The true costs of participatory sanitation

Plan International USA and The Water Institute at UNC have conducted the first study to present comprehensive, accurate, disaggregated costs of a WaSH behaviour-change programme.  The study calculated programme costs, and local investments for four community-led total sanitation (CLTS) interventions in Ghana and Ethiopia.

Jonny Crocker, Darren Saywell, Katherine F. Shields, Pete Kolsky, Jamie Bartram, The true costs of participatory sanitation : evidence from community-led total sanitation studies in Ghana and Ethiopia. Science of The Total Environment, vol. 601–602, 1 Dec 2017, pp: 1075-1083. DOI: 10.1016/j.scitotenv.2017.05.279 [Open access]

Abstract

Evidence on sanitation and hygiene program costs is used for many purposes. The few studies that report costs use top-down costing methods that are inaccurate and inappropriate. Community-led total sanitation (CLTS) is a participatory behaviour-change approach that presents difficulties for cost analysis. We used implementation tracking and bottom-up, activity-based costing to assess the process, program costs, and local investments for four CLTS interventions in Ghana and Ethiopia. Data collection included implementation checklists, surveys, and financial records review. Financial costs and value-of-time spent on CLTS by different actors were assessed. Results are disaggregated by intervention, cost category, actor, geographic area, and project month. The average household size was 4.0 people in Ghana, and 5.8 people in Ethiopia. The program cost of CLTS was $30.34–$81.56 per household targeted in Ghana, and $14.15–$19.21 in Ethiopia. Most program costs were from training for three of four interventions. Local investments ranged from $7.93–$22.36 per household targeted in Ghana, and $2.35–$3.41 in Ethiopia. This is the first study to present comprehensive, disaggregated costs of a sanitation and hygiene behaviour-change intervention. The findings can be used to inform policy and finance decisions, plan program scale-up, perform cost-effectiveness and benefit studies, and compare different interventions. The costing method is applicable to other public health behaviour-change programs.

USAID GWASH – Lessons Learned: Hybrid CLTS Approach to Improving Sanitation

GHANA WASH PROJECT: Lessons Learned: Hybrid CLTS Approach to Improving Sanitation, 2014. 

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USAID’s Ghana Water, Sanitation and Hygiene (GWASH) Project aimed to improve rural sanitation access through the provision of household latrines to households in targeted communities. In the beginning of the project, GWASH used a “high-subsidy” approach for household latrine provision, providing households with a 60 percent subsidy per latrine.

It was in this vein that GWASH aimed to meet its project target of constructing 4,680 household latrines over the course of a four-year period. During the second year of the project, the Government of Ghana (GOG) implemented a new sanitation policy that promoted a pure Community-Led Total Sanitation (CLTS) approach.

The strategy is a no-subsidy approach that emphasizes community-level demand creation for sanitation improvements aimed at stopping open defecation and supporting household and community efforts to independently construct improved household latrines.

 

USAID SAREP – CLTS Monitoring and Evaluation Toolkit and Manual

CLTS Monitoring and Evaluation Toolkit and Manual, 2016. USAID SAREP (South Africa Region Environmental Programme)

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This toolkit and manual contains all forms and materials that are need for a CLTS monitoring team to be established in communities.

It is aimed at CLTS facilitators and Natural Leaders who wish to take the next step in ensuring their community becomes Open Defecation Free (ODF).

It also contains a training agenda and training materials so that M&E team members in communities are able to train other people to become part of the team.

Focus on Community-Led Total Sanitation – Water Currents, April 18, 2017

Focus on Community-Led Total Sanitation – Water Currents, April 18, 2017

Welcome to the inaugural external issue of Water Currents, a biweekly publication from USAID’s Water Team. 

Water Currents aims to replace the WASHplus Weekly, which ceased publication in 2016 when the WASHplus Project ended.

Each issue of Water Currents will have a special focus on a featured topic, as well as an update on recent water sector news.

This issue highlights community-led total sanitation (CLTS), including selected 2017 reports and articles on the subject, as well as coverage on open defecation and behavior change and recent CLTS videos. Our “In the News” section features recent articles on household water treatment, WASH training materials and other water matters.

Articles and Reports
Keeping Track: CLTS Monitoring, Certification and Verification. IDS, January 2017. These critical elements of the CLTS process ensure the sustainability of open defecation free achievements and support the behavior change education necessary to improve CLTS implementation.

Local Governance and Sanitation: Eight Lessons from Uganda. Global Sanitation Fund (GSF), April 2017. This case study presents eight lessons learned from the GSF-supported Uganda Sanitation Fund on coordinating, planning, and implementing CLTS at scale through a decentralized government system.

View the complete issue/subscribe.

Discovering sanitation realities through rural immersions

Discovering sanitation realities through rural immersions. by Jamie Myers, CLTS, March 2017.

At the end of last year the CLTS Knowledge Hub heard that the Indian Institute of Management (IIM), Indore, in collaboration with UNICEF and the Government of Madhya Pradesh, were sending 630 of their first year management students to spend a week living in 157 open defecation free (ODF) villages. 

The villages cut across 13 districts in the central Indian State of Madhya Pradesh. Students were asked to verify ODF status of villages through a household survey and early morning and evening inspections of open defecation sites. They were also tasked with collecting data on school and Anganwadi (child and mother care) centres sanitation and handwashing facilities.

The sheer number of people involved was impressive in itself as was the level of detail that could be collected in the length of time they were able to spend there. Furthermore, the fact that they would be staying overnight meant that they would be in the villages at the times when open defecation was most common, early in the morning and later in the evening. Needless to say we were excited to hear not only about their findings but also the process and methodology.

Read the complete article.

Keeping Track: CLTS Monitoring, Certification and Verification

Keeping Track: CLTS Monitoring, Certification and Verification: CLTS Knowledge Hub Learning Paper, January 2017. 

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Author: Katherine Pasteur

Monitoring, verification and certification are critical elements of the CLTS process and contribute to ensuring sustainability of ODF as well as learning about changes that are needed to improve implementation. Monitoring includes both process and progress monitoring.

Verification tends to be led by NGOs or government with clear criteria and methodologies being developed, often incorporating multiple assessment visits over an extended period of time. Certification and celebration of ODF communities acknowledge their achievement and helps to raise awareness in the surrounding areas.

The adoption of CLTS as a national approach in many countries has resulted in national protocols and guidance documents as well as various methodologies for community engagement and data collection to aid the processes of monitoring, verification and certification. Increasingly, the importance of post ODF monitoring is being recognised. We need to know more about how to incorporate this into implementation to ensure longer term sustainability of behaviour change and of toilets.

Similarly, effective collection, management and utilisation of data are a challenge. Other emerging issues relate to reliability and accuracy of monitoring and verification; encouraging appropriate attitudes to encourage learning rather than fault finding; and how to incentivise staff involved in monitoring and verification. We also need to know more about monitoring for long term sustainability of behaviour change and inclusion. Many of these issues are being investigated through local, national and international learning processes.

This Learning Paper summarises challenges, innovations and gaps in knowledge in the area of monitoring, verification and certification.

Progress on CLTSH – Findings from a national review of rural sanitation in Ethiopia – UNICEF

Progress on CLTSH – Findings from a national review of rural sanitation in Ethiopia: WASH Learning Note. December 2016.

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KEY POINTS

• Rural sanitation coverage in Ethiopia continues to improve. The survey found on average 68% latrine usage, similar to the 2015 JMP estimate
• The majority (89%) of household toilets are unimproved
• There are strong regional disparities in coverage. 5 regions have over 50%, whilst in 3 regions open defecation is still dominant
• CLTSH is not always implemented as intended. There are regional variations and some aspects of the triggering and follow-up are omitted
• The Post-ODF follow-up of the CLTSH approach is limited. Very few communites are recorded as having reached ’level 2’ of ODF
• Handwashing Rates are low. Only 19% of respondents were found to wash hands at all critical times, and only 45% after using the toilet