What Makes Ghanaians More Likely to Stop Open Defecation and Build Latrines?

What Makes Ghanaians More Likely to Stop Open Defecation and Build Latrines? Global Comunities, November 2019.

This brief focuses on the findings from studies in Ghana. This knowledge product is developed by Global Communities in order to make the findings and recommendations of the full report more accessible and actionable by the Government of Ghana Ministry of Sanitation and Water Resources (MSWR) as well as by other development partners working in rural sanitation in Ghana.

The Government of Ghana MSWR has basic sanitation guidelines to achieve 100% open defecation-free (ODF) status and equitable and adequate access to sanitation and hygiene for all by 2030, with special emphasis on the poor and vulnerable.

This knowledge product is part of the USAID-funded WASH for Health program to provide sustainable access to dignified, safe, and improved water supply and sanitation, and to educate people on the knowledge and behaviors necessary to live a healthy lifestyle. In particular, the WASH for Health program targets rural communities where these services are needed the most and helps achieve the goals of the MSWR in Ghana.

Key Findings

• Factors that determine the success of CLTS interventions are attendance rate of participants during the triggering event, the number of community leaders participating in the triggering event, whether participants believed they would receive rewards like installation of water wells and materials for toilets, and the number of follow-up visits provided by facilitators weeks after triggering.
• Households that socially identify strongly with their communities are more likely to construct latrines after CLTS interventions.
• Combining CLTS with other behavior change models did not significantly increase intervention effects.

Shaping the Sanitation Market with Product Innovations in Ghana

Shaping the Sanitation Market with Product Innovations in Ghana. WASHfunders, May 2019.

Over 10 million urban Ghanaians live with unimproved sanitation services or are openly defecating causing a severe public health concern according to WHO/UNICEF. The World Bank estimates that poor sanitation and hygiene in Ghana leads to $290 million in economic losses each year.

While businesses are trying to address the sanitation crisis, they face several barriers including lack of high quality and affordable product offerings for consumers, poor access to financing, and insufficient support to manage their business better and more professionally.

The SATO pan, a plastic toilet pan with a self closing flush mechanism that provides product innovation to Ghanaian consumers is being marketed to sanitation businesses by Total Family Health Organisation (TFHO) and PSI with funding from the USAID Supporting International Family Planning Organizations 2 (SIFPO2) Project. The product is manufactured by LIXIL, a global corporation that makes water and housing products.

Read the complete article.

Indigenous plants for informal greywater treatment and reuse by some households in Ghana

Indigenous plants for informal greywater treatment and reuse by some households in Ghana. Journal of Water Reuse and Desalination (2018) 8 (4): 553-565.

Poor greywater management is one of Ghana’s sanitation nightmares due to longstanding neglect. This study looks at local practices of informal phytoremediation, and identifies commonly used plants and benefits. Greywater (kitchen, bathroom and laundry) is mainly disposed of into the open, with few using septic tanks and soakaway systems.

The majority of respondents perceived plants as agents of treatment and most could list 1–2 beneficial functions of the plants. A total of 1,259 plant groups were identified which belonged to 36 different plant species. The top five indigenous plants used are sugarcane, banana/plantain, taro, sweet/wild basil, and dandelion.

The major plant benefits identified were food and medicine. Statistically, no association was identified between the numbers of plants grown and their perceived plant roles, with the exception of an association between plant numbers and benefits. There is demand for improving local practices of using plants in greywater treatment and reuse, since native plants also come with other benefits.

BBC News – Menstruating girls banned from crossing Ghana river

Menstruating girls banned from crossing Ghana river. BBC News, January 11, 2018.

Ghanaian schoolgirls have been banned from crossing a river while they are menstruating – and on Tuesdays.

Girls living near Kyekyewerein (not pictured) are affected by the ban

The ban, apparently given by a local river god, has outraged children’s activists, especially as girls must cross the river to reach school.

It means girls in the Upper Denkyira East district, in the Central Region, could miss out on their education.

Sub-Saharan Africa is already struggling to keep girls in school during their periods.

The UN’s scientific and education organisation, Unesco, estimates one in 10 girls in the region does not attend school because they are menstruating, while a World Bank report notes that 11.5m Ghanaian women lack the appropriate hygiene and sanitation management facilities needed.

Read the complete article.

Global Waters Radio: Establishing a Sustainable Market for Water Purification Tablets in Ghana

Global Waters Radio: Establishing a Sustainable Market for Water Purification Tablets in Ghana. Global Waters, July 18, 2017.

“We feed ourselves out of the sale of Aquatabs — so financially, Aquatabs has helped given us a very sustainable job, and we are proud of it.” 

Ernest Saka Ansong is managing director for Health Top Up Services, a private Ghanaian company that serves as Aquatabs’ official importer. Photo Credit: Health Top Up Services

Aquatabs are one of the world’s most popular water purification tablets, produced by Medentech, a company specializing in manufacture of disinfection products.

Through partners, more than 11 billion liters of water were treated with Aquatabs worldwide in 2016.

First introduced to the Ghanaian market roughly 10 years ago by the USAID Ghana Sustainable Change Project, the tablets remain in high demand today — more than 4 million tablets were sold in Ghana alone in 2015, with similar sales figures in 2016.

Why so popular after all these years? First and foremost, affordability — but also a proven ability to bolster community health, and reduce the prevalence of dangerous waterborne illnesses like cholera.

Read the complete article.

When Water Doesn’t Flow: Why Lack of Water Matters in Healthcare Facilities

When Water Doesn’t Flow: Why Lack of Water Matters in Healthcare Facilities. PLoS Global Health Blog, June 29, 2017.

Why Lack of Water Matters in Healthcare Facilities

Water, as well as the availability of sanitation and hygiene infrastructure, are essential to providing safe, quality healthcare. Without water, surfaces remain unclean and medical equipment cannot be sterilized. Water shortages within healthcare facilities are particularly concerning when thinking about the water needed for surgery or in maternity units.

When water does not flow from the piped water supply within the hospital, jerry cans (the yellow containers shown) are used to collect water from a nearby lake

According to the World Health Organization’s Essential Environmental Health Standards in Health Care, 100 liters of water are needed per medical intervention preformed in healthcare facilities.  As an example, if one hospital in Ghana reported that 138 babies were born in one month then 13,800 liters of water would be needed to ensure safe delivery of all babies. Based on my experiences as a researcher and a patient in a rural Ghana hospital, meeting this requirement would be virtually impossible.

During my hospitalization, water did not flow through the pipes within the hospital and the donated water treatment system was not operating due to water scarcity and intermittent power in the region.

The lack of water sparked a series of managerial decisions, which in turn affected patients’ access to toilets and handwashing facilities, which led to clinical staffing shortages. Without adequate water in the hospital, management locked the bathrooms within the wards and rationed water for staff handwashing.

My infirmed neighboring bedmates were told to use an open area behind the ward to relieve themselves. In a few cases, these sick patients were too weak to do so, and the floor next to their beds quickly became soiled contributing to environmental contamination. The hospital would then dispatch valuable nursing staff to a lake –located half a mile away to get water in order to clean floors.

Read the complete article.

Ghana – Think tank for sanitation management inaugurated

Think tank for sanitation management inaugurated. Graphic, June 28, 2017.

An environmental sanitation think tank to serve as a focal point for providing long-term solutions to sustainable and environmental sanitation management in Ghana has been inaugurated in Accra.

Mr Joseph Kofi Adda, the Minister of Sanitation and Water Resources, swearing in the board of the Tersus Ghana Environmental Sanitation Think Tank at the Ghana Academy of Arts and Science conference room in Accra. Picture: EMMANUEL QUAYE

The think tank, called Tersus Ghana, will provide input and guidance for rigorous empirical research that will produce environmental sanitation-related information relevant to the sector and the nation as a whole.

Tersus, a Latin word for ‘clean-up’, will operate as a not-for-profit, non-partisan group with a membership made up of government, academia, as well as non-governmental organisations (NGO) and industry-based experts.

Read the complete article.

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. 

• Full text

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.

 

WSUP -Webinar: A toilet in every compound – what we’ve learned so far from Kumasi and Accra, Ghana

Published on Oct 10, 2016
Many low-income residents of Kumasi and Ga West (Accra) live in compound housing where they share the same living space with more than 20 people. The vast majority will have no access to in-house sanitation, instead relying on the high number of public toilets which typify Ghana’s urban centres.

Kumasi Metropolitan Assembly (KMA) and Ga West Municipal Authority (GWMA) are responding to this challenge through a 5-year compound sanitation strategy, now being implemented with support from the USAID Sanitation Service Delivery (SSD) program.

This webinar presented the learning we’ve had so far, and the successes and failures of the strategy.

Presenters: Georges Mikhael (Head of Sanitation, WSUP), Frank Romeo Kettey (Project Manager, WSUP Ghana) and Richard Amaning (WASH Financing Expert, SNV). Moderated by Sam Drabble (Research and Evaluation Manager, WSUP).