Category Archives: South Asia

USAID Joins 100,000 Women in India to Bring Dignity, Safety, and Health to a City of Two Million

USAID Joins 100,000 Women in India to Bring Dignity, Safety, and Health to a City of Two Million | Source: Christian Holmes/USAID, Global Waters, June 27, 2016 |

At USAID we recognize the threat poor sanitation combined with rapid urbanization presents to human health, dignity, and prosperity. This is why we have made urban sanitation a global priority for the Agency. During a recent visit to India, I was able to see some of the work being done to bring sanitation services to urban areas, and had the good fortune to meet some inspiring women who are advancing these efforts in their communities.

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USAID Global Water Coordinator Christian Holmes visits with young students at a Vizag municipal school. Children also have a role to play as change agents in ending open defecation in their communities. Their school is now the number one-ranked Swachh Bharat school in the entire city, and its students’ academic performance has improved considerably. Photo Credit: USAID/India

Currently, more than 300 million people live in India’s urban areas, a number that is quickly increasing. The growing population of city dwellers is straining the country’s ability to provide safe drinking water and sanitation services.

To address this, the Government of India has committed to providing sanitation and household toilet facilities for all 4,041 cities in India through Swachh Bharat (Clean India) Campaign.

India’s commitment to this effort is vital. Close to 600 million people in the country practice open defecation, which contaminates water and can spread diseases. Lack of access to sanitation can keep people from productive activities such as work and school, either due to illness or time spent searching for private, safe locations to defecate. In India, it is estimated this lack of access results in an annual economic loss of approximately $54 billion or 6.4 percent of the nation’s gross domestic product.

Read the complete article.

3 steps to improve rural sanitation in India – a pathway to scale and sustainability

3 steps to improve rural sanitation in India – a pathway to scale and sustainability | Source: World Bank Water Blog, July 7 2016 |

Almost 600 million Indians living in rural areas defecate in the open. To meet the ambitious targets of the Indian government’s Swachh Bharat Mission Grameen (SBM (G)) – the rural clean India mission – plans to eliminate open defecation by 2019.

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Child using a latrine in Rajasthan. Photo credit: World Bank

SBM (G) is time-bound with a stronger results orientation, targeting the monitoring of both outputs (access to sanitation) and outcomes (usage). There is also a stronger focus on behavior change interventions and states have been accorded greater flexibility to adopt their own delivery mechanisms.

The World Bank has provided India with a US$1.5 billion loan and embarked on a technical assistance program to support the strengthening of SBM-G program delivery institutions at the national level, and in select states in planning, implementing and monitoring of the program.

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India – 328 children below 5 die of diarrhoea daily

India – 328 children below 5 die of diarrhoea daily | Source: Times of India, July 11 2016 |

NEW DELHI: Around 328 children under 5 years of age die of diarrhoea every day, latest assessment by the health ministry shows. This has prompted the ministry to intensify its diarrhoea control programme to reach out to over 10 crore children with ORS solution this year from 6.3 crore last year.

Estimates show that over 1.2 lakh children less than five years of age succumb to diarrhoea every year. The primary reasons for diarrhoeal attacks among children are contaminated water and food, malnutrition, inadequate sanitation and lack of immunization. Diarrhoeal deaths are usually clustered in summer and monsoon months

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Drivers of sustained hygiene behaviour change: A case study from mid-western Nepal

Drivers of sustained hygiene behaviour change: A case study from mid-western NepalSocial Science & Medicine, August 2016.

Authors: Celia McMichael, Priscilla Robinson

Behaviour change is central to the prevention of many population health problems, yet it is typically difficult to initiate and sustain. This paper reports on an evaluation of a water, sanitation and hygiene (WASH) intervention in mid-western Nepal, with particular focus on the drivers and barriers for handwashing with soap/ash and elimination of open defecation.

The research was conducted during October–November 2014, two and half years following the intervention’s end-point. Qualitative data were collected from the target community (n = 112) via group discussions, interviews and drawings/stories of ‘most significant change’. Households’ handwashing/water facilities and toilets were observed.

Analysis was informed by a model that highlights environmental, psychosocial and technological factors that shape hygiene behaviours across multiple levels, from the habitual to the structural (Dreibelbis et al. 2013). Findings indicate the intervention has supported development of new norms around hygiene behaviours.

Key drivers of sustained hygiene behaviour were habit formation, emotional drivers (e.g. disgust, affiliation), and collective action and civic pride; key constraints included water scarcity and socio-economic disadvantage. Identifying and responding to the drivers and constraints of hygiene behaviour change in specific contexts is critical to sustained behaviour change and population health impact.

Handwashing, sanitation and family planning practices are the strongest underlying determinants of child stunting in rural India

Handwashing, sanitation and family planning practices are the strongest underlying determinants of child stunting in rural indigenous communities of Jharkhand and Odisha, Eastern India: a cross-sectional study. Maternal & Child Nutrition, June 2016.

Authors: Jennifer Saxton, Shibanand Rath, et. al.

The World Health Organisation has called for global action to reduce child stunting by 40% by 2025. One third of the world’s stunted children live in India, and children belonging to rural indigenous communities are the worst affected. We sought to identify the strongest determinants of stunting among indigenous children in rural Jharkhand and Odisha, India, to highlight key areas for intervention.

We analysed data from 1227 children aged 6–23.99 months and their mothers, collected in 2010 from 18 clusters of villages with a high proportion of people from indigenous groups in three districts. We measured height and weight of mothers and children, and captured data on various basic, underlying and immediate determinants of undernutrition. We used Generalised Estimating Equations to identify individual determinants associated with children’s height-for-age z-score (HAZ; p < 0.10); we included these in a multivariable model to identify the strongest HAZ determinants using backwards stepwise methods.

In the adjusted model, the strongest protective factors for linear growth included cooking outdoors rather than indoors (HAZ +0.66), birth spacing ≥24 months (HAZ +0.40), and handwashing with a cleansing agent (HAZ +0.32). The strongest risk factors were later birth order (HAZ −0.38) and repeated diarrhoeal infection (HAZ −0.23).

Our results suggest multiple risk factors for linear growth faltering in indigenous communities in Jharkhand and Odisha. Interventions that could improve children’s growth include reducing exposure to indoor air pollution, increasing access to family planning, reducing diarrhoeal infections, improving handwashing practices, increasing access to income and strengthening health and sanitation infrastructure.

From waste-picker to waste professional: A Bengaluru organisation recycles livelihoods

From waste-picker to waste professional: A Bengaluru organisation recycles livelihoods | Source: The News Minute, June 17 2016 |

Hasiru Dala also creates awareness about segregating dry waste and wet waste.

Thirty-eight-year-old Lakshmi has been working as a waste-picker in Bengaluru for five years. “We are called thieves when we are collecting waste. Some have even gone to the extent of calling the police,” said Lakshmi lamenting the state of waste-pickers in the city. Hasiru (1)

However, all that changed when Hasiru Dala, a social enterprise that organise waste-pickers came forward and provided Lakshmi with an ID card. “The green card from Hasiru Dala helps us avoid such problems,” she said.

Hasiru Dala, an organisation that turn waste-pickers to waste professionals aids the Bruhat Bengaluru Mahanagara Palike (BBMP) in managing Bengaluru’s massive waste production by providing waste management services for homes, apartments, commercial set-ups and events.. From a family wedding to a city-wide marathon, Hasiru Dala (Green Army in Kannada) provides waste management services for all kinds of events.

Along with recycling waste, Hasiru Dala has also managed to recycle the livelihoods of thousands of waste pickers in the city like that of Lakshmi. Shekhar Prabhakar, Managing Director of Hasiru Dala said, “Waste-picking is a job totally dependent on luck. It is not an easy job. Waste pickers bend down hundreds of times in covering a 10 km stretch. We are aiming to create dignified labour by providing waste-pickers with ID cards.” Hasiru Dala has helped around 7500 waste-pickers obtain an ID card.

Read the complete article.

Sanitation in Bangladesh: Revolution, Evolution, and New Challenges

Sanitation in Bangladesh: Revolution, Evolution, and New Challenges, 2016. CLTS Knowledge Hub Learning Paper.

Author: Dr Suzanne Hanchett.

Our 2015 discussions with people at all levels of Bangladesh society reveal both pride in sanitation achievements and concern about meeting future challenges. A combination of approaches – subsidies, non-subsidies, micro-credit, sanitation market improvements, programming at various scales, motivating of individuals and groups – has resulted in a majority of households’ using latrines rather than defecating openly.

Policy documents have created frameworks to guide activities in diverse areas. Issues such as quality, faecal sludge removal, and appropriate subsidies for very poor households remain, however. Hard-to-reach geographical areas lag behind the rest of the country. As Professor Mujibur Rahman’s 2009 overview pointed out, failing to address these challenges will threaten the sustainability of achievements.

Unique characteristics of the Bangladesh sanitation situation include the focus on its local government institution (the union), its long history of NGO-sponsored community mobilisation, and its high population density. Donor involvement has been a regular feature of the sanitation scene for more than three decades. It is a relatively small country, the size of only one of India’s states. All of these special conditions and characteristics have supported its achievements to date.

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