Ethiopian Entrepreneur Improves Village Sanitation in Just 21 Days
Discovering the link between sanitation and health, entrepreneurs start businesses through market-based sanitation programs.
For Tesfaye Getu, a resident of Kebele 17 in Lay Gayint Woreda, Ethiopia, life without a working toilet and fresh water in the household was taking a toll on her family. Her three children often fell ill caused by the open toilet near their home—infested with flies, waterborne disease, and foul smells. "The toilet was a source of discomfort and disease,” she told iDE in January.
For as long as she could remember, Tesfaye had been trapped in a constant cycle of health issues. Ongoing treatment for sanitation-related illnesses meant her children were missing school, and her health, livelihood, and peace of mind were steadily deteriorating.
Core to the PReSERVE program was ongoing coaching and capacity building for the toilet business owners, masons, and entrepreneurs that sold and built toilets for families.
In 2023, during one of those visits she attended a iDE-facilitated community education session hosted by the local health extension worker at a nearby church. There she first learned about the critical link between sanitation and health; she was struck by the realization that many of the health problems in her family could be prevented by installing a toilet slab with Sato Flex.
The training was part of the behavioral change component of the iDE-run ‘Poverty Reduced Sustainably in an Environment of Resilient and Vibrant Economy (PReSERVE)’ program. This initiative is led by Food for the Hungry Ethiopia (FHE) in partnership with iDE and other organizations. Funded by a $143 million grant from USAID, PReSERVE’s goal was to improve food security and sanitation in Ethiopia’s Amhara Region in Northern Ethiopia, where many communities struggle with access to clean water.
In the 21 days after attending the health training session, and with the help of local masons, Tesfaye had a newly installed Sato Flex toilet pan supported by a concrete slab, fitted in her home. Recognizing an opportunity, she started her own toilet business shortly after.
The Sato Flex toilet, designed by iDE to safely contain waste and prevent disease, was part of a market-based approach where 34 local entrepreneurs, toilet business owners, and sales across two districts were trained to educate communities and sell the toilets affordably on credit. By training Toilet Business Owners and sales agents, iDE was helping build a local supply chain for sanitation products across the region, while providing jobs and increasing the health of communities in the process.
Nearby in Kindomeda Kebele, Kes Gebeyaw Beka, his wife, W/ro Fikre Getu, and five children faced similar sanitation challenges to Tesfaye. After speaking with a visiting health worker about the community’s issues, Kes was also introduced to the Sato Flex toilet. That same week, he arranged for an improved toilet to be installed at his home. Within days, foul smells and insects were gone, and the new toilet provided much-needed privacy for his wife and three daughters.
“Ever since we upgraded to the new toilet slab with Sato Flex, I feel a deep relief knowing that our children are safe and our home is cleaner. It’s a small change that brings a huge improvement in our daily lives,” said Kes.
The Sato Flex toilet, developed by iDE to safely manage waste and reduce disease, was introduced through a market-based approach that trained 34 local entrepreneurs to educate communities and sell the toilets affordably on credit in two districts.
Neighbors took notice, and after Kes shared his experience and directed them to the supplier, several families upgraded their toilets—improving hygiene at home and across the community.
Core to the PReSERVE program was ongoing coaching and capacity building for the toilet business owners, masons, and entrepreneurs that sold and built toilets for families like Kes. Behavior change strategies, led by religious leaders and health workers, like those who met Tesfaye, helped increase demand for toilets and change mindsets across the region. Finally, access to low-cost loans and local production helped suppliers meet the growing demand as attitudes towards toilet ownership and hygiene practices began to change.
Despite challenges, the program supported entrepreneurs in selling 294 toilets by March 2025, improving sanitation and livelihoods for 1,470 people in Lay Gayint and Simada, Amhara.
Despite challenges like rising material costs, security issues, and limited access to affordable housing, the program—which concluded in March 2025—supported entrepreneurs in selling 294 toilets, improving the health and economic well-being of 1,470 people across the Lay Gayint and Simada woredas of the the Amhara region. Through this effort, local entrepreneurs are not only transforming sanitation in their communities but also creating lasting economic opportunities for themselves and others.
"Now, I see a future where my children are healthy, where we have a clean and safe environment, and where others in my community can benefit from the same transformation," said Tesfaye.
