Priorities for the WASH sector in Ethiopia: report from a multi-stakeholder forum

By María Florencia Rieiro, Independent WASH Consultant

The annual Water, Sanitation and Hygiene (WASH) Multi-Stakeholder Forum (MSF) is the most important WASH sector event in Ethiopia with over 300 participants. The first WASH MSF was conducted in 2006 under the auspices of the European Union Water Initiative for WASH sector coordination. The Government Ethiopia’s WASH organisations (education, finance, health and water) took over the WASH sector coordination process later on and, since then, the Ministry of Water, Irrigation and Energy has led the National WASH Steering Committee and the organisation of the MSF.

2019 marked the 10th MSF for WASH and the 2nd MSF for the Joint WASH-WRM. The event was held in Addis Ababa on 26th-27th November under the theme “Accelerating integrated, inclusive, sustainable and quality WASH services and water resources management for achieving the SDGs”. Among the WASH topics discuss, it is relevant to highlight equity, inclusion and accessibility in WASH, WASH marketing, WASH financing gaps and financing and equity, quality in WASH, sustainability in WASH, climate-resilient water safety planning and WASH sector institutional capacity building. The MSF 10 also comprised the launch of Ethiopia’s Open Defecation Free Campaign (2020-24).  

The MSF 10 full proceedings present the main highlights of the two days event together with the 12 priority undertakings for the year 2020. From the WASH side, the priority undertakings for 2020 are the following ones:

• Improve the institutional capacity to deliver WASH services.
• Increase the WASH sector financing.
• Improve the business climate for the private sector and improve the private sector’s capacity to deliver WASH services.
• Develop robust functional planning, monitoring, and a management information system for WASH.
• Develop rollout national strategies and the ODF campaign 2024 to eliminate open defecation (and urination) in rural and urban areas, and to improve the access to safe sanitation with dignity.

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.

Identifying the last 10% of households practising open defecation in rural Tanzania

Since 2017, SNV and the Government of Tanzania have been implementing the Sustainable Sanitation and Hygiene for All (SSH4A) programme in eight Tanzanian districts. To date, the number of households that use toilets has increased to 90%. In the period March–April 2019, SNV Tanzania undertook a household survey in the eight project districts to identify the 10% of households still practising open defecation or sharing toilets despite the concerted government and SNV sanitation interventions. The findings show the majority of the households still practising open defecation and sharing latrines in the rural districts of Tanzania are not those commonly cited by the literature and sanitation programming – the people in poverty, the elderly people, people with disabilities, and those with other specific vulnerabilities. The majority in ‘the last mile’ are: 1) the ‘defiant’ households that have the socio-economic resources to build themselves latrines but prefer to practise open defecation or share toilets; 2) the socially isolated households that do not have a financially able family member who can support them; and 3) the geographically isolated households that are far from information centres. The SNV study also revealed a relatively high percentage of households headed by single mothers and those living in difficult terrains as part of the last mile. Furthermore, the study identified opportunities to increase access to sanitation among the last mile groups. These are: 1) introduction of behaviour change re-enforcement interventions tailored to different target groups; 2) promotion of context-specific sanitation technologies; and 3) introduction of community-led ‘social exclusion’ strategies.

Read the full report. SNV, 2019. Identifying the last 10% of households practising open defecation in rural Tanzania. Dar es Salaam, Tanzania: SNV Tanzania. 14 p.

Nigeria needs a more effective sanitation strategy. Here are some ideas

Nigeria needs a more effective sanitation strategy. Here are some ideas. Phys.org, June 5, 2019.

Our research shows that while community-led total sanitation is effective in Nigeria’s poorer areas, there are two main challenges.

First, community-led total sanitation had no perceivable impact in the wealthier half of our sample. There, open defecation remains widespread. And second, even in poor areas, a large number of households still engaged in open defecation after the intervention.

This suggests that while community-led total sanitation can be better targeted, it needs to be complemented with other policies—subsidies, micro-finance or programmes that promote private sector activity in this under-served market.

Read the complete article.

World Bank – Shifting Social Norms to Reduce Open Defecation in Rural India

Shifting Social Norms to Reduce Open Defecation in Rural India. World Bank, December 2018.

This study of Uttar Pradesh systematically measures relevant social norms and cultural schema persistent in rural villages. The study finds two pathways through which social norms inhibit latrine use: (i) beliefs/expectations that others do not use latrines or find open defecation unacceptable; and (ii) beliefs about ritual notions of purity that dissociate latrines from cleanliness.

The study finds a statistically significant positive relationship between latrine use and social norms. To confront these, the study piloted an information campaign to test the effectiveness of rebranding latrine use and promoting positive social norms, by making information about growing latrine use among latrine owners more salient.

The results show statistically significant improvements in open defecation practices across all treatment households, with latrine use scores in treatment villages increasing by up to 11 percent, relative to baseline. Large improvements were also observed in pro-latrine beliefs.

This suggests that low-cost information campaigns can effectively improve pro-latrine beliefs and practices, as well as shift perceptions of what others find acceptable vis-à-vis open defecation

Community-based approaches to tackle open defecation in rural India: Theory, evidence and policies

Community-based approaches to tackle open defecation in rural India: Theory, evidence and policies. Observer Research Foundation, December 2018.

Open defecation (OD), an age-old practice in India, impacts the health of individuals as well as their communities. To tackle the problem, the Government of India launched the Swachh Bharat Mission (SBM) in 2014, aimed at making the country open-defecation free (ODF) by October 2019 by giving more attention to community-based approaches.

However, while such approaches have helped solve the sanitation riddle in many countries, curbing OD in India is much more complicated: the root of the problem is a combination of lack of sanitation infrastructure and deep-seated habits. So far, India’s sanitation policies have used the top-down approach, focusing on financial assistance for latrine construction.

While this is necessary, considering the social determinants at play, the emphasis must be on changing collective behaviour through participatory methods, a component that has been largely absent from past policies on sanitation.

Demand-driven approaches must be adopted, keeping in mind their strengths and weaknesses and ensuring equity-focused actions through community-monitored, locally appropriate and culturally sensitive interventions.

Jack Sim – Making India open defecation free

Opinion | Making India open defecation free. by Jack Sim in Livemint, October 17, 2018.

Many people view toilets as impure and refrain from installing them within their household premises 

The risks associated with open defecation in India are not just restricted to diseases. Rapes occur when women and young girls are on their way to fields to defecate at night. Photo: Mint

For most of us, going to the toilet is as simple and natural as breathing. However, for many it is a daily nightmare. About 2.3 billion people in the world do not have access to clean, safe and reliable toilets. They have to walk for miles every day to reach a safe spot where they can relieve themselves in the open. Inadequate sanitation is estimated to cause 280,000 deaths worldwide, annually.

In India, about 732 million people do not have access to proper toilets. As much as 90% of the river water is contaminated by faeces. People drink water from the same rivers, bathe and wash their clothes and utensils there, and even cook food with the contaminated water. Pathogens and worms from the faeces spread life-threatening diseases like diarrhoea, cholera, typhoid, schistosomiasis and trachoma.

Read the complete article.

Dean Spears on what motivated ‘Where India Goes?’

Dean Spears on what motivated ‘Where India Goes?’ Community Led Total Sanitation, March 30, 2018.

In this short video interview Dean Spears (Executive Director, RICE/Assistant Professor of Economics, University of Texas at Austin) talks about the key motivations behind the award-winning book he co-authored with Diane Coffey, ‘Where India Goes: Abandoned toilets, stunted development, and the cost of caste.’ 

The book addresses a central puzzle: why is open defecation so persistently high in rural India?

And what to do about it?

It presents evidence showing that poor sanitation is an important determinant of the poor health outcomes of India’s children, and that the continuing relevance of the purity, pollution and untouchability norms of the caste system keeps open defecation alive today despite decades of government latrine construction programmes.

The main motivation for writing the book as Dean reflects in the interview, ‘hopefully it will get people involved and excited about trial and error around these solutions to these problems of purity and pollution and latrine pits filling up. Hopefully that can lead to something that really can accelerate the decline of open defecation in rural India.’

Webinar – Contribution of Community-Led Total Sanitation to Ending Open Defecation: Findings of a Desk Review

Webinar – Contribution of Community-Led Total Sanitation to Ending Open Defecation: Findings of a Desk Review, December 14, 2017. 

• Link to Webinar

On Wednesday, December 13, 2017, the USAID-funded Water, Sanitation and Hygiene Partnerships and Learning for Sustainability (WASHPaLS) Project held a webinar on the role of community-led total sanitation (CLTS) in helping to end open defecation.

WASHPaLS presented key findings from a desk review assessing the knowledge base on CLTS program performance. The findings and identified evidence gaps will inform the WASHPaLS research agenda for subsequent years of the project.

 

USAID/WASHPaLS webinar on CLTS and open defecation

The USAID-funded Water, Sanitation and Hygiene Partnerships and Learning for Sustainability (WASHPaLS) Project invites you to a webinar examining how community-led total sanitation (CLTS) has contributed to the goal of ending open defecation.

WASHPaLS will present key findings from a desk review assessing the knowledge base on CLTS program performance. The findings and identified evidence gaps will inform the WASHPaLS research agenda for subsequent years of the project. Please view the invitation below for more information and to register.

Register and learn more: https://www.bigmarker.com/waterckm/WASHPaLs-review