USAID CLA Case Analysis Deep Dive: Zambia’s Community-Led Total Sanitation Program

USAID CLA Case Analysis Deep Dive: Zambia’s Community-Led Total Sanitation Program, July 2019.

This case study focuses on Akros’ CLA-aligned approach to improving sanitation in Zambia, conducted as part of the Zambian Sanitation and Health Program (ZSHP) in partnership with UNICEF and funded by DFID from 2012 to 2018. Akros’ involvement began in 2014 with its introduction of a Mobile-to-Web (M2W) application to the CLTS process in a small number of pilot districts.

Upon successful completion of these pilots, Akros scaled the M2W application to 68 rural districts. Akros eventually incorporated into its intervention close collaboration with traditional leaders. As part of USAID’s efforts to build the evidence base for CLA and one of two Deep Dive case studies (the other concerns Global Communities’ response efforts to the Ebola outbreak in Liberia), this analysis seeks to assess evidence about whether intentional, systematic, and resourced approaches to CLA made plausible contributions to development outcomes in this case

Conclusions: This deep dive into CLA integration, implementation, and impact in CLTS efforts in Zambia yields a number of insights into the specific contributions CLA made to the response. It suggests that strategic collaborations with government officials, traditional leaders, and community members led to greater feelings of local ownership, self-reliance, and in many cases, effective behavior change.

An important dimension of this shift was rooted in CLA’s focus on social inclusion and facilitating diverse, culture-specific adaptations. Enabled by donor flexibility, and strengthened by a broad range of leadership support and participation, CLA approaches in this case incorporated innovative digital monitoring using the M2W app that led to better quality data and speedier feedback loops.

Chiefs/chieftainesses and headmen/women were also involved in ways that supported development outcomes, thereby demonstrating how traditional leaders can be constructive agents of change rather than anachronistic obstacles to development.

This case study utilizes and adapts innovative methods for assessing the contribution of CLA to intervention outcomes through process tracing and contribution analysis. Drawing on numerous sources of evidence, the study provides detailed descriptions of how CLA was integrated into program activities, which may inform future program design and implementation of CLA approaches for USAID staff, implementing partners, and other development practitioners.

The social dynamics around shared sanitation in an informal settlement of Lusaka, Zambia

The social dynamics around shared sanitation in an informal settlement of Lusaka, Zambia. Journal of Water, Sanitation and Hygiene for Development, March 2019.

This study explored the social dynamics affecting collective management of shared sanitation in the Bauleni compound of Lusaka, Zambia. In-depth interviews were conducted with landlords (n = 33) and tenants (n = 33). Elinor Ostrom’s eight design principles for the management of common-pool resources was used as a framework to analyse the data.

Social capital within plots was also assessed. Pit latrines were predominantly shared by landlords and tenants on residential plots. However, unwelcome non-plot members also used the latrines due to a lack of physical boundaries. Not all plot members fulfilled their cleaning responsibilities equally, thereby compromising the intended benefits for those conforming. Landlords typically decided on latrine improvements independent of tenants.

Latrines were not systematically monitored or maintained, but punishment for non-conformers was proportionate to the level of infraction. There was no system in place for conflict resolution, nor local organizations to regulate the management of sanitation. Lastly, there were few enterprises associated with peri-urban sanitation.

Social capital was moderately high, and tenants were willing to invest money into improving sanitation. The social dynamics illuminated here provide an important basis for the development of a behavioural intervention targeted towards improving urban sanitation.

The social dynamics around shared sanitation in an informal settlement of Lusaka, Zambia

The social dynamics around shared sanitation in an informal settlement of Lusaka, Zambia. Journal of Water, Sanitation and Hygiene for Development, December 2018.

This study explored the social dynamics affecting collective management of shared sanitation in Bauleni compound of Lusaka, Zambia.

Pit latrines were predominantly shared by landlords and tenants on residential plots. However, unwelcome non-plot members also used the latrines due to a lack of physical boundaries. Not all plot members equally fulfilled their cleaning responsibilities, thereby compromising the intended benefits for those conforming.

Landlords typically decided on latrine improvements independent of tenants. Latrines were not systematically monitored or maintained, but punishment for non-conformers was proportionate to the level of infraction. There was no system in place for conflict resolution, nor local organizations to regulate the management of sanitation.

Lastly, there were few enterprises associated with peri-urban sanitation. Social capital was moderately high, and tenants were willing to invest money into improving sanitation. The social dynamics illuminated here provide an important basis for the development of a behavioural intervention targeted towards improving urban sanitation.

San-Dem: Formative Research in Zambia: Briefing Note – SHARE

San-Dem: Formative Research in Zambia: Briefing Note. SHARE, November 2017.

• Full text, pdf

Conclusions: Shared sanitation in Bauleni compound and possibly other similar settings present challenges for coordinating, cleaning and ensuring proper use of toilets by plot members. 

Improvements are dependent on landlords whose primary motives for making these improvements are financial, social, and familial.

Properly designed demand-side interventions may be able to increase peri-urban sanitation quality in a cost-effective way.

Recommendations for the intervention

• Target landlords as the primary target audience because they are responsible and financially capable of making toilet improvements.
• Aim towards strengthening social cohesion on plots, as toilets are maintained as a shared resource
• Primarily use the status and nurture motives, which scored highest, while also emphasizing justice and disgust to promote social cohesion and cleanliness
• Encourage the use of different financial investment schemes by landlords to encourage savings for deliberate, planned toilet improvements

Duncan Mara – Disease Priorities in Zambia

Disease Priorities in Zambia. Am Jnl Trop Med Hyg, July 2016.

• Full text

Author: Duncan Mara. School of Civil Engineering, University of Leeds, Leeds, United Kingdom. E-mail: d.d.mara@leeds.ac.uk

An excerpt: Neonatal disorders are very important. Deaths due to neonatal sepsis and other neonatal infections have been rising steadily from 2,121 in 2000 to 2,704 in 2013. This may reflect poor WASH, the difficulty of accessing even basic-level health-care facilities in rural areas, and/or rural mothers not recognizing early symptoms of these diseases. Poor WASH should be addressed, as it is known to adversely affect maternal, infant, and child mortality. There also needs to be improved rural health care and targeted health/hygiene education for mothers and mothers-to-be.

Diarrheal diseases caused significantly fewer deaths in 2013 than in 2000. This parallels the decrease in unsafe water, unsafe sanitation, and unsafe hand hygiene, which must be sustained. The most dramatic decrease, nearly 60%, was seen in the number of human immunodeficiency virus, acquired immune deficiency syndrome, and tuberculosis deaths during 2010–2013. This truly excellent performance needs, of course, to continue.

As highlighted in this letter, an initial broad-brush approach using GBD Compare (or similar tools) is likely to produce good guidance on health priorities, especially in rural areas and periurban slums. Targeted detail can then follow.

 

 

 

 

Schools Promoting Learning Achievement through Sanitation and Hygiene – SPLASH

Why Latrines Are Not Used: Communities’ Perceptions and Practices Regarding Latrines in a Taenia solium Endemic Rural Area in Eastern Zambia

Why Latrines Are Not Used: Communities’ Perceptions and Practices Regarding Latrines in a Taenia solium Endemic Rural Area in Eastern Zambia. PLoS Neg Trop Dis, Mar 2015.

• Full text 

Authors: Séverine Thys , Kabemba E. Mwape, et al.

Livestock owners from small scale farms are most vulnerable for Neglected Zoonotic Diseases (NZD) in developing countries and their risk behavior leads to more intense and complex transmission patterns. Studies in Africa have shown that the underuse of sanitary facilities and the widespread occurrence of free-roaming pigs are the major risk factors for porcine cysticercosis. However the socio-cultural determinants regarding its control remain unclear. We hypothesize that via a bottom-up culture-sensitive approach, innovative control strategies can be developed that are more adapted to the local reality and more sustainable than current interventions.

By assessing the communities’ perceptions, practices and knowledge regarding latrines in a T. solium endemic rural area in Eastern Zambia, we found that more than health, seeking privacy underlies motivation to use latrines or not. The identified taboos related to sanitation practices are in fact explained by the matri- or patrilineal descent and because men are responsible for building latrines, sanitation programs should focus more often on men’s knowledge and beliefs. In order to contribute to breaking the vicious cycle between poverty and poor health among livestock owners in developing countries, disease control strategies should always consider the socio-cultural context.

FSM services in Lusaka: moving up the excreta management ladder

Despite most residents of African and Asian cities depending on non-sewered sanitation, only a handful of sanitation authorities have addressed the management of faecal sludge from these systems. This Practice Note describes the launch of a faecal sludge management (FSM) service in the peri-urban area of Kanyama, in Zambia.

Click on the image below for a free download.

IIED presents SHARE-funded City-Wide Sanitation Project findings

May 6, 2014 – IIED presents SHARE-funded City-Wide Sanitation Project findings at the 11th International Conference on Urban Health at the University of Manchester | Source: SHARE website

SHARE partner IIED presented its findings on the challenges and opportunities of different models for improving sanitation in deprived communities at the 11th International Conference on Urban Health at the University of Manchester. 

The work presented was published last year in a paper entitled “Overcoming obstacles to community-driven sanitary improvement in deprived urban neighbourhoods: lessons from practice”. Sanitary improvement has historically been central to urban health improvement efforts. Low cost sanitation systems almost inevitably require some level of community management, and in deprived urban settlements there are good reasons for favouring community-led sanitary improvement.

• Read the situational analyses for Blantyre (Malawi), Dar es Salaam (Tanzania), Kitwe (Zambia), and Chinhoyi (Zimbabwe) 
• Read the country specific policy briefs documenting the first year of the SHARE-funded City-Wide Sanitation Project

It has been argued that community-led sanitary improvement also faces serious challenges, including those of getting local residents to act collectively, getting the appropriate public agencies to co-produce the improvements, finding improvements that are acceptable and affordable at scale, and preventing institutional problems outside of the water and sanitation sector (such as tenure or landlord-tenant problems) from undermining improvement efforts. This paper examines these sanitary challenges in selected cities where organizations of the urban poor are actively trying to step up their work on sanitary issues, and considers they can best be addressed. 

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 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:

• IRC – Sustainable Sanitation and Hygiene for All
• SNV – Sustainable Sanitation & Hygiene for All Results Programme

 

Source: SNV, 28 Apr 2014