Category Archives: Africa

San-Dem: Formative Research in Zambia: Briefing Note – SHARE

San-Dem: Formative Research in Zambia: Briefing Note. SHARE, November 2017.

Conclusions: Shared sanitation in Bauleni compound and possibly other similar settings present challenges for coordinating, cleaning and ensuring proper use of toilets by plot members. Share_Logo_MAIN_STRAP_RGB

Improvements are dependent on landlords whose primary motives for making these improvements are financial, social, and familial.

Properly designed demand-side interventions may be able to increase peri-urban sanitation quality in a cost-effective way.

Recommendations for the intervention

  • Target landlords as the primary target audience because they are responsible and financially capable of making toilet improvements.
  • Aim towards strengthening social cohesion on plots, as toilets are maintained as a shared resource
  • Primarily use the status and nurture motives, which scored highest, while also emphasizing justice and disgust to promote social cohesion and cleanliness
  • Encourage the use of different financial investment schemes by landlords to encourage savings for deliberate, planned toilet improvements

What We’re Learning: Long-Term Outcomes of USAID’s Water and Sanitation Efforts

What We’re Learning: Long-Term Outcomes of USAID’s Water and Sanitation Efforts. by Globalwaters.org, September 2017.

Authors: Annette Fay, Water Communications and Knowledge Management Project monitoring and evaluation specialist and lead researcher for the evaluation series, and Elizabeth Jordan, USAID water and sanitation specialist.globalwaters2

To better understand the long-term impact and sustainability of its interventions, the USAID Water Office is conducting a series of independent ex-post evaluations of the Agency’s water, sanitation, and hygiene (WASH) activities to inform future USAID investments in the sector.

This evaluation series will help USAID understand whether and how its activity results have been sustained years after projects close. All activities included in the series must have been closed for a minimum of three years and could not be recipients of Office of U.S. Foreign Disaster Assistance or Food for Peace funding. Preference is given to USAID missions that are at a point in their design cycle to incorporate learnings into upcoming WASH programs.

This evaluation series builds upon USAID and Rotary International’s WASH Sustainability Index Tool, which is a framework to assess a WASH activity’s likelihood to be sustainable according to five factors: availability of finance for sanitation, local capacity for construction and maintenance of latrines, the influence of social norms, and governance.

In September 2016, the first evaluation in this series studied the Madagascar Rural Access to New Opportunities for Health and Prosperity (RANO-HP) activity.

What We Did

RANO-HP, implemented by a consortium led by Catholic Relief Services from 2009 to 2013, aimed to increase sustainable access to safe water supply, improve sanitation coverage, and expand hygiene practices.

This evaluation of RANO-HP focused on the sustainability of the activity’s sanitation and hygiene components, which included community-led total sanitation (CLTS), behavior change messaging, public WASH “monoblocks” (combined public water point, latrine, shower and laundry station) managed via public-private partnerships, commune-level water and sanitation business plans, village savings and loans associations (VSLAs), and microfinance products for sanitation investments. Through household survey and interviews with beneficiaries the evaluation team explored barriers and facilitators of sustainability.

Read the complete article.

WSSCC Releases New Global Sanitation Fund Equality and Non-Discrimination Study

How can WASH programmes leave no one behind, as called for in the Sustaionable Development Goals? WSSCC’s new study, Scoping and Diagnosis of the Global Sanitation Fund’s Approach to Equality and Non-Discrimination, helps answer this question.

The study reveals that many people who may be considered disadvantaged have benefited positively from WSSCC’s Global Sanitation Fund (GSF)-supported programmes, particularly in open defecation free verified areas. In addition, a range of positive outcomes and impacts related to empowerment, safety, convenience, ease of use, self-esteem, health, dignity, an improved environment and income generation were reported by people who may be considered disadvantaged.

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Photo Credit: WSSCC

However, the study finds that GSF has not yet systematically integrated EQND throughout the programme cycle. Across all countries, there are people who have either fallen through the net or whose lives have become more difficult after being unduly pressured, or after taking out loans and selling assets to build toilets. More proactive attention is needed throughout the programme cycle to build on current successes and ensure that people are not left behind or harmed through the actions or omissions of supported programmes.

GSF is in the process of putting the study’s recommendations into practice through revised guidelines, minimum standards, practical tools and other mechanisms.

Download the full study, plus a summarized version with GSF reflections, and annexes

Global Waters Radio: Establishing a Sustainable Market for Water Purification Tablets in Ghana

Global Waters Radio: Establishing a Sustainable Market for Water Purification Tablets in Ghana. Global Waters, July 18, 2017.

“We feed ourselves out of the sale of Aquatabs — so financially, Aquatabs has helped given us a very sustainable job, and we are proud of it.” 

Ernest Saka Ansong is managing director for Health Top Up Services, a private Ghanaian company that serves as Aquatabs’ official importer. Photo Credit: Health Top Up Services

Ernest Saka Ansong is managing director for Health Top Up Services, a private Ghanaian company that serves as Aquatabs’ official importer. Photo Credit: Health Top Up Services

Aquatabs are one of the world’s most popular water purification tablets, produced by Medentech, a company specializing in manufacture of disinfection products.

Through partners, more than 11 billion liters of water were treated with Aquatabs worldwide in 2016.

First introduced to the Ghanaian market roughly 10 years ago by the USAID Ghana Sustainable Change Project, the tablets remain in high demand today — more than 4 million tablets were sold in Ghana alone in 2015, with similar sales figures in 2016.

Why so popular after all these years? First and foremost, affordability — but also a proven ability to bolster community health, and reduce the prevalence of dangerous waterborne illnesses like cholera.

Read the complete article.

Global Waters: In Mali, Communities Take Health and Well-Being into their Own Hands

In Mali, Communities Take Health and Well-Being into their Own Hands. Global Waters, July 18, 2017.

In the center of Simaye village in Mali’s Mopti Region, men, women, and children gather under a large tree to listen. Two USAID-trained facilitators discuss the health challenges facing the village.

Tackling open defecation in communities is a starting point for improved health. Ensuring the drinking water sources are clean is another. USAID works with local artisans in communities like Anga to repair or rehabilitate artesian drilling, such as this one, as an incentive to become ODF-certified. Photo Credit: CARE Mali

Tackling open defecation in communities is a starting point for improved health. Ensuring the drinking water sources are clean is another. USAID works with local artisans in communities like Anga to repair or rehabilitate artesian drilling, such as this one, as an incentive to become ODF-certified. Photo Credit: CARE Mali

Only three latrines serve many families, so more than half of the people are practicing open defecation; the water point no longer functions, so most families are pulling dirty water from the river; many of the infants and young children are not benefitting from exclusive breastfeeding or a diversified diet, so they are malnourished.

Holding a glass of clear water and pointing to feces on the ground, the facilitators paint a clear picture of the health risks associated with leaving feces in the open — contaminated drinking sources, diarrheal disease, and poor outcomes for children and their families.

Their objective: to trigger a sense of disgust, a determination in the community to control their own health and well-being, and to set in motion plans and solutions to create open defecation free (ODF) communities through a process known as community-led total sanitation (CLTS).

Read the complete article.

The Period Movement: Meet the Men Fighting to Stop Menstruation-Shaming

The Period Movement: Meet the Men Fighting to Stop Menstruation-Shaming. Newsweek, July 12, 2017.

Ganga Gautam stood at the back of a high school classroom in Kathmandu, Nepal, helplessly watching as a teenage girl started bleeding. Gautam, a professor of English education at Tribhuvan University, was observing one of his students teach a class two years ago.

Joshua Omanya, center, is an educator with The Cup program who teaches boys in the Kibera slum in Nairobi, Kenya, about menstruation and gender equality.

Joshua Omanya, center, is an educator with The Cup program who teaches boys in the Kibera slum in Nairobi, Kenya, about menstruation and gender equality.

Three girls were sitting on a bench next to him, and one of them was clearly in distress.“I noticed that she was menstruating. The blood was coming,” he says. “She wasn’t prepared. She didn’t have a pad, and there was a male teacher teaching.”

Gautam saw the young girl open her pen and drip ink over the blood in an effort to hide it. As soon as class ended, she placed a piece of paper over the red stain and ran out. He never saw her in school again. “That happened many times,” he says. “I saw so many girls bleeding in classrooms and panicking.

They leave the classroom and never come back. That just killed me.”Around the world, girls and women miss classes, drop out of school and fail to reach their full potential because of a natural biological process: menstruation.

Read the complete article.

When Water Doesn’t Flow: Why Lack of Water Matters in Healthcare Facilities

When Water Doesn’t Flow: Why Lack of Water Matters in Healthcare Facilities. PLoS Global Health Blog, June 29, 2017.

Why Lack of Water Matters in Healthcare Facilities

Water, as well as the availability of sanitation and hygiene infrastructure, are essential to providing safe, quality healthcare. Without water, surfaces remain unclean and medical equipment cannot be sterilized. Water shortages within healthcare facilities are particularly concerning when thinking about the water needed for surgery or in maternity units.

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When water does not flow from the piped water supply within the hospital, jerry cans (the yellow containers shown) are used to collect water from a nearby lake

According to the World Health Organization’s Essential Environmental Health Standards in Health Care, 100 liters of water are needed per medical intervention preformed in healthcare facilities.  As an example, if one hospital in Ghana reported that 138 babies were born in one month then 13,800 liters of water would be needed to ensure safe delivery of all babies. Based on my experiences as a researcher and a patient in a rural Ghana hospital, meeting this requirement would be virtually impossible.

During my hospitalization, water did not flow through the pipes within the hospital and the donated water treatment system was not operating due to water scarcity and intermittent power in the region.

The lack of water sparked a series of managerial decisions, which in turn affected patients’ access to toilets and handwashing facilities, which led to clinical staffing shortages. Without adequate water in the hospital, management locked the bathrooms within the wards and rationed water for staff handwashing.

My infirmed neighboring bedmates were told to use an open area behind the ward to relieve themselves. In a few cases, these sick patients were too weak to do so, and the floor next to their beds quickly became soiled contributing to environmental contamination. The hospital would then dispatch valuable nursing staff to a lake –located half a mile away to get water in order to clean floors.

Read the complete article.