| Summary: | Sanitation workers provide an essential public service that is key to achieving the Sustainable Development Goals (SDG), but often costs them their dignity and health. Many governments in low- and middle-income countries fail to support their sanitation workforce. This is due, in part, to a lack of knowledge about sanitation workers’ needs and the challenges they face. This study aims to address this knowledge gap through four assessments conducted in Burkina Faso, Nigeria, Tanzania, and Zambia that explored the health and safety, financial security, legal protection, and dignity of sanitation workers. Methodologies included literature reviews, key informant interviews (110), focus group discussions (7), and a survey. The findings suggest that sanitation workers across Africa face serious health and safety risks, heightened by a lack of adequate protective equipment and access to healthcare services. Their pay is insufficient and unstable, and the regulatory environment offers them little legal protection. Many also face stigma and discrimination. These challenges were found to be more acute for manual emptiers and those working informally. The study concludes that governments must develop context-specific action plans to support their sanitation workforce, guided by the results of national and sub-national assessments and in collaboration with sanitation worker groups.
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