Copenhagen Consensus Center – WASH targets in the Post-2015 Development Agenda

Link to reports: www.post2015consensus.com/water-and-sanitation 

Here, Copenhagen Consensus Center has just released its latest research on water and sanitation targets for the post-2015 development agenda. Guy Hutton, Senior Economist, at the Water and Sanitation Program (WSP), World Bank writes the main report, with research assistance provided by Mili Varughese, Operations Analyst at WSP. 

Guy Hutton, Senior Economist for the World Bank’s Water and Sanitation Program, writes a paper examining the costs and benefits of ending open defecation and providing universal access to water and sanitation. He finds that in general, it is more cost-beneficial to serve rural populations since they save more time from having improved access to water and sanitation facilities. Additionally, it is more effective to provide for the poorest, because they start with poorer health and have greater capacity to improve from access. Regardless of location and income, providing water and sanitation passes a cost-benefit test.

Dale Whittington, Professor, Departments of Environmental Sciences & Engineering at University of North Carolina, makes a critical examination of the assessment paper, noting several challenges with the benefit-cost calculations. In particular, he outlines concerns with how time savings are calculated, the likelihood of 100% take up of the interventions, assumptions around the cost base and how sensitivity analysis is applied in the paper. Despite these issues, Whittington agrees that water and sanitation interventions are likely to be cost-beneficial, though very sensitive to local conditions.

Dale Whittington also writes a stand-alone paper on water resources management targets. In a thought-provoking discussion he argues that global average benefit-cost ratios for water resource management investments are not useful because investments must be analyzed at the local level. Secondly, he suggests that it would be wrong for low-income countries to prioritize health interventions over large scale water infrastructure, since the latter are a necessary pre-requisite for the former.

Mary Ostrowski and Allan Jones of the World Chlorine Council present their views on the ‘safely managed drinking water service’ aspect of the proposed WASH targets. They argue that the most effective way to check drinking water quality is testing for the chlorine residual to ensures that the water is safe and free from disease causing germs.​

Waterlines, Jan 2015 issue on Menstrual Hygiene Management

WATERLINES – JANUARY 2015 (Complete issue)

Selected articles: 

Guest editorial: tackling the stigma and gender marginalization related to menstruation via WASH in schools programmes (abstract/order info)
Menstrual hygiene management has been defined as: ‘Women and adolescent girls using a clean menstrual management material to absorb or collect blood that can be changed in privacy as often as necessary for the duration of the menstruation period, using soap and water for washing the body as required, and having access to facilities to dispose of used menstrual management materials’ (UNICEF and WHO, 2014). However, menstrual hygiene is not just about the management of the menstrual period but also the need to address societal beliefs and taboos surrounding the issue. 

Until recently, the development sector including WASH (water, sanitation and hygiene) had not explored and attempted to address the challenges related to Menstrual Hygiene Management (MHM), an important issue affecting the health, dignity and privacy of millions of girls and women on a daily basis. It is great to have a whole issue of Waterlines dedicated to MHM, as it will help us, the maledominated, engineering-based sector, to increase our understanding of this aspect of the development work we do on a daily basis.

Putting the men into menstruation: the role of men and boys in community menstrual hygiene management (full text)
This paper examines how men and boys have an essential role in effective menstrual hygiene programmes and describes an initiative to engage men and boys in Uttar Pradesh, India. As a result of the initiative, men and boys have begun to talk about menstruation more freely and are better able to support the MHM needs of women and girls within the household, community, and school.

Adolescent schoolgirls’ experiences of menstrual cups and pads in rural western Kenya: a qualitative study (full text)
A randomized controlled feasibility study was conducted among 14–16-year-old girls, in 30 primary schools in rural western Kenya, to examine acceptability, use, and safety of menstrual cups or sanitary pads. Focus group discussions (FGDs) were conducted to evaluate girls’ perceptions and experiences six months after product introduction.

Mainstreaming menstrual hygiene management in schools through the play-based approach: lessons learned from Ghana (full text)
The study objective was to identify and document the effectiveness of the play-based approach in promoting menstrual hygiene management (MHM) in schools and share lessons learned. The study used a mix of approaches including qualitative and quantitative techniques. The author carried out an exploratory evaluation on the promotion of MHM activities as part of WASH in Schools programmes in 120 public schools in Ghana. Comparison was drawn between 60 schools currently using the play-based approach in promoting MHM, and 60 schools which are not using the play-based approach.

Developing games as a qualitative method for researching menstrual hygiene management in rural Bolivia (abstract/order info)
In 2012, Emory University and UNICEF conducted a multi-country formative study to gain a global perspective of girls’ experiences. A compendium of tools was created to ensure investigation of common themes across all settings. This paper describes the process of adapting the focus group discussion (FGD) tool for Bolivia into a board game as a method to ease girls’ discomfort discussing menstruation and elicit richer data.

WaterSHED – Rural Consumer Sanitation Adoption Study in Cambodia

Rural Consumer Sanitation Adoption Study: An Analyis of Rural Consumers in the Emerging Sanitation Market in Cambodia, 2014.

• Link

WaterSHED has published the findings from its comprehensive review of rural consumer sanitation adoption in Cambodia. The study evaluates WaterSHED’s Hands-Off sanitation marketing program, which was designed to catalyze the market for improved sanitation in rural Cambodia by stimulating household demand and improving the supply of affordable sanitation options for rural households. 

The study confirms that the WaterSHED program has resulted in a substantial acceleration in improved latrine coverage and usage in the study areas. Household consumers are now able to access an improved latrine more easily and more cheaply than before.

New distribution and sales mechanisms are increasing household awareness of and exposure to more affordable latrine products and increasing motivation to invest in an improved latrine.

Enterprises are demonstrating that they serve at least some segments of the previously unserved rural market.

Nonetheless, significant challenges still remain. The study reveals a number of opportunities to break down remaining barriers to uptake of improved latrines and to further evolve WaterSHED’s market-based approach.

Guy Hutton – Why Choosing the Preferred Sanitation Solution Should Be More Like Grocery Shopping

Guy Hutton – Why Choosing the Preferred Sanitation Solution Should Be More Like Grocery Shopping 

When we go to the supermarket, our decision-making is considerably aided by having the price, ingredients and source of goods clearly labeled. This allows us to rapidly compare the characteristics, perceived benefits, and price of different products to make what is usually an informed and instantaneous purchase decision.

When it comes to making investment choices for public programs, we do not traditionally have the same luxury of information. The full benefits and costs of those interventions, including the long-term costs to maintain and operate a service, are rarely understood or taken into account in the decision. As a result, public decisions are usually made based on the most visible costs (capital investment required from the public budget), historical choices and the political process.

To reduce the detrimental effects of these influences, we need to move public sector decision making more towards the supermarket model, and increase the availability of key information so that decisions can be more rational, consistent, and transparent.

Since 2007, the Water and Sanitation Program (WSP), part of the World Bank’s Water Global Practice, has been attempting to put a price on sanitation by essentially understanding two sides of the same coin: what the costs of current inaction on sanitation are (i.e. how much poor sanitation costs households and the wider economy) and how much acting will cost (i.e. increasing access to sanitation services).

When it comes to acting, we need to understand the alternatives. What technology option best suits the preferences and local practices, available land, population density, disposable income, and willingness to pay of different population groups? What are the benefits of different technology options? And who is able to pay for the costs of behavior change, capital investment and sustained service delivery?

Read the complete post on the World Bank Water Blog, Jan 2015.

You can a join an ongoing discussion on this blog on the SuSanA Forum.

WSP – Economic Assessment of Sanitation Interventions in Southeast Asia: A Six Country Study Conducted in Cambodia, Indonesia, Lao PDR, the Philippines, Vietnam and Yunnan Province (China)

Economic Assessment of Sanitation Interventions in Southeast Asia:  A Six Country Study Conducted in Cambodia, Indonesia, Lao PDR, the Philippines, Vietnam and Yunnan Province (China) under the Economics of Sanitation Initiative, 2015. Water and Sanitation Program.

• Full text, pdf

Excerpts: The present study has presented evidence on the costs and benefits of sanitation improvements in different programmatic and geographical contexts in Southeast Asia. This evidence enables explicit comparison of sanitation options on the basis of their relative merits and thus informs both public and private decisions on sanitation investment.

The high socioeconomic returns of sanitation investment indicate that it should be promoted as a central development priority. The economic evidence generated in this study has demonstrated the importance of improved sanitation for a number of development outcomes, including public health, the natural environment, education, economic development, social outcomes, gender equality, and poverty alleviation. Improved evidence on the costs of sanitation and those potentially willing to pay for it, gives an evidence base for sanitation planners and providers on which to estimate the market size for sanitation goods and services.

World Bank – Promoting Handwashing and Sanitation Evidence from a Large-Scale Randomized Trial in Rural Tanzania

Promoting Handwashing and Sanitation: Evidence from a Large-Scale Randomized Trial in Rural Tanzania, 2015. World Bank.

• Full text, pdf

Authors: Bertha Briceño, Aidan Coville, Sebastian Martinez

The association between hygiene, sanitation, and health is well documented, yet thousands of children die each year from exposure to contaminated fecal matter. At the same time, evidence on the effectiveness of at-scale behavior change interventions to improve sanitation and hygiene practices is limited.

This paper presents the results of two large-scale, government-led handwashing and sanitation promotion campaigns in rural Tanzania. For the campaign, 181 wards were randomly assigned to receive sanitation promotion, handwashing promotion, both interventions together, or neither. One year after the end of the program, sanitation wards increased latrine construction rates from 38.6 to 51 percent and reduced regular open defecation from 23.1 to 11.1 percent.

Households in handwashing wards show marginal improvements in handwashing behavior related to food preparation, but not at other critical junctures. Limited interaction is observed between handwashing and sanitation on intermediate outcomes: wards that received both handwashing and sanitation promotion are less likely to have feces visible around their latrine and more likely to have a handwashing station close to their latrine facility relative to individual treatment groups.

Final health effects on child health measured through diarrhea, anemia, stunting, and wasting are absent in the single-intervention groups. The combined-treatment group produces statistically detectable, but biologically insignificant
and inconsistent, health impacts. The results highlight the importance of focusing on intermediate outcomes of take-up and behavior change as a critical first step in large-scale programs before realizing the changes in health that sanitation and hygiene interventions aim to deliver.

Presentations from the 3rd International Conference on Faecal Sludge Management

SuSanA has developed a page which contains presentations from FSM3, the 3rd International Faecal Sludge Management Conference, Hanoi, Vietnam, January 2015.

Also, follow the interesting discussions about the conference on the SuSanA Forum.

Below is a partial listing of some of the presentations:

• Turning the tide on Fecal Sludge Management: Almud Weitz, Principal Regional Team Leader at Water and Sanitation Program East Asia & the Pacific and South Asia – World Bank, Indonesia
• Market Structuring of Fecal Sludge Management for the Benefit of Poor Households in Dakar: Mbaye Mbeguere, ONAS, Senegal
• On-site Sanitation Systems and Willingness-to-pay of Emptying in urban areas in Indonesia: Reini Siregar, Water and Sanitation Program World Bank, Jakarta, Indonesia 
• Septage Management: An option for improved sanitation in Tripura: Ashutosh Jindal, Urban Development Department, Government of Tripura, India
• Political economy analysis (PEA) of FSM services: Ian Ross, Oxford Policy Management, Oxford, United Kingdom
• A Technology Applicability Framework to enable sustainable sanitation technology introduction: Alison Parker, Cranfield Water Science institute, Cranfield University, Bedford, United Kingdom
• Status of Faecal Sludge Management in Botswana: Review of Policies and Practices: Phillimon T. Odirile, University of Botswana, Mopipi, Botswana