Developing CLTS in very vulnerable villages in Mali despite the various social obstacles

Creating a new Social NormCommunity Approaches to Total Sanitation (CATS)

1Evolution of Community ApproachesWhat have we learned?In the past 40 years the WASH sector has been involved in 21 different software approachesConfusion over the difference between the provision of information, advocacy, behaviour change, social change and changing social norms.Limited formative research on insightsConverting insights to actionFocusing on collective action and Public reasoningSequencing of activities

Why Sanitation?Professional PerspectiveUsers PerspectiveImproves Health

Enhances Social Development

Dignity and privacy for women and girls

Generates economic benefits

Protects the Environment

Privacy

Social Status (modern)

HealthEconomicIt is important to clarify between the programming reasons for encouraging such change (Health, social and economic benefits, privacy, dignity, etc) and what drives change within individuals and communities. Programmatically, we are driven by evidence on the impact of poor sanitation practices on children and thus traditionally we have assumed that similar information will stimulate community change You must build a latrines to stop your child getting diarrhoea without contextualizing such information into the overall schema as to why the community practices open defection. The reality being that in many communities there is no empirical expectations on individuals and families to change everyone is doing it. If we put this into context we will see that the existing situation determines that the best practice from a personal perspective of an individual is generally to practice open defecation which can be illustrated as follows:

3Old ApproachesNew ApproachesBuilding Toilets

Individual/family

Health Message Focused

Top Down & Externally Driven

Didactic

Technologies predetermined

Subsidized

Dont mention the S*** word

Changing Social Norms

Social/Community

Economic, Social, Health, disgust,

Community led Internal, demand driven

Participatory natural & traditional leaders

Local technologies, community capacity

Rewards PRIDE celebration

Talk SHIT faeces, Poo, Kaka, toilets, latrinesVarious efforts and approaches to improve sanitation coverage have been taken over the years. Through these experiences much has been learnt, particularly in terms of engaging communities, creating demand for sanitation, behavior change, developing appropriate technologies and fostering sustainability of systems. While the learning curve has been steep, new approaches have evolved which address sanitation from a social rather than a technical perspective In the past sanitation was seen as a purely technical problem which would be solved by building toilets. The types of toilets to be used were predetermined by outside engineers who felt they knew what the best solution was from a technical perspective. Where families could not afford these technologies various systems were established to subsidize or build these toilets for families. Many projects were thus externally driven and while efforts were made to ensure community involvement, the messaging was often health focussed and didactic. Even where more participatory approaches were used the target was individual/family behaviour change without considering the broader context of the social norms in the community. So while there were some islands of success there were few open defecation free communities. Some members of the community did change and these were often the early adaptors who saw the benefits of having a toilet for their families (Privacy, Health) or others who were driven by the social status of being a toilet owner. In some instances toilets were subsidized and built but never used by individuals or their families and while it was always considered that the reason for this was lack of understanding or behaviour change in hindsight one of the key reasons for this may have been that there was no empirical expectation for the family to use the toilet and there is some anecdotal evidence of families being ridiculed by others when their child gets diarrhoea or for defecating in the same place as their daughters-in-law, etc.New approaches have shifted the focus to the creation of a new social norm where entire communities become open defecation free. It is a community focussed approach which is internally led by the community and demand driven. It is participatory by design and facilitates community led discussions and interactions concerning open defecation - its economic, social and health implications for the community, while also allowing for deeper discussions on more traditionally held beliefs about sanitation (sharing toilets, defecating in a room, witchcraft, etc) that the community as a whole can address themselves. It builds on established networks (schools, traditional leaders, religious elders, womens groups, etc) while also encouraging natural leaders who emerge from the various groups during discussions. Disgust is a powerful emotive experience which is built upon during community interactions and used in the triggering process with communities with the key reward being pride. Technologies are locally developed and built requiring no external support, (once a new social norm has been established local capacities can be developed and markets explored to ensure people have access to enhanced technologies and services to better sustain the social norm) and no external subsidies are provided to individual households but communities plan and decide themselves what needs to be done to become open defecation free.

4Adopter Categorization

Innovators Early Adopters Early --Majority Late Late MajorityLaggardsReach a Critical Mass of AdoptersCommunity Approaches to Total Sanitation Background:UNICEF supports Community Approaches to Total Sanitation (CATS) with the goal of eliminating open defecation in communities around the world. CATS is an umbrella term developed by UNICEF Sanitation practitioners in 2008 to encompass a wide range of community-based sanitation programming. The CATS Essential Elements are the common foundation for UNICEF sanitation programming globally. These principles provide a framework for action and a set of shared values which can be easily adapted for programming in diverse contexts.

CATS: The Essential ElementsAt their core, CATS rely on community mobilization and behavior change to improve sanitation and integrate hygiene practices.

They are demand-driven and community-led, and emphasize the sustainable use of safe, affordable, user-friendly sanitation facilities.The Essential Elements are based on lessons learned from decades of sanitation programming, and are a framework for action providing a common foundation for work in the sector reflective of UNICEFs Global WASH Strategy.

CATS &Social norm theoryHow is CATS implemented? The example of CLTS

9Pre-triggering

Selecting a community and building a rapport before triggering takes place (Network Theory & Defining Target Audience)10Social norm theorySelect a community

Start in the least challenging communities

Once they are ODF, move on to the more challenging ones

Quality is always more important that quantity

Select communities close to each other2. Build a rapport

Build a rapport with leaders and the entire community.

Everyone needs to trust the facilitator before triggering can begin

Important that the facilitator does not disclose why they are visiting the community. They are just there to look at the health situation of the community.123. Get to know and understand the community

Formal and informal structures

Community groups

Demographics

Inclusion and exclusions!!!4. Map the various networks

Family and Clan groups (inside and outside the village

Religious ties

Savings clubs, etc13Triggering

Using a variety of demonstrations to encourage a community to face the hard reality of open defecation and the impact it is having on their village (Community Engagement, Triggering, Public Declaration)14Social norm theoryTool 1: The Transect WalkThe community takes a tour of the village to view areas of open defecation.

This creates a sense of collective embarrassment forcing the community to acknowledge their sanitation situation.

No individual shame is involved in this process.

16Tool 2: Open Defecation MappingCommunity members help draw a map of their village including all major structures, water points and areas of open defecation

A representative from each household should draw their own house

17Tool 3: Food and FecesThe facilitator places the a sample of feces (discretely collected during the Transect Walk) on the floor next to a piece of food (e.g. bowl of rice or banana). Flies will most likely move between the feces and food. When asked, people will refuse to eat the food. The facilitator asks the community why? and the link is then made between open defecation and eating feces.

18

Tool 4: Water and Feces

The facilitator places the a sample of feces inside a bottle containing drinking water). When asked, people will refuse to drink the water.

The facilitator asks the community why? and the link is then made between open defecation and eating feces. 19Tool 5: Shit and ShakeThe facilitator gathers the community for a meeting.

They use a leaf or hand to wipe away their shit after defecating (using charcoal or clay). The community is asked what is left on my fingers?

The facilitator then shakes hands with other members of the community including the chief.

Food is offered to those people who have shaken hands with each other.

This sparks the understanding that shaking a neighbours hand and not washing may lead to you eating their shit.

20Natural LeadersAfter the triggering, the facilitator will ask the community what they will do about their sanitation situation.

Natural Leaders are highly motivated community members who volunteer to help improve sanitation situation in their community.

They help motivate households to build their latrines and help oversee construction

Natural Leaders often go on to trigger other communities in the surrounding area and are therefore critical in the scale-up of CLTS

21Community Action Plan The Natural Leaders encourage the community to draw up their own plan of action

Includes a realistic time frame for completion (no more than 3 months)

Displayed in a central/public location

Each household is checked off following the completion of their latrine

22Post-triggeringLatrine construction, monitoring and follow-up, ODF verification, declaration and celebration (Monitoring and Evaluation, Incentives, Diffusion)

23Social norm theoryLatrine Construction

25ODF CertificationThe indicators for ODF verification vary between countries.

However, most generally require all households to have and be using their own latrines and Open Defecation must be eradicated.

Examples of additional indicators include:

Mali: HWWS facilities and latrine covers

India: safe disposal of child feces and institutional latrines (schools and hospitals) must also be present

26ODF Certification

27ODF Declaration and Celebration

Once all latrines have been completed and the community meets the required ODF standards, it can be declared Open Defecation Free.

Verification must be carried out by independent monitors (e.g. District Council, other NGOs etc).

The community then celebrates their new ODF status

28Where is CATS being implemented?CATS is currently being implemented in 54 countries

29Number of people with access to household latrines as a result of UNICEF-supported CATS interventionsMore than 25 million people now have live in ODF communities as a direct result of UNICEF-support, indirectly, 92 million people have benefitted

30CLTS in Mali first results

In the first 3 months after triggering latrine coverage increased from average of 30% to 100% in the first triggered communities31

In Zambia a sample of communities was selected for a more detailed study into the quality of toilets constructed. Which revealed that 99% of toilets were in use, 90% had superstructures (although only 45% had roofs), 90% had lids for the squatting holes and 85% were covered at the time of the visit, and 88% had a smooth and clean squatting. It was also found that 76% of toilets had hand-washing facilities (a significant improvement on the initial pilot), 84% of which had water, and that 51% of households were using soap and 34% using ash for hand-washing. CATS - If we have a new Norm?Social norm theoryHow CLTS works: From theory to practiceDefine target audience: Communicate around socio-ethnically relevant issues: CLTS based around the universal emotions of shame and disgust (not health based). Community Engagement: CLTS works directly with community members. A CLTS facilitator is there to learn. It is not a prescriptive strategy; there are no latrine plans given.Triggering: The CLTS tools facilitate a dialogue around sanitation that ultimately arrives at a situation where the community members themselves decide to change their situation. The tools are designed to arrive at this moment

How CLTS works: From theory to practicePublic Declaration: A public declaration is made by community members to stop open defecation. This is the moment when the new social norm is createdCommunity Action Plan and Monitoring: The community develops their own plan on how to improve their sanitation situation and sets time limits. Community members are able to see who has complied and who hasnt. This creates a community by-law that is self-enforced.Incentives: CLTS creates both internal and external incentives to achieving ODF status. Positive internal incentive: pride in the community. Negative internal incentives include shame and disgust in the act of open defecation. External incentives include the ODF certification process and the celebration for achieving the ODF status.

How CLTS works: From theory to practiceDiffusion: Through the celebration process, traditional and political leaders are engaged from neighboring communities and districts. As CLTS is scaled up, there is also national diffusion through national level celebrations and awards. Network Theory: During the triggering, natural leaders are identified through their participation in the process. These leaders are then implicated closely in the process to ensure community compliance and offer support as needed. They are often also implicated in triggering in nearby villages.

Beyond CATSWhat are we learning about CATS?What do we still need to do better?What about Sanitation Marketing?Does CATS fit with UNICEFs equity Agenda?www.communityledtotalsanitation.orghttp://intranet.unicef.org/PD/WASH.nsf

Chart2

With UNICEF direct supportREGIONCOUNTRYNo. of ODF communities (Direct)ODF population (Direct)No. of ODF CommunitiesODF PopulationWCARO1Benin8138,232ESARO23,232ROSA10,547,8482Burkina FasoWCARO10,296ESARO8,333,2503Cameroon166291,795ROSA5,737WCARO5,275,8914CAR206,312EAPRO665EAPRO507,6435Chad316285,000TACRO104TACRO16,1546Congo Brazzaville 187102,461MENA105MENA07Cote d'Ivoire25774,330TOTAL40,139TOTAL14,132,9388DRC726490,7889Gambia8329,80010Ghana10932,70011Guinea-Bissau315102,45712Guinea Conakry5432,38713Liberia418,40414Mali686548,67915Mauritania809377,65416Niger8644,71617Nigeria2,9571,944,11418Senegal332158,49319Sierra Leone2,991644,20520Togo8063,364TOTAL10,2965,275,891

ESARO21Angola 2338,26222Burundi2374,85623Eritrea230182,21124Ethiopia15,0005,083,06325Kenya1,341950,00026Lesotho27Madagascar1,421227,50728Malawi1,500450,00029Mozambique713544,31930NamibiaTBCTBC31 Somalia22,23232South Sudan5TBC33Swaziland34Uganda537268,50035Zambia2,437512,30036Zimbabwe00TOTAL23,2328,333,250

ROSA37Afghanistan4042,210,00038Bangladesh39India40Nepal3562,513,00041Pakistan4,9775,824,848TOTAL5,73710,547,848

EAPRO42Cambodia494379,88643China44Indonesia75112,50045Kiribati0046Laos0047Myanmar101,66448Timor Leste343,59349Vietnam5210,000TOTAL665507,643

MENA50Djibouti0051North Sudan105157,218

52Yemen00TOTAL1050

TACRO53Bolivia10416,15454Haiti00TOTAL10416,154Worldwide Total (UNICEF direct support)40,13924,680,786Worldwide Total (Indirect support)28,52288,256,423TOTAL68,661112,937,209

With UNICEF indirect support REGIONCountryNo. of ODF communities (Indirect)ODF population (Indirect)WCAROBurkina Faso5500Niger3129,831Senegal197102,113ESAROMalawi20060,000ROSABangladesh*4,048,783India **28,00284,006,000EAPROTimor Leste***879,196TOTAL28,52288,256,423713544,31928,52288,256,42328,52288,256,423

*UNICEF indirectly supports CATSin Bangladesh by working with the Government on strategy, policy and implementation. The figure reflects the number of ODF upa zilas in UNICEF-supported SHEWA-B areas. This has been achieved through significant technical support from UNICEF.

**UNICEF indirectly supports CATS in India by working with the Government on strategy, policy and implementation. The figure reflects the total of gram panchyats awarded as Nirmal Gram Puraskar (NGP) by the Government of India. This has been achieved through significant technical support from UNICEF. After NGP has been certified in India, there are many challenges in sustaining ODF status.

***Government and NGO-supported ODF communities (not directly supported by UNICEF). UNICEF participated in policy development and advocacy and is focal point for collection of data on CLTS/CATS in Timor Leste.

TOTALSREGIONCOUNTRYNo. of ODF communities (Direct)ODF population (Direct)No. of ODF communities (Indirect)ODF population (Indirect)TOTAL ODF PopulationODF Population (TOTAL)WCARO1Benin8138,2320038,232ROSA103,014,7952Burkina Faso1259,898550060,398WCARO6,412,6623Cameroon226270,00072,720272,720ESARO5,750,1854CAR206,312006,312EAPRO579,8665Chad423324,4092813,107337,516MENA266,6856Congo Brazzaville 187102,46100102,461TACRO37,0377Cote d'Ivoire297127,526236,058133,584TOTAL116,061,2308DRC903622,33500622,3359Gambia18927,312237,24234,55410Ghana933264,16110362,041326,202 ODF Population (Direct)11Guinea-Bissau355197,609131,808199,417ROSA11,429,89212Guinea Conakry180186,65100186,651WCARO6,075,03913Liberia297,518235,80913,327ESARO5,414,45514Mali622584,9274840,932625,859EAPRO544,64615Mauritania1,057466,42200466,422MENA266,68516Niger196128,7653235,245164,010TACRO37,03717Nigeria1,6541,157,800001,157,800TOTAL23,767,75418Senegal565274,200182162,161436,36119Sierra Leone4,3761,128,018001,128,01820Togo117100,48300100,483ODF Population (Indirect)TOTAL12,4226,075,039487337,6236,412,662ROSA91,584,903WCARO337,623ESARO21Angola 2338,2620038,262ESARO335,73022Burundi2374,8560074,856EAPRO35,22023Eritrea230272,10100272,101MENA024Ethiopia7,0322,042,735002,042,735TACRO025Kenya1,341950,00000950,000TOTAL92,293,47626Madagascar1,421227,50700227,50727Malawi2,666666,500609152,250818,75028Mozambique713544,31900544,31929 Somalia4950,0000050,00030South Sudan2310,0000010,00031Swaziland0000032Uganda7223,760556183,480207,24033Zambia2,437512,30000512,30034Zimbabwe92,115002,115TOTAL16,0395,414,4551,165335,7305,750,185

ROSA35Afghanistan404214,3071,000530,120744,42736Bangladesh0004,048,7834,048,78337India1,3782,556,03428,00284,006,00086,562,03438Nepal3521,200,0004503,000,0004,200,00039Pakistan5,2457,459,551007,459,551TOTAL7,37911,429,89229,45291,584,903103,014,795

EAPRO40Cambodia494379,88600379,88641China0000042Indonesia75112,50000112,50043Kiribati146,400006,40044Laos0000045Myanmar165,9432919,42425,36746Philippines1217,0000017,00047Timor Leste395,122879,19614,31848Vietnam7917,795336,60024,395TOTAL729544,64614935,220579,866

MENA49Djibouti0000050North Sudan105157,21800157,21851Yemen23109,46700109,467TOTAL128266,68500266,685

TACRO52Bolivia16224,5370024,53753Haiti2412,5000012,500TOTAL18637,0370037,037Worldwide Total (UNICEF direct support)36,88323,767,75431,25392,293,476116,061,230

Indicator Traffic LightsREGIONCOUNTRYODF population (Direct)Country PopulationDiarrhoea ranking (as cause of under-5 mortality)% Open DefecationCATS ODF population as % of Country PopWCARO1. Benin38,2328,850,000356%0.43%2. Burkina Faso59,89816,469,000359%0.36%3. Cameroon270,00019,599,00046%1.38%4. CAR6,3124,401,000320%0.14%5. Chad324,40911,227,000162%2.89%6. Congo Brazzaville 102,4614,043,00048%2.53%7. Cote d'Ivoire127,52619,738,000328%0.65%8. DRC622,33566,760,0000.93%8. Gambia27,3121,728,00032%1.58%9. Ghana264,16124,392,000619%1.08%10. Guinea-Bissau197,6091,515,000131%13.04%11. Guinea Conakry186,6519,982,000320%1.87%12. Liberia7,5183,994,000145%0.19%13. Mali584,92715,370,000214%3.81%14. Mauritania466,4223,460,000254%13.48%15. Niger128,76515,512,000279%0.83%16. Nigeria1,157,800158,423,000222%0.73%17. Senegal274,20012,434,000317%2.21%18. Sierra Leone1,128,0185,868,000128%19.22%19. Togo100,4836,028,000451%1.67%

ESAROAngola 38,26219,082,000125%0.20%Burundi74,8568,383,00011%0.89%Eritrea272,1013,660,000287%7.43%Ethiopia2,042,73582,950,000146%2.46%Kenya950,00040,513,000114%2.34%Madagascar227,50720,714,00048%1.10%Malawi666,50014,901,000441%4.47%Mozambique544,31923,391,000153%2.33% Somalia50,0009,331,000418%0.54%South Sudan10,00010,300,000427%0.10%Swaziland01,068,0000.00%Uganda23,76013,089,0000.18%Zambia512,30012,571,0004.08%8Zimbabwe2,11512,750,0000.02%

ROSA1. Afghanistan214,30731,412,000117%0.68%42. Bangladesh 0148,692,00054%0.00%3. India2,556,0341,224,614,000451%0.21%54. Nepal1,200,00029,959,000349%4.01%35. Pakistan7,459,551173,593,000323%4.30%

EAPRO1. Cambodia379,88614,138,00062.69%2. China003. Indonesia112,500239,871,00040.05%4. Kiribati6,400100,00026.40%5. Laos06,201,00050.00%7. Myanmar5,94347,963,00040.01%Philippines17,00094,850,0000.02%2. Timor Leste5,1221,124,00020.46%6. Vietnam17,79587,848,00090.02%

MENA1. Djibouti0889,00020.00%2. North Sudan157,21834,300,00050.46%4. Yemen109,46724,053,00010.46%

TACRO1. Bolivia24,5379,930,00030.25%2. Haiti12,5009,993,000128%0.13%

ProgressREGIONCOUNTRYNo. of ODF communities (Direct)ODF population (Direct)No. of ODF communities (Indirect)ODF population (Indirect)TOTAL ODF PopulationCommentsODF Population Change (Direct Beneficiaries) since December 2012WCARO1BeninNO UPDATE SINCE JUNE 2012ROSA16% increase2Burkina FasoWCARO15% increase3CameroonESARO38% decrease4CARConflictEAPRO6% increase5ChadMENANo change6Congo Brazzaville No change in figures since December 2012TACRO130% increase7Cote d'IvoireTOTAL3% decrease8DRC9Gambia10Ghana11Guinea-Bissau12Guinea Conakry13LiberiaDownward adjustment of figures14MaliDownward adjustment of figures15Mauritania16Niger17Nigeria18Senegal19Sierra Leone20TogoTOTAL

ESARO21Angola No update since December 201222BurundiNO UPDATE SINCE JUNE 201223Eritrea24EthiopiaDownward adjustment of figures25KenyaNo change in figures since December 201226MadagascarNo update since December 201227MalawiNo update since December 201228Mozambique31 Somalia32South Sudan33Swaziland34UgandaDownward adjustment of figures35Zambia36ZimbabweTOTAL

ROSA37AfghanistanNo change in figures since December 201238BangladeshNO UPDATE SINCE JUNE 201239IndiaNo update since December 201240NepalDownward adjustment (by 3 communities) / plus drastic reduction in population estimate of communities 41PakistanTOTAL

EAPRO42CambodiaNO UPDATE SINCE JUNE 201243ChinaNo update since December 201244IndonesiaNO UPDATE SINCE JUNE 201245Kiribati46LaosNO UPDATE SINCE JUNE 201247MyanmarNO UPDATE SINCE JUNE 201248Philippines49Timor Leste50VietnamNo update since December 2012TOTAL

MENA51DjiboutiNo update since December 201252North SudanNo update since December 201253YemenNo update since December 2012TOTAL

TACRO54Bolivia55HaitiTOTALWorldwide Total (UNICEF direct support)

RankingsCOUNTRYODF population (Direct)Country PopulationCATS ODF population as % of Country PopSierra Leone1,128,0185,868,00019.22%Mauritania466,4223,460,00013.48%Guinea-Bissau197,6091,515,00013.04%Eritrea272,1013,660,0007.43%Kiribati6,400100,0006.40%Pakistan7,459,551173,593,0004.30%Zambia512,30012,571,0004.08%Nepal1,200,00029,959,0004.01%Mali584,92715,370,0003.81%Malawi666,50014,901,0004.47%Chad324,40911,227,0002.89%Cambodia379,88614,138,0002.69%Congo Brazzaville 102,4614,043,0002.53%Ethiopia2,042,73582,950,0002.46%Kenya950,00040,513,0002.34%Mozambique544,31923,391,0002.33%Senegal274,20012,434,0002.21%Guinea Conakry186,6519,982,0001.87%Togo100,4836,028,0001.67%Gambia27,3121,728,0001.58%Cameroon270,00019,599,0001.38%Madagascar227,50720,714,0001.10%Ghana264,16124,392,0001.08%DRC622,33566,760,0000.93%Burundi74,8568,383,0000.89%Niger128,76515,512,0000.83%Nigeria1,157,800158,423,0000.73%Afghanistan214,30731,412,0000.68%Cote d'Ivoire127,52619,738,0000.65% Somalia50,0009,331,0000.54%North Sudan157,21834,300,0000.46%Timor Leste5,1221,124,0000.46%Yemen109,46724,053,0000.46%Benin38,2328,850,0000.43%Burkina Faso59,89816,469,0000.36%Bolivia24,5379,930,0000.25%India 2,556,0341,224,614,0000.21%Angola 38,26219,082,0000.20%Liberia7,5183,994,0000.19%Uganda23,76013,089,0000.18%CAR6,3124,401,0000.14%Haiti12,5009,993,0000.13%South Sudan10,00010,300,0000.10%Indonesia112,500239,871,0000.05%Vietnam17,79587,848,0000.02%Philippines17,00094,850,0000.02%Zimbabwe2,11512,750,0000.02%Myanmar5,94347,963,0000.01%Swaziland01,068,0000.00%Bangladesh 0148,692,0000.00%Laos06,201,0000.00%Djibouti0889,0000.00%China000.00%

GraphODF Population (Direct)ROSA11.4WCARO6.07ESARO5.4EAPRO0.54MENA0.267TACRO0.1

Chart10.990.90.450.90.850.880.76

Overall23%94%14%102%10%51%18%100%7%100%0%93%77%100%43%107%65%65%52%100%55%55%2%95%23%88%BeforeAfter

Overall00000000000000000000000000

SiamunyeuSiatemboSiakachekaSiankopeSibbilisokweMunapuutuChidakwaSiachiwenaChambwaSibajeneMachaDibbilizweOVERALL% sanitation coverage

Latrine dataLatrines in use95%Latrines with superstructures98%Roofed latrines32%Latrines with lid80%Covered latrines72%Smooth and clean squatting surface68%Latrines with handwashing facilities18%

Latrine data0000000

Sheet3VillageSiachiwenaChaambwaMachaSimalumbaHamushinkaSimulanguDibilizweSibajeneMizingaMukuumaChidakwaSichiitaTOTAL%No. of toilets20420101926132024192717219Toilets in use2042010192610202419271721699%Toilets with superstructures204209192613201419211319890%Roofed toilets13399523158101849945%Toilets with lids204179162012202319201719790%Covered orifices204179162012202319201719790%Smooth and clean squatting surface2042010192013181219201719288%Toilets with handwashing facilities17318101621818118211516676%Handwashing facilities with water1721810142151818131314084%Handwashing with soap033611140911314108451%Handwashing with ash170141701051375634%Toilets in use99%Toilets with superstructures90%Roofed toilets45%Toilets with lids90%Covered orifices85%Smooth and clean squatting surface88%Toilets with handwashing facilities76%

Sheet30000000