As a first step we therefore had to map the WASH context in South Africa using the UN and JMP criteria as guidelines. The concept of physical service value chains is one way to depict such context and is used as an example in this paper to depict the WASH context in South Africa. A value chain in the WASH context represents a set of activities or processes that must be performed to deliver coherent WASH services. From the literature review it was found that, in general, the value chains for WASH services in South Africa are similar to the value chains for WASH services in the rest of Africa. The value chains for South Africa would therefore also be applicable to the rest of Africa and most of the developing world beyond Africa.
4.1 Water Value Chain
Several value chains for ‘formal’ or improved water and sanitation services in South Africa were found during our literature review. In general ‘formal’ water services is a nonstop sequential delivery process from source-to-tap and from tap-to-source [42, 43]. It involves natural water resources, treatment works (processing), distribution infrastructure and effective operation to deliver potable (drinkable) water and safe sanitation. Rainfall runoff flows into rivers and is captured and stored in dams. Water from dams and other sources, such as groundwater, is purified and treated, and piped to reservoirs for distribution to customers (domestic, business and industrial users). Once the water is consumed, grey water (wastewater from washing, laundry etc.) and sewerage are collected and passed through a network of sewers to a treatment works. The wastewater is purified and treated, after which it is released back into rivers or dams, again becoming a water resource [42, 43]. This formal water and sanitation sector perspective does, however, not provide the complete picture of the water and sanitation sector is South Africa and Africa. As a start, it excludes the ‘non-formal’ water sources and sanitation services, as it applies to most of the rural domestic inhabitants. It also excludes the agriculture sector not dependent on the ‘formal’ water supply. Agriculture is the largest user of water globally . In 2015, agriculture in South Africa used 62% of the available water in the country . Water use in agriculture, as a specific focus, is, however not addressed in this paper. It was therefore necessary to augment the existing value chains to represent the complete picture.
Although statistics vary between region and metropolitan areas, the main sources of drinking water in South Africa, according to the 2016 General Household Survey (GHS)  and categorised using the JMP ladder, are:
Safely managed water (piped water on premises): Approximately 46.4% of households had access to piped water in their dwellings in 2016 and 26.8% accessed piped water on site.
Basic improved water (piped water not on premises): A further 13.3% of households relied on water from communal taps and 2.4% relied on water from neighbours’ taps (called RDP standard in the GHS, provided that the distance to the water source is less than 200 m).
Unimproved water resources: An estimated 3.7% of households in 2016 still had to fetch water from rivers, streams, stagnant water pools, dams, wells and springs (down from 9.5% in 2002).
Based on analysis of literature on the sources and value chains for drinking water in South Africa and Africa, is a schematic presentation of the sources of water and the diversity of water distribution in South Africa, also applicable to other African countries (see for example ). Unlike cities in the United Kingdom, Europe, North America and other industrial nations in the north, where there is often a single source of water serving all residential and most industrial customers, in Africa (urban and rural) there can be a wide variety of water suppliers. Water can be obtained from household wells, neighbours’ wells, springs, storing rainwater, water carriers, hand carters, carters using animal traction (unimproved water), standpipes, boreholes with manual pumps (basic/limited water), or even individual connections to the ‘formal’ city or town water networks (improved water) [42, 45].
4.2 Sanitation Value Chain
Once the water is used/consumed, the sanitation process kicks in. The sanitation value chain is fragmented, characterised by a wide range of stakeholders, businesses, from sole traders to multinationals, the majority responding to limited segments of the chain. Only a few companies/organisations have developed a business model that runs almost entirely across the value chain with the majority concentrating their core activities at either end of the value chain . No specified value chain for sanitation for South Africa could be found in literature, but the general value chain for sanitation is also applicable to South Africa. The general sanitation value chain includes six phases [47, 48]: capture of sludge, containment of sludge, emptying of sludge, transport of sludge, collection and treatment of sludge, and safe reuse or disposal of treated sanitation waste.
According to the 2016 GHS , the majority of households in the City of Johannesburg (95.5%) and Nelson Mandela Bay (92.8%) had access to improved sanitation facilities, while households in the City of Tshwane (82.9%) and eThekwini (83.0%) were the least likely to have access to improved sanitation. Nationally, the percentage of households without sanitation, or who used bucket toilets decreased from 12.3% to 4.2% between 2002 and 2016. Despite the improved access to sanitation facilities in South Africa, the 2016 GHS  indicated that many households continue to be without any proper sanitation facilities.
Derived based on an analysis of literature regarding the supply sanitation practices in South Africa and Africa, Fig. 3 is a schematic representation of how the overall sanitation market works in South Africa, which is also applicable to other African countries (see for example ). Inhabitants adopt one of several basic solutions to the problem of disposing of human waste at the household level. The choice often depends on the physical conditions and on how much money they can spend on construction and periodic cleaning of the sanitation solution/facility. Solutions range from a simple pit or ditch, lined or unlined, with or without a platform slab (unimproved sanitation), to a toilet with provision for flushing to a soak pit for the waste water (basic/limited sanitation), or, at the high end of the market, a two-stage lined septic tank and a piped sewerage system (improved/safely managed sanitation).
No value chain specifically for hygiene could be found in literature. There are, however, guidelines on when to wash hands and how to wash hands. In general hands should, for example, be washed [49, 50]: before, during, and after preparing food, before eating food or feeding children, before and after caring for an infected or ‘at risk’ person, after using the toilet, after changing diapers or cleaning up a child who has used the toilet, after touching an animal, animal feed, or animal waste, after handling pet food or pet treats, after handling money (or using an ATM), etc.
The Centers for Disease Control and Prevention  (CDC) recommends a five step process for washing hands when soap and water is available: wet, lather, scrub, rinse and dry. If soap and water are not available, CDC recommends the use an alcohol-based hand sanitiser that contains at least 60% alcohol, although it is said not to be as effective as handwashing when hands are visibly dirty or greasy and cannot eliminate all types of germs and harmful chemicals. If no soap is available or affordable, ash or mud can be used as abrasive, before rinsing . Another alternative in Africa is the use of Moringa oleifera powder .