Kwame Nketia usually treks the quarter of a km from his home at Kotobabi-Down, a suburb of the Ghanaian capital, Accra, to board a vehicle each morning to work at the Central Business District (CBD).

As a young man working in a Foreign Exchange Bureau, he usually puts on his well ironed purple shirt and a blue neck-tie over a dark-blue pair of trousers, with a shiny pair of black Italian leather shoes to match.

Due to the laterite nature of the road, walking down the station and back, whether in the dry or rainy season, requires extra care to avoid any stains in one's attire or shoes.

This Monday morning, as usual, Nketia was chose what he considered to be a safer walkway to avoid stepping into the muddy portions of the road, as it had rained the previous night.

But the unexpected thing happened! One of the rear tires of a taxi cab moving in the opposite direction run over a black polythene bag stuck in a pothole, bursting and splashing its dirty content all over Nketiah's face and his carefully ironed dress.

He did not need any careful examination to notice that the substance was feces mixed with maggots. Obviously, someone had thrown the black polythene bag and its content into a fast- flowing water in a drain the previous night during a downpour.

However, the drain refused to carry the polythene bag which rather got stuck and dragged onto the muddy road.

That is a common spectacle in Ghana during the rainy season when people with no household toilets and the homeless defecate in polythene bags and dump them into nearby drains, hoping they would be carried away.

The practice even continues during the dry season when most people practice open defecation in drains and bushes around town.

As in 2010, more than 20 million citizens, representing about 87 per cent of the population, lacked access to improved household toilets, the Environmental Health and Sanitation Directorate (EHSD) of the Ministry of Local Government and Rural Development (MLGRD) stated in January 2011.

In the capital, the largest city in Ghana with a population of approximately 4.5 million, and over one million visitors operating in the capital for various businesses daily, over 20,000 households are without toilets.

Moreover, an estimated 60 percent of the population lives in low-income areas of the city with little or no access to improved sanitation facilities. Most of these people who depend on these poorly kept public toilets queue to wait for their turn to ease themselves.

Those who cannot follow the regime of queuing and paying to visit the toilets, devise a variety of crude methods, ranging from defecating into wrappers and polythene bags in their bathrooms and backyards and throwing them into open drains or nearby bushes at night.

Others dump their human excreta into refuse bins for refuse collection companies to cart them to poorly kept final disposal sites.

With the onset of the raining season, reports of cholera, malaria and typhoid at Out-Patient Departments (OPDs) of hospitals are beginning to increase, bringing to the fore the need for drastic measures to end the menace of filth in the country.

Seeing the importance of environmental sanitation in human development, the government of Ghana developed a policy for the sector to inform actions that would bring about successful environmental sanitation initiatives.

The Ghana Environmental Sanitation Policy, first published in 1999, was revised and re-launched in September 2010, with the aim of making environmental sanitation an integral part of the national socio-economic development framework, the Ghana Poverty Reduction Strategy-GPRS II , now the Ghana Shared Growth and Development Agenda (GSGDA).

The policy sets out to develop a clear and nationally accepted vision of environmental sanitation as an essential social service to be one of the cardinal determining factors for improving health and the quality of life.

It focuses on seven main themes of Capacity Development, namely Information, Education and Communication; Legislation and Regulation; Sustainable Financing and Cost Recovery; Levels of Service; Research and Development; as well as Monitoring and Evaluation.

At the time of the launch of the document, it was projected that Ghana's five largest cities (Accra, Kumasi, Sekondi-Takoradi, Tamale and Tema) would account for about 19 percent of the total population with their residents generating an estimated 3,200 tonnes of solid waste per day.

There are also around 105 other urban localities, each with populations above 15,000 grappling with environmental sanitation challenges similar to those of large cities.

These other urban localities, comprising about 34 percent of the total population, also generate waste in excess of 5,000 tonnes each day.

The Millennium Development Goal Seven (MDG-7) seeks to ensure environmental sustainability through improving access to safe water supply and sanitation, and to reduce the proportion of population without access to basic water supply and sanitation by 50 percent by 2015 and 75 percent by 2025

As rightly captured by the policy document, "Environmental sanitation powerfully demonstrates the linkages between all the eight MDGs and their related targets, and sustained progress in any target will depend on sustaining improvements in environmental sanitation."

Various strategic actions were planned for adoption to achieve these policy goals. However it does not look like progress made has met the expectations of the authorities.

The 2013 Multiple Indicator Cluster Survey (MICS 2013) report puts Ghana's improved sanitation (safe toilet) access rate in 2012 at 15 percent against the 2015 MDG-7 target of 54 percent.

The survey puts the country's open defecation rate at 23 percent, while recording improved sanitation coverage for urban Ghana at 21 percent, and rural Ghana at 9.0 percent.

In terms of regional distribution for open defecation, the Greater Accra and Ashanti regions score 9.0 percent and 10 percent respectively, while the Upper East, Upper West and Northern regions have open defecation rates of 89 percent, 72 percent and 71 percent respectively.

Stakeholders therefore contend that the current coverage rate for improved sanitation implies that one in four Ghanaians defecate in the open every day.

It also implies that, with the coverage rate of one percentage point per annum, if Ghana's population remains static, it is likely to take 40 years for it to reach the MDG-7 target of 54 percent for sanitation and another 46 years to reach universal coverage.

Beside the health implications of insanitary conditions in the country, there could be devastating consequences for it now fledging aviation industry, as an ecologist pointed out recently.

Augustus Asamoah, acting director of Conservation Programs for Ghana, had cautioned operators of the aviation industry that the growing insanitary conditions in Accra could give rise to many scavenging birds, a situation that could pose a major threat to the safety of aircraft.

He explained that "improper waste disposal in the city provided foraging for birds like crows and vultures to cause bird strikes through collision of birds with aircraft."

Asamoah warned that the potential hazard of bird strike was becoming a real challenge to aviation managers in the sub-region, following recent dramatic increase in air traffic in countries such as Ghana, Nigeria and Cameroon.

Government of Ghana and its stakeholders will therefore be seeking to upscale sanitation services in the country through stronger stakeholder partnership during this year's annual stakeholder conference.

The 24th Mole Conference under the theme: ''Building Effective Partnership for Scaling-Up Sustainable Sanitation Services in Ghana", will take place in the second largest city, Kumasi, 270 km north of the capital.

It will be held at a time the West African country faces serious sanitation challenges, especially poor individual and community attitude, poor and inadequate facilities and negative socio-cultural issues that militate against the achievement of the MDG-7.

The Mole Conference is one of the biggest multi-stakeholder annual platforms in the Water, Sanitation and Hygiene (WASH) sector in Ghana, named after its maiden venue, Mole, in the Northern Region of Ghana.

Clearly, the problem of sanitation is huge and can only be tackled head-on with close collaboration and effective partnership backed by effective resource deployment.

Community members, traditional authorities, local government authority, national government, private sector and development partners must all pool resources to resolve the challenge, said hosts, the Coalition of NGOs in Water and Sanitation (CONIWAS).

CONIWAS hopes that the outcomes of the 24th Mole conference scheduled for Aug. 13-16, and the activities of the NGO coalition in general will be important in highlighting these critical issues at the district and community levels.

High on the agenda include key issues such as exploring options and opportunities for sustainable sanitation delivery in Ghana, and examining public-private partnership models for accelerated sanitation delivery, among others.

Theodora Adomao-Adjei, extensions services coordinator of the Community Water and Sanitation Agency (CWSA), said, "There is the need to work with stakeholders in order to achieve the MDGs on Sanitation, and so the theme is very appropriate."

The CWSA is the state agency in charge of water and sanitation services delivery in rural areas,

She urged the conveners to ensure that decisions taken at the conference are implemented so the conference does not become one of business as usual.

"Our sanitation coverage in Ghana is very low, and so the issue about partnership for up-scaling sanitation service delivery becomes very critical because you need the support of all to move sanitation forward in Ghana," she stressed.