Sanitation Innovations

USAID Hygiene Improvement ProjectCORE Spring Meeting

April 29, 2010

WORLDWIDE STATE OF EMERGENCY!

• 2.6 billion people or 39 per cent of the world’s population live without access to basic sanitation.

Some good news: Open defecation declining

BUT• 1.1 billion people still defecate in the open. 81% in 11

countries: India, Indonesia, China, Ethiopia, Pakistan, Nigeria, Sudan, Nepal, Brazil, Niger and Bangladesh

THIS CRISIS CALLS FOR NEW APPROACHES!

• The old way – “one size fits all” latrines subsidized by development partners – simply has not worked.

• USAID’s Hygiene Improvement Project is trying some new ways of increasing access to sanitation:

Community-Led Total Sanitation and HygieneSanitation as a Business

Ethiopia: Total Sanitation and Hygiene Behavior Change …

•Integrated into the national Health Extension Program•Walk of shame & disgust through open defecation sites - •Ignites the community to ACT.•Follow up with IPC to help negotiate improved practices, moving “up the ladder” over time.

Key learning: Sustainability comes through linking to a national strategy, and also by linking total sanitation to hygiene and handwashing through household IPC

Sanitation as a Business

Madagascar

1. Production and marketing of latrine slabs through local small enterprises

2. Local masons trained to become community entrepreneurs for building latrines

3. PPP pay-for-use toilet/shower

facilities, privately managed –

Portion of revenue creates revolving

fund for reinvestment in sanitation

Peru: Alternative Pro-poor Sanitation Solutions

A market approach for sanitation

A catalog of sanitation options according people’s expectation

Affordable market loans for sanitation

Integrated communication marketing strategy

Strengthening of local providers.

Key learning: The poor aspire to aesthetically pleasing toilets that don’t look like latrines that ID them as poor

Uganda: Sanitation Marketing - District pilot effort linked to CLTS

• Training of local masons in improved latrine design

• Formalized training through local vocational training institutes

• Design innovations (unreinforced dome shape) to reduce materials needed latrine

• Cost reduction measures for cement and rebar

• Public advertising for local certified latrine entrepreneurs

Improved Hygiene Behaviors that HIP promotes

“Use and maintenance of improved or hygienic latrines”

and …

“Handwashing with soap at critical times” (e.g. after latrine use)

DESPERATELY SEEKING…..

Multiple communication channels and non-traditional partners for new approaches to the sanitation crisis

• NGOs and Unusual Partners (ex. Scouts)– Create demand for sanitation and hygiene services and

products

• Private sector– meet customer demand for improved sanitation

• Local entrepreneurs– Provide affordable, appropriate goods and services

• Community extension or frontline health workers– Promote good practices

• Communities– Community-led total sanitation to end open defecation

Tools And Products For Hygiene And Sanitation Behavior Change

Creating demand through advertising, and community promotion

Peru poster promoting toilets as thrones for royalty!Madagascar poster advertising enabling products for sale for the 3 key practices

Simple, affordable enabling technologies

Latrines adapted to needs of persons living with AIDS

Tools for negotiating small doable actions with households

Measuring household hygiene and sanitation improvement:

“Access and Behavioral Outcome Indicators for Water, Sanitation, and Hygiene”

A MANUAL DEVELOPED BY HIP

PUBLISHED FEBRUARY 2010

AVAILABLE AT HTTP://HIP.WATSAN.NET

The manual includes “Essential and Expanded Hygiene Indicators”

Hygiene Content Area Indicator

Hand Washing with Soap at Critical Moments

HW1. % of respondents who know all critical moments for hand washingHW2. % of households with soap and water at a hand washing station commonly used by family membersHW3. % of households with soap and water at a hand washing station inside or within 10 paces of latrines HW4. % of households with soap or locally available cleansing agent for hand washing anywhere in the household

19

Hygiene Content Area Indicator

Access to and Use of Sanitary Facilities for the Disposal of Human Excreta

SAN1. % of households with access to an improved sanitation facility (urban and rural)SAN2. % of households with reliable access to sanitary facilitiesSAN3. % of households spending less than 10 minutes to travel to public or shared facilitiesSAN4. % of children <36 (or 60) months whose feces were disposed of safelySAN5. % of households using the available (improved) sanitation facilitySAN6. % of households with sanitary facilities that practice adequate cleanliness to encourage useSAN7. % of households with sanitary facilities that practice adequate maintenance to keep them operationalSAN8. # of communities achieving open defecation free statusSAN9. % of communities that are maintaining their open defecation free status

20

21

Access to sanitation, Madagascar

Percent

INTEGRATING HYGIENE INTO OTHER PROGRAMS

HANDWASHING WITH SOAP! REDUCES DIARRHEA BY NEARLY 50%

The easiest practice to integrate into CS/MCH programs:

Integration possibilities include:

• Handwashing stations and promotion in health centers

Handwashing promotion at the community level

Handwashing and hygiene promotion for home-based care givers and people living with HIV-AIDS

Handwashing promotion in schools

And in church!

Celebrate

GLOBAL HANDWASHING DAYOctober 15An initiative of the Public Private Partnership for Handwashing

Thank You!