the manoff group planning alternatives for change llc pathways consulting services ltd
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Summary of Study Findings. Assessment of the Sustainability of Sanitation Behaviors, Facilities and Programs Using Community-wide Open Defecation Free Approaches. The Manoff Group Planning Alternatives for Change LLC Pathways Consulting Services Ltd. [ROUGH DRAFT- FOR DISCUSSION -12 May 2010]. - PowerPoint PPT PresentationTRANSCRIPT
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Assessment of the Sustainability of Sanitation Behaviors, Facilities and
Programs Using Community-wide Open Defecation Free Approaches
The Manoff GroupPlanning Alternatives for Change LLCPathways Consulting Services Ltd.[ROUGH DRAFT- FOR DISCUSSION -12 May 2010]
Summary of Study Findings
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Goals of This Research
To document the present status of sanitation in unions that were officially declared to be “100%” open defecation free more than 4.5 years ago
To analyze the factors that challenge or contribute to continuation of the ODF achievement:
– Programs and institutions– People’s perceptions– Technical issues– Availability of supplies and services– Principal challenges– Main factors and forces contributing to sustainabilty
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Topics covered in the study
Defecation practice only, not other aspects of sanitation (hand washing, environmental pollution, solid waste management):
– LATRINES & OPEN DEFECATION ONLY The context of latrine use: supply chain (latrine
selling businesses, free distribution, installation and pit cleaning services), UP activities, social norms
No direct assessment was done of intervention program impacts. No evaluation was done of any specific organization’s work.
Specific unions are not identified by name in this study.
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Approach Used to Achieve “ODF/100%” in 50 Study Unions*
GOB-only approach: 23
CLTS approach: 10 (8 ASEH, 2 Dishari)
Non-CLTS/NGO approach: 9
GOB-donor: 8 (DPHE-Danida/UNICEF)
*3 additional: RRA/Reconnaissance only::GOB-only, GOB-Donor, & NGO
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Follow-up ProgramsApproach Follow-up No Follow-up Total
CLTS 4 6 10
Non-CLTS 5 4 9
GOB-Donor 7 1 8
GOB-only 14 9 23
Total 30 20 50
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Geographical Area
Total Arid/Plain Char Flood Coastal Hilly Mixed
CLTS 7 0 1 1 0 1 10
% within Approach 70.0% .0% 10.0% 10.0% .0% 10.0% 100.0%
Non-CLTS 2 0 4 1 0 2 9
% within Approach 22.2% .0% 44.4% 11.1% .0% 22.2% 100.0%
Gob-Donor 0 0 5 0 1 2 8
% within Approach .0% .0% 62.5% .0% 12.5% 25.0% 100.0%
GOB-only 4 3 4 1 2 9 23
% within Approach 17.4% 13.0% 17.4% 4.3% 8.7% 39.1% 100.0%
Total HH Counts 780 180 840 180 180 840 3000
% within Approach 26.0% 6.0% 28.0% 6.0% 6.0% 28.0% 100.0%
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Methodology
Selected 50 unions out of 481 that met the selection criterion: “ODf/100%” declaration >4.5 years ago
Quantitative: Survey of 3000 households in 50 unions
Qualitative: RRA, reconnaissance, and/or in-depth team visits in 18 unions (15 covered by hh survey)
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Summary of Study Findings
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The Sanitation Campaign
UP leadership Numerous others: govt
officers, volunteers, women/men
School children active The campaign was
compared to national liberation movement (jagoron)
Faridpur District, Bhanga Uz., 2005 Rally for Safe Sanitation and Solving the Arsenic Problem
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Different Approaches to the San. Campaign
All did: – surveys, – public notices, – general meetings, – religious leaders, – miking, – rallies
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GOB areas: – strong threats, – some breaking and
burning of open/hang latrines,
– filing bogus “papers” warning people to stop OD,
– distribution of ring-slab sets
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CLTS areas: – stressed
motivation & local donations;
– less use of violence and fear
Bhola 2002
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Survey Responses
Punishment (or Fear of) Recalled
Approach Total
CLTS Non-CLTS
GOB-Donor
GOB Only
Jail/Confinement 29.6 40.8 49.2 43.3 40.7
Burning/Breaking 8.7 10.7 47.7 24.9 24.5
Monetary fine 48.3 21.4 12.5 24.9 28.4
Public humiliation 8.2 38.8 18.4 22.7 18.9
Physical punishment/Holding the ear 12.2 8.7 9.7 7.8 9.5
Chowkidar warning 3.0 0 5.9 1.7 2.9
Others 4.5
No. 402 103 321 630 1456
Percent of all respondents mentioning 67% 19% 67% 46% 48.5%
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Have you heard about all using latrines here?
Yes 68.1
No 31.9
N= 3000
% 100
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Perceived Benefits of Being ODF: Focus Groups and Key Informants
Less disease spread 29
Stopping water pollution/spread of water-borne diseases
5
Elimination of bad smells 12
Improves the environment 10
Village: honor, social dignity, peace, prestige 8
OD ‘not good’, causes ‘pollution’(Bengali dushon or noshto kora)
5
Other 20
Total 89
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Current Views Regarding “ODF” or “100%”
Focus group participants in 13 out of 18 in-depth study unions were mostly enthusiastic about the idea about their villages being free of open defecation.
In five villages negativity was widespread. Reasons for this were:
– Some people are bypassed by development efforts– Insecure land tenure– Mistrust of local leaders– Low motivation to overcome practical problems: flooding,
water shortages, very hard soil, & others
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Perceived Benefits of Latrine Use
Avoid ‘shame’ Convenient for women Essential to family status, respectability Improves marriage arrangement prospects Enhances spiritual life by ensuring
cleanliness and purity Negatives; Ghosts at night, snakes, bad
smells, and danger of injury
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Institutional Supports
1. UP current activities 2. NGO/Other current program 3. Schools 4. Latrine parts & Installation services 5. Funding for latrine purchases 6. Pit cleaning services
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Union Parishad: Current Efforts
Out of 53 UP Chairmen interviewed or observed, around 2/3 are still working to improve sanitation in their unions.
UP members also are active, more so than chairmen in some cases
No formal monitoring by UP, but some chowkidars (vill. police) & members check up
Out of 18 in-depth study unions, 10 using ADP funds for latrine distribution, 7 not, one information unclear.
Perceived “rules” against open defecation.
Supported by their UNOs Work well with NGOs
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Who Comes to Discuss Sanitation, by Presence or Absence of Current Sanitation Program (multiple responses)
Current Program
Who Comes Yes No Total
Local Leaders 1 10 11
0.2% 4.0% 1.5%
UP Chairman/Member 32 108 140
6.5% 43.0% 18.8%
Health/NGO Worker 473 143 616
95.7% 57.0% 82.7%
Student 0 1 1
0.4% 0.1%
Total Respondents 494 251 745
66.3% 33.7% 100.0%
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The Role of Schools
Sanitation now established as part of the health & hygiene curriculum
Madrasas also teaching san. Students are actively interested in the
issue School latrines: problems exist, madrasas
better
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Public Latrines
Observed: ____ Much money spent to
build some of them Bazaar latrines: - Only one had a paid
caretaker - None were clean - [OTHER INFO] Caretakers are very
difficult to hire. Many quit the job.
School and mosque latrines better maintained, but school latrines are over-used.
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Latrine Parts Sellers
Mass production of latrine rings and slabs now well established, in response to sanitation campaign
Diversification of products is common
Some are former masons or “sanitation engineers”
Costs increasing more than prices
Give discounts to poor buyers
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Pit Cleaners Pit cleaning is becoming a well-
paying occupation.
Some Muslims are taking up the profession (secretly or openly), competing with Hindu Sweeper caste people
Social stigma exists Charge by the ring: Cost is Tk. ___
to Tk. ___ & distance to dumping place
Frequency of pit cleaning depends on no. of latrine users and ability to pay.
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Funding latrine purchases
[Survey data]
In some places micro-credit is not available for this purpose, although most micro-credit organizations did fund latrine purchases when they were starting up.
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Open Defecation
Some open defecation (OD) persists
– OD mentioned in survey responses: 26 out of 50 unions
– High (5) / Moderate (6) levels of OD in 11 out of 18 in-depth study unions
Related to: weak enforcement of rules, extreme poverty & crowding
More in CLTS areas
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Household Latrines
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“Improved” Latrine
-Enclosed pit, confines contents
(not intentionally broken)
-Slab/Cover over pit, with or without water-seal or vent pipe
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“Unimproved”
Uncovered pit Open/Hang latrine Other type:
intentionally drained out to open place
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% of latrine use Total
Open/Hang latrine Improved latrine no covered/
water seal
Improved latrine with covered/
flap
Improved latrine with water seal
N %
CLTS 42.5 16.8 34.7 100.0 600
Non-CLTS 10.7 46.1 1.9 41.3 100.0 540
GoB-Donor 17.5 41.0 4.0 37.5 100.0 480
GoB only 9.9 47.5 3.0 39.6 100.0 1380
Not active 14.5 46.7 2.5 36.3 100.0 1140
Ultra Poor 15.4 58.3 7.0 19.3 100.0 602
Poor 13.9 52.0 8.5 25.6 100.0 598
Middle 10.3 47.3 7.5 34.8 100.0 600
Upper Middle 7.2 42.7 4.2 45.9 100.0 599
Highest 5.5 25.6 1.5 67.4 100.0 601
T (%) 10.5 45.2 5.7 38.6 100.0 3000
T (N) 314 1356 172 1158 3000
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Superstructure
Approach Total
CLTS Non-CLTS GoB-Donor GoB only
Pucca (brick) with roof
23.8% 15.9% 11.5% 21.8% 19.6%
Tin/ bamboo walls with roof
30.3% 28.5% 40.6% 31.5% 32.1%
Tin/ bamboo walls without roof
13.4% 18.7% 11.3% 11.8% 13.3%
Walls made of jute, cloth, /polythene
12.7% 14.2% 18.0% 14.3% 14.5%
Walls made of jute sticks, straw, leaves
18.8% 22.4% 18.2% 20.0% 19.9%
Abandoned 1.0% .2% .5% .5% .6%
Total Count 575 508 434 1279 2796
% within Approach
100.0% 100.0% 100.0% 100.0% 100.0%
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Superstructures
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Superstructure Type
Wealth-ranking Total
LowestLow-
Middle MiddleHigh-
Middle Highest
Pucca with Roof 2.8% 4.6% 9.0% 20.6% 57.4% 19.6%
Tin/ bamboo fencing with roof25.3% 27.4% 34.6% 42.3% 30.2% 32.1%
Tin/ bamboo fencing without roof 15.5% 17.4% 15.5% 13.1% 5.6% 13.3%
Fencing with jute cloth/polythene 23.3% 19.4% 18.6% 9.4% 3.2% 14.5%
Fencing with jute stick/straw/leaf 31.9% 30.4% 21.6% 14.5% 3.2% 19.9%
Abandoned 1.1% .7% .7% .0% .3% .6%
Total Count 529 540 566 572 589 2796
% within Wealth-ranking100.0% 100.0% 100.0% 100.0% 100.0%
100.0%
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Latrine Ownership
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Lowest Mid-Low
Mid Mid-High
Highest
Ownership of Latrine, by Economic Status
Pct. Rent Hse
Pct. Oth.Own
Pct. Jt. Own
Pct. Own
Individual HH ownership percentage increases with economic level.
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Alternative Technologies & Home-made Types
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Clay Rings (paat)
Clay rings (paat), or clay + concrete [Kurigram, Bogra, Gopalganj, Naogaon]
GOB, Non-CLTS Low cost, no need for skilled
labor to install, very deep pits, less pit cleaning expense
Believed to last long when combined with one or two concrete rings at top of pit
Rodents & white ants go insideNaogaon District
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Duli or dongi bamboo pit liner
Duli or dongi bamboo pit liner [four districts, Lalmonirhat, Chapai-N., Naogaon, Kurigram, all with some ASEH/CLTS program/follow-up]
Low cost No need to empty pit Does not last a long
time Rodents or tree roots
get inside
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Others
Boitak offset model [Noakhali]
Pit (jar-shape) with narrow opening [Narsingdi & Lalmonirhat, Non-CL & CL)
Motka offset model [CLTS union, Naogaon]
Unlined pits in areas with hard earth [Narsingdi]
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What is a ‘hygienic latrine’? FGD & Key Informants (104 comments)
No bad smell
Feces not visible
Clean
Ring-slab (concrete)
Water-seal
Expensive
No flies/mosquitoes
Covered
A whole system of good latrines
Pucca/Concrete parts or super-structure
Soap/Ash available for hand washing
No idea (4)
Other: Looks nice, lined pit, deep hole, has
vent pipe, has door/curtain, has walls, off-set tank, plenty of water used, footwear used, no disease spread
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Maintenance Arrangements
[TO BE ADDED]
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“Hygienic” vs. “Unhygienic”
Among the 50 unions, only 35% of “improved” HH latrines are “hygienic” in terms of maintenance:– No feces visible on the floor or pan;– No major leakage from the tank/pit;– Pit is not broken to let contents run out into
an open place; and/or– No strong, bad smell comes out
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Sharing a Latrine
36% of improved latrine owners share with another HH
Sharing HH lower economic level than non-sharing HH
Many types of arrangements: regular share, temporary share, occasional, seasonal
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Sharing (2)
Problems keeping them clean
Long queues Sharing pit cleaning
costs Can lead to open
defecation Cancellation of
sharing also can lead to OD
Latrine Shared, by HH Economic Status
0.0%
20.0%
40.0%
60.0%
80.0%
100.0%
Share
No Share
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The “Sanitation Ladder”
47% using the same latrine for the past five years; 41% two latrines during the 5-year period; and 10% had used three or more different latrines. Almost a half of the latrines used by the survey
households had been installed within the past four years, and 30 percent within the past 2 years.
Changes are mostly made within the same latrine type: for example, adding rings, changing location.
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•Reasons for changing the latrine at any time during the past five year period:
-Latrine damage (39%), -Wanting or being pressured to install a latrine (39%), -Filling up of the pit (29.7%), and -Change of residence (11%).
•Latrine damage was the most frequently mentioned reason for first, second, and third latrine changes in GOB-only areas. •In CLTS areas it was filling up of the pit: 1st, 2nd, 3rd. •In GOB-Donor areas and Non-CLTS areas: filling-up of the pit and wanting or being pressured.
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Unhygienic proportion of latrines in different main groups
Grouping
% Unhygienic by maintenance
% Hy-gienicOpen +
Hang
Improved, no covered/ water
seal
Improved with cover/
flap
Improved, Water seal
All
By Approach:
CLTS 100 71.0 68.3 39.4 61.3 38.7
Non-CLTS 100 78.7 90.0 54.3 71.1 28.9
GoB, Donor 100 71.6 63.2 56.7 70.6 29.4
GoB only 100 74.5 69.0 36.6 61.8 38.2
Wealth-ranking:
Ultra-Poor 100 79.2 69.0 64.7 78.9 21.1
Low-Middle 100 72.3 72.5 56.2 72.1 27.9
Middle 100 78.9 57.8 54.1 70.8 29.2
Upper-Middle 100 70.3 80.0 44.7 61.1 38.9
Highest 100 64.3 77.8 26.7 41.1 58.9
N 314 1356 172 1158 3000 3000
All 100 74.2 69.2 43.6 64.8 35.2
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Shared vs. Not Shared (Improved Only)
Hy-gienic
Unhy-gienic
Total
NotShared
45.2% (714)
54.8% (866)
100%(1580)
Shared 28.9% (245)
71.1%(602)
100% (847)
Total 39.5% (959)
60.5%(1468)
100%(2427)
Improved latrines only
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Some comparisons relating to ‘hygienic’ latrine findings
GOB-only approach has been most effective in raising the over-all ‘hygienic’ status of latrines– But less effective in improving practices of poor
households relative to others in the union CLTS, Non-CLTS, and GOB-donor
approaches have had a greater impact on poor households’ latrine maintenance practices than GOB-only approaches.
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G O B - D o n o r Unions : W e a l t h - r a n k i n g of Sample H H
01020304050607080
G-Do-9
G-Do-3
G-Do-7
G-Do-8
G-Do-6
G-Do-4
G-Do-5
G-Do-2
Poor
Middle
U-Middle
Not Poor
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GOB-donor areas: percentages improved & hygienic latrines relative to union wealth-ranking (most- to least-poor)
0.010.020.030.040.050.060.070.080.090.0
100.0110.0
G-Do-9 G-Do-7 G-Do-3 G-Do-8 G-Do-5 G-Do-6 G-Do-4 G-Do-2 Total
Ultra PoorPoorMiddleUpper MiddleNot PoorImpromed latrineHygienice latrine
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Wealth Ranking of Sample HHC L T S U n I o n s
0102030
40506070
CL-4/D CL-2 CL-3 CL-10 CL-1 CL-9 CL-8 CL-7 CL-6 CL-5/D
PoorMiddleU-MiddleNot Poor
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0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
90.0
100.0
110.0
CL-4/D CL-2 CL-1 CL-10 CL-8 CL-9 CL-3 CL-6 CL-7 CL-5/D Total
Ultra PoorPoorMiddleUpper MiddleNot PoorImpromed latrineHygienice latrine
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Challenges and Positive Factors: Summary of Findings
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Challenges to Sustainability (1)
Local Leadership-Weak commitment of 1/3 union chairmen-Hardware emphasis > Awareness raising or public
education. “Latrinization”-Building new houses, new settlements without
attention to sanitation: no local building codes or strong requirements
-None are formally monitoring; - No firm rules or regulations
-OTHERS-Some UP chairmen and members reluctant to pressure their people before election
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Challenges to Sustainability (2)
Economic
-Extreme economic hardship in some parts of the population
-Concerns about pit cleaning costs
-Crowding, congested settlements
-Space for disposal of pit contents may be limited
-Large numbers of agricultural laborers or floating people
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Challenges to Sustainability (3)
Social divisions and disparities
-Insecurity of land tenure (khaash land)
-Social exclusion: ethnic minorities (adivasi), new settlers, “colonies”
-Local class conflict
-Latrine sharing
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Technical- Poor quality of concrete latrine parts, some not
using reinforced concrete- Self-installed latrines may not be technically sound- Superstructure – especially lack of a roof- Soil conditions: very hard earth, sandy soil- Floods (low-lands), Flash floods, cyclones & storms- Inconvenient water supply or seasonal water
shortage: low priority given to carrying water for cleaning
Challenges to Sustainability (4)
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Positive Forces: Contributing to Sustainability (1)
Expansion of public programs in past 5 years to the full population
Public understanding of health benefits is nearly universal
Strong role of schools in building and maintaining awareness
Being ODF is perceived as a national priority, which helps to reduce divisions at local and regional levels
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Positive Forces (2)
Institutional Ongoing efforts of UP (2/3 active) and inspired volunteers
-A few ‘rules’ & requirements (or perceived)-Good cooperation between GO & NGO-Chowkidars: some observing, reminding -Pit cleaners in one union remind and warn people too
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Positive Forces (3)
Social Change in public ‘mind-set’ resulting from 5 – 30
years of sanitation promotion programs: ‘shame’ (lojja) assoc with OD
Local pride & public occasions – village festivals, cultural events
Family Social status needs: marriage arrangement, good relations with in-laws
Perceived spiritual/religious benefits of latrine use
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Positive Forces (4)
Neighbors remind each other about problems: quarrels, even some salish – sign of social norms changing
Self-help mentality in some poor communities:– Install their own latrines– Maintain their latrines (at high rates in places)– Do their own pit cleaning
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Positive Forces (5)
Enhanced economic capacity of households getting remittances from abroad
Adequate supply of latrine parts and pit cleaning services has developed in recent years
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Conclusions
[TO BE ADDED]
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THANK YOU
FOR YOUR PARTICIPATION