Author Archives: dietvorst

The true costs of participatory sanitation

Plan International USA and The Water Institute at UNC have conducted the first study to present comprehensive, accurate, disaggregated costs of a WaSH behaviour-change programme.  The study calculated programme costs, and local investments for four community-led total sanitation (CLTS) interventions in Ghana and Ethiopia.

CLTS cost study highlights.jpg

Jonny Crocker, Darren Saywell, Katherine F. Shields, Pete Kolsky, Jamie Bartram, The true costs of participatory sanitation : evidence from community-led total sanitation studies in Ghana and Ethiopia. Science of The Total Environment, vol. 601–602, 1 Dec 2017, pp: 1075-1083. DOI: 10.1016/j.scitotenv.2017.05.279 [Open access]

Abstract

Evidence on sanitation and hygiene program costs is used for many purposes. The few studies that report costs use top-down costing methods that are inaccurate and inappropriate. Community-led total sanitation (CLTS) is a participatory behaviour-change approach that presents difficulties for cost analysis. We used implementation tracking and bottom-up, activity-based costing to assess the process, program costs, and local investments for four CLTS interventions in Ghana and Ethiopia. Data collection included implementation checklists, surveys, and financial records review. Financial costs and value-of-time spent on CLTS by different actors were assessed. Results are disaggregated by intervention, cost category, actor, geographic area, and project month. The average household size was 4.0 people in Ghana, and 5.8 people in Ethiopia. The program cost of CLTS was $30.34–$81.56 per household targeted in Ghana, and $14.15–$19.21 in Ethiopia. Most program costs were from training for three of four interventions. Local investments ranged from $7.93–$22.36 per household targeted in Ghana, and $2.35–$3.41 in Ethiopia. This is the first study to present comprehensive, disaggregated costs of a sanitation and hygiene behaviour-change intervention. The findings can be used to inform policy and finance decisions, plan program scale-up, perform cost-effectiveness and benefit studies, and compare different interventions. The costing method is applicable to other public health behaviour-change programs.

Lessons learned from WASH and NTD projects

wash-combat-ntd-150pxWater, sanitation and hygiene (WASH) are essential for preventing and managing diseases including neglected tropical diseases (NTD) which affect over 1 billion people among the poorest communities.

Closer coordination of WASH and NTD programmes is needed to ensure WASH services are reaching the most vulnerable populations. Many WASH and NTD actors have started to work together on the planning and implementation of their projects and have documented their experiences and lessons learnt.

The World Health Organization (WHO) has published a paper that draws on examples from eighteen countries to summarise emerging successes and challenges. Several examples relate to WASH in Schools projects. Two case studies are highlighted: the Lao PDR and Cambodia CL-SWASH initiative and the CARE Integrated WASH and NTDs Programme in Ethiopia.

WHO, 2017. Water, sanitation and hygiene to combat neglected tropical diseases : initial lessons from project implementation. Geneva, Switzerland: World Health Organization. 6 p. WHO reference number: WHO/FWC/WSH/17.02. Available at: www.who.int/water_sanitation_health/publications/wash-to-combat-neglected-tropical-diseases/en/

 

#InDeepShit

By Ingeborg Krukkert, Lead Asia Programmes | Sanitation and hygiene specialist, IRC

Human beings are being used to plug the gaps in failing sanitation systems – Bezwada Wilson.

#InDeepShit is the title of an event I attended on Saturday 22 April 2017. Talking about toilets and who is able to use one – or not; talking about who cleans them and how – sometimes literally with their hands deep in shit. I know this does not sound like an event a sane person would like to join on their day off. But you are mistaken! And I was not the only one. Around 80 young and critical people in the room showed that this was an event important enough to spend their free Saturday morning on.

I was triggered by the quote on the invitation saying: “Any human cannot clean somebody’s shit for the sake of roti. This is Independent India?”. The quote is from Bezwada Wilson, an Indian activist against manual scavenging. He was one of eight very interesting speakers invited to address the meeting. They covered a wide range of challenges: from barriers disabled people face when wanting to use a toilet (“we can’t hire you because we do not have a toilet for you”), to safety issues for transgender people (“we have progressive laws on paper, but this is not what I encounter in real life”), to accountability and manual scavenging.

Nine years

Almost nine years ago Bezwada Wilson was an inspiring and eloquent speaker at the IRC Symposium on Urban Sanitation for the Poor. Nine years and the same problems still need to be addressed. At that time he said: “sanitation is much broader than simply toilets. Effective sanitation also requires hygiene education – people have to change their practice as well as get access to toilets. It is inevitable that the main focus is on the early part of the chain (building toilets), but there is increasing awareness that the most difficult problems relate to the removal of faecal sludge […]. In many cities, treatment, disposal or reuse is not managed” and – as Bezwada Wilson put it so eloquently in his presentation during the symposium: “human beings are being used to plug the gaps in failing sanitation systems”.

Bezwada Wilson

Bezwada Wilson

Nine years later, this is exactly what is happening with the Swachh Bharat Mission. With the hard deadline of 2019 to reach the target of a toilet for every household, state and districts seem to have no choice but to focus on constructing toilets and on doing it fast. More than 700 million toilets to go…. There is no time to focus on use, no time to focus on what is happening with all that human waste after using the toilet, no focus on what happens when the pit is full, and no focus on who is emptying the toilet or how it is done.

Nine years of activism and there is still manual scavenging. Bezwada Wilson has not changed; he seems more motivated than ever. And with reason! It’s not only about dignity, safety is a huge issue too. Workers are dying, even in 2017, he points out referring to the recent sewage plant accident in Noida.

Chief Executive VK Madhavan from WaterAid India, however, also sees positive developments. He acknowledges that we cannot change where we are born, or in which family or caste. So true and yet so easy to forget: that privilege – or not – is no contribution of us as individuals, no contribution at all. What we can do is provide a space to those who are denied to speak up or to interact with the government. That is why WaterAid India together with Youth Ki Awaaz organised this event. Youth Ki Awaaz is India’s largest platform where young people can publish their stories to drive impact.

And this is what Bezwada Wilson has also done. He is founder and National Convenor of the Safai Karmachari Andolan (SKA), a national movement committed to the total eradication of manual scavenging and the rehabilitation of all scavengers for dignified occupations. SKA was instrumental in eradicating manual scavenging in as many as 139 districts in India since 2009. He created a change of perspective. And he is not alone. Mrs Lali Bai, a former manual scavenger, also shared her experiences with us. She is now an activist and founder of Rashtriya Garima Abhiyan, a national campaign for dignity and eradication of manual scavenging. For a long time many of us, including government officials, ignored or even denied the existence of manual scavenging. But there are many examples that manual scavenging is still going on as this picture from Cambodia shows.

Manual scavenger in Cambodia (photo by Danny Dourng)

Manual scavenger in Cambodia (photo by Danny Dourng)

Any shortcuts to change?

In India more and more authorities start to acknowledge the problem. Our role is to provide space to make this happen. It all goes terribly slowly though and I asked the panel if there is no shortcut to change. Nobody could answer that question. Can you?

The blog was originally posted on 24 April 2017 on the IRC website.

World Bank targets smarter sanitation communication for rural Ethiopia

By Peter McIntyre, IRC Associate

The World Bank in Ethiopia has commissioned a rapid survey of what motivates people to upgrade their latrines, with the aim of delivering behaviour change communication materials with greater impact.

Ethiopia Worldbank_bcc_launch_2_addis_230317

Sanitation rapid survey launch meeting Addis Abeba, 23 March 2017 (Photo: Sirak Wondimu)

The survey is being conducted in four regions, with the main target audiences being adult women, male heads of households, opinion leaders and existing sanitation businesses.

The aim is to pilot and produce materials that emphasise the dignity, prestige and status of having improved sanitation, rather than focusing only on health messages.

The WB decided a new approach was needed after Demographic and Health Survey (DHS) figures for 2016 suggested that only 4% of rural households in Ethiopia have improved toilets facilities while a further 2% have facilities that would be considered improved if they were not shared. This is well below the Joint Monitoring Program figure of 28% for improved latrines (although we understand this may be revised down to around 14%). Indeed, according to DHS, although access to some form of sanitation has risen, access to an improved latrine has declined in percentage terms over the past ten years. Most latrines in rural areas (55%) do not have an effective slab or lid while more than a third of rural households (39%) practise open defecation.

The Government of Ethiopia has a flagship programme to increase use of improved latrines to 82% by 2020.

At a launch meeting in Addis on 23 March 2017, social market consultant, Addis Meleskachew, said that this initiative will develop a memorable brand for marketing materials that will encourage the private sector to provide materials and will attract rural families to buy them.

Dagnew Tadesse,Hygiene and Environmental Health Case Team Leader for Ministry of Health, welcomed the initiative to attract business but emphasised that the GoE approach is based on a comprehensive health education strategy with multiple messages including hygiene awareness, handwashing and safe food, and said that these important messages should not be abandoned.

Jane Bevan, rural WASH Manager at UNICEF Ethiopia offered to share extensive data that UNICEF has collected for its country programme on attitudes to sanitation, which has identified the high cost of concrete slabs as a significant obstacle. She presented examples of low cost options for upgrading sanitation in a pilot project in Tigray region. It was agreed to collate all existing KAP studies and relevant data including research by SNV.

Monte Achenbach from PSI and John Butterworth from IRC spoke about the work being started by USAID Transform WASH to market innovative sanitation models. John Butterworth said there is a need to make people aware of what is available and to get materials to where they are needed.

The World Bank research is being conducted by 251 Communications.

This blog was originally posted on 5 April 2017 on the IRC website.

A financially viable and safe solution for managing human waste

Collecting small monthly payments will help waste collectors build their business.

Bangladesh - pit latrine empytiers

Pit latrine workers in Bangladesh collecting and transporting human waste to a site where it is processed into fertiliser. Image: Neil Palmer (IWMI). Credit: University of Leeds

Spreading the cost of emptying pit latrines over a series of monthly payments could make it more affordable for poor households and help kick start the safe reuse of faecal sludge as fertiliser and biogas. This is the conclusion of a willingness-to-pay study carried out in a rural sub-district of Bangladesh covered by the BRAC WASH Programme II.

The study has already caught the attention of policymakers, and influenced the development of Bangladesh’s first regulatory framework for faecal sludge management. Some of the authors are members of the Bangladesh National Committee for Fecal Sludge Management.

Currently, households struggle to pay a lump sum of US$13 every three to four years to empty their pit latrines. This is approximately 14% of their monthly income. Instead, the study found they could pay small monthly payments of as little as US$ 0.31 per month, comparable to what they spend each month on a mobile phone service. These up-front payments help waste collectors to invest in the development of their service. Nevertheless, a government subsidy would still be needed to cover the full cost of safe removal and transport of faecal sludge.

As mentioned above, there is potential for waste collectors to generate extra revenue by converting faecal waste into fertiliser and biogas. The profitability of these waste by-products, however, can be effected by existing subsidies for chemical fertilisers and conventional fuels. Another factor that can reduce profitability is the low energy or calorific value of human waste compared to other organic wastes. A companion study carried out as part of the BRAC WASH Programme II tested solutions to increase the calorific value by co-processing human waste with other agricultural wastes.

The willingness-to-pay study is an output of the Value at the end of the Sanitation Value Chain (VeSV) research project, lead by the University of Leeds. VeSV was one of six action research projects funded by the Embassy of the Kingdom of the Netherlands (Bangladesh) through IRC. Additional funding was provided by the CGIAR Research Program on Water, Land and Ecosystems.

For more information read “Spreading the cost to transform sanitation“, published by the University of Leed’s School of Civil Engineering, 22 March 2017.

Citation: Balasubramanya S, et al. (2017) Towards sustainable sanitation management : establishing the costs and willingness to pay for emptying and transporting sludge in rural districts with high rates of access to latrines. PLoS ONE 12(3): e0171735. doi:10.1371/journal.pone.0171735

This news item was originally published on the IRC website, 27 March 2017.

March is #WaterActionMonth!

Water Action Month

Organizations around the world are coming together behind a common goal of keeping governments accountable to promises made with regards to providing safe water and sanitation to all.

To support them in this work, End Water Poverty is organizing exciting conversations to cover important aspects of water, sanitation, and hygiene. These webinars are open to the public, so please share these widely amongst your networks:

– Thursday March 16th; 3:30 PM GMT: “Realizing the Human Right to Water and Sanitation
Register here: http://bit.do/WAM-webinar-HRTWS

– Thursday March 23rd; 3:30 PM GMT: “How to Finance an End to the Water and Sanitation Crisis”
Register here: http://bit.do/WAM-webinar-Finance

– Tuesday March 28th; 3:30 PM GMT: “How and Why to Involve Children and Youth in WASH Initiatives”
Register here: http://bit.do/WAM-webinar-Youth

Join the conversation this Water Action Month!

Tender: SuSanA Stakeholder Market Study

On behalf of SuSanA (Sustainable Sanitation Alliance), the Stockholm Environment Institute (SEI) has launched an open and global Invitation to Tender  to produce a Stakeholder Market Survey consisting of a baseline market assessment, a communications strategy for SuSanA and a template for measuring the impact of SuSanA on the targeted market. All this to improve SuSanA’s reach, its content as a Knowledge Management (KM) platform and its impact on stakeholder’s work. Tenders are due April 3rd, 2017.

Download tender

See also here on SuSanA Discussion Forum.