ZAMBIA SITUATIONAL ANALYSIS ON CLTS/SLTS/ULTS

Prepared by: Wiscot M. Mwanza

Dated: June 2012Executive SummaryCommunity Led Total Sanitation (CLTS) is one of several approaches currently being implemented in Zambia to increase rural sanitation coverage. The Joint Monitoring Programme (JMP) on Water Supply and Sanitation

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estimated rural sanitation coverage in Zambia to be 43% in 2008 (UNICEF/WHO, 2010). The MDGs Report 2008 showed that Zambia had made significant progress towards reaching MDGs in all goals, except the MDG7: Ensuring environmental sustainability, Target 7c: Halve, by 2015, the proportion of the population without sustainable access to safe drinking water and basic sanitation. The achievements of sanitation targets are an obvious priority in Zambia, where over 80% of all diseases in Zambia are environmental and related to water and sanitation2.

Following a successful pilot in Choma District in 2007, implemented by the GRZ and UNICEF, where within a period of two months sanitation coverage increased from 23% to 88% and 75% of the villages were verified as open defecation free (ODF), CLTS became a key sanitation approach in Zambia. At the district level, CLTS is overseen by MLGH through the Local Authorities (District, Municipal and City Councils) who implement as well as coordinate activities of other government stakeholder bodies and agencies including Plan International, Oxfam GB, UNICEF, Africare, Village Water and World Vision.

In an effort to assess the processes of the CLTS programme, and to recommend ways of improving and scaling-up the programme to other parts of Zambia, this independent evaluation was commissioned by MLGH and UNICEF in June 2011 to look at programme aspects of CLTS and evaluate CLTS in the strategic areas of relevance, efficiency, effectiveness, sustainability and impact.

In taking CLTS to scale in Zambia, experiences have been spreading based on a strong history of promoting lessons learned from the successful pilot district of Choma in starting programmes in other districts. A good capacity exists and many ideas for taking the programme forward, and there has been some investment in the development of national, district and community level structures to oversee and carry on CLTS activities. District visits including interviews with communities indicate that in areas where CLTS has taken root people are taking responsibility for day to day use and maintenance of facilities, and a general hygiene improvement is noticeable. However there are a number of critical gaps that require stronger oversight.

This is highlighted by a review of data available which indicates that the gains achieved in the pilot district of Choma have not yet been replicated on the same scale in other districts, with a somewhat overall lower proportion of ODF villages against villages triggered achieved when discounting the pilot District of Choma. Despite this there are very positive results demonstrated on the ground in some of the other districts visited and a strong basis has been formed for future activity. With a more comprehensive rolling out of systems planned to the districts and dedicated resources put towards a greater centralized focus overseen by a dedicated management unit, CLTS could achieve better results. Strengthened monitoring and information management systems are needed at all levels, and an active verification and certification system would strengthen the numbers currently being reported. Setting up an independent third party certification is needed, as well as a clear and uniform definition of what constitutes ODF.

Monitoring systems should also emphasize and be clear on different indicators and milestones towards reaching ODF status versus reaching 100% sanitation coverage according to government standards. In terms of training and facilitation, more focus on developing a roster of a group of highly skilled champion facilitators with proven experience in successful triggering is needed. At the village level, a major gap noted during the evaluation is the inadequate resources for support and training of local community members to carry on activities without a reliance on district staff. To ensure sustainability, more resources are needed to support EHTs (community health workers) through training and other support systems to monitor the programme on the ground. Follow ups, whether they are done by District staff, or EHTs are essential in maintaining sustainability of interventions.

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1. BACKGROUND1.1 IntroductionZambia covers an area of 752,620 square kilometers, which is divided, for administrative purposes, into nine provinces and 72 districts. Zambia is a multi-party democracy and follows a representative form of Government consisting of central government and local government with jurisdiction over each district. Through the National Decentralisation Policy, developed in 2002 but launched in August 2004, Government aims to strengthen local government structures and decentralise government responsibilities and functions to the district councils

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through “devolution”. Provision of basic services including water supply and sanitation (WSS) will be implemented through local authorities at district level1.

Population Size and DistributionThe population of Zambia has been increasing from 7,759,161 in 1990, 9,885,591 in 2000 and 13, 046, 508 persons in 2010. This gives an average annual growth rate of 2.8 percent between 2000 and 2010. Of the 2010 population, 49 percent were males and 51 percent were females.

The population count from the 2010 Census of Population and Housing for Zambia is 13,046,508 as at October 2010. Of the 13,046,508 persons, 6,394,455 were males while 6,652,053 were females. The regional distribution of the population shows that 7,978,274 people (61 percent) resided in rural areas and 5, 068, 234 (39 percent) resided in the urban areas2.

Table 1: Population Size and Distribution by Province and Sex, 1990- 2010Province

1990 2000 2010Male Female Total Male Female Total Male Female Total

Central 385,230 386,588 771,818 510,501 501,756 1,012,257

626,823 640,980 1,267,803

Copperbelt

739,519 718,940 1,458,459

799,402 781,819 1,581,221

973,770 984,853 1,958,623

Eastern 492,909 511,784 1,004,693

648,676 657,497 1,306,173

836,165 871,566 1,707,731

Luapula 278,222 286,271 564,493 387,825 387,528 775,353 467,613 491,363 958,976Lusaka 498,704 492,522 991,226 705,778 685,551 1,391,3

291,080,152

1,118,844

2,198,996

Northern 456,865 469,000 925,865 629,976 628,720 1,258,696

861,628 897,972 1,759,600

North-western

212,826 225,390 438,216 290,856 292,494 583,350 345,025 361,437 706,462

Southern 474,488 491,103 965,591 601,440 610,684 1,212,124

786,394 820,399 1,606,793

Western 302,813 335,943 638,756 371,844 393,244 765,088 416,885 464,639 881,524Zambia 3,841,5

763,917,541

7,759,117

4,946,298

4,939,293

9,885,591

6,394,455

6,652,053

13,046,508

Economic Conditions Zambia’s economic performance has declined, in real terms, over the last two decades. Per capita income which was around US$630 in 1980 has fallen to less than half (US$300) in 2000 but was in 2006 again back at US$630. However, real GDP growth rates have fluctuated between 2 and 5% over the last five years. Inflation and interest rates have shown a declining trend over the same period3.

Sanitation overview4Sanitation coverage is one of the most serious development concerns facing Zambia. The Joint Monitoring Programme (JMP) on Water Supply and Sanitation estimated rural sanitation coverage in Zambia to be 43% in

1 NRWSSP 2006-20152 Census 20103 Ibid4 CLTS in Zambia Evaluation Report 2011-MLGH

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2008 (UNICEF/WHO, 2010). The MDG Report 20083 showed that Zambia had made significant progress towards reaching MDGs in all goals, except the MDG7: Ensuring environmental sustainability, Target 7c: Halve, by 2015, the proportion of the population without sustainable access to safe drinking water and basic sanitation. The achievement of sanitation targets is an obvious priority in Zambia, where over 80% of all diseases in Zambia are environmental and related to water and sanitation4.

In order to reach these far reaching inequities, the Government of Republic of Zambia (GRZ) has set out a National Rural Water Supply and Sanitation Programme (RWSSP) (2006-2015), which sets out conditions and strategies to improve access, meet the MDGs and achieve universal coverage to water and sanitation by 2030.

The community led total sanitation (CLTS) approach, an innovative results-based methodology which mobilises communities to completely eliminate open defecation (OD) through facilitating their own appraisals and analysis promoting them to take action to become ODF (open defecation free), is now a key sanitation method being promoted by the GRZ. In Zambia, as in many other countries, past approaches to household and community sanitation have not resulted in adequate increases in sanitation coverage which is generally defined by the ratio of the number of toilets to the number of households, and therefore further for effective methods were explored.

In order to meet the challenges in scaling up sanitation coverage in Zambia, in 2007 GRZ in conjunction with partner UNICEF decided to pilot the CLTS approach in Choma district in Zambia’s Southern province where overall sanitation coverage was at 27%, in order to see whether CLTS could offer an effective strategy for rural sanitation implementation in the country. Twelve communities were initially triggered by trained CLTS facilitators who were trained by Karmal Kar at a national workshop held in November 2007. Within the period of two months, sanitation coverage increased from 23% to 88% within a population of 4,536 and 75% of the villages were verified as ODF, surpassing the MDG target for sanitation in the pilot area in just two months 5. The Chiefdom, of 115 villages became ODF in 2010. Based on these successes, which was largely due to strong involvement of dynamic local leadership including Chief Macha, CLTS was expanded through the remaining parts of the district, and in other districts in Zambia as well. According to a CLTS in Africa workshop report (2010), there are now over 1,200 villages triggered and 751 declared ODF in 18 districts. The GRZ now recognizes CLTS as an effective approach to and sees the CLTS as one of the most proactive interventions that would help in the attainment of the MDGs goal number 7 and has decided to give CLTS full recognition and adoption. In 2011, CLTS is now a national programme, being implemented in 18 of the 74 districts of Zambia through a range of International and local NGOs, government departments and other stakeholders and donor funds.

In Zambia, a locally-adapted CLTS approach has been promoted throughout the country, through a distinct “3 pronged” approach which relies on the leadership of traditional leaders, councilors (elected officials) and technocrats. Another feature of CLTS which has been adapted by the government is a “total sanitation” approach which not only focused on latrines, but also household hand washing devices and other forms of environmental sanitation such as refuse pits.

Considering the relative successes of CLTS in Zambia, interest amongst different institutions is growing although rapid institutional take-up of CLTS has raised some dilemmas, as to how the approach can be established in the different regions throughout the country, which each pose their own particular challenges. Therefore the GRZ through MLGH has stated they are interested to understand the relative strengths and drawbacks of the approach to date, in order to ensure that the quality of the approach is maintained. Six districts were chosen by MLGH/UNICEF and the evaluators were seen has having a spread of experiences. The following map and table outline data collection methods against locations (districts).

Sanitation Situation in Zambia/National policy context

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5The Joint Monitoring Programme (JMP) on Water Supply and Sanitation estimated rural sanitation coverage in Zambia to be 43% in 2008 (UNICEF/WHO, 2010). Although the GRZ states in their National Rural Water Supply and Sanitation Programme (NRWSSP) document (2006-2015) that coverage of rural sanitation is at 13%, this is according to the higher standards of “improved sanitation” being defined. As demonstrated in the 2008 MDG report, sanitation targets are off-track although significant progress is being made in all other goals. It is also estimated that 30% of Zambians do not have access to any type of sanitation facility, which represents around 2 million people6. The GRZ estimates that taking into account population growth rates (and their own coverage definitions), in order to reach MDGs for sanitation, 4.3 million people will need access to sanitation in the 74 districts. The new program therefore has to reach 1 million people per year.

The MLGH is the main government agency tasked with Rural Water Supply and Sanitation (RWSS), with programmes being implemented and coordinated through the Local Authorities. MLGH has policy as well as technical oversight and facilitates all approaches being implemented, and as such, developed the National Rural Water Supply and Sanitation Programme (NRWSSP) to set out approaches for provision of improved access to safe and adequate water and sanitation in rural Zambia in 2006. The GRZ takes a highly coordinated and harmonised approach to RWSS. One of the specific objectives of the NRWSSP is to increase and improve the number of proper sanitation facilities in rural areas through promotion of household latrine construction, health and hygiene education, and strategic demonstration facilities.

Specifically, in terms of sanitation policy, MLGH has as set five main aims in the accompanying National Rural Water Supply and Sanitation Programme Sanitation and Hygiene Component:

To proactively support the creation and nurturing of a stand-alone national policy and strategy on sanitation and hygiene

Support the designation of an institutional home and clear responsibilities for sanitation with accountability for sanitation

Ensure that sanitation is explicit in key national strategy documents and investment plans Advocate for public sector allocations for adequate human and financial resources Facilitate a harmonized approach and implementation guidelines

The GRZ has adopted CLTS as one of the innovative approaches for scaling up sanitation and as a part of the RWSS framework, and recognizes that CLTS has a great potential for contributing towards meeting the Millennium Development Goals, however is mainly relevant for areas with low coverage of any type of toilet. The document suggests that the Western Province, followed by Southern and Eastern Provinces, thus had the highest proportion of households with no toilet facility it is more beneficial to concentrate the use of the CLTS approach in areas. The document goes on to say that “The sustainability of the impressive increase in sanitation coverage in areas where implemented is therefore being closely monitored so that lessons learnt can be used for adjustments of the approach, if required.” Despite this appraisal in the Sanitation Programme policy component, there is no clear individual policy on CLTS.

The government now plans to expand CLTS from the current 18 districts to all of the 74 districts in the country through the 6th National Development Plan (SNDP 2011~2015). There are currently a range of different agencies implementing CLTS programmes as a key methodology for sanitation provision in Zambia, including UNICEF, Oxfam, Plan International, Village Water, Africare and other NGOs such as World Vision, and WaterAid are either planning or looking at approaches. MLGH is also independently (with other government counterparts) implementing CLTS in 13 districts through donor funds such as DANIDA. Additionally, several donors have provided funds for CLTS programming through implementing partners, including to the MLGH for direct implementation.

5 Ibid

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ApproachesCLTS approaches being implemented in Zambia are based on original approaches developed by Karmal Kar, although approaches have been adjusted in order to suit national characteristics8. Features of the CLTS approach are to enable communities to analyse their sanitation conditions collectively and internalize the impacts of open defecation (OD) on public health for the entire community. This is carried out through a series of triggering activities, which then should lead to “no-subsidy” community developed approaches from elimination of OD to construction of latrines. According to the CLTS Handbook (Kar and Chambers, 2008) a new style of facilitation has evolved, using the crude local word for “shit” and includes community visits to filthiest areas, with a self-appraising and analyzing process which aims to shock and disgust and then leave action to the community.

Zambia Specific Approaches: In Zambia all of these aspects have been adopted, with additional “locally adapted” aspects. One of these has been the development of the “3 rope” approach which revolves around leadership of 3 elements: the traditional leadership (through Chiefs primarily as well as Headmen), technocrats (district and field level government staff from a variety of government departments) and civic leaders including elected officials such as councilors. The Chiefs were seen to represent the custodians of values, and had the power to address cultural taboos. The 3 rope approach enables leaders from all 3 groups to attend CLTS trainings and be involved in or facilitate triggering and conduct follow ups as well as monitoring.

The other aspect of CLTS being implemented in Zambia includes a “total sanitation” approach. Messages being spread by facilitators focus on not only the range of behaviour related to open defecation and construction of toilets but also according to the MLGH CLTS Brief (2010) “washing hands with soap before preparing food and eating, after using the toilet, and after contact with babies’ faeces, or birds and animals; handling food and water in a hygienic manner; and safe disposal of animal and domestic waste to create a clean and safe environment”. This is evidenced by Chief Macha’s slogan in Choma District “One family one toilet, one toilet one hand washing facility”. Monitoring of CLTS programming includes not only indicators on sanitation coverage but also hand washing devices, refuse pits, and dish racks. Therefore, approaches are output-focused, not only on changing sanitation habits but also on the increase in access to a range of household “hardware”.

The final locally adapted aspect of CLTS being implemented in Zambia is the legal enforcement approach, which is a strategy initiated to address and confront “urban nuisances” related to sanitation as well as food and general hygiene. Trainings have been held in 7 districts and are currently being rolled out to the entire country. The aim of the trainings is to sensitize the business community, government and public on adhering to public health and food safety laws. Through the programme over 60 court cases have been brought and prosecuted before Courts of Law. The specific target of legal enforcement is public buildings (i.e. government buildings, schools), food establishments and lodges etc. in urban areas9.

Leadership, Facilitation and Staffing of CLTS programmesCLTS as an approach is facilitated centrally through a CLTS National team, therefore management decisions and training and facilitation methods are developed centrally. The national team, which sits under MLGH, has a wide representation a range of interests and including the National CLTS Coordinator has representatives from MOH, Legal Enforcement (under MLGH), Media, WASHE/NGO Forum and Judiciary. The National Team meets quarterly, however there are also challenges in finding appropriate times as members have other commitments, such that there has been no meeting to date in 2011. Information flow from the decisions reached is communicated through the CLTS focal points in each of the districts.

Responsible Authority for Sanitation and Sector Position In accordance with the Local Government Act, the National Water Policy and the Water Supply and Sanitation Act, the local authorities and the Ministry of Local Government and Housing (MLGH) have the main

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responsibility over rural water supply and sanitation (RWSS). MLGH provides policy guidance, technical and financial control, and facilitates mobilisation of foreign and local funds for capital development. The Ministry of Health (MOH) has responsibility over sanitation and hygiene promotion, Ministry of Education (MOE) has responsibility over school sanitation, and Ministry of Energy and Water Development (MEWD) is responsible for water resources management.

The framework devolves water supply functions to local authorities in accordance with the 1991 Local Government Act, the 1994 National Water Policy, the 1997 Water and Sanitation Act, and the Decentralisation Policy of 2002. Under this new institutional framework, responsibility for delivery of water and sanitation services, as well as the necessary funding, will be devolved from central government to the local authorities. Planning and budgeting for rural water supply and sanitation will be based on a ‘bottom-up’, community- and demand-driven system originating in “V-WASHEs”, which are sub-components of Village Development Committees. Overall district rural water supply and sanitation priorities will be set by elected representatives (Councillors). The management of the NRWSSP is anchored on the successful operationalisation of this institutional framework.

Presently, there are two key regulatory institutions for the water sector: The Water Board, a statutory body reporting to MEWD, is responsible for regulating the use and abstraction of surface water through a system of water rights; groundwater abstraction is currently not regulated. The other regulator, NWASCO, also reporting to MEWD, is the water supply and sanitation sector regulator.

Related National Policies and Strategies For more than a decade, Government has been implementing the Public Service Reform Programme (PSRP) aimed at improving efficiency and effectiveness in delivery of services by the public sector. The PSRP embarked on streamlining the functions, structures, establishments, and operations of ministries/institutions so as to improve efficiency and effectiveness, and accountability. One of the key components of PRSP was decentralisation and strengthening of Local Government.

The National Decentralisation Policy, developed in 2002 and launched formally in August 2004, aims at decentralising government responsibilities and functions to lower level government through “devolution”. The Decentralisation Policy reaffirms the district councils as the institutions responsible for water supply and sanitation. More importantly, it acknowledges the need for the Government to “decentralise with matching resources, some of its functions to the district”, thus empowering the local authorities to discharge their responsibility with respect to RWSS. The RWSS sub-sector will benefit from the implementation of the policy, as the institutional framework for RWSS discussed in subsequent sections is in line with the key provisions of the decentralisation policy. With full implementation of the policy, staff of line ministries of health, community development, education, and water resources will be transferred to local authorities. This would strengthen the local authorities’ capacity and inter-sectoral coordination for the provision of RWSS services. Staff transfers have not yet been effected and financial management systems are yet to be fully implemented.

Between 2002 and 2004, Zambia implemented the Poverty Reduction Strategy Paper (PRSP) aimed at addressing poverty through a multi-sectoral and integrated approach for sustainable economic growth (GRZ, 2002). Provision of rural water supply and sanitation was identified as one of the key interventions for dealing with poverty in rural areas. However, only a small budget was allocated and even less was released to rural water supply and sanitation.

Based on the National Water Policy framework, a number of strategies relevant to the RWSS sub-sector have been developed and include: Strategy and Institutional Framework for the Water and Sanitation Sector (1995) which specifies the institutional arrangements for provision of WSS by local authorities; National Environmental Sanitation Strategy (1998) aimed at raising the profile of sanitation in provision of basic social

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services, as well as outlining the strategies for provision of sanitation services), the Community Water Supply and Sanitation Strategy (2000) targeted at RWSS; and Mainstreaming Gender in Water Supply and Sanitation Sector (2000). To varying degrees these strategies have an impact on the implementation of service delivery of water supply and sanitation to Zambia’s rural areas.

The most significant strategy with respect to RWSS is WASHE (Water, Sanitation and Health Education) adopted in May 1996. Its objective is to promote integrated development of water, sanitation and hygiene education so as to improve the health impact of water and sanitation interventions and to promote community management in order to ensure sustainability of services through better financial support and operation and maintenance. Implemented through the Local Authorities, the WASHE strategy brings together different local stakeholders drawn from district level. The Revised Institutional Framework for the Rural Water Supply and Sanitation2 announced by MLGH in November 2004 reinforced the Local Authorities’ roles in leading district level water supply and sanitation activities and promotion of the WASHE concept.

Legal Framework for Water Supply and Sanitation

The legal framework for the water and sanitation sector is anchored by two main pieces of legislation: the Local Government Act No. 22 of 1991, and the Water Supply and Sanitation Act No. 28 of 1997. The main tenets of the two acts are outlined below: a) Local Government Act No. 22 of 1991 gives the local authorities prime responsibility for the provision of

water supply and sanitation services to all areas within the local authority boundary, including rural areas. The local authorities are also empowered to make by-laws, set standards and guidelines for provision of services. According to this Act the local authorities operate under the control of the minister responsible for local government (presently Minister of Local Government and Housing).

b) Water Supply and Sanitation Act No. 28 of 1997 specifies how local authorities may provide urban water supply and sanitation services, and establishes the National Water Supply and Sanitation Council (NWASCO) as the regulator for the water supply and sanitation sector. Local authorities may provide services by themselves or through commercial utilities licensed and regulated by NWASCO.

There are other pieces of legislation which have an impact on provision of water supply and sanitation in rural areas in Zambia. The Water Act, Cap. 198 (enacted in 1948) is concerned with the development and management of surface water resources throughout the country excluding parts of river basins that are part of international boundaries. The Act also excludes groundwater. A revision of the Water Act is scheduled to be presented to Parliament in 2007. The proposed new act will have provisions for regulating groundwater (currently unregulated), and this will have an impact on development and management of groundwater for rural water supply and sanitation. The Environmental Protection and Pollution Control Act of 1990 deals with protection of the environment and control of pollution; and the Public Health Act of 1995, which has provisions for the management of sanitation and prevention of pollution to water supplies by the local authority.

This legal framework is not sufficient for the development of the RWSS sub-sector. In addition, given that the GRZ is now moving towards implementation of the revised RWSS institutional framework, anchored in the Decentralisation Policy, cognisance is taken of the fact that there may be need for further elaboration of the legal framework. Legal revision should also address regulation of RWSS service provision.

Key Sector Issues Low access to safe drinking water supply. Extremely low levels of access to adequate sanitation facilities. In total, 30% of rural population or

about 2 million people do not use any type of latrine. Leadership of the RWSS sector is diffused at national level.

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Inadequate policy and institutional framework to facilitate sustainable provision of water supply and sanitation. Aspects of community ownership of assets, community contributions, definition of basic service levels, and regulation of service provision are not clear.

Lack of sector investment plans. Service provision is not demand-driven, and investment planning is done without effective participation of stakeholders.

Lack of systematic collection and management of RWSS sector information. Lack of an effective maintenance system for community water supply facilities. Low financial sustainability of RWSS at local level. Government funding of the sector is low, and major investments in the last decade have been from

donor funding with inadequate contributions from the treasury. Inadequate technical, financial, and institutional capacities at district council level to support planning,

implementation and maintenance of rural water supply facilities.

Other shortcomings with respect to the RWSS policy include: (i) levels of community contributions are not specific, with different projects charging different amounts; (ii) the policy is silent on the ownership of community based assets or facilities; and (iii) lack of policy direction on sector coordination resulting in varied development approaches, duplication of effort and aid ineffectiveness. The RWSS policy is also inadequate with respect to rural sanitation. There is no definition of basic service level with respect to RWSS facilities; the policy is also silent regarding investment support for individual or household sanitation facilities; and roles and responsibilities for rural sanitation. The National RWSS programme will address these shortcomings in order that the GRZ can meet the MDGs for WSS in the rural areas.

Major Ongoing programmes/InitiativesMajor RWSS investments in the past have been funded primarily by donors and some smaller scale investments by a number of international and local NGOs. They include the on-going KfW financed Eastern Province RWSP and North-Western RWSP, the AfDB financing Northern and Luapula Provinces RWSSP, the Danida finance RWSSP in Western, Central and Southern Provinces, and the JICA financed Groundwater Development and Sanitation Improvement Project in Northern Province. The above financial flows suggest that annual expenditure for RWSS between 2000 and 2007 has been about US$15m, not far off the FNDP figures of US$14m. UNICEF with funding from DFID is supporting scalability of CLTS to all the 74 rural districts in Zambia with an investment of British Pound19 million. While other support in CLTS and SLTS is from Plan International, DAPP, WaterAid, SPLASH, etc in selected districts under the sector wide approach model.

3. Pan African CLTS Programme in Zambia

Target group:120,000

Geographical coverage:Mansa Programme Unit

Overall objective:To contribute to the reduction of child mortality and improvement of households’ food security in ten (10) wards of Mansa District, Zambia with a total population of 120,000.

Specific objectives: To increase the sanitation coverage through the CLTS approach in order to reduce infectious diseases

associated with faecal contaminations that contribute to high child morbidity and mortality rates.

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To promote the concept of multiple uses of water in order to encourage communities to grow nutritious

food to address the stunted growth in children, high morbidity and mortality rates.

To improve access to safe water sources to reduce water borne diseases that contribute to high child

morbidity and mortality rate;

To improve hygiene practices in the communities order to reduce communicable diseases.

Key Successes in 2011:

Construction of school latrines22 double latrines have been constructed schools.

CLTS triggering of 105 villages105 villages were triggered with CLTS and of the triggered villages, 35 have attained ODF whereas the remaining 70 were still working towards attainment of ODF. This brings the cumulative number of triggered villages in Mansa to 202.

Training of natural leaders390 natural leaders were trained in Mansa Program Unit. Of those trained, 199 were men, 129 women and 62 were children. 104 were trained in Lukangaba community, 40 in Lukola, 99 in Lwingishi, 30 in Myulu, 57 in Mutuna and 60 in Chibeleka. The trained natural leaders have been instrumental in continued monitoring of hygiene related activities at village level. This has led to an increased number of villages with improved sanitation profiles.

Participation in the Global hand washing dayPlan Mansa participated in the Global Hand washing Day that is commemorated annually on 15 th October 2011. This year’s commemoration was under the theme: “More than just a Day.”The commemoration was held at Malamba Basic School in Lukangaba community which is north-west of Mansa. The objective of the commemoration was to highlight the importance of hand washing and hygiene in the prevention of water and sanitation related diseases like diarrhoea. A total of 900 children and 100 adults attended the commemoration. Of these 700 were schools going children whereas 200 were non-school going children. Thirty seven (37) government workers from different departments and 5 Plan staff were among those present during the commemoration. Apart from speeches read out, the Guest of Honour, the Deputy Mayor of Mansa, Mansa Program Unit Manager and entourage demonstrated the correct way of washing hands with soap. This was followed by the children, guest of honour, government staff and community members present. Plan provided hand washing facilities and soap whereas the District Health Office provided chlorine.

Undertaking a CLTS exchange visit to ChomaPlan Mansa, undertook a CLTS Exchange visit to Choma district of Zambia from 27 th September-1st October 2011. The exchange visit involved the district CLTS facilitation team (WATSAN Coordinator, 1 CDF, 2 staff from health, 1 staff from education and 1 staff from the council) and some traditional leaders(Chief Kasoma-Lwela and 3 village headpersons) who went to learn and share knowledge and experiences with their Choma counterparts on the implementation of CLTS. During the exchange visit, Chief Singani’s chiefdom was visited by the team to learn how the chiefdom was implementing CLTS.

The exchange visit helped expose CLTS practitioners from Mansa to successful CLTS implementation arrangements in Choma and learn from Chiefs Macha and Singani whose chiefdoms are the only chiefdoms to be Open Defecation Free (ODF) in Zambia. The lessons will help scale-up CLTS in the district. The exchange visit aimed at;

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Exposing members to CLTS verification and certification techniques that can be adopted and applied in Mansa;

Enabling traditional leaders learn and share experiences in CLTS implementation so as to enable them implement CLTS with quality in their respective areas; and

Getting best practices in CLTS implementation in Choma that can be replicated by the project in Mansa district.

After the exchange visit the traditional leaders in Kasoma-Lwela chiefdom convened a meeting to map up a strategy on how to ensure that the chiefdom becomes ODF.

CONCLUSIONS: POTENTIAL FOR SCALING UPWith CLTS currently being implemented in 18 of Zambia’s 74 districts, and plans for coverage in further districts, CLTS is already being replicated quickly. There has been a great deal of evolution of the approach practiced in Zambia, with spread and adaptation over time. Despite the clear success of Choma district, and the incremental successes in other districts such as Mansa, Kaoma and Chadiza who have experienced a increase in uptake of ODF coverage, there is a need for targeted efforts in streamlining progress for further scaling up. The successes of current implementation of CLTS Choma, Mansa, Kaoma and Chadiza clearly indicates that when implemented with the right institutional support, with quality facilitation and resources to monitor results, that sustainable results can be yielded at scale over a short period.

Champions in the districts, including traditional leaders, key government staff and community champions have often been the major drivers of going to scale to date in Zambia. Further activities are dependent on using resources to further a more centralized overview and support to the important functions of monitoring, certification, information management and hands on training in triggering communities. There is a need to use other innovative approaches such as sanitation marketing to ensure that messages are targeted and are based on real motivations for sanitation uptake. Streamlined approaches, greater oversight, and clear guidance to districts is needed – with specific attention to monitoring and information management.

CLTS has been held as being the key approach in reaching MDGs, due to its effectiveness and ability to go to scale relatively quickly. In order to meet MDGs time demands, a quick uptake is needed. CLTS likely poses the most effective option given resources available, however in order to meet this great challenge, scale up must be paced according to communities ability to sustain interventions.

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Reference

National Rural Water Supply and Sanitation Programme 2006- 2015, Government of the Republic of Zambia, Ministry of Local Government and Housing: Lusaka

Census 2010, Government of the Republic of Zambia, Ministry of Finance: Lusaka

Ibid

Community Led Total Sanitation in Zambia: An Evaluation of Experiences and Approaches to Date, 2011, Ministry of Local Government and Housing: Lusaka

CLTS Programme Highlights, 2011, Plan Zambia: Mansa

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