Category Archives: South Asia

Changing behaviours: there is no quick fix!

Experts come up with better ways to promote sanitation in India.

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School toilets, West Bengal, India, Photo: Stef Smits/India

India is home to the largest numbers of open defecators in the world. Over the last few decades the government has implemented national programmes, which attempted to address this complex challenge. The demand for sanitation, meaning a genuine demand for toilets and actual use, hasn’t been encouraging. In October 2014, the government launched the Swachh Bharat Mission (SBM), a national programme to eliminate open defecation by 2019. SBM has a rural (gramin) and an urban subcomponent.

Dialogue on behaviour change communication

On 23 September 2016, experts met in New Delhi to discuss how behaviour change communication (BCC) can best help to achieve India’s sanitation goals. They were invited by the India Sanitation Coalition, TARU and IRC to take part in “Insights: WASH Dialogues on Sanitation Promotion and Behavioural Science“.

When we set out to improve life for others without a fundamental understanding of their point of view and quality of experience, we do more harm than good (Lauren Reichelt, 2011)

Sector experts and experts involved in Corporate Social Responsibility (CSR) initiatives in sanitation, argued that it is crucial not just to look at how behaviour change interventions work, but also to understand what doesn’t work. There is general agreement that “soft interventions” are important at the community level to ensure that toilets are not just built but also used. Despite all the investments in sanitation over the years, little has been achieved in sanitation. There seems to be a gap between the planning of behaviour change communication interventions and how they are actually implemented.

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Letter from India: How Poop is Becoming Big Business for Small Companies

Letter from India: How Poop is Becoming Big Business for Small Companies. by Devyani Singh, The Dialogue, January 27, 2017.

An excerpt: Small businesses can help governments and corporations build reliable value chains and introduce new services into local markets. They create employment in emerging markets, and increase access to goods and services that could potentially improve the lives of the underserved. toilet-696x387.jpg

Business solutions

A fascinating example of a business solution to the sanitation crisis in India is Samagra Sanitation. Founded in 2011 by Swapnil Chaturvedi, famously known as “Poop Guy,” Samagra is a small business working at the intersection of design, technology, and behavioral science, to tackle the issue of open defecation in 140 locations in Pune, India.

Samagra operates in urban slums and has so far built more than 300 toilet seats with more than 150,000 daily users, almost half of which are young girls and women. Samagra designs, manages, and renovates community toilet blocks in partnership with the municipality, which pays for maintenance and utilities like water and electricity. Each block is run by local women who act as Kiosk Managers (or “Loo-Preneurs”) and is regularly cleaned by Samagra’s “Cleaning Force.”

Slum dwellers can use Samagra toilets for free, but those who pay for usage get access to value added services or “LooRewards” such as mobile tops-ups, bill payments, banking, and health services. The cleaning staff also receives 100 percent of the revenue collected. In this way, the impact of Samagra goes beyond better sanitation to give women in these communities a means to earn a stable income.

Changing Perceptions

What is often missing from even the savviest of entrepreneurial efforts is a systematic process for conceptualizing a business model that replicates global best practices. Enviu, a developer of innovative social businesses from the Netherlands, is working to harness the power of business in India by co-creating impact businesses that can drive system-change. By leveraging the experience and knowledge of its network across the globe, Enviu works with local businesses to develop what it calls “bottom-up solutions”.

Read the complete article.

Unsafe Child Feces Disposal is Associated with Environmental Enteropathy and Impaired Growth

Unsafe Child Feces Disposal is Associated with Environmental Enteropathy and Impaired Growth.  Journal of Pediatrics, June 2016.

Authors: Christine Marie George, Lauren Oldja, Shwapon Biswas, et al.

Objective – To investigate the relationship between unsafe child feces disposal, environmental enteropathy, and impaired growth, we conducted a prospective cohort study of 216 young children in rural Bangladesh.

Study design – Using a prospective cohort study design in rural Bangladesh, unsafe child feces disposal, using the Joint Monitoring Program definition, was assessed using 5-hour structured observation by trained study personnel as well as caregiver reports. Anthropometric measurements were collected at baseline and at a 9-month follow-up. Stool was analyzed for fecal markers of environmental enteropathy: alpha-1-antitrypsin, myeloperoxidase, neopterin (combined to form an environmental enteropathy disease activity score), and calprotectin.

Findings – Among 216 households with young children, 84% had an unsafe child feces disposal event during structured observation and 75% had caregiver reported events. There was no significant difference in observed unsafe child feces disposal events for households with or without an improved sanitation option (82% vs 85%, P = .72) or by child’s age (P = .96). Children in households where caregivers reported unsafe child feces disposal had significantly higher environmental enteropathy scores (0.82-point difference, 95% CI 0.11-1.53), and significantly greater odds of being wasted (weight-for-height z score <2 SDs) (9% vs 0%, P = .024). In addition, children in households with observed unsafe feces disposal had significantly reduced change in weight-for-age z-score (0.34 [95% CI 0.68, 0.01] and weight-for-height z score (0.52 [95% CI 0.98, 0.06]).

Conclusion – Unsafe child feces disposal was significantly associated with environmental enteropathy and impaired growth in a pediatric population in rural Bangladesh. Interventions are needed to reduce this high-risk behavior to protect the health of susceptible pediatric populations

Understanding Open Defecation in Rural India: Untouchability, Pollution, and Latrine Pits

Understanding Open Defecation in Rural India: Untouchability, Pollution, and Latrine Pits. Economic & Political Weekly, January 7, 2017.

Authors: Diane Coffey, Aashish Gupta, Payal Hathi, Dean Spears, Nikhil Srivastav, Sangita Vyas

India has far higher open defecation rates than other developing regions where people are poorer, literacy rates are lower, and water is relatively more scarce. In practice, government programmes in rural India have paid little attention in understanding why so many rural Indians defecate in the open rather than use affordable pit latrines.

Drawing on new data, a study points out that widespread open defecation in rural India is on account of beliefs, values, and norms about purity, pollution, caste, and untouchability that cause people to reject affordable latrines.

Future rural sanitation programmes must address villagers’ ideas about pollution, pit-emptying, and untouchability, and should do so in ways that accelerate progress towards social equality for Dalits rather than delay it.

Exploring “The Remote” and “The Rural”: Open Defecation and Latrine Use in Uttarakhand, India

Exploring “The Remote” and “The Rural”: Open Defecation and Latrine Use in Uttarakhand, India. World Development, January 2017. Authors: Kathleen O’Reilly, Richa Dhanju, Abhineety Goel.

Highlights

  • Remote places are different than rural places due to physical and social distance.
  • Remoteness significantly contributes to practices of open defecation.
  • Structural inequalities produce conditions that impede sanitation uptake.
  • Addressing infrastructural causes of remoteness is key to reducing open defecation.
  • Reducing multi-scalar, socio-spatial inequalities can lead to latrine adoption.

Open defecation is a major global health problem. The number of open defecators in India dwarfs that of other states, and most live in rural places. Open defecation is often approached as a problem scaled at the site of the individual, who makes a choice not to build and/or use a toilet.

Attempts to end rural open defecation by targeting individuals, like social marketing or behavior change approaches, often ignore the structural inequalities that shape rural residents’ everyday lives. Our study explores the question, “What is the role of remoteness in sustaining open defecation in rural India?” We deploy the concept of remoteness as an analytical tool that can capture everyday practices of open defecation as a function of physical and social distance.

Using ethnographic methods, we interviewed and observed 70 participants in four villages in Uttarakhand, India over a three-month period in 2013. We find that remoteness in general, and its lived nuances, form a context for prevalent open defecation. Structural inequalities across space will need to be addressed to make latrine building and usage viable in remote places.

 

Appraising the Sanitation and Hygiene Situation in Urban India and its Determinants

Published on Dec 15, 2016
Dr Papiya Guha Mazumdar, Associate Professor, Institute of Public Health Kalyani, West Bengal delivered lecture and highlighted the need to improve existing sanitation and hygiene situation in urban India, how the determinants should be decided and why behaviour change as a critical determinant needs to be looked at in greater detail.

She emphasized that building knowledge on good practices of sanitation and hygiene related behaviour change, and drawing relevant lessons for preparing a plan of action for sustainable development is extremely important. She discussed through a few good case studies how interventions have helped.

 

How a Bunch of College Kids Made Two Delhi Slums Become Almost Completely Open Defecation Free

How a Bunch of College Kids Made Two Delhi Slums Become Almost Completely Open Defecation Free. The Better India, Jan 3, 2017.

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Enactus is a global non-profit organisation run by students at individual university and college levels committed to using the power of entrepreneurial action to transform lives and shape a better and more sustainable world. In India, Enactus is active in more than 150 colleges and universities involving more than 4,300 students working on nearly 122 projects across the country. The SSCBS Enactus team comprises of 70 students, of which 20 are directly involved in Project Raahat.

In a bid to prevent open defecation and usher in hygiene and cleanliness among slum-dwellers of New Delhi, a group of college students have initiated a unique campaign that has brought down the open defecation rates in some slums from 95% to 3%.

Had you visited or wandered close to the slums in Sultanpuri and Kirti Nagar in New Delhi a year ago, you would have witnessed a common and appalling sight of slum-dwellers walking into open fields with a tin can to relieve themselves. You might have walked past stinky toilet complexes lying vandalized with broken, leaky walls, and pipes. But not anymore!

Thanks to a group of enterprising college students from Shaheed Sukhdev College of Business Studies (SSCBS), Delhi University, the open defecation rates in these slums have come down from 95% to a mere 3% in just one year.

Read the complete article.