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Six steps to a successful sanitation campaign

Suvojit Chattopadhyay's picture

new latrineInadequate sanitation costs India $54 billion a year. To that, add the challenge of juggling our nationalistic aspirations of superpowerdom with the ignominy of housing the largest share of human population that defecates in the open.  In light of this, here are six steps to a success sanitation campaign.

Amid many reports that the Swachh Bharat Abhiyan (SBA) is failing, we need a dose of optimism. While SBA might be failing, it certainly isn’t the first, nor will it be the last state-led sanitation programme to fail in India. Our large schemes to tackle this challenge have, more often than not, ended up as models of just what one should avoid doing if they are serious about bringing about total sanitation.
 
It is now widely acknowledged that conventional approaches are not working: those that set up a false dichotomy between construction and behaviour change; those that are content with pit latrines as opposed to functional toilets; those that use reductionist conceptions such as communities being open defecation free rather than focusing on personal and environmental sanitation and hygiene as a whole; and those that settle for incremental coverage instead of full coverage from the start.
 
However, it’s not that there are no success stories within India or in our immediate neighbourhood. For one, the experiences of locally-embedded NGOs that have taken their interventions to scale can be highly instructive. There have also been state-led successes in Maharashtra and Himachal Pradesh that can offer valuable lessons. So what could some key design elements in a sanitation programme be?
 

Why do sanitation campaigns fail?

Suvojit Chattopadhyay's picture

The study finds that the govt’s rural sanitation programme, implemented by NGOs, was unable to reduce exposure to faecal matter.

A recently published Lancet paper looks at the impact of the erstwhile Total Sanitation Campaign in the coastal Puri district in Odisha. The study finds that the government’s rural sanitation programme, implemented by NGOs and community-based organisations, was unable to reduce exposure to faecal matter. As a result, this sanitation programme had no impact on the incidence of diarrhoea and malnutrition. The authors of the paper conclude that in order to realise concrete and sustainable health benefits, sanitation programmes need to increase both the coverage and use of toilets, as well as improved hygienic practices.

No one denies the importance of good sanitation and the impact it has on human health. It must follow therefore that the lack of positive impact is down to poor implementation of the sanitation programme in the study area. In fact, a process evaluation of the programme concludes that the implementation was far from perfect, both in terms of the levels of coverage achieved and the levels of awareness. Over an implementation period of 13 months (January 2011—January 2012), the villages where the programme was implemented saw an increase in toilet coverage from 9% to 63%, but only 38% of the households had a functional toilet. It would have been interesting to learn more about the gap between toilet construction and usage (25 percentage points). In any case, the state of implementation, the authors point out, is typical of the prevalent Total Sanitation Campaign across the country.
 

The false dichotomy among sanitation-for-all advocates

Suvojit Chattopadhyay's picture

The sanitation debate has suffered from a seemingly irreconcilable dichotomy when it comes to identifying the best approach towards sanitation for all.

A good way of blocking progress in an argument is to present two aspects of a whole as a dichotomy. The sanitation debate, in recent years, has suffered from a seemingly irreconcilable dichotomy when it comes to identifying the best approach towards sanitation for all. This is the one that pits subsidies against motivation and correspondingly, construction against behaviour change communication. And yet, in a comprehensive and prudent programme design, there is no need for these ideas to be opposed to each other. I call this then, the false dichotomy in the world of sanitation advocates.

The current sanitation programme in India has at its centre a subsidy and incentive for individual households constructing toilets. This is a programme that has clearly not worked, irrespective of the minister or bureaucrat at the helm of affairs. India holds the ignominious record of having the largest number of people defecating in the open. At the same time, the popularity of the community-led total sanitation (CLTS) approach has risen. This approach depends on using shame and motivate as a call to action to build basic pit latrines (rejecting subsidies completely) and has worked in multiple countries around the world, as well as in certain states in India.
 

Technology Alone Will Not Save the World: Lessons from the 2015 Gates Letter

Suvojit Chattopadhyay's picture

Melinda and Bill Gates have made an annual tradition of publishing their thoughts on international development and its key challenges. Given the substance, I assume these letters reflect an annual manifesto for the organisation they head, the Bill and Melinda Gates Foundation (BMGF). Last year, I wrote about how the Gates Annual Letter was disappointing, perhaps not in the context of what the BMGF itself does, but what it ought to be doing, given its $42 bn muscle and its influential promoter, Bill Gates.

This year, the letter makes four “big bets” for 2030: child deaths will go down by half, and more diseases will be eradicated than ever before; Africa will be able to feed itself; mobile banking will help the poor radically transform their lives; and better software will revolutionise learning. In short, fast-tracking the identification ­technological fixes and expanding their reach over the next fifteen years will deliver a better world.

Unfortunately, these bets seem to me to be wildly optimistic. I may be quibbling, but from what we have learnt from research, there seem to be many reasons to suggest that we should be cautious with our optimism regarding what we can achieve with technology. The complexities of working on power, politics and implementation find no mention in the letter. Let us look a little more closely at each one of the bets to find out why that matters so much.

The Things We Do: Shame is a Powerful Thing

Roxanne Bauer's picture

Billions of dollars are spent each year on sanitation, healthcare, and good governance, but the results vary quite a bit from place to place.  What separates successful programs from the unsuccessful?
 
Those that achieve their goals try to change behavior alongside introducing new methods or making investments. One way to change behavior is to use shame— an overwhelmingly negative emotion —to emotionally link individuals to the communities in which they live.
 
Shame and Sanitation

Shame was, in fact, a central ingredient to a program in Bangladesh that reduced the percentage of Bangladeshis defecating out in the open from 19% in 2000 to only 3% in 2012.

The program utilized the Community-Led Total Sanitation (CLTS) method, which “focuses on instigating a change in sanitation behaviour rather than constructing sanitation infrastructure.” Changes in sanitation behaviors are accomplished through a process of deliberation and discussion within communities to build consensus on the need to end open defecation and clarify the hazards that open defecation poses.

Campaign Art: Kick Off Your Birthday by Bringing Fresh Water to the Sahel

Roxanne Bauer's picture

People, Spaces, Deliberation bloggers present exceptional campaign art from all over the world. These examples are meant to inspire.

charity: water, launched its annual "September Campaign" this month in which the organization selects a country or region for targeted support. This year, the Sahel region was chosen, and the September Campaign seeks to bring clean water to 100,000 people of Mali and Niger that are living in the strip of land between the Sahara desert to the north and the Sudanian Savannah to the south.  The area is frequently affected by drought and famine, and access to clean water is rare.

Unlike other nonprofits that speak about the organization and mission first, charity: water puts their supporters at the center of their communications and empowers them to tell personal stories and fundraise individually, using a method known as inbound marketing. Inbound marketing promotes an organization through blogs, video, enewsletters, whitepapers, SEO, and other forms of content marketing which attract the attention of key audiences and draw people to their website. By contrast, buying attention through advertisements, cold-calling, direct paper mail, and radio, are considered "outbound marketing."

Central to their inbound marketing method, charity: water appeals to supporters to start 'your own campaign.' The website offers visitors the ability to, "start a fundraising campaign and bring clean drinking water to people in need around the world." The personalized and social nature of the campaign allows people to share their own stories and encourage friends and followers to do the same. Supporters have been creative with their campaigns, starting birthday fundraisers, running marathons, and welcoming newborns with donations.

   

Sanitation For All: Ignore Quality at Your Own Peril

Suvojit Chattopadhyay's picture

The excellently named Research Institute for Compassionate Economics (R.I.C.E) recently published an equally excellently named survey – the SQUAT (Sanitation Quality, Use, Access and Trends) survey. Based on the findings of this survey conducted in five north Indian states, R.I.C.E calls for a latrine use revolution - since the bottleneck is not the non-availability of a latrine (since even those with a government latrine are not using them), nor is it lack of funds (since far poorer countries and communities have built and used latrine). It is an issue of messaging around hygiene, towards which we need to set our firm focus.

My first job in the development sector was with an NGO, Gram Vikas in Odisha and my experience there has shaped many of my core beliefs about working in this sector. At the core of Gram Vikas' work was the conviction that the 'poor can and will pay for quality services'. So when I think toilets (not latrines – and there is a key difference in the definition), I often use the 'quality' lens and make the argument about how the usage of physical facilities installed by projects has a direct link with what community perception of what counts as good quality. This also has a strong link with the extent to which they feel a sense of ownership for the facility.

Weekly Wire: The Global Forum

Roxanne Bauer's picture

These are some of the views and reports relevant to our readers that caught our attention this week.


Three reasons investors are beginning to take sustainability seriously
The Guardian
Most of the ingredients for a healthy, secure, and fulfilling existence come to us from nature. Food, clean water, pollination, and natural hazard protection are all essential goods and services that underpin our economy and secure our wellbeing. But business models that exploit these benefits unsustainably are intensifying pressure on our planet's natural resources, putting their future – and ours – in jeopardy. How can we relieve this pressure before it is too late? As a first step, we need to recognise that rapidly declining natural systems are bad news for business. There is a two-way street between the economy and the environment: businesses damage the environment, and the damaged environment then creates risks to the bottom lines of businesses. But why should members of the investment community care?

Does transparency improve governance? Reviewing evidence from 16 experimental evaluations
Journalist's Resource- Harvard Kennedy School
The idea that transparency can make institutions more effective and provide greater accountability and better results for the public seems uncontroversial on the surface. But scholars and bureaucrats who have been involved in the wave of transparency initiatives over the past decade continue to debate the particular merits of various approaches. Some commentators have been troubled that as a reaction to scrutiny, malfeasance and inefficiency could increasingly be kept hidden and transparency could erode public trust in institutions and personal privacy. The many types of transparency initiatives around the globe are often confused, making sharp distinctions all the more essential.

Campaign Art: Help a Child Reach 5

Roxanne Bauer's picture
People, Spaces, Deliberation bloggers present exceptional campaign art from all over the world. These examples are meant to inspire.

Facebook and Youtube are the first and third most popular social media platforms in South Asian countries, respectively. The company Lifebuoy used both platforms in a highly successful corporate social responsibility campaign called “Help a Child Reach 5.” It aimed to promote hand washing to save lives in India. Every year in India, two million children fail to reach their fifth birthday because of diseases like diarrhea and pneumonia; the simple act of washing ones hands could help erase this tragedy.
 
Help a Child Reach 5

Government Spending Watch - A New Initiative You Really Need to Know About

Duncan Green's picture

I’m consistently astonished by how little we know about the important stuff in development. Take the Millennium Development Goals – the basis for innumerable aid debates, campaigns, and negotiations. A large chunk of the MDG agenda concerns the size and quality of public spending – on health, education, water, sanitation etc. So obviously, the first thing we need is to know how much governments are spending on these things, right?

Well no actually, because we don’t have those numbers. Until now. Oxfam has teamed up with an influential and well-connected NGO, Development Finance International, which advises developing country governments around the world. Working with a network of government officials, DFI has pulled together and analysed the budgets of 52 low and middle income countries (With another 34 to follow). The result is a new database, called Government Spending Watch, (summary of overall project here) and a report ‘Progress at Risk’, previewed in Washington last Friday in a joint DFI/Oxfam America event to coincide with the IMF and World Bank Spring meetings. The full report won’t be ready ‘til May, but an initial draft exec sum is available, and here’s what it says.

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