People living in the low income informal urban areas of Ghana are more reliant on public latrines than similar communities anywhere else in the world. In Kumasi, the second city of Ghana, where the ACF programme is underway, it is estimated that 60% of the approximately 2 million population visits a public latrine at least once per day.
While there are some excellent examples in Kumasi of high standard public latrines many fall way below what can be considered to be acceptable. Not only are many of the facilities of very poor quality they are also badly maintained, but despite this they are such an essential part of the sanitation provision of the city that at peak times, such as early morning, people have to queue for hours to use them.
WSUP, under the ACF programme, has been working with the Kumasi Metropolitan Assembly (KMA) to develop approaches that will bring about city wide improvements in the quality of public latrines and the service that they provide.
In December 2010 WSUP arranged for David Kuria from Ecotact in Kenya to visit Kumasi and share the approach that he has developed in Kenya with a range of key stakeholders in Kumasi. This visit has had a significant positive impact in Kumasi and David Kuria’s approach has become the reference point for discussions within the municipal authority on improvements to public sanitation blocks within the city. A local Bank has also shown a lot of interest in the possibility of providing loans for the rehabilitation or construction of latrine blocks. Following the David Kuria model a large new public latrine has recently been constructed in one of the large markets areas in central Kumasi.

Attendees at David Kuria's workshop included the Mayor, members of the Metropolitan Assembly, staff of the Waste Management Dept (WMD), local business men and representatives of a local commercial bank
Waste management staff at the KMA do not have a definitive list of all the latrine blocks that exist in Kumasi and has no detailed picture of the condition of the facilities. In close collaboration with the KMA the ACF programme is about to award a contract for the mapping of all the public latrine blocks in Kumasi. This will provide a detailed picture of what is where, what facilities are available at each location, what particular management arrangement each block is operating under, and it will also provide an estimate of the number of users per day.In a recent interview with a staff member at the waste management department, it was learnt that A comprehensive policy change has already occurred as a direct outcome of the visit by David Kuria.