Exploring the Barriers to Scaling Up Sanitation Enterprises Using Q-Methodology

Despite decades of effort, progress in safely managed sanitation─a public sector mandate─is stalling due to limited public funding and poor governance, among other reasons. As a result, public health has suffered and environmental degradation has continued. Social enterprises that use innovative business models to provide on-site sanitation services, also known as sanitation enterprises, are considered an emerging solution. However, sanitation enterprises have not yet successfully replaced public provision at scale. This work explores the barriers that sanitation enterprises encounter in lower- and middle-income countries. Q-Method, a mixed-methods approach that assesses social perspectives on an issue, is used to evaluate major barriers and groups of dominant perception for 19 sanitation enterprises operating across 20 countries. A total of 25 mutually exclusive, collectively exhaustive barriers are identified, ranging from affording capital expenses to navigating political corruption. The results show that most of the identified barriers fall into the financial barrier category, with reaching economies of scale being the greatest obstacle for sanitation enterprises. On the basis of these results, the premise of independent profitability underlying the sanitation enterprise value proposition should be reevaluated. Four enterprise types are proposed and can explain half of the variance among the sanitation enterprises studied. The context of a sanitation enterprise, including its countries of operation, size, customer base, sources of revenue, and section of the sanitation value chain, influences the barriers that the enterprise encounters. This research underscores the crucial role of context in influencing barriers for sanitation enterprises, emphasizing the need for investment and for policy makers to take these contextual dimensions into account.