Three main patterns of access can be observed (see figure).
a) The first case is prevalence of open defecation, which is the situation in rural areas of countries such as Côte d’Ivoire and Ethiopia, where more than half of the population follows this insanitary practice.
b) The second case is prevalence of traditional latrines, the situation in both urban and rural areas in many countries such as the Democratic Republic of Congo and Nigeria.
c) The third case is prevalence of improved sanitation in urban areas—whether latrines or septic tanks—though usually with a sizable minority continuing to rely on traditional latrines. This pattern is typically found in higher-income countries such as Gabon and South Africa.
Each of these situations is distinct and demands a very different policy response.
Patterns of access to sanitation in Africa across different countries and settings