Tag Archives: Ethiopia

Active trachoma and community use of sanitation, Ethiopia

Active trachoma and community use of sanitation, Ethiopia. WHO Bulletin, April 2017.

Objective – To investigate, in Amhara, Ethiopia, the association between prevalence of active trachoma among children aged 1–9 years and community sanitation usage.

Methods – Between 2011 and 2014, prevalence of trachoma and household pit latrine usage were measured in five population-based cross-sectional surveys.

Data on observed indicators of latrine use were aggregated into a measure of community sanitation usage calculated as the proportion of households with a latrine in use. blt-logo

All household members were examined for clinical signs, i.e. trachomatous inflammation, follicular and/or intense, indicative of active trachoma.

Multilevel logistic regression was used to estimate prevalence odds ratios (OR) and 95% confidence intervals (CI), adjusting for community, household and individual factors, and to evaluate modification by household latrine use and water access.

Findings – In surveyed areas, prevalence of active trachoma among children was estimated to be 29% (95% CI: 28–30) and mean community sanitation usage was 47% (95% CI: 45–48). Despite significant modification (p < 0.0001), no pattern in stratified ORs was detected.

Summarizing across strata, community sanitation usage values of 60 to < 80% and ≥ 80% were associated with lower prevalence odds of active trachoma, compared with community sanitation usage of < 20% (OR: 0.76; 95% CI: 0.57–1.03 and OR: 0.67; 95% CI: 0.48–0.95, respectively).

Conclusion – In Amhara, Ethiopia, a negative correlation was observed between community sanitation usage and prevalence of active trachoma among children, highlighting the need for continued efforts to encourage higher levels of sanitation usage and to support sustained use throughout the community, not simply at the household level.

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.

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

 

Laying the Groundwork to Scale Up Sanitation Marketing in Ethiopia

Laying the Groundwork to Scale Up Sanitation Marketing in Ethiopia, 2016. WASHplus.

Between February 2, 2015 and October 31st, 2015, with support from USAID’s WASHplus project and the Vitol Foundation, iDE implemented a project to scale up rural sanitation marketing in rural areas of four regions of Ethiopia (SNNPR (Southern Nations, Nationalities and Peoples), Amhara, Oromia, Tigray). Building on the success of a pilot project that established the potential to scale sanitation marketing in rural Ethiopia, this project aimed to:

1. Continue developing and refining the design of the latrine products (slab and pit lining) as well as the business model for sales and delivery of the latrine;

2. Develop sales training and marketing materials for sales agents and manufacturers.

 

Teachers and Sanitation Promotion: An Assessment of Community Led Total Sanitation in Ethiopia

Teachers and Sanitation Promotion: An Assessment of Community Led Total Sanitation in Ethiopia. Env Sci Tech, May 2016.

Authors: Jonny Crocker, Abiyot Geremew, Fisseha Atalie, Messele Yetie, and Jamie Bartram

Community-led total sanitation (CLTS) is a participatory approach to addressing open defecation that has demonstrated success in previous studies, yet there is no research on how implementation arrangements and context change effectiveness. We used a quasi-experimental study design to compare two interventions in Ethiopia: conventional CLTS in which health workers and local leaders provided facilitation and an alternative approach in which teachers provided facilitation.

In 2012, Plan International Ethiopia trained teachers from 111 villages and health workers and leaders from 54 villages in CLTS facilitation. The trained facilitators then implemented CLTS in their respective villages
for a year. Latrine ownership, use, and quality were measured with household surveys.

Differences between interventions were explored using surveys and interviews. The decrease in open defecation associated with teacher-facilitated CLTS was 8.2 percentage points smaller than for conventional CLTS (p = 0.048). Teachers had competing responsibilities and initially lacked support from local leaders, which may have lessened their success.

Teachers may be more appropriate for a supporting rather than leading role in sanitation promotion because they did demonstrate ability and engagement. Open defecation decreased by 15.3 percentage points overall but did not change where baseline open defecation was below 30%.

Ownership of a latrine with stable flooring increased by 8.7 percentage points overall. Improved latrine ownership did not change during the intervention. CLTS is most appropriate where open defecation is high because there were no significant changes in sanitation practices or latrine upgrades where baseline open defecation was low

USAID Ethiopia Water Fact Sheet

USAID Ethiopia Water Fact Sheet, March 2016. USAID Ethiopia.

Water cuts across nearly every aspect of USAID programming. Used for drinking, hygiene, and health care, water is also needed to irrigate crops, feed livestock and develop renewable energy. Scarce water supplies can become potential sources of conflict.

USAID incorporates WASH activities within its governance, health, nutrition, resilience and emergency assistance activities with a focus on sustainability. USAID also helps strengthen the Ethiopian Government’s capacity to coordinate WASH and water resource management.

 

DFID pledges €28 million to SNV for multi-country sanitation programme

More funding for a local government-led approach introduced in 2008 by SNV and IRC to scale up sanitation from community to district level.

The UK’s Department for International Development (DFID) has awarded SNV Netherlands Development Organisation a €28 million (US$ 32 million) service contract to fund the Sustainable Sanitation & Hygiene for All (SSH4A) Results Programme. Introduced by SNV and IRC in 2008 in Nepal, Bhutan, Cambodia, Viet Nam and Laos, SSH4A is a comprehensive, local government-led approach to scale up sanitation from community to district level.

With funding from the DFID Results Fund, the SSH4A Results Programme will provide improved sanitation to more than 2 million people in nine countries: Ethiopia, Ghana, Kenya, Mozambique, Nepal, South Sudan, Tanzania, Uganda and Zambia. The programme will also reach out to over 2.7 million people with hygiene promotion, make 1,200 communities Open Defecation Free (ODF), ensure that 400,000 people practice hand washing with soap at critical times, assist the preparation of district sanitation plans and improve local governments’ capacity for steering improved sanitation.

SSH4A diagram

SSH4A programmes have been implemented with rural communities in 15 countries across Asia and Africa. In Asia, more than 2.2 million rural people have been reached, of whom 700,000 received improved sanitation.

More information:

 

SourceSNV, 28 Apr 2014

Study examines sustainability of CLTS programmes in Africa

Plan-ODF-sustainability-coverDespite the widespread implementation of Community Led Total Sanitation (CLTS) programs and many claims of success, there has been very little systematic investigation into their sustainability.  A new study, which aims to change that, is creating a stir in the WASH sector.

A study commissioned by Plan International on the sustainability of CLTS programs in Africa revealed that 87% of the households still had a functioning latrine. This would indicate a remarkably low rate of reversion (13%) to open defecation (OD) or “slippage”.

However, if the criteria used to originally award open defecation free (ODF) status to villages are used, then the overall slippage rate increased dramatically to  92%. These criteria are:

  • A functioning latrine with a superstructure
  • A means of keeping flies from the pit (either water seal or lid)
  • Absence of excreta in the vicinity of the house
  • Hand washing facilities with water and soap or soap-substitute such as ash
  • Evidence that the latrine and hand washing facilities were being used

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