Assessment, Issues, and Challenges

Weak sanitation governance

Many institutions are armed with sanitation-related mandates, but not one of them takes the lead in pushing for reforms in the sector. Although the DOH plays a key role due to the impacts of poor sanitation on health, only a small unit in the agency is concerned with sanitation. Its role is limited to policy formulation, thereby causing significant gaps between policy implementation and enforcement. In particular there is an inability to deliver commitments made under existing laws. Moreover, the Sanitation Code formulated in 1975 may no longer be appropriate for the requirements of a rapidly urbanizing population, particularly increasing population densities. The said code also does not consider the anticipated complications caused by climate change.

Inequitable access to basic sanitation facilities and sewerage and septage management services

As in the water supply subsector, statistics on sanitation are uncoordinated and conflicting. This notwithstanding, WHO/UNICEF JMP on the MDGs show a general trend of improving13 coverage from 1990 to 2008, with corresponding reductions in open defecation. From a 1990 baseline coverage of about 55 percent, the MDG target is to increase coverage to 84 percent by 2015. The DOH, however, sets a higher national target of 91 percent, with 96 percent for urban areas and 86 percent for rural areas. Similar to access to water supply, access to sanitation is much lower in rural areas compared to urban areas with a visible disparity amongst regions as well.

Figure 5.2. Percentage Access to Sanitary Toilets

Source: Philippines Progress Report on the Millennium Development Goals 2010

Table 5.3. Estimated Coverage for Sanitation: 1990-2008

Source: WB/UNDP JMP 2010 Report

Based on WHO/UNICEF JMP estimates, the Philippines is on track to meeting its MDG target for sanitation. Data from the DOH and 2010 Progress Report on MDGs, however, show fluctuating year-on-year coverage due to low investment levels, combined with a rapidly increasing population and the increasing frequency of natural disasters that affect the sustained operations of existing facilities.

For sanitation facilities to be sustainable and make an impact on health outcomes, sewerage or septage management support is required. Unfortunately, there have been few investments in proper sewage collection and treatment, especially outside Metro Manila. Less than 10 percent of the population has access to sewerage services. Outside Metro Manila, selected highly urbanized cities (HUCs) provide services to less than 3 percent of their respective area populations. (WB 2005) This situation poses major health and environmental problems, especially in HUCs and during or after natural disasters (i.e., at evacuation centers and during rehabilitation of affected areas).

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13 For MDG monitoring, an improved sanitation facility is defined as one that hygienically separates human excreta from human contact.