SUSTAINABLE SANITATION

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• SUSTAINABLE SANITATION HYGIENE EDUCATION FOR
  BETTER HEALTH
• (INTER SECTORAL CONVERGENCE OF TSC WITH NHRM)

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Areas of Convergence with NRHM

• TSC and NRHM have shared goals
• Integration of health, sanitation and hygiene
  education through effective intersectoral
  convergence is key to achieving MDGs by both TSC
  and NRHM
• Strengthen Village Health and Sanitation
  Committees in preparing and implementing village
  health and sanitation pIans.

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Areas of Convergence

• Convergence meetings held under the Joint
  chairpersonship of Secretaries of both the
  Departments including Empowered Committee meeting
  of National Rural Health Mission to strategies
  the areas of convergence between the programmes
  of the two Departments.
• Joint Letters issued by Secretaries of both Depts
  to States to strengthen intersectoral convergence
  initiatives These include
• Integration of activities of State Water
  Sanitation Mission (SWSM), District Water
  Sanitation Committees (DWSC), under TSC with
  State Health Society and District Health Society,
  under NRHM. Identify Functions, mechanisms of
  pooling of financial and human resources of staff
  under TSC and NRHM

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Convergence ASHA for Health and Sanitation

• ASHA Village level health activist Role Model
  for awareness in the community on health ,
  hygiene, nutrition, sanitation, safe drinking
  water Inclusion and active involvement of ASHA
  workers in VHSC
• Incentive to ASHA workers by provision of
  toilets through TSC funds for their role in
  Community mobilization on demand creation for
  sanitation facilities and health and hygiene
  education programmes particularly in school and
  anganwadis.
• Total Sanitation Campaign (TSC) guidelines has a
  provision of giving incentives to motivators
  which includes ASHA workers at earmarked for
  IEC. The amount of incentives is fixed by State
  Governments and varies for eg in Bihar it is Rs.
  75
• Access to toilet in the household an essential
  criteria for selection of Asha Workers
• Inputs given on inclusion of messages on good
  personal hygiene, importance of use of toilets,
  water and sanitation related illnesses and their
  prevention in training curriculum for ASHA
  workers

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Areas of Convergence

• Inclusion of Vector Borne Diseases Control
  Programme (VBDCP) activities by the Village and
  Sanitation Committees (VHSC) for prevention of
  vector borne disease at the village level out of
  annual untied grants of Rs. 10, 000 to each VHSC.
  Prevention of vector mosquito breeding by filling
  up of unused /unwanted wells/ditches disposal of
  solid waste.
• Joint Information Education Communication (IEC)
  action plans on preventive and curative aspects
  of water , sanitation, health and hygiene
• Joint Meeting of officials under TSC and NRHM of
  high Polio risk Districts of UP and Bihar was
  convened by Secretary DWS to assess the extent of
  prevalence and undertake coordinated actions to
  eradicate Polio by combining immunization with
  provision of sanitation facilities and improving
  health and hygiene practices in the Polio endemic
  areas.
• Inputs were given on the mechanism for
  integrating the Nirmal Gram Puruskar Awardees as
  Model Village and Training Centres also for
  Health Programmes.

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Areas of Convergence

• Comments were given on Guidelines for Training
  Programme under RCH I Programme of Ministry of
  Health and Family Welfare for inclusion of
  messages on importance of personal and food
  hygiene practices by women, menstrual health and
  hygiene amongst adolescent women.
• Inputs were given to NRHM regarding integrated
  web based Management Information System of the
  Department of Drinking water Supply for online
  monitoring of progress made in programme
  implementation. Includes baseline data, updated
  data on sanitation coverage for all TSC
  components, viewed on the website- www.
  ddws.nic.in.

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Intersectoral Convergence by States (Some
Examples)

• Manipur Utilization of services of the ASHA
  workers, District media experts and social
  mobilization under NRHM for coordination on IEC
  and HRD activities under TSC
• Uttaranchal Doctors being involved in TSC
  programme. Use of Rubber stamp messages on
  health and hygiene by doctors
• Assam- TSC mobilization entrusted to existing
  VHC/VH SC rather than forming a new VHWSC.
  Inclusion of WATSAN messages in ASHA Radio
  programme sponsored by NRHM

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Intersectoral Convergence Road Ahead Priority
Areas

• Strengthen Intersectoral convergence initiatives
  in the areas of Institutional structures and
  mechanisms, Planning and Operational strategies,
  Field teams implementation, Reporting and
  Monitoring
• Strengthen formation / integration of VHSC in
  states. Define roles, responsibilities ,
  mechanism for pooling of human and financial
  resources from both programmes.
• Regular review and monitoring of of progress
  made by States on intersectoral convergence
  initiatives like provision of toilets/incentives
  to Asha workers
• Strengthen Capacity building programmes for ASHA
  workers, ANMs , MPHW and other officials under
  TSC and NRHM with a synergy on WATSAN. Link
  Communication and Capacity development Units and
  Key resource Centres under TSC with the Regional
  Resource Centres and other training institutions
  under NRHM for developing common curriculum.

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Intersectoral Convergence Road Ahead Priority
Areas

• Joint IEC and Media Campaign and documentation of
  best practices and case studies on models on
  integration of sanitation and health hygiene
  Education
• Strengthen Convergence of School Health Hygiene
  Education Programme( SSHE) with the School Health
  programme which would include the provision of
  safe drinking water, construction of toilets for
  both boys and girls, proper use of toilets, in
  schools, personal health and hygiene, menstrual
  hygiene education programmes.
• Common coding standards for intersectoral
  convergence at database level and mechanism for
  information sharing on water supply programmes in
  states, water quality, waste water and poor
  sanitation related diseases, impact of provision
  of sanitation and health and hygiene on
  improvement of health indictors like MMR, IMR
  may be worked out between the two Ministries
  through a common MIS.
• Common information and monitoring mechanism
  system for identification of endemic areas of
  water quality affected areas and tracking of
  water and sanitation related diseases polio,
  cholera, typhoid , hepatitis, developing response
  system for to outbreaks within the institutional
  mechanism

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Intersectoral Convergence Road Ahead Priority
Areas

• Joint Monitoring mechanisms on both health
  programmes and water and sanitation facilities in
  the village
• Research and development activities on
  sustainable, low cost, locally appropriate
  technologies on water and sanitation and
  prevention and cure of most prevalent illnesses
  in the village, emergency joint action plans for
  management of outbreak of communicable diseases,
  impact of sanitation on health indicators of a
  region.
• Follow up Workshop of officials of TSC and NRHM
  on Polio Eradication and management in high
  polio risk districts of Bihar and UP.
• National Workshop on Sustainable Sanitation for
  improved Health- Convergence of programmes of TSC
  and Dept. of Health in partnership with NRHM, and
  NHSRC to review of progress made, identify gaps
  and building synergies on intgersecotral
  convergence at Central , State and Village level

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Sustainable Sanitation for Better Health

• We shall not finally defeat AIDS, tuberculosis,
  malaria, or any of the other infectious diseases
  that plague the developing world until we have
  also won the battle for safe drinking water,
  sanitation and basic health care.
• -- Kofi Annan, Former Secretary-General,
• United Nations

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Sustainable Sanitation for Better Health
INTERSECTORAL CONVERGENCE

• TSC and NRHM has shared goals outcomes,
  strategies and plan of action
• Intersectoral Convergence can be effective if
  synergies are built at all levels-
• Institutional structures / mechanisms
• Planning and Operational strategies
• Field teams / implementation
• Reporting / Monitoring
• COMING TOGETHER IS BEGINNING
• WORKING TOGEHER IS PROGRESS
• REACHING TOGETHER IS SUCCESS

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