Author Archives: WSSCC

Toilet touring in Uganda: experiencing the true spirit of Community-Led Total Sanitation

Patrick England, who recently joined the Global Sanitation Fund secretariat, travelled to Uganda to participate in a learning exchange mission. The mission turned out to be a unique opportunity to experience the true spirit of community-led total sanitation (CLTS). Read about his experiences below.

Representatives from Madagascar’s Fond d’Appui pour l’Assainissement (FAA) programme demonstrating CLTS facilitation in Amuria District. Credit: Patrick England/WSSCC

Representatives from Madagascar’s Fond d’Appui pour l’Assainissement (FAA) programme demonstrating CLTS facilitation in Amuria District. Credit: Patrick England/WSSCC

When I first entered the field of international development, I had no idea that ‘shit’ would become a standard part of my professional vocabulary. But as a Portfolio Support Analyst with the WSSCC’s Global Sanitation Fund (GSF), my mission is to discover and document everything about shit: how communities are dealing with it, and how to support our programme partners to tackle the world’s growing sanitation and hygiene crisis. So in June 2015, I received my first opportunity to become a professional toilet tourist with the GSF during a cross-programme exchange to Uganda.

Just prior to my Ugandan journey, I was working with Concern Universal, the GSF Executing Agency in Nigeria. I supported the development of case studies and lessons learned for the GSF-supported Rural Sanitation and Hygiene Promotion in Nigeria programme, which carries out Community-Led Total Sanitation (CLTS) activities in the south-east of the country. Similar to Uganda, Nigeria’s GSF-supported programme is fully owned and implemented by government agencies. However, for local officials and civil servants, the participatory, spontaneous, and dynamic ethos of CLTS often runs in direct contrast to decades of enforcing toilet construction. Not only must CLTS trigger improved sanitation and hygiene behaviour in communities themselves, but it must also trigger government authorities to create enabling environments for communities to climb the sanitation ladder.

CLTS learning journeys converge: the GSF cross-programme exchange
Dazed after two days of travel from Calabar to Kampala, I met my new Uganda colleagues in the rural district of Pallisa. Accompanying them was a delegation from Madagascar’s GSF-supported programme. While much could be written on this band of Malagasy medical doctors-cum-sanitation crusaders, let’s just say that they definitely know their ‘shit’. For them, CLTS isn’t just an approach to increase sanitation coverage and reduce under-five mortality; it’s an action-affirmative philosophy that underpins a movement to improve the health of entire countries. Most importantly, this movement must be wholly owned by communities themselves – a point continuously emphasized throughout our district visits in Uganda.

Map of districts visited in Uganda, based on image retrieved on d-maps.com.

Map of districts visited in Uganda, based on image retrieved on d-maps.com.

Our exchange crossed the entire country – from the shores of Lake Victoria to the jungles along the border with the Democratic Republic of the Congo – working alongside District Health Office staff to improve their CLTS approach. Led by the Malagasy doctors, each visit comprised a systematic review of existing practices, a hands-on demonstration of best-practice triggering and follow-up, and a critical self-analysis by health staff to enhance their community engagement. As was the case in Nigeria where decades of latrine enforcement and health sensitization failed to achieve any notable impact, this intensive learning process focused on ‘de-programming’ the old behaviours of local government facilitators.

Compared to Nigeria, where 25 percent of the population practices open defecation, Uganda has a relatively high level of sanitation coverage (where seven percent practice open defecation)[1]. This was made evident by the number of well-built latrines I observed during our visits to rural communities. Until then, I never entertained the notion that a toilet could be beautiful: walls carefully smoothed and polished, meticulously patterned with charcoal and red mud paint, all topped with round thatch roofs. One elderly woman in Koboko District proudly demonstrated how she used a local weed to give her latrine’s mud floor a glossy sheen. However, the presence of toilets – even those ornately designed – did not mean that these communities were open defecation free (ODF). These latrines frequently went unused, especially during planting and harvesting seasons, while a lack of adequate fly-proof covers and handwashing facilities meant that these community members were still unintentionally eating their own, and others’, shit.

Read the full blog on the WSSCC website

Not just another day

Global Handwashing Day is there to remind us of how simple the solutions to serious issues can be.

Global Handwashing Day is on the 15 October. Photograph: Concern Universal

Global Handwashing Day is on the 15 October. Photograph: Concern Universal

I’ve always been a sceptic when it comes to world “Days”. However noble the cause, what difference can they really make? The International Day of Peace – as if the various factions in Syria or Nigeria’s Boko Haram extremists paused from their daily destruction to consider alternative approaches. How many acres of forest are cleared for extracting resources or planting cash-crops every World Environment Day? Aside from providing a hook for advocacy press releases, how could those involved possibly think that one day could positively affect the suffering on the front lines of poverty and insecurity? Well, having run behaviour change projects in West Africa over the last five years I am beginning to believe that it can.

Today is Global Handwashing Day, and together with its cousin World Toilet Day on 19 November, it brings attention to the most basic issues – hygiene and sanitation – that to our shame still account for two million child deaths a year.

A third of the world’s population – 2.4 billion people – live with poor sanitation and hygiene which, according to the World Bank, costs countries $260 billion annually. Every day 2,000 children die before reaching their fifth birthday due to diarrhoeal diseases, the vast majority caused by poor sanitation and hygiene.

Diarrhoea alone killed far more young children in Nigeria over the last 12 months – around 150,000 – than Boko Haram’s slaughtering and the wars in Syria combined. Whilst we continue the daily search for even a hint of a resolution to these two brutal and complex conflicts, we already know the simple solution to tackling hygiene and sanitation-related diseases.

We know that handwashing with soap is the most effective and inexpensive way to prevent diarrhoeal diseases – reducing incidence by up to 47% – and combined with improved sanitation, this is boosted to 68%. We know that in countries with the highest child mortality rates as few as 1% of people wash their hands effectively, and that the global average is only 19%. Most frustratingly, effective tools and participatory methods are readily available and it is estimated that interventions that promote handwashing could save close to a million lives. So why is hygiene promotion not a focus of most development projects?

Read the full article in the WSSCC partner zone on the Guardian.

Learning, progress and innovation: Sanitation and hygiene promotion in Madagascar

Learn how the Global Sanitation Fund-supported programme in Madagascar is promoting sustainability and achieving strong sanitation and hygiene results trough a cycle of learning, progress and innovation.

Download the complete case study or explore the sections below:

The national context

Photo: Members of a local sanitation and hygiene advocacy group in the fokontany of Anjalazala celebrate achieving open defecation free status. Credit: FAA/Nirina Roméo Andriamparany

Photo: Members of a local sanitation and hygiene advocacy group in the fokontany of Anjalazala celebrate achieving open defecation free status. Credit: FAA/Nirina Roméo Andriamparany

The latest report from the Joint Monitoring Programme of the United Nations Children’s Fund and World Health Organization highlights revealing statistics on Madagascar’s sanitation and hygiene situation. Approximately 12 percent of the country’s population have access to improved sanitation, while 18 percent have access to shared sanitation that is unimproved, and 30 percent have access to other types of unimproved sanitation. Furthermore, 40 percent defecate in the open. Ensuring improved sanitation and hygiene for all remains a major challenge in the country, but innovations from local partners supported by the Global Sanitation Fund (GSF) are vigorously helping to transform this situation.
Learn more

The CLTS journey

Photo: ‘Triggering’ children in the commune of Mangarano, using the open defecation mapping tool. Credit: FAA/Fano Randriamanantsoa

Photo: ‘Triggering’ children in the commune of Mangarano, using the open defecation mapping tool. Credit: FAA/Fano Randriamanantsoa

In rural Madagascar, CLTS is the preferred approach for eliminating open defecation, and these actions also drive overall improvements in sanitation and hygiene. CLTS was introduced in the country in 2008, following its success in Asia. The crux of the approach lies in creating an enabling environment in which communities become self-reliant and improve their own sanitation and hygiene situation without external help.

Video: CLTS ‘triggering in action

CLTS focuses on igniting change in sanitation and hygiene behavior within whole communities, rather than constructing toilets through subsidies. During this social awakening, or ‘triggering’ process in Madagascar, the community looks for visible faeces in their environment. When people realize they are eating faeces this provokes disgust, shame and impacts on dignity. The community then makes and immediate decision to end open defecation. These steps are highlighted in the above video.
Learn more

Innovations in sanitation and hygiene behaviour change methods
As the first GSF programme, the Fonds d’Appui pour l’Assainissement (FAA) was the testing ground for various approaches based on the essence of CLTS, which helped to drive the programme’s learning and sharing culture. Sub-grantees have utilized a range of approaches within local communities, sharing their challenges and success with the larger FAA team. Through FAA’s strong learning and sharing system, many of these approaches have been evaluated for their potential to be implemented on a larger scale, and some have become best practices, both within and outside of Madagascar. This case study highlights three best practice approaches evaluated and utilized by the FAA programme: Follow-up MANDONA, local and institutional governance and sanitation marketing.

Follow-up MANDONA
Mandona-visual
Inspired by CLTS triggering approaches, Follow-up MANDONA is aimed at helping communities speed up their achievement of open defecation free status and initiate the development of local governance mechanisms for sustainability.
Learn more

Read the full article on the WSSCC website.

Boosting dialogue on sanitation and hygiene behaviour change and sustainability: WSSCC and SuSanA launch online learning event

The WSSCC Community of Practice on Sanitation and Hygiene in Developing Countries (CoP) and the global Sustainable Sanitation Alliance (SuSanA) launched an online learning event today on the topic, ‘Sanitation and hygiene behaviour change programming and sustainability: habit formation, slippage, and the need for long-term programming’. The learning event runs for three weeks from 22 September to 12 October on both the WSSCC CoP and SuSanA online discussion forum. People interested in the topic are encouraged to join and participate in the learning event.

Both platforms have over 5,000 members each working in water, sanitation and hygiene (WASH) and other related sectors. The learning event is therefore an opportunity to bring together these two global communities to share learning and ideas, identify best practice and explore links between research and practice on behaviour change. This is the first time the two networks have come together to host an online collaborative learning event.

The learning event is taking place simultaneously on both platforms, with a coordinator ensuring that content is shared across both communities. Discussions will look at a number of key issues relating to sanitation and hygiene behaviour change programming and sustainability. The main topic for discussion is divided into three inter-linked sub-topics, to further explore how behaviour change can be better understood and improved to ensure health and WASH outcomes are sustained. The sub-topics are:

  • Programming for scale, including the following key questions: What are some examples of successful scale-up? How did these models address the issues of inclusion and equity? In the cases of successful scale-up, were programmes initiated and sustained by governmental or non-governmental actors?  What is the role of the private sector in implementing sanitation at scale?
  • Sustainability for behaviour change, including the following key questions: How can behaviour change become systematized and sustained? What are the behavioural determinants and behaviour change techniques we should be aware of? What constitutes an enabling environment for sustainability?
  • Open defecation free (ODF) and slippage, including the following key questions: How is ODF defined? What are some of the local strategies in place to strengthen sustainability of ODF – within communities and beyond? What are the patterns of slippage? How and when can slippage be monitored in large-scale programmes? Are there more innovative ways looking at not only the physically visible aspects – what about the health impact and the perceptions and views of communities?

WASH sector experts leading the discussion include, among others:

  • Tracey Keatman, Senior Associate, Partnerships in Practice (learning event coordinator)
  • Suvojit Chattopadhyay, Consultant, focused on monitoring and evaluation
  • Poy Dy, Project Coordinator, Santi Sena (a Global Sanitation Fund (GSF) sub-grantee in Cambodia)
  • CLTS Knowledge Hub, Institute of Development Studies, University of Sussex
  • Clara Rudholm, Senior Programme Officer, Global Sanitation Fund
  • Carolien van der Voorden, Senior Programme Officer, Global Sanitation Fund
  • Matilda Jerneck, Programme Officer, Global Sanitation Fund

Weekly summaries of discussions will be posted on both the WSSCC CoP and SuSanA forum. In addition, a summary report of each topic, along with an overview of all issues generated from the discussions, will be available in late October on both platforms.

To join and participate in the discussions, visit the WSSCC CoP and SuSanA forum.

Questions can be posted directly on the platforms or sent to the following addresses: shcopadmin@wsscc.org and info@susana.org.

Global Sanitation Fund empowers close to 10 million to end open defecation

The latest results from the Global Sanitation Fund (GSF) show that national programmes stretching from Cambodia to Senegal have enabled close to 10 million people in more than 36,500 communities to end open defecation.

These results are published in the GSF’s latest Progress Report, highlighting cumulative results from the start of the fund up to the middle of 2015. Nationally-led programmes supported by the GSF have helped:

  • 8.21 million people access improved toilets
  • 9.92 million people in 36,524 communities live in open defecation free environments
  • 13.46 million people access handwashing facilities

Currently, 2.4 billion people, close to 35 percent of the global population, lack access to decent sanitation. Of those, close to a billion defecate in the open. Diarrheal disease, largely caused by poor sanitation and hygiene, is a leading cause of malnutrition, stunting and child mortality, claiming nearly 600,000 lives of children under 5 every year. Inadequate facilities also affect education and economic productivity and impact the dignity and personal safety of women and girls.

GSF reaches 10 million - Slider

Established by WSSCC, the GSF funds behaviour change activities to help large numbers of poor people in the hardest-to-reach areas attain safe sanitation and adopt good hygiene practices. These activities are community-led, support national efforts, and bring together a diverse group of stakeholders in order to address, at a large scale, the severe deficiencies in access to sanitation and hygiene.

The GSF is a pooled financing mechanism with the potential to further accelerate access to sanitation for hundreds of millions of people over the next 15 years. Between 2014 and mid-2015, the GSF reported a 95 percent increase in people with improved toilets across target regions in 13 countries. During this same period, the GSF has also supported a more than 40 percent increase in the number of people living in open defecation free environments in those same areas. The United Nations system has identified global funds as an important tool to enable member countries to achieve their national development targets, including those for sanitation and hygiene. Read more

Results reported by the GSF have been achieved due to the work of more than 200 partners, including executing agencies and sub-grantees composed of representatives from governments, international organizations, academic institutions, the United Nations and civil society. One of the strongest success factors in the GSF approach is that it allows flexibility for countries to develop their programmes within the context of their own institutional framework and according to their own specific sanitation and hygiene needs, sector capacity and stakeholders. This implementation methodology is used to reach large numbers of households in a relatively short period of time and is vital for scaling up safe sanitation and hygiene practices.

The Governments of Australia, Finland, the Netherlands, Norway, Sweden, Switzerland and the United Kingdom have contributed to the GSF since its establishment in 2008. More than $109 million has been committed for 13 country programmes, which aim to help more than 36 million people end open defecation.

Download the GSF Progress Update here

Can WASH deliver more than just sanitation?

Through successful WASH intervention, communities access a new service that improves their quality of life, and also learn about equity and inclusion.

Blog by development expert Suvojit Chattopadhyay

The abysmal state of access to safe water and sanitation facilities in the developing world is currently a major cause for alarm; 580,000 children die every year from preventable diarrheal diseases. This is due largely to the 2.5 billion people around the globe who do not have access to safe sanitation. Not only can an effective WASH intervention save lives, it can also engineer changes in the social fabric of communities that adopt these behavioural changes. This points to a key attribute of a successful WASH intervention – that through these programmes, communities not only access a new service that improves their quality of life, but they also learn from being part of a concrete intervention that emphasises equity and inclusion.

Let me explain how. Safe sanitation is essentially ‘total’. In a community, even one family practising open defecation puts the health of other families at risk. Also, unsafe sanitation practices pollute local potable and drinking water sources in the habitations. Together, this can undo any gains from partial coverage of WASH interventions. This much is now widely accepted by sanitation practitioners around the world. However, there remains a serious challenge when it comes to the implementation of this concept.

When a community is introduced to a WASH-focused behaviour change campaign, there are often variations in the levels of take-up in different families. This could be because of several barriers – financial ability, cultural beliefs, education levels, etc. In response, external agencies have many options. They can focus more on families in their behaviour change campaigns, offer them material and financial support or incentives, or exert peer pressure (which may in some cases become coercive, etc).

However, the best approach – whether facilitated by an external agent or not – is for a community to devise a collective response. The issue should be framed as a collective action problem that requires solving for the creation of a public good. In many instances, communities have come together to support the poorest families – social engineering at its finest. At its best, recognising the needs of every member of a community will lead to a recognition of the challenges that the typically marginalised groups face. It is this recognition that could prompt a rethink of social norms and relationships.

Read the full article on the WSSCC Guardian partner zone.

Can We Finance Sustainable Development?

Huffington Post blog by Chris Williams, WSSCC Executive Director

The Millennium Development Goals (MDGs) have been the most comprehensive international poverty alleviation movement in history. Since 1990, extreme poverty has been cut by half; 17,000 fewer children die each day; and 2.3 billion people gained access to clean drinking water. A multi-stakeholder coalition of governments, international organizations, and civil society groups have tackled crucial issues ranging from education to improved sanitation to gender equality.

And yet, the challenge of empowering hundreds of millions more to gain access to proper healthcare, sanitary facilities, and education is enormous. As more countries have attained middle-income status, inequality has soared. The wealthiest individuals have become wealthier while growth-with-equity remains a distant prospect.

In Dodoma, Tanzania, a community group comes together every Saturday to organize their finances. Villagers earn interest on their savings and give out loans. Everyone plays a role - here three keyholders open the chest containing the loan registrations. Photograph: WSSCC/Jenny Matthews

In Dodoma, Tanzania, a community group comes together every Saturday to organize their finances. Villagers earn interest on their savings and give out loans. Everyone plays a role – here three keyholders open the chest containing the loan registrations. Photograph: WSSCC/Jenny Matthews

This week, the global development community will congregate in Addis Ababa to decide how to finance the next fifteen years of inclusive growth and the elimination of poverty. The positive news is that Member States have painstakingly created a set of Sustainable Development Goals (SDGs), a comprehensive post-2015 plan that will strike at the heart of global poverty, and set the poorest nations and communities on the path towards equitable and long-lasting growth.

While the goals seek to augment, broaden, and expand upon the wide-ranging successes of the MDGs, the sobering fact is that the conventional model for financing development is in need of a massive overhaul. Traditional channels of overseas development assistance (ODA) from developed nations to the developing world are not only insufficient for financing the ambitious post-2015 agenda, but it’s clear that development as we know it is no longer relevant, nor desirable.

No longer relevant, because the world has changed and the expertise that will drive post-2015 growth is being cultivated in-country by capitalizing on local solutions. And no longer desirable, because much of the development assistance has been self-serving and ineffectively utilized in the first place. The system is broken and it is time to redo development, building from the ground up.

This week’s conference on how to finance development is therefore a seminal turning point for how we will solve some of the most intractable development challenges of the day. A turning point because there is recognition from donor countries that they need to be more effective in selecting funding priorities and disbursing ODA. And a turning point in that the developing countries are realizing that the solution lies at their fingertips.

Developing countries harbour a technical knowledge base within their borders – the expertise, innovations, and solutions necessary for inclusive growth are home-grown and just waiting to be tapped. Increasingly, innovative citizens are creatively devising south-south, country-to-country delivery models for development. Channelled effectively, this has the potential to finance the vast majority of sustainable growth in the developing world.

This is a radical departure from the traditional paradigm of massive donor-funded agencies issuing a loan, which often takes three years to develop, 100 staff to implement, and then is neither tracked nor delivered. Donor funds can now form a much smaller portion of the resources required to solve the development challenges in the global South. The question for governments that continue to provide official ODA is therefore how best to apply funds that can leverage these different sources of domestic capital?

One of the answers lies in innovative financing methods for development. Global multi-stakeholder partnerships have proven successful in the field of health, including the Global Fund to Fight AIDS, Tuberculosis and Malaria, the Global Sanitation Fund (GSF), and the Vaccine Alliance (GAVI). All of these funds use ODA efficiently by leveraging community savings, public investment and private capital, therefore putting into action the principles behind the SDGs.

The GSF, a fund administered by my organization, the UNOPS-hosted Water Supply and Sanitation Collaborative Council (WSSCC), invests in behavior change activities that enable large numbers of people in developing countries to improve their sanitation and adopt good hygiene practices. The only global fund solely dedicated to sanitation and hygiene, the GSF is light of foot and heavy on scale. Households and local governments work with local entrepreneurs and a network of hundreds of partners. Together, they create the conditions for tens of millions of people to live in open defecation free environments and access adequate toilets and handwashing facilities.

Importantly, individual household investments in sanitation mobilized by GSF programming currently amount to four times the value of its funding. A grant of $5 million can therefore yield $20 million in community savings per country. The most powerful by-product of this investment then materializes in the form of public capital, once governments realize the commitment that their people have made. Private sector engagement is yet another positive outcome, as demand for products and services is generated through the behavior change of society. This is the exact model that the development world is seeking -community-based solutions that are government supported and commercially operated.

Read the full article on Huffington Post