Testing CLTS Approaches for Scalability: Nepal Learning Brief

Pour Flush Toilet in Nepal. Photo Credit: Vidya Venkataramanan

Plan International supports Community-led Total Sanitation (CLTS) implementation in a number of districts in Nepal. In this learning brief, we review Plan International Nepal’s CLTS activities. We found government targets and definitions to be ambitious while decentralized planning allowed a focus on community-led processes. Plan International and other sanitation practitioners can support CLTS outcomes by providing post-triggering training and technical support to community volunteers, focusing on achieving gradual, yet sustained outcomes in program areas, and continuing to work with local governments to ensure that financing mechanisms for the poor are locally developed and equitable.

Link to learning brief: https://waterinstitute.unc.edu/files/2015/11/learning-series-nepal-learning-brief-2015-11.pdf

Citation: Community-led Total Sanitation in Nepal: Findings from an Implementation Case Study. Venkataramanan, Vidya, Alexandra Shannon, and Jennifer Bogle. 2015. Chapel Hill, USA: The Water Institute at UNC.

New Video Offers Five Lessons for Sanitation Policy and Practice

A new video from Plan International and the Water Institute at UNC offers a preview of five exciting lessons on sanitation policy and practice, based on findings from operational research on community-led total sanitation (CLTS). These lessons relate to CLTS planning at the national and local levels, its place in national sanitation systems, and the importance of involving local actors. In particular, government officials, teachers, and natural leaders can play important roles in improving access to basic sanitation, and their involvement can ensure sustainable outcomes over time.

Livestream of Bonn WASH Nutrition Forum – November 11 & 12, 2015

The Bonn WASH Nutrition Forum is going to have a livestream on the 11th and 12th November. It will start at 10am CET on the 11th November.

• Link to the Livestream
• Agenda | Day 1 | Day 2

Why should I watch the livestream of the Bonn WASH Nutrition Forum on 11th & 12th November, 10am CET? This innovative forum that will bring WASH experts and their Nutrition Expert counterparts together, but not only in the audience. 

Overcoming malnutrition is a great challenge that will require true collaboration between the WASH and nutrition sectors. The main aim of the forum is to bring together the relevant experts from both sectors.

We intend to have an effective mix of thematic inputs and discussions during so-called “mirror sessions”. Here, relevant sector professionals in similar positions from both the WASH and Nutrition sector will be asked to present their work / perspective.

Water, Sanitation, Hygiene, and Nutrition in Bangladesh:

Water, Sanitation, Hygiene, and Nutrition in Bangladesh” Can Building Toilets Affect Children’s Growth? 2015.

• Full text

Authors: Iffat Mahmud and Nkosinathi Mbuya. World Bank.

This report provides a systematic review of the evidence to date, both published and grey literature, on the relationship between water and sanitation and nutrition. 

We also examine the potential impact of improved water, sanitation, and hygiene (WASH) on undernutrition. This is the first report that undertakes a thorough review and discussion of WASH and nutrition in Bangladesh.

The report is meant to serve two purposes. First, it synthesizes the results/evidence evolving on the pathway of WASH and undernutrition for use by practitioners working in the nutrition and water and sanitation sectors to stimulate technical discussions and effective collaboration among stakeholders.

Second, this report serves as an advocacy tool, primarily for policy makers, to assist them in formulating a multisectoral approach to tackling the undernutrition problem.

Unilever unveils new film and rural programme about handwashing with soap for newborn survival

Unilever’s health soap, Lifebuoy introduced ‘Chamki’, a compelling new film to raise awareness of the importance of handwashing with soap for new mums as part of Lifebuoy’s Help A Child Reach 5 handwashing programme.

This year, the campaign focuses on a child’s neonatal period (the first 28 days of life). It also coincides with the launch of a partnership with the Children’s Investment Fund Foundation (CIFF) to scale up Lifebuoy’s handwashing programmes in rural Bihar, India.

The newest Help a Child Reach 5 film was developed by Mullen Lowe Group and shot by the famous feature film director, Anand Gandhi. The film showcases the emotional journey of a real pregnant mother and her aspirations for her child.

It highlights the importance of doing something very simple, yet important during pregnancy and early in the child’s life: washing hands with soap.

University of Maryland celebrates Global Handwashing Day 2015

For the fourth year, students from the Global Public Health Scholars program at the University of Maryland, College Park visited the Center for Young Children (CYC), a laboratory school on the UMD campus. 

Children at the CYC arrive in the morning and make their way to the child-sized sinks to wash their hands. They bring the skill home, reminding their families to wash hands after they use the bathroom and before dinner.

Global Public Health Scholars visited the Kindergarten class in the Blue Room, sang handwashing songs, led a handwashing educational activity using the “Glo-Germ,” and worked with the children to make a beautiful Global Handwashing Day banner. 

The activity raised awareness about the importance of handwashing for disease prevention and alerted children, college students, and parents about many events happening to celebrate Global Handwashing Day around the world.

Recent WASH studies on NTDS, shared sanitation, detection of E. coli

The Effect of Hygiene-Based Lymphedema Management in Lymphatic Filariasis-Endemic Areas: A Systematic Review and Meta-analysis. PLoS NTDs, Oct 2015. Authors: Meredith E. Stocks, Matthew C. Freeman, David G. Addiss.

Full text: http://goo.gl/J9WBEM

For people who already have lymphedema, WHO recommends simple hygiene-based measures that include skin care and limb movement. Yet only a small proportion of those with LF-related lymphedema have been trained in these measures. To determine the effectiveness of hygiene-based lymphedema management, we reviewed the scientific literature. Overall, use of hygiene-based measures was associated with 60% lower odds of inflammatory episodes, known as “acute attacks,” in the affected limb. Hygiene is also effective for managing LF-related lymphedema and reducing suffering caused by acute attacks. Training people with lymphedema in hygiene-based interventions should be a priority for LF programs everywhere.

Evaluation of an Inexpensive Growth Medium for Direct Detection of Escherichia coli in Temperate and Sub-Tropical Waters. PLoS One, Oct 2015. Authors: Robert E. S. Bain , Claire Woodall, John Elliott, Benjamin F. Arnold, Rosalind Tung, Robert Morley, Martella du Preez, Jamie K. Bartram, Anthony P. Davis, Stephen W. Gundry, Stephen Pedley

Full text: http://goo.gl/O6fOTk

We developed a new low-cost growth medium, aquatest (AT), and validated its use for the direct detection of E. coli in temperate and sub-tropical drinking waters using IDEXX Quanti-Tray®. AT is reliable and accurate for the detection of E. coli in temperate and subtropical drinking water. The composition of the new medium is reported herein and can be used freely.

Shared sanitaion for the urban poor: understanding what works

The MapSan study aims to explore the links between sanitation, population density, and health outcomes in Maputo, Mozambique. The video describes a controlled, before-and-after trial of an urban sanitation intervention to reduce enteric infections in children:

WASHplus Weekly: Lessons Learned in Sanitation

Issue 211 | Oct. 23, 2015 | Lessons Learned in Sanitation

This issue includes studies and resources on lessons learned and innovative approaches in sanitation. Included are a UNICEF learning series, recent studies from USAID, and studies on fecal sludge management, urban sanitation, hygiene, and behavior change.

• Print version

UNICEF

UNICEF East and Southern Africa Region Sanitation and Hygiene Learning Series. Link
This series is designed to improve knowledge of best practice and lessons learned in sanitation and hygiene programming across the region. The series has been funded in part by the Bill and Melinda Gates Foundation in support of improved knowledge management in the sanitation sector.  Field notes, technical briefs, and journal articles are written by practitioners for practitioners and should encourage adoption of innovative or new approaches and technologies within the region and contribute to scaling up access to sanitation and hygiene for the most under-served.

Documents included in the series are:

• Going Beyond ODF: Combining Sanitation Marketing with Participatory Approaches to Sustain ODF Communities in Malawi
• CLTS in Fragile and Insecure Contexts: Experience from Somalia and South Sudan
• Triggering Handwashing with Soap in CLTS: Insights on What Works from Malawi
• Real-Time Monitoring of Rural Sanitation at Scale in Zambia Using Mobile-to-Web Technologies
• Micro-Planning for CLTS: Experience from Kenya
• Evaluation of the SOPO School Handwashing Promotion Programme: Nyanza and Rift Valley Provinces, Kenya
• Key Findings of a Sanitation Supply Chains Study in Eastern and Southern Africa

USAID

USAID/West Africa Sanitation Service Delivery – Making Kumasi a Cleaner City.PSIIMPACT, Sept 2015. D Ward. Link
Dana Ward, PSI country representative in Ghana and chief of party for Sanitation Service Delivery (SSD) Project in Ghana, Benin, and Cote d’Ivoire interviewed Anthony Mensah, director, Waste Management Department Kumasi Metropolitan Authority, about the city’s strategy to make Kumasi among the five cleanest cities in Africa. 

Water and Sanitation Assistance: USAID Has Increased Strategic Focus but Should Improve Monitoring, 2015. GAO. Link
The U.S. Government Accountability Office recommends that USAID take steps to improve monitoring and reporting of WASH activities by identifying and addressing reasons for Missions’ inconsistent adherence with Agency guidance. USAID generally concurred with the recommendations and, in particular, outlined steps it is taking to address the report’s second recommendation.

INNOVATIVE APPROACHES

Innovative Tools for Sanitation Capacity Mapping and Planning in Kenya, 2015. Water and Sanitation Program. Link
Lack of capacity is a major bottleneck that hinders progress in achieving access to sanitation. The Water and Sanitation Program has developed and tested a set of practical tools designed to support clients at the local level as they plan, build, and sustain sanitation capacity.

Plan International – Testing CLTS Approaches for Scalability: Indonesia Learning Brief

Testing CLTS Approaches for Scalability: Indonesia Learning Brief, 2015. Plan International.

Sanitation Marketing Project in Grobogan District, Indonesia. photo credit to Jonny Crocker

• Link to Learning Brief

Plan International supports Community-led Total Sanitation (CLTS) implementation in a number of sub-districts in Indonesia.

In this learning brief, we review the roles of local actors in Plan International Indonesia’s program activities and highlight considerations for scalability, planning, implmentation, and evaluation.

Plan International and other sanitation practitioners can support the national government and local actors by placing more responsibility on sub-district staff to lead triggering, enlisting the added support of village facilitators to lead post-triggering, and scaling up village-based financing mechanisms to sustain CLTS outcomes.

Link to project website: http://waterinstitute.unc.edu/clts/