination, implementation, and monitoring (World Health Organization [WHO]. 2015). Improved water, sanitation, and hygiene for better nutrition: policy and program solutions). On the national, regional, district, village, and general population levels are summarized in Table 2.2. Similarly, in Ghana, the government established the Sanitation and Water Resource Ministry and the National Sanitation Authority, both of which have the human and financial resources to expedite the implementation of sanitation laws and regulations (Appiah-Effah, Duku, Azangbego, Aggrey, Gyapong-Korsah, & Nyarko, 2019). Regardless, COVID-19 has aggravated many sanitation-related difficulties. Communal sites such as poorly maintained public latrines or open defecation areas have become unhealthy due to people's isolation. Sanitation workers add another health risk to an already long list. That inadequate sanitation puts everyone at risk has been shown by the epidemic (Barton, Grant, & Guise, 2021). Table 2.2: The role of government in sanitation, a case of Tanzanian. “Level of Government Planning and Budgeting Coordination Implementation Monitoring National Select the districts Define budget and targets per district Criteria for selection of communities Inter-ministerial coordination committees Develop guidelines for implementation Organize national trainings (Develop promotion materials and messages) Collect national progress data quarterly and report to Donors Sporadic visits to some Districts Regional Plan & budget for own supervision activities. Collect district plans and budgets No role Provide technical advice to Districts Collect regional progress data quarterly Regular monitoring visits (Promote knowledge management) District Select communities for intervention Make a proposal of district budget and activities (Ensure synergies between actions at district level) Develop NSC schedule at local level with wards and villages Create awareness at village level Train masons Purchase moulds Conduct CLTS triggering session (Supervise masons) (Organize marketing events) Collect district progress data quarterly Train data takers at village level (Supervise ODF achievement) Village No role Inform people of date of main meetings, promoting participation Select data takers for baseline Select masons to be trained Select follow-up committee Provide resources and/or transport for follow-up and data taking” Source: Jiménez, Mtango, & Cairncross (2014). Table 2.2 illustrates and summarizes and the role of government at various level of governance in the promotion of sanitation in Tanzania. Government role according to Table 2.2 can be segmented into four major parts - planning and budgeting, coordination, implementation, and monitoring. 2.3 Consequences of poor sanitation 2.3.1 Health According to UNICEF (2020), poor sanitation would cause 830000 deaths annually from preventable diseases, and cholera outbreaks will continue in areas with poor sanitation. The goal of eradicating polio globally may not be achieved owing to re-emergence in areas with poor sanitation, and health systems in these areas may be overloaded treating unnecessary infections. Women will refuse to give birth in filthy hospitals, increasing infection rates among patients. However, persons who practice open defecation and irrigation with untreated wastewater will remain diseased. Repeated diarrhoea, caused by inadequate sanitation, deprives individuals, especially children, of the nutrients they need to develop and flourish (Bhutta, Berkley, Bandsma, Kerac, Trehan, & Briend, 2007). Assuring adequate sanitation systems (SDG goal 6.2) is critical to reducing the unacceptably high burden of sanitation-related illness (WHO, 2020). Poor sanitation also burdens the government financially and weakens the health system's ability to react to epidemics (Madhav, Oppenheim, Gallivan, Mulembakani, Rubin, & Wolfe, 2018). A report from the Joint External Evaluation of International Health Regulations (IHR) on Ghana’s core capacities and attainment of the six core areas of the Global Health Security (GHS) index, it emerged that Ghana has performed fairly well in all spheres of the GHS index and this was demonstrated during the Ebola Virus Disease (EVD) outbreak (WHO, 2017). Nonetheless, Ghana’s overall average score on the GHS index as presented in Figure 2.3 is 35.5 which is below global average of 40.2 (GHS, 2019). And according to Madhav, Oppenheim, Gallivan, Mulembakani, Rubin, & Wolfe, (2018) poor sanitation will put more pressure on the health system, hence reducing capacity of the health system to withstand any health issue that may arise as a result of poor sanitation. Figure 2.7: Ghana’s average in comparison to West Africa and Global average Source: Author’s construction (2021) using data from GHS (2019) Figure 2.7 shows Ghana's GHS index, together with the West African and worldwide averages. The GHS Indicator is a well-known index that assesses and benchmarks health security and associated competencies across 195 nations. It assesses nations' preparation for epidemics and funding shortfalls globally (GHS, 2019).  It also captures a country's rapid response (rapid response to and mitigation of epidemic spread), Health System (sufficient and robust health system to treat the sick and protect health workers), and Compliance with International Norms (commitments to immunize and protect health workers) (overall risk environment and country vulnerability to biological threats). With an average overall Global Health Security Index score of 40.2 out of 100, the GHS index report released in October 2019 before the Covid-19 outbreak revealed that most countries' health systems are unprepared to deal with a globally catastrophic biological event, indicating that national health security is fundamentally weak around the world. Ghana's overall score is 35.5, better than the West African average of 32.59. Nonetheless, the score indicates that Ghana's health capability is insecure, and poor sanitation would exacerbate the problem. 2.3.2 Global Social Impacts Among the costs associated with poor sanitation are household out-of-pocket expenses and travel expenses for health care, income loss due to sickness, lost productivity due to time spent looking for a place to defecate openly, and environmental and water resource pollution coping costs, such as water treatment. In contrast, missed advantages and savings from a well-managed sanitation system may be assessed in terms of time, cash, enhanced food output, and educational possibilities (UNICEF, 2020). According to a 2012 WHO research, not investing in water and sanitation costs nations billions of dollars. The research found that poor sanitation and water availability caused economic losses ranging from 0.5 to 3.2 percent of GDP, or 1.3 percent globally. Sub-Saharan Africa felt the largest effect. According to WHO, sanitation has a five-to-one benefit-to-cost ratio over water provision (2012). Many studies on the economic impact of inadequate sanitation have been published. According to a study (Hutton, Patil, Kumar, Osbert, & Odhiambo, 2020), insufficient sanitation costs 2 percent of GDP in East Asia and the Pacific, and 4 percent of GDP in South Asia. The economic losses and rate of return on sanitation initiatives suggest that governments must intervene. Such a massive loss necessitates quick government intervention (Hutton et al., 2020). 2.4 Ghana’s Preparedness Towards Achieving The SDGs Sanitation Target 2.4.1 Financing Approach Existing and new water, sanitation, and hygiene (WASH) infrastructure need long-term funding. But depending too much on foreign funding, it is said, would halt WASH progress (Appiah-Effah, Duku, Azangbego, Aggrey, Gyapong-Korsah, & Nyarko, 2019). With the numerous tools and strategies available for WASH financing, efforts must be stepped up to meet the SDG objective. The development of innovative finance techniques is required to sustain long-term, low-cost, and pro-poor sanitation services (Appiah-Effah, Duku, Azangbego, Aggrey, Gyapong-Korsah, & Nyarko, 2019). Financial guarantees, insurance, subsidies, equity grants, term extensions, pooled finance, Project Preparation Funds, hedging instruments, benchmarking, microfinance, and credit ratings are some of the novel financing strategies used to attract capital for water and sanitation projects (Kolker et al. 2015). Ghana will have to find new ways to fill the financial gap as development partners' financial assistance continues to dwindle. With the help of Water and Sanitation for the Urban Poor (WSUP), the Ga West Municipal Assembly (GWMA) in Ghana studied the addition of sanitation surcharges in property taxes (WSUP). It was adopted in October 2016 and came into effect in January 2017. (WSUP). A portion of the funds will go towards building sanitary facilities in low-income areas. Recent research shows the GWMA has been successful in obtaining funding through Ghana's property tax sanitation surcharge. From 2017 to 2018, the surcharge policy generated GHS 30,365 (ten percent of the property rate). The impact on sanitation access was minimal. An eastern Ghana municipality, Akwapim North, has introduced a similar model (WSUP 2018). Rural Sanitation and Hygiene Marketing (RuSHing) in Northern Ghana is an initiative by iDE Ghana to provide a complete solution for people wanting to construct a toilet. Global Affairs Canada funded the start of the Sama Sama in 2016. Sama Sama sanitation project started by Savelugu-Nanton Municipality in northern area encompasses eleven districts in northern and upper east region and restored approximately 600 toilet facilities. It costs $515 for a toilet, but customers may pay in 18 monthly instalments of $43. Homeowners may now buy and pay for toilets directly (Appiah-Effah, et al, 2019). This shows Ghana's dedication to addressing sanitation issues. An estimated US$150 million has been allocated to the Greater Accra Metropolitan Assembly (GAMA) to help improve water and sanitation (The World Bank-International Bank for Reconstruction and Development-International Development Association, [World Bank-IBRB-IDA], 2013). The World Bank and the Global Partnership for Output-based Aid (GPOA) have sponsored Ghana's GAMA Sanitation and Water Project (GASP). To serve the poorest homes in these LIUCs, around 250,000 individuals will benefit from improved sanitation and water supply services (The World Bank-International Development Association 2013). These incentives assist low-income city people purchase cheaper toilets. Before toilet building can begin, the GAMA has requested the assistance of reputable financial institutions to help eligible households save regularly and affordably (Tenders.com.gh 2017). Approximately 18,363 residential toilets and 406 school toilets have been erected in 12 Assemblies, according to publicly accessible GAMA figures (GAMA SWP 2019). At this point, the initiative has achieved 96% of its ultimate target of 19,100 toilets. Ghana's government has committed to spending US$200 million year on sanitation and water, US$50 million annually in hygiene education, and an additional US$150 million annually in sewage and faeces treatment (Government of Ghana 2010; MWRWH 2010; The World Bank-International Development Association 2013). As part of its commitment to waste management, the Ghanaian government has established an Environmental Health and Sanitation Directorate (EHSD), purchased trucks, and hired 40 engineers to assist MMAs around the nation. 2.4.2 Institutional Reforms and Arrangement Implementing sanitation policies requires effective inter-institutional cooperation and collaboration. The Ghanaian government has made considerable institutional changes in the water and sanitation sectors during the past two decades to improve governance. The Ghanaian government decentralized infrastructure development and sanitation service administration to the 110 MMDAs in 1993. (The World Bank-IDA 2013). The water, sanitation, and hygiene sector in Ghana now has a distinct institutional framework and responsibility. Decentralized WASH service delivery with national authorities formulating policies and local governments implementing MMDA. The Ministry of Sanitation and Water Resources (MSWR) is in charge of WASH policy formulation, harmonization, and coordination (Narayan et al., 2021). MMDAs decentralize sanitation and water services in rural and small areas. It is based on local objectives and regulations that MMDAs plan, fund, and execute. The Chief of the Local Government Service says local governments must be fully staffed. The need for sanitary services necessitates the development of a national sanitation authority (NSA). The NSA will create national sanitation standards and manage a National Sanitation Fund, according to the MSWR. Following the above changes, there is now a clear institutional distinction between sanitation and water supply services. (Kadhila) 2.5 Potential Barriers Towards Achieving the SDGs Target for Sanitation 2.5.1 Unclear Sanitation Service Delivery Guidelines Given the National Environmental Science Program (NESP) and strategy, MMDAs planning sanitation services have little assistance outside of donor-funded initiatives (WSUP 2017). MMDAs concentrate on solid waste management due to the absence of management requirements for sanitation services (liquid waste) (WSUP 2017). In most assemblies, rubbish collection trumps sanitary services. Solid trash is viewed as a higher burden since it is visible and frequently connected with public outrage. Excreta is commonly dumped in sewers, unauthorized locations on the outskirts, or bagged and dumped in solid trash. Most politicians associate cleanliness with garbage. Less waste management resources are allocated to solid waste management rather than sludge management (WSUP 2017). 2.5.2 High Cost of Sanitation Technologies and Extensive Use of Public Latrine The NESP in Ghana compels households to pay for their own domestic amenities (Ministry of Local Government, and Rural Development [MLGRD], 2010a) In recent years (2010–2014), statistics show that households contributed for the bulk of overall WASH expenditure. (GLAAS 2016; WHO 2017) 74.2 percent in 2013 and 74.9 percent in 2014 (GLAAS 2016), with total WASH expenditures of US$1.260 million and US$1.252 million, respectively (users). However, the expensive cost of sanitary infrastructure is a major hindrance to sanitation in Ghana (Duku 2017; WSUP 2017). Because sewage systems are often inadequate or non-existent, on-site solutions are common. According to WHO and UNICEF JMP standards, "increased onsite sanitation facilities (septic tanks, ventilated improved pits, pour-flush, composting toilets) are quite costly." For low-income Ghanaians who depend on the informal sector for daily income, installing these options may cost up to $1,000 (WSUP 2017; Duku et al. 2018). (WSUP 2017). Home facilities investment accounts for between 66 and 29% of annual family revenue in the three lowest income quintiles, based on average annual household income of GHS 6,571 (US $1,516) to GHS 14,823 (US $3,420). (WSUP 2017). According to the World Bank – International Development Association (IDA), the costs of inadequate sanitation are regressive and unequally distributed (The World Bank-IDA 2013). Poor sanitation often costs a bigger proportion of a poor person's income than wealthier individuals " (The World Bank-IDA 2013). Space constraints also make home toilet facilities difficult to build in densely populated areas. This suggests that public bathrooms are realistic solutions for families living in slums or heavily crowded areas (WSUP 2017). People use public restrooms in Ghana's cities (World Bank-IDA 2013), especially in low-income, densely populated regions. While international organizations and global society continue to push private single-household toilets as preferable sanitation, Mariwah et al. (2017) concluded that many urban poor communities or households are unlikely to adopt this soon. Public toilets are the major option to the far more hazardous (and growing) practice of open defecation in high-density, "informal" urban settlements in Ghana (and many other countries that have not met their MDG sanitation objectives) (Mariwah et al. 2017). Worryingly, public bathrooms look to be okay and meet hygienic needs. Using public bathrooms has become a socially acceptable sanitary option for city inhabitants (WSUP 2017). Because public toilets are unregulated, many people avoid using them owing to poor hygiene, maintenance, and cost structure (Mariwah et al. 2017). (The World Bank-IDA 2013; WSUP 2017). They defecate in the open, which is far dangerous. The widespread usage of public toilets in Ghana has led to the belief that cleanliness is the responsibility of the state or an outsider "Ayee et al. With just 15% of Ghanaian households having access to sanitation (WHO/UNICEF 2017), demand is low and private investment is limited. 2.5.3 Perception Towards Sanitation in Africa A bigger socio-cultural and mental problem may be at play in Ghana. The general reversal in sanitation progress is attributable to mindsets (Nimoh et al. 2014a, 2014b; Appiah-Effah et al. 2015). Acceptability is critical for latrine adoption. Cultural beliefs may also favor open defecation (Mariwah 2018). Some cultures see faeces as harmless, while others view them as filthy. There are places where open defecation is socially accepted, and residents may not see the necessity for latrine technology (Cotton et al. 1995). A research by WaterAid (2009) in four West African nations – Burkina Faso, Ghana, Mali, and Nigeria – highlighted shame, odour, social status, need to host, evil, and ancestral habits as hurdles to avoiding open defecation. It makes individuals feel guilty or embarrassed if close relatives see them approaching a toilet. Excrement is considered a private affair, therefore defecating in the bush provides seclusion. Defecating in a building or superstructure is prohibited, although open defecation is considered an old custom. The research also found that being near human excrement was uncomfortable owing to the terrible smell. For example, Ghanaians preferred open defecation over latrines due to the unpleasant odour. Northern Ghanaians still defecate outside because they think public toilets are inhabited by evil spirits and should be avoided, while others believe using a latrine would rob one of magical powers. Others defecate outdoors to escape the stink or odour of the toilet or pit latrine, even if nearby. It is this denial mechanism that prevents the adoption of new sanitation technologies. Also, some families consider human excreta as a waste rather than a resource (Nimoh et al. 2014b). People also dislike excreta, to the point that the term "faecal sludge" puts some people off, despite the fact that it is a valuable agricultural resource. According to Nimoh et al. (2014a, 2014b), most people in Ghana's southern region think excreta or faecal sludge should never be touched, which is why washing hands after using the restroom is crucial. 2.6 Conclusion In summary, this chapter expounded on the concept of sanitation and the resolve to meeting the SDG 6.2 which pertains to sanitation and the key targets to meet by 2030. Though progress have been made across the globe and in Ghana to be specific in the area of sanitation, the pace at which these progress have been chalked is worrying as a huge of countries may not be able to meet the target by 2030. Evidence from Ghana still shows that the government and other relevant institutions enacted to manage sanitation issues in the country are unable to contain the overwhelming waste generated on daily basis due of limited resources, lack of implementation of policies and laws designed to manage sanitation, peoples’ attitude and perception, etc. The health and social consequences of poor sanitation are presented in this chapter and empirical evidences shows that these consequences are dire hence the need for government and other relevant institutions to up their responsibilities and also make efforts to meeting the SDG target on sanitation. 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State of the world’s sanitation: an urgent call to transform sanitation for better health, environments, economies and societies. World Health Organization. (2020). Global progress report on water, sanitation and hygiene in health care facilities: Fundamentals first. UNICEF. WHO/UNICEF Joint Water Supply, & Sanitation Monitoring Programme. (2014). Progress on drinking water and sanitation: 2014 update. World Health Organization. WHO/UNICEF (2017). Progress on Drinking Water, Sanitation and Hygiene: 2017 Update and SDG Baselines – Launch Version, 1st edn. World Health Organization, Geneva, Switzerland and United Nations Children’s Fund, New York, USA. https://washdata.org/sites/default/files/documents/reports/2018-01/JMP-2017-report-final.pdf. Willcock, S., Parker, A., Wilson, C., Brewer, T., Bundhoo, D., Cooper, S., ... & Hutchings, P. (2021). Nature provides valuable sanitation services. One Earth, 4(2), 192-201. WSUP (2017) Situation Analysis of the Urban Sanitation Sector in Ghana. https://www.wsup.com/content/uploads/2017/09/Situation-analysis-of-the-urban-sanitation-sector-in-Ghana.pdf. WSUP (2018) Research Around Sanitation Surcharges Included in Property Taxes in Ghana. https://www.wsup.com/content/uploads/2018/01/UrbanSanitationResearchInitiative-ResearchCall-SanitationSurchargesPropertyTax-29Jan2018-1.pdf. CHAPTER THREE RESULTS AND DISCUSSION 3.1 Introduction This particular chapter presents the results and discussion on the data collected from the respondents via personal interviews. The interviews were recorded in an audio format and later transcribed into Microsoft Word document for onward analysis. The results from the transcribed interviews were done using thematic analysis keeping the objectives in mind. Out of the sample size of 15 respondents, it was only 13 respondents that were available to participate in the study, hence, the analysis is based on the responses of the 13 participants. This chapter begins with a summary of the socio-demographic information on the thirteen (13) respondents that were interviewed. This is followed by a thematic summary of the participants’ responses based on the study objectives. As indicated in the first chapter the main objective of the study is to examine Ghana’s efforts towards sustainable management of sanitation. In pursuit of this general objectives, three underlying themes emerged, these are; the roles of citizens and the state towards achieving SDG 6.2, assessment of the efficacy of implementation strategies geared towards attaining SDG 6.2, and analyse the implementation challenges of SDG 6.2 in Ghana. Since the participants were thirteen in number, they were labelled from 1 to 13. Where 1=driver from Kaneshie, 2=drivers mate (Kaneshie), 3=Passenger