What Poor Households in Haiti Would Pay for Clean Sanitation, and What It Means for Subsidies

In the crowded neighborhoods of Cap Haitien, Haiti’s second-largest city, one of the most basic promises of modern infrastructure remains out of reach for most families: a safe, private toilet that does not endanger the household or the community. A new study published in PLOS Water offers one of the most detailed pictures yet of what households in an urban Haitian setting would actually pay for a sanitation service that works, and the findings carry significant implications for how governments and service providers design subsidies for basic services in low-income cities worldwide. The research, led by Maya Lubeck-Schricker and colleagues, surveyed 603 households across four neighborhoods of Cap Haitien and combined quantitative willingness-to-pay estimates with qualitative focus group discussions to understand not just how much people would pay, but why.

The service at the center of the study is EkoLakay, a container-based sanitation system operated in northern Haiti that provides households with a toilet that collects waste in sealed containers, which are swapped out weekly and transported to a treatment facility. In a country where sewer connections are rare and pit latrines often discharge untreated waste into the environment, container-based sanitation is one of the only household-level options that qualifies as safely managed sanitation under international definitions. The service currently costs 350 Haitian gourdes per month, a fee equivalent to less than three US dollars, yet even this modest amount proves prohibitive for some households. That gap between the cost of running the service and what the poorest families can afford is precisely where the question of targeted subsidies enters, and where the study makes its most consequential contribution.

To measure willingness to pay, the researchers used contingent valuation, a survey-based method in which respondents state whether they would pay a specified price for a good or service. It is a technique long used in environmental and development economics to attach values to things that lack market prices, and it requires careful design to avoid inflating or deflating responses. In this study, households were asked about their willingness to pay for EkoLakay service at different price points, and the resulting distribution tells a clear story. Sixty percent of surveyed households said they would pay the current fee of 350 gourdes per month. When the hypothetical price dropped to 250 gourdes, willingness to pay rose to 77 percent, and at 150 gourdes it reached 85 percent. In other words, demand for the service is high but highly price-sensitive, and each reduction in the monthly fee unlocks a substantial additional share of the population.

Those percentages translate directly into policy arithmetic. The authors calculate that a subsidy reducing the effective price to between 150 and 200 gourdes per month could push container-based sanitation coverage in the study area to as much as 80 percent of households. That is a striking figure for a city where safely managed sanitation coverage is otherwise minimal, and it suggests that relatively modest per-household transfers could produce large gains in public health protection. The economics hinge on the fact that the service already functions at scale; the constraint is not the technology or the collection logistics but the affordability of a recurring fee for households living close to the margin. Subsidy design, in this framing, becomes the central lever for expanding coverage rather than an afterthought.

Perhaps the most analytically interesting part of the study is its multivariate regression analysis, which examined which household characteristics were associated with willingness to pay. Three factors stood out: household wealth, the degree of privacy afforded by the household’s current sanitation arrangement, and satisfaction with that current facility. Wealthier households were more willing to pay, which is unsurprising but important, because it means that a uniform price will systematically exclude the poorest, reinforcing the case for targeted rather than universal subsidies. Households whose current toilets offered more privacy, and those who were dissatisfied with what they had, were also more willing to pay for the container-based service, indicating that the perceived quality and dignity of existing arrangements shape demand in measurable ways.

Just as revealing was what did not predict willingness to pay. Whether a household currently owned a private toilet showed no significant association with its willingness to pay for EkoLakay service. At first glance this seems paradoxical: why would families who already have a toilet pay for another one? The focus group discussions, conducted with household members and community leaders, supplied the answer. Participants described the hidden and recurring burdens of pit latrines, including the high cost of emptying a full pit, the persistent smell, and problems with pests. In dense urban neighborhoods where pits are difficult or impossible to empty safely, these costs can be substantial and unpredictable, making a flat monthly fee for a service that removes waste weekly genuinely attractive even to toilet owners.

The focus groups also surfaced contextual factors that a survey alone would have missed. Some participants expressed a desire for multiple toilets within the home, reflecting household sizes and living arrangements that a single facility cannot comfortably serve. Others pointed to the particular value of container-based sanitation in flood-prone areas, where pit latrines can overflow during heavy rains and contaminate yards, wells, and streets. Cap Haitien, like much of coastal Haiti, faces recurrent flooding that turns inadequate sanitation from a chronic nuisance into an acute hazard. In such settings, a sealed container that is removed before it fills offers a form of resilience that conventional on-site systems cannot match, and households appear to recognize and value that difference.

These findings matter well beyond northern Haiti. Container-based sanitation has attracted growing attention in the global sanitation sector as a service model for dense, low-income urban areas where sewers are infeasible and on-site systems fail to protect public health. Operators in Kenya, Ghana, Peru, and elsewhere face the same core dilemma as EkoLakay: the full cost of weekly collection and treatment cannot be recovered from the poorest customers at a price they can afford. The Cap Haitien study provides a template for how operators and governments can estimate the demand curve for such a service and identify the price point at which coverage expands most efficiently. It also demonstrates that willingness to pay is shaped by service attributes, such as privacy and flood resilience, that conventional subsidy formulas based purely on income may overlook.

The study’s implications for targeting are subtle. Because wealth predicts willingness to pay, subsidies aimed at the poorest households would reach those least able to pay the current fee, which is the standard logic of targeted transfers. But because satisfaction with existing sanitation and privacy also predict willingness to pay, a subsidy design that considers the quality of a household’s current facility, not just its income, could allocate resources more effectively. A family with a recently built, well-maintained private toilet may have less to gain from switching than a family using an unimproved shared latrine, even at similar income levels. Incorporating such indicators into eligibility criteria could stretch limited public budgets further, a consideration of acute importance in Haiti, where fiscal capacity is severely constrained and donor funding for water and sanitation is volatile.

The authors are careful to note the limits of what contingent valuation can establish. Stated willingness to pay is not the same as actual payment behavior, and hypothetical responses can diverge from what households do when a real bill arrives. Yet the consistency of the pattern across price points, the plausible direction of the regression results, and the corroborating qualitative evidence give the findings credibility, and the practical payoff is concrete: a quantified estimate that reducing the monthly fee to 150 to 200 gourdes could lift coverage to roughly 80 percent of households in the study area. For basic service providers and government partners in the region, that number converts an abstract debate about equity into a specific, costable policy choice. For the residents of Cap Haitien, it raises the prospect that a safe, dignified, and reliably collected toilet, one of the most fundamental determinants of urban health, could move within reach of the majority of families rather than a fortunate few.

Subject of Research: Willingness to pay for container-based sanitation services and targeted subsidy design in urban Haiti

Article Title: Willingness-to-pay for container-based sanitation and implications for targeted subsidy design in urban Haiti

Article References: Lubeck-Schricker, M., Bauza, V., Felix-Jean, W., Goddard, F. G., Pierre, M. F., Ozeris, B., Schelling, M., & Kramer, S. (2026). Willingness-to-pay for container-based sanitation and implications for targeted subsidy design in urban Haiti. PLOS Water, 5(9), e0000618. https://doi.org/10.1371/journal.pwat.0000618

Image Credits: AI Generated

DOI: 10.1371/journal.pwat.0000618

Keywords: container-based sanitation, willingness to pay, Haiti, Cap Haitien, sanitation subsidies, contingent valuation, EkoLakay, urban sanitation, PLOS Water, public health, pit latrines, flood resilience