The factors that lead to this poor sanitation situation in the city include:

• Low priority given to sanitation because of lack of awareness regarding its linkages to public health
• Fragmented institutional roles and responsibilities
• Lack of integrated approach in dealing with the problem
•  Lack of consideration to the user perspectives in dealing with sanitation issues

The document proposes the need for development of a city sanitation task force that involves mobilisation of stakeholders at every level and specifying legal and regulatory institutional mechanisms to reach the goal of making a clean and open defecation free city.

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