DemandDemand--led approachesled approaches

to Sanitation to Sanitation

“What is the greatest medical milestone of the last 150 years?”

SanitationPoll carried out for the British Medical Journal,

2007

MDG 7, Target 10:

To halve, by 2015, the proportion of people without

access to safe drinking water and sanitation

“That’s 2076 where I live!”

The Awful Truth…

2.6 Billion people (almost 40% of global

population) lack access to basic sanitation

5,000 children under 5 die each day due to diarrhoeal

diseases routed in inadequate water &

sanitation – deaths which are preventable…

88% of global diarrhoeal disease is attributed to

safe water supply, inadequate sanitation,

and hygiene

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Objective of IY of S is to put the global community on track to achieve the sanitation MDG

5 key messages of the I Y of S are:

1. Sanitation is vital for health – we’ve seen the statistics

2. Sanitation is a good economic investment

3. Sanitation contributes to social development- Less illness; improved nutrition among children; increased learning and

retention among pupils; higher work productivity among adults; more dignity and privacy for all

4. Good sanitation practice protects the environment

5. Improved sanitation is achievable- $9.5 billion annual cost to reach the MDG

443 million school days lost each yeardue to diarrhoea: 4 in 10 children will

not reach their full educational potential

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How would you approach the following need?

Poor beneficiary community c.700 homes (4,200 pop.)

High incidence of diarrhoea, especially in under 5s, and worms amongst school-age children

Very low proportion of latrine ownership, with prevailing evidence of poor use and maintenance

Open defecation is prolific

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The problem with supply-driven approaches

Coverage may increase but take-up of proper latrine use is low, and mis-use is common

Inappropriate technology (standardised approaches) often used

No focus on cultural and social considerations

Sanitation remains the poor relative in “WASH” or “Watsan”

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Demand-led (Demand-responsive) approaches

Although improved sanitation leads to improved health, people associate toilets with other benefits:

Privacy

Safety(especially for

women)Comfort &

convenience

Less embarrassment

for visitorsDignity!

Asset

Easy to use and maintain

Less flies around

compound

Status

Rationale to a marketing approach:

Many people, including the poor, are willing to pay for good sanitation that will satisfy their requirements if the

technology is packaged and marketed appropriately, and the supply mechanism is easily accessible

Apply a marketing approach to sanitation

Social marketing offers a more promising approach to promoting positive hygiene behaviours compared to traditional, health education-based approaches

Social (or Sanitation-) Marketing

Definition of Social Marketing

'The use of commercial marketing techniques to promote the adoption of behaviour that will improve the health or well-

being of the target audience or of society as a whole' (Weinreich, 1999)

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Demand & Supply:Demand & Supply:

Applying a marketing approach to sanitation is not just about advertising; it is also about ensuring that appropriate sanitation optionsare made available and that suppliers have the necessary capacity to provide the desiredservices.

Sanitation marketing is about

ensuring a balance between demand (user) and supply

(products, provider)

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How do you market sanitation?

• Monitor the programme (spread/ response to the campaign, quality of services provided etc)

• Feedback and modify the programme as appropriate Monitor and feedback

• Produce promotion materials (e.g. posters, flyers, radio jingle, billboard) • Launch a campaign (e.g. road show, launch event) • Run a promotion campaign for about 3 months

Implement promotion campaign

• Identify partners with expertise for the design and development of marketing concepts

• Develop marketing concepts and creative design • Pre-test and refine creative design • Develop promotion strategy

Message and material development

• Identify potential suppliers of latrines & other related services • Assess and develop their capacity to provide desired services • Identify and/or set place(s) where consumers can access the sanitation

services being marketed (eg toilet centres) • Work with the public sector to establish strategy for disposal of sludge from

toilets

Set up supply mechanism

• Identify and develop marketable sanitation facilities & services (e.g. latrine

technologies /options, latrine information service, latrine centre)

Product identification and development

• Develop preliminary marketing mix (Product, Price, Place, Promotion)Programme aims and

objectives

• Identify market research expertise • Establish and train the research team • Conduct consumer research • Conduct producer research

Market Research

Who’s involved in sanitation marketing?

SM creates opportunity for users, public sector, private sector, and NGOs all to get involved / to work together;

A partnership for sanitation marketing could be made up of the following groups:

- Households

- Informal toilet builders

- Pit emptying truck operators

- Market research agencies

- Communication/advertising agencies

- NGOs

- Government agencies

- Financial institutions

Meeting social aspirations does not make a toilet a sanitary facility. That can only happen when the sanitation system is combined with hygienic behaviour based on an understanding of the effect on health of good hygiene practice and safe excreta disposal.

Personal and public hygiene and care for even the simplest sanitary facility are at the core of good sanitation!

Sanitation marketing does NOT mean neglecting hygiene education:

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Case StudiesCase Studies

Dar es Salaam, Tanzania

West Bengal, India

Sulabh, Bihar State, India

Advocacy in promoting demand-led approach

• Hygiene education often left to NGOs, with government coming in on structural phase > Limited buy-in by govts.

“Hook sanitation on health, and promote politically through citizen’s rights approach” (ODI)

> Sanitation as a public right, not just a private good: governments to take more responsibility

• Acknowledge sanitation in the wider development agenda *

• Use notion that sanitation is a good investment

• Discrete budgets for sanitation are needed

• Government incentives to stimulate private sector development

• Long-term commitments: government planning processes must allow for this

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Community Led Total SanitationCommunity Led Total Sanitation

(CLTS)(CLTS)

Focuses on igniting a change in sanitation Focuses on igniting a change in sanitation

behaviour rather than constructing toilets. behaviour rather than constructing toilets.

Achieved through a social awakening, stimulated Achieved through a social awakening, stimulated

by facilitators.by facilitators.

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Community Led Total SanitationCommunity Led Total Sanitation

CLTS does not identify standards or designsfor latrines, but encourages local creativeness. This leads to greater ownership, affordability

and therefore sustainability.

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Key components and methodology:Key components and methodology:

Begins with a community-based appraisal of current sanitation practices, including open defecation. Methodology includes:

Mapping defecation areas, Mapping defecation areas,

Transect walksTransect walks

Calculations of faecal loadCalculations of faecal load

Action planningAction planning

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Difference between traditional approach and CLTS

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Film clipFilm clipCommunityCommunity--Led Total Sanitation, Led Total Sanitation,

by Kamal Karby Kamal Kar

Produced by Plan International with the Institute of Development Studies

Impact on our sanitation programming?Adopt demand-led approach wherever possible, and consider sanitation in respect of development outcomes generally, not just as a “WASH component”

Avoid straight subsidies on sanitation hardware

Let every latrine be a wanted latrine (and therefore used) *

Re. advocacy, linkage of sanitation with water is often unhelpful – sanitation usually loses out to water (policy, strategy, budgets).

Consider approaches such as CLTS, but support with long-term hygiene education programmes (e.g. PHAST), and ensure hard sanitation outputs (latrines, disposal sites) are included in sanitary surveys.

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Impact on our sanitation programming? continued

Public sector still has important role:

- creating the right policy environment: incl. regulation (for price, quality, environmental impact, protection of water resources, etc.)

- incorporating subsidies for hygiene promotion, sanitation marketing, supporting small-scale-providers, school sanitation, institutional sanitation, etc.

Consider urban & peri-urban (e.g. squatter, slum) projects: 60%60% urbanisation by next generation, of which 60%60% will be unofficial settlement!

Consider schools and churches as demonstration / entry points (Resources...)

Global Sanitation Fund (Launched March 2008)

Run by the Water Supply and Sanitation Collaborative Council (WSSCC) of the UN

Financing mechanism established to boost expenditure on sanitation and hygiene: Goal is to help large numbers of poor people attain safe and sustainable sanitation services and adopt good hygiene practices

GSF supports other organisations’ (NGOs, CBOs, Local Govt.) implementation work by giving grants from a pooled global fund to selected organisations in eligible countries

Must be linked to national sanitation policies/strategies

Demand-led approaches, NOT supply- or subsidy-driven

First round countries: India, Pakistan, Nepal, Senegal, Burkina Faso, Uganda, Madagascar. Second round of countries to be announced in 2009