Perspective Chapter: Access to Rural Water and Sanitation Services in Cameroon within the Context of Sustainable Development Goals (SDGs)

Abstract

This chapter examines the situation of rural water and sanitation services in Cameroon within the context of sustainable development goals (SDGs), to establish whether Cameroon is on right track of meeting the SDG, and proposes actions to be taken to achieve universal access for water and sanitation. Based on the analyzed data obtained from national surveys and the Joint Monitoring Program for 2021, it argues that Cameroon is unlikely to reach universal access to water and sanitation in rural area by 2030. Factors contributing to poor access to rural water and sanitation services include the poor application of the policy and legal framework, the poor coordination of interventions between the actors involved in the sector, the low financial viability of the sector, the low efficiency of expenditure related to water and sanitation, and the lack of human resources in the sector. The implementation of the policy and legal framework, the stability of the institutional framework, the reaffirmation of the major role of the State of the changed Ministry of water, and the collaboration of all the actors of the sector within the mechanisms provided for this purpose are of fundamental importance to achieve SDG 6.1 and 6.2 in Cameroon.

1. Introduction

The recent report of the Joint Monitoring Programme for Water Supply, Sanitation and Hygiene (JMP) states that 771 million people in 2020 remain without access to basic water services and an estimated 1.69 billion without access to basic sanitation services [1]. The majority of people who still lacked even basic services lived in rural areas. Failure by governments to ensure access to basic water and sanitation services in rural areas is the result of a failure to ensure that infrastructure, once in place, continues to effectively provide the expected services over time [2]. For illustration, some studies [3, 4] have shown that 30–50% of rural water supply systems become inoperable 5 years after their construction.

The issue of the sustainability of rural water and sanitation services in Sub-Saharan Africa is not new and has received international attention since the International Decade of Potable Water and Sanitation (1981–1990). In this context, the focus to address rural water supply and sanitation systems failure was at the level of the community during the implementation phase of new facilities [2]. Since the Millennium Development Goals (MDG) era, emphasis has been placed on post-construction support to service providers, professionalization, and diversification of service delivery models [5].

With the adoption of the sustainable development goals (SDGs), governments have committed to ensure universal and equitable access to water and sanitation for all by 2030; to reduce inequalities in access to drinking water and sanitation; and to provide high levels of water and sanitation service in terms of quality, accessibility, and reliability. The SDGs thus pose a triple challenge, viz., i) improving the levels of service provided; ii) ensuring the sustainability of services and promoting universal access to drinking water; and iii) sanitation [6]. In this context, it has become essential to better understand the factors of sustainability for rural water and sanitation services. Therefore, this chapter examine the situation of rural water and sanitation services in Cameroon within the context of sustainable development goals (SDGs), establish whether Cameroon is on track of meeting the SDG, identify factors that affect access to rural water and sanitation services, and proposes actions to be taken to achieve universal access for water and sanitation.

2. Country context

Cameroon is located in Sub-Saharan Africa between West and Central Africa at the extreme North Eastern end of the Gulf of Guinea (Figure 1). It lies between latitudes 2° and 13° North of the equator and between longitude 8° and 16° East of the Greenwich Meridian. It has a total surface area of 475,650 km² with a mainland surface area of 466,050 km² and a maritime surface area of 9600 km², respectively [7]. The estimated population is 27 million [1]. The rural population represent 41.3% of the total population. About 35% of the urban population lives in the economic capital, Douala, or the administrative capital, Yaoundé [8]. Administratively, Cameroon is divided into 10 regions, 58 divisions, and 360 sub-divisions. Cameroon has 14 cities and 360 councils.

Figure 1.

Location of Cameroon.

Average GDP growth in real terms in Cameroon is around 4% over the past 5 years [9]. This development has not been sufficient to promote poverty reduction. Indeed, the population living below the poverty line is estimated at around 40%, which means that nearly half of the population is unable to access basic social services, including water [10]. This socioeconomic snapshot of the country has a direct impact on the Drinking Water, Hygiene and Sanitation sector. Indeed, the rate of access to drinking water is 66% while that of sanitation is 45% [1].

In rural areas, domestic water is supplied through wells and boreholes equipped with hand pumps and by rural distribution networks. Since 2010, the municipalities have been project owners and operators of facilities that are not part of the perimeter granted to the Cameroon Water Utilities Corporation (Camwater). However, the facilities remain in the domain of the State. Few data are available on the failures of rural water and sanitation system (RWSS). With the regard to sanitation, individual facilities including traditional latrines (receiving excreta, sewage and gray water) and improved facilities (ventilated single or double pit latrines and flush toilets connected to a septic tank) are the main sanitation facilities in rural areas.

3. Snapshot of the current state in terms of water and sanitation

In rural areas, very few data are available on access to drinking water and sanitation. The analysis presented in this section is based on data published by the Joint Monitoring Program (JMP) of WHO and UNICEF in 2021. According to these estimates, the rate of access to drinking water in rural has increased from 36.8% in 2000 to 43.5% in 2020, an increase of 6.7 points. About 6 million people living in rural areas would not have access to an improved water source. According to the JMP, Cameroon is not on track to achieve the sustainable development goal (SDG) relating to drinking water (SDG 6.1), set at 100% in 2030 (Figure 2a).

Figure 2.

Progress in water supply and sanitation coverage in Cameroon.

This situation is exacerbated by the high number of non-functional rural drinking water supply system (RDWSS). Deal and Furey [11] estimated that 32% of hand pumps were inoperable at all times. In addition, isolated studies in some Cameroonian councils showed that 10–60% RDWSS were broken or not functioning optimally [6, 12, 13, 14]. According to RESEN [15], a third of schools in the country have a source of drinking water supply, while MINEDUB statistics indicate a school drinking water coverage rate of 39% [16] only.

Achieving the target 6.1 means addressing the “unfinished business” of extending services to 6 million people who still lack even a basic water service. It also implies going beyond households and providing access to services in schools, health-care facilities, and other institutional settings. The commitment to “leave no one behind” will require increased attention on disadvantaged groups and efforts to monitor elimination of inequalities in drinking water services.

Achieving universal access to adequate and equitable sanitation and hygiene by 2030 is a major challenge in rural areas in Cameroon. Target SDG 6.2 calls to end open defecation, to ensure that everyone has access to a basic toilet and to put in place systems for safe management of excreta. Based on an average population of 4.4 inhabitants per household and 1.8 households per plot served by a latrine, there would be approximately 330,197 improved facilities in rural areas. The sludge, in the absence of a fecal sludge treatment station, is discharged into the natural environment or, once the pit is full, it is sealed and a new pit is built near the previous one. The facilities of many public establishments (hospitals, schools, markets, etc.) are deficient.

Due to the rapid growth of the rural population, the rate of access to sanitation fell from 24.1% to 22.7% between 2000 and 2020, that is, a decline of 1.4 points. The country is therefore, to achieve the 100% fixed sanitation SDG seems to be difficult task (Figure 2b). The situation of poor access to water and sanitation services is accentuated by the many humanitarian crises affecting the country, i) internal and cross-border population displacements (Nigeria to Cameroon, Central African Republic to Cameroon), ii) nutritional and environmental crises (floods since 2012), iii) climate change and variability, and iv) health (cholera, polio, measles).

The health situation in the country has naturally been affected by the decline in access to sanitation facility. Thus, from 2009 to 2011, Cameroon experienced a serious epidemic of cholera, a fecal peril disease, and a second epidemic occurred in 2014. From 2009 to 2015, the country brought a total of 37,539 cases of cholera and 1694 deaths [17]. WHO estimates that diarrheal diseases due to poor drinking water supply, basic sanitation and hygiene practices cause 18,300 deaths per year and 13.4% morbidity in Cameroon [17].

4. Enabling and accelerating progress

This section focuses on the enablers for progress in the water and sanitation sector in rural areas in Cameroon and the challenges and obstacles faced, based on the Mol for water and sanitation (governance, finance, capacity development, data acquisition, and monitoring). They are interlinked and essential elements in meeting SDG targets for water and sanitation.

4.1 Policy and legal frameworks

4.1.1 Current status

Cameroon has many policy and strategy instruments, including the National Drinking Water Supply and Sanitation Policy in rural areas [18], the National Liquid Sanitation Strategy [19], and the National Community-Led Total Sanitation Strategy [17]. As for the legislative and regulatory framework, it is mainly based on Law No. 64/LF/23 of November 13, 64 on the protection of public health, Law No. 98/005 of April 14, 1998 on the water regime in the Cameroon, Law No. 2019/024 of December 24, 2019 on the general code of local authorities, and Decree No. 2010/0239/PM of February 26, 2010 setting the terms for the exercise of certain powers transferred by the State to the Municipalities in drinking water supply in areas not covered by the public water distribution network granted by the State.

The politico-legal framework analysis of the management of water and sanitation services in rural areas highlights many constraints and challenges. First of all, the obsolescence of the legal framework, in particular Law No. 64/LF/23 of November 13, 64 on the protection of public health and Law No. 98/005 of April 14, 1998 on the water regime. Indeed, with the changes in the socioeconomic and institutional landscape that Cameroon has experienced over the past two decades, these laws are proving obsolete. These laws are an extension of colonial legislation through which water and sanitation management follows Western models with a centralized management system [20]. In addition, there are discrepancies and even contradictions between the various texts governing water management in rural areas [17, 18, 19].

In addition to the question of the harmonization of laws and regulations governing the sector of management of rural water services in Cameroon, there is the problem of their applicability due to the fact either of the absence of implementing texts (decrees and decrees) or their pure and simple non-application despite the existence of laws and regulations [21]. Indeed, Law No. 98/005 of April 14, 1998 on the water regime in Cameroon provides for application decrees that are not all taken, and others not applied. This renders the application of this law obsolete. For illustration, the National Water Committee created by decree No. 2001/161/PM of May 8, 2001 and which is not fully functional, because it met only once, whereas the statutory provisions impose at least two regular meetings per year. The same is true for Law No. 2019/024 of December 24, 2019 on the general code of local authorities where there are not yet many implementing decrees such as the decree setting the procedures for exercising powers transferred by the State to the Communes in terms of sanitation in rural areas. Moreover, in the absence of sufficient financial resources, the national policy for drinking water supply and sanitation in rural areas has not, however, initiated any significant reform of the sector.

In addition, the context of the formalization of economic and social life, the weakness of the State’s own means, makes it even more difficult to apply this normative system [22]. Moreover, the current legislative and regulatory texts do not mention the administration of water and sanitation in Cameroon [18]. The sector is still poorly “equipped” at the regulatory level. There is a lack of legislative and regulatory texts concerning the management of water and sanitation services. In addition, the place of rural sanitation in policy documents is very limited.

4.1.2 Accelerating progress

The analysis of the legal and institutional framework for the management of water and sanitation services shows that the legal basis for water and sanitation remains inconsistent and relatively inefficient. This legal basis is deemed insufficient and requires clarification, particularly with regard to the programming, construction, and ownership of the works. Significant efforts must be made to update and harmonize the political and legal framework for the management of water and sanitation services in rural areas. The ongoing review of Law N98/005 of April 14, 1998 on the water regime opens up prospects for taking into account the weaknesses identified and the establishment of a water and sanitation code. In addition, concerted efforts must be made to ensure greater effectiveness of the rich existing political and legal framework in the area of water and sanitation. Moreover, many efforts remain to be made to coordinate the implementation of various legislative and regulatory instruments in order to ensure synergy in this area, a source of efficiency in the interventions of the various actors.

4.2 Institutional arrangements

4.2.1 Current status

In Cameroon, the Ministry of Energy and Water (MINÉE) is responsible for the design, formulation and implementation of drinking water supply and sanitation strategies in rural areas. However, without a national policy or direction specifically dedicated to sanitation, the actions of the MINEE in rural areas are mainly oriented toward the construction of rural drinking water system and the organization of drinking water supply. In addition, the decentralized services of MINÉE experience difficulties in carrying out their mission (weak human and financial resources, difficulties in collaborating with local authorities, particularly in the area of WASH).

The main constraint of the institutional framework is the weak coordination of interventions between the MINÉE and the other Ministries involved in water and sanitation management and non-governmental organizations. Indeed, each of these actors intervenes with different logics and in quasi-autarky without coordination [17, 18, 19]; even if the National WASH Committee is in place, it struggles to assume the responsibilities of strong coordination of the sub-sector. Further, there is an overlap in the skills of MINEE in the management of water and sanitation services with other State structures. The lack of coordination between the public institutions of the State, having legal prerogatives of intervention in the field and the poor articulation between the functional levels, is sources of conflicts of competence, poor use of resources, and inefficiency [18].

Additionally, the centralized administrative organization and the unilateral “top-down” policy of the State also constitute to remain a major constraint. Indeed, the State has concentrated all the prerogatives in terms of water in the hands of these central or regional structures. Most of the water and sanitation programs piloted are in fact implemented centrally [18]. The drinking water supply and sanitation works are programmed on the basis of the available financial envelope and this programming is more guided by a concern for balance in the sharing of resources between the 10 regions of the country. State institutions in fact register requests from several sources: elites, deputies, or representatives of the populations. But the satisfaction of the needs expressed by the local actors is above all a function of their ability to influence decisions at the central level.

4.2.2 Accelerating progress

The stability of the institutional framework of the WASH sector, the reaffirmation of the major role of contracting authority under the State of the changed Ministry of water, and the collaboration of all the actors of the water sector and sanitation within the mechanisms provided for this purpose (the National Water Committee and the WASH sector group) are of fundamental importance to achieve SDG 6.1 and 6.2 in Cameroon. Thus, it is necessary to make the coordination mechanisms not only functional but also vibrant to provide for this purpose. The suggested interventions, in particular, are discussed below:

4.2.2.1 National Water Committee

The National Water Committee is an administrative body whose mission is to coordinate the actions of the main ministerial sectors involved in the water sector. It is made up of representatives of the main ministerial departments that play an important role in the field of water. It should play a pivotal role in the water sector under the new orientation of the institutional landscape which will let the ministerial departments formulate and implement their sectoral water strategies.

4.2.2.2 WASH Committee

The WASH Committee is responsible for providing multifaceted support to the administrations responsible respectively for water and public health, basic education, secondary education, and territorial administration. The WASH committee should be more proactive on the matters of concern to revamp the existing infrastructure and distribution networks so that the water supply and sanitation can play a strategic role in the fight against poverty. WASH Committee should aspire more to ensure advocacy with the Government, national and international institutions, and economic operators for support for the activities related to developing proper water supply, sanitation, and sewage treatment/disposal mechanism in the country.

4.2.2.3 Water information system unit

The Water Information System Unit is housed within the Water Resources Management Department, and it aggregates data from the Water and Sanitation sector in order to ensure reporting and tools decision support for investments in the sector. It is the focal point for monitoring SDG 6 in Cameroon. There is a need to develop and strengthen the data collection, analysis, and implementation of programs based on the correct felt needs of water supply and demand and this unit should reach to the aspirations for realizing the SD goals in water sector in the country.

4.3 Finance

Funding for water and sanitation in rural areas in Cameroon comes from three sources: i) tariffs, ii) taxes, and iii) transfers, known as the “three Ts.” Tariffs typically come from user fees and household investments, covering self-supply solutions and household sanitation. Taxes are typically the largest source of funding in rural areas in Cameroon. “Taxes include all funding from public budgets allocated by governments (at the central or local levels) for investment, subsidies and general sector funding” [23]. Transfers involve financing from overseas in the form of official development finance (ODF), and contributions from NGOs and remittances [23].

4.3.1 Tariffs

Actually, cost recovery from tariffs is lower for water supply and almost absent for sanitation. Indeed, the financial flows generated by the sale of water are very low and do not cover most of the operation and maintenance costs. This situation contributes to the increase in the duration of repairs and to the increase in the rate of non-functionality of water supply infrastructures [24, 25, 26]. In addition, this situation is aggravated by an almost general absence of a culture of selling water. Indeed, the construction of a local water market depends on the willingness to pay of populations. However, this depends on several factors. First of all, the principle of payment for water appears in opposition to the shared values of peoples. Free water is associated with the representation that water is a gift from nature. Therefore, it is considered an inalienable resource that must be accessible to all. This conception is inseparable from the social dimension of water. In addition, the presence of other water points where access to water is free (traditional well, river, etc.) tends to have a negative impact on water demand from modern water points where access is chargeable [27].

[Note: In rural India, too the water is considered as nature’s free gift but in urban areas where the piped water is being supplied it has become a chargeable commodity. The rates, however, are not substantial. Bottled water, however, is very costly but people who can afford to pay are willing to pay for assured quality of drinking water.

If the principle of payment for water is accepted in some localities in rural areas, there are difficulties related to its application. Indeed, social ties are strong and are linked to kinship and neighborhood relationships. It is difficult to refuse to provide water to a relative or neighbor who cannot afford it. In addition, for a long time, the State gave free water to the populations and it is now becoming very difficult to make users pay for the water service. This absence of the culture of the sale of water coupled with the ability of users to pay for the water service makes it possible to determine the willingness of the user to pay for water. Under such circumstances, while the water supply and sanitation network is being developed by the government exchequer without much return in monetary terms, we may think of positive impacts and indirect benefits such as the people will contribute more efficiently in nation building and overall GDP will move in positive direction if they remain healthy and do not fall sick as in case of non-existent of such facilities and services.

4.3.2 Taxes and transfers

The planning, budgeting, and execution of financing allocated to the water and sanitation sector have undergone significant variations over the years. Thus, for the improvement of access to drinking water, the Government and the technical and financial partners of the sector have been deploying for several years an investment effort in line with the achievement of the SDGs. This effort is estimated at 277.985 billion between 2007 and 2016, and 270.2 billion between 2007 and 2015 respectively for urban water supply, rural water supply, and sanitation [28]. The same is true for the liquid sanitation program, which requires an investment of around 285 billion FCFA (US $ 600 million) for the next 10 years.

However, the situation is worrying with regard to budgetary allocations. Indeed, in its public expenditure review conducted in April 2009, the World Bank noted for the drinking water supply and rural sanitation sector: “Neither the Caisse Autonome d’Amortissement (CAA), nor financial services, nor the technical services were able to provide data on allocations and executions of external resources, year by year for the period 2002–2007” [29].

In addition, the effectiveness of expenditure remains relatively poor: Control mechanisms are incomplete or inoperative, unit prices are higher than in comparable countries, the market is not attractive enough (due to administrative red tape and the corruption), and the number of structures built is relatively low: an average of around 700 water point equivalents [29]. The current low efficiency of spending means not only that there is a certain level of wastage of financing but also that the achievement of SDGs 6.1 and 6.2 is unrealistic.

Faced with this situation that could be detrimental to the achievement of SDG-6, the Government of Cameroon has initiated, with the support of UNICEF, a traceability survey of public expenditure in the water, hygiene, and sanitation sector. This initiative currently will not only improve the efficiency, impact, and equity of public action but also to advocate for an increase in the resources allocated by the government to the drinking water sector, the hygiene, and sanitation. In addition, as part of the UNICEF Government of Cameroon Cooperation Program for the period 2018–2020, the country will have a strategy for mobilizing the resources needed to finance the drinking water, hygiene, and sanitation sector. However, the implementation of this strategy is not yet perceptible.

4.4 Capacity development

With Cameroon joining the “Structural Adjustment Program” of the 1990s, the recruitment of executives for the benefit of the water and sanitation sector was frozen. This situation has resulted in a drastic reduction in the staff of the water and sanitation sector, jeopardizing the capacity of the public water administration to properly carry out its missions. The current situation reveals that the staff is insufficient in juxtaposition with the existing institutional framework and the missions assigned to the water and sanitation sector.

Furthermore, human resources are almost non-existent in the decentralized territorial communities. The vast majority of local authorities do not yet have qualified personnel able to assume the new missions assigned to them under decentralization [30]. In addition, the populations have weak participatory capacities. Illiteracy, lack of information, education, and communication among rural populations are main obstacles to their conscious and responsible participation in the sustainable management of infrastructure and even water resources. The private sector exists in the construction of structures, but the quality of the structures built by them is often deficient due to the lack of normative documents, quality control, and experienced personnel [31].

In view of the above, it is important that the capacities of all actors involved in the management of water services in rural areas be strengthened. In this perspective, it is worth mentioning the establishments of initial, continuous, or professional training in the water and sanitation professions, which can be mobilized in particular the State Universities and the Private Institutes of Higher Education (IPES), the Training Center for Municipal Actors (CEFAM), strengthens the technical capacities of municipal staff and the National Training Program for City Trades (PNFMV). In addition, recruitment of additional staff and sensitization of users should be undertaken. Raising user awareness will enable water users to take an active part in the water service management process.

4.5 Data acquisition and monitoring

4.5.1 Current status

Cameroon through the Ministry of Economy, Planning and Regional Development (MINEPAT), with the support of the United Nations System, led in 2015, the process of inclusive localization of the SDGs. At the end of this process, the development actors gave their opinion on the relevant targets for Cameroon based on two main criteria, which are anchoring in development strategies and policies and taking into account the challenges emerging. As a logical follow-up to this, the National SDG-6 indicator framework for Cameroon was developed in October 2018. It presents the measurement indicators for each target, the data sources, the actors in charge of data collection, the analysis, and dissemination of indicators. However, the data currently available on access to drinking water supply, hygiene, and sanitation (WASH) services are those from surveys conducted as part of the JMP and MICS (Multiple Indicator Cluster Survey). These surveys are done by sampling and often do not reflect reality. Also, the estimates are not disaggregated according to the guidelines of the SDG implementation monitoring system.

To take into account the particularity and the complexity of the calculation of the SDG-6 indicators and more particularly indicators 6.1 on access to drinking water and 6.2 on basic sanitation, Cameroon has a WASH Infrastructure Data Management System housed in the Water Information System Unit and initiated in 2015 the inventory and geolocation of infrastructure. The information relates to the type, location, functionality, and management method of the structures and will ultimately be used to calculate the indicators to measure the level of achievement of SDG-6. However, the results of this inventory initiated with the help of the African Development Bank are not yet available and the mechanism for monitoring SDG-6 at the national level is not yet operational.

4.5.2 Accelerating progress

“We cannot plan and manage what we do not measure and monitor” is a statement that few would disagree with. Data acquisition and monitoring provide the foundation for good governance [23]. It is not possible to plan, manage, and evaluate rural water and sanitation services without available data. Cameroon lack the financial, institutional, and human resources to acquire and analyze data to support governance. The mechanism put in place to monitor the implementation of SDG-6 is not yet operational. Efforts must therefore be made to make this mechanism operational. In addition, on the basis of the main guidelines of the Monitoring and Accountability Supervision Framework, it is necessary to finalize the development of the framework for monitoring simplified indicators of progress toward SDG-6 by the populations themselves. In addition, annual sector reviews should be held with all the technical and financial partners involved in the management of water and sanitation services in rural areas. This could be done, for example, within the framework of the WASH cluster.

5. Conclusion

This chapter provides information on access to rural water and sanitation services in Cameroon. Analysis of data from the MICS surveys and the JMP 2021 suggests that at the current rate, it will be highly difficult to achieve SDG 6.1 and 6.2 in rural areas of Cameroon. Data analysis also suggests that factors such as i) weak application of the politico-legal framework for the management of water and sanitation services, ii) weak coordination of interventions between actors involved in the sector, iii) weak financial viability of the management of water and sanitation services, iv) the low efficiency of expenditure related to water and sanitation, and the v) insufficiency of human resources in the sector constitute major barriers to the achievement of the universal access to water and sanitation in rural areas.

Further, strengthening the implementation of the politico-legal framework, upgradation and modernizing the stability of the institutional framework of the WASH sector, ensuring the reaffirmation of the major role of Project Owner under the State of the changed Ministry of Water, and the whole hearted concerted efforts to ensure the collaboration of all actors/players in the water and sanitation sector within the mechanisms provided for this purpose (The National Water Committee and the WASH sector group) are of fundamental importance to achieve SDG 6.1 and 6.2 in Cameroon. While achieving a surmounting task is difficult yet not impossible, the need of hour is to start the much required action to achieve targets. We are quite optimistic and convinced that with the help and support of people of Cameroon and guidance of experts within or outside the country and finances generated from within the country or external support, achieving SDG-6 can be a reality 1 day provided most honest and sincere efforts are made till the goal is achieved.

Conflict of interest

The authors declare no conflicts of interest.

Acronyms and abbreviations

AMCOW

African Ministerial Council on water

CAA

Caisse Autonome d’Amortissement

GDP

Gross Domestic Product

JMP

Joint Monitoring Programme for water supply, sanitation and Hygiene

MICS

Multiple Indicator Cluster Survey

MINEDUB

Ministry of Basic Education

MINÉE

Ministry of Energy and Water

RWSN

Rural Water Supply Network

RWSS

Rural Water and Sanitation System

SDG

Sustainable development goals

UNICEF

United Nation International Children Emergency Fund

WASH

Water, Sanitation and Hygiene

WHO

World Health Organisation