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Community Approaches to Total Sanitation in South Asia – an overview
UNICEF meeting on CATS
New York - 2-5 November 2010
Sanita&oninSouthAsia1990‐2008
Source: WHO/UNICEF JMP 2010 update.
Theposi&ve:thenumbersofopendefecatorsisdeclining,slowly
Sanitation coverage…. Millions of open defecators
Per cent
Sanita&oninSouthAsia…
Source: MISC and DHS surveys
Theposi&ve:strategiesfordisparityreduc&onatscaleexistintheregion
Disparities rural India…. Disparities rural B’desh….
1 6 12
27
73
0
20
40
60
80
100
Poorest 20% Second 20% Middle 20% Fourth 20% Richest 20%
Improved Unimproved Open defecation
34
48 56
66
86
0
20
40
60
80
100
Poorest 20% Second 20% Middle 20% Fourth 20% Richest 20%
Improved Unimproved Open defecation
• CountriesusingCATS:Afghanistan,Bangladesh,India,Nepal,Pakistan,
• CountriesnotusingCATS:Bhutan,Maldives,SriLanka– usingCAbutnotTS…
4
CATSinSouthAsia…
PeopleinODFcommuni&esinSouthAsia…
Country Est.numberofpeople
Afghanistan 50,000
Bangladesh 1million(or18mln?)
India 6to8million
Nepal 500,000
Pakistan 770,000(or350,000?)
Source: Robert Chambers’ estimates 2010
CATSprinciplesinIndiaTSC…
Principles Rating
ODF communities 2 of 5
Full community engagement 2 of 5
Communities lead process 1 of 5
No subsidies to households 0 of 5
Household choose design 2 of 5
Govt participation 5 of 5
Builds local capacity 3 of 5
Hygiene promotion included 2 of 5
Entry point for social change 1 of 5
• India’sTSCprogrammedoesnotaimforODF
• WithinTSC,NGPaimsforODF
– Theawardisthetrigger– Workedwellini&ally
– Atscale,poorfacilita&on– Verifica&onprocesspoorlydone
• Varia&onsbyState
CATSprinciplesinIndia…
CATSprinciplesinBangladeshSHEWA‐B…
Principles Rating
ODF communities 1 of 5
Full community engagement 4 of 5
Communities lead process 4 of 5
No subsidies to households 5 of 5
Household choose design 4 of 5
Govt participation 5 of 5
Builds local capacity 3 of 5
Hygiene promotion included 5 of 5
Entry point for social change 3 of 5
• SHEWA‐Bfollowsademand‐drivencommunity‐basedapproach
• PrinciplesaresimilartoCATS• CommunityAc&onPlansbasedontriple‐Aapproacharecoretotheproject
CATSprinciplesinBangladeshSHEWA‐B…
CATSprinciplesinPakistan…
Principles Rating
ODF communities 2 of 5
Full community engagement 1 of 5
Communities lead process 1 of 5
No subsidies to households 2 of 5
Household choose design 1 of 5
Govt participation 1 of 5
Builds local capacity 0 of 5
Hygiene promotion included 0 of 5
Entry point for social change 1 of 5
• Startedin2004,reachingnearly1,000communi&es
• Problemsinscalingup:– Poorqualityprocessfacilita&on– Nodesignop&onsofferedforcommunitychoice
– ODFcer&fica&onocenincomplete
– Desludgingofpitlatrinesproblema&c– Riskofgroundwaterpollu&onfromleachpits
• Notsurprising:disappoin&ngresults
CATSinPakistan…
CATSprinciplesinNepalSLTS…
Principles Rating
ODF communities 4 of 5
Full community engagement 4 of 5
Communities lead process 3 of 5
No subsidies to households 5 of 5
Household choose design 4 of 5
Govt participation / leadership 5 of 5 / 3 of 5
Builds local capacity 3 of 5
Hygiene promotion included 3 of 5
Entry point for social change 4 of 5
• CLTSintroducedin2009(aspilotinoneprovince)• 124mastertrainersatna&onalandin34provinces
• FiveNGOsarefacilita&nginsixprovinces• CommunityHealthWorkers,CommunityDevelopmentCouncilmembers,teachers,religiousleadersandvillageeldersandwomenShuras(commieees)involved
• Plansforscaleupthroughlocalandinterna&onalNGOs• CLTSapproachisinthena&onalWASHpolicy
CATSinAfghanistan…
• MaintainprincipleswhenGovtleadsandfunds• Qualityoffacilita&on;qualityofpar&cipa&on• Balancebetweenqualityandpace• Lackofskilledhumanresources• Monitoring–verifica&on(ofchangedbehavior)• SustainingODFincommuni&es• Func&onalsanita&oninallschools• Lackofsecuritylimi&ngaccess• Solu&onsforpeople/householdswithspecialneeds• ODForODF+orODF++??• Placeofecologicalsanita&on
CATSscalingupwithquality:challenges…
• IncreasingGovernmentfunding
• UNICEFcanadaptitsroleastheapproachisscaledup• Increasingdecentraliza&on• Par&cipa&onofextensionworkers• SpaceforNGO/CBOpar&cipa&on• CATSprinciplesinsanita&onpolicy• Longhistory:learnaboutsustainability• ‘ODandna&onalpride’• Pakistanfloodsemergency:earlyrecovery• RewardachievementofODF• Moreintegra&onwithEduca&onandHealth
CATSscalingupwithquality:opportuni&es…
• WomenplayaleadroleinCATS
• Third‐partymonitoringinSHEWA‐B– Allowsforrapidprogrammecorrec&ons
• CLTSreviewinPakistan(Sumaro)– Manypeoplereverttoopendefeca&on– Movingupthesanita&onladderappearsnecessarytosustainODF
• (shouldlearnmoreof:)theSriLankasuccessstory• NGPevalua&oninIndiaTSC
– Thechallengetomakeitworkatscale
• Adap&ngCATStocountryspecific:’PATS’So:movingtheCATSuptheladderorgeongmoreCATSontheladder??
CATSlearning…
NGP Sustainability Status in 2008 of NGP Awarded GPs in 2004-05 and 2005-06
Proportion of NGP Awarded GPs Reporting Open Defecation
State Proportion of People Going for Open Defecation
Total None < 20% 20% -
40% 40% - 60%
60% - 80% > 80% 100%
Andhra Pradesh 5 4 1 10
Chhattisgarh 4 5 1 10
Maharashtra 6 36 4 6 7 1 60
Tamil Nadu 11 6 9 5 2 33
Uttar Pradesh 1 7 6 1 15
West Bengal 11 18 3 2 34
Total 6 64 39 29 20 4 - 162
Reasons for disuse of household toilets
Poor/ Unfinished installation; 31%
No Super Structure; 14%
Blockage, Pan choked, poor disposable
arrangement; 26%
Lack of behaviour change; 18%
Wrong location; 5%
Lack of water; 9%
Destroyed by Flood; 3%
Prescriptive designs ?
Poor follow-up and Monitoring ?
Lack of community involvement ?
CLTS in Afghanistan (courtesy: Tearfund)
• Triggers:disgust,shame,pride,awards
• Diverseregion• Integra&nghygieneintheCATSapproach• Sanita&onmarke&ng
CATSinnova&ons…