Demandled approaches to Sanitation

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Demand-led approachesto Sanitation
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What is the greatest medical milestone of the
last 150 years? Sanitation Poll carried out for
the British Medical Journal, 2007
Thats 2076 where I live!
MDG 7, Target 10 To halve, by 2015, the
proportion of people without access to safe
drinking water and sanitation
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The Awful Truth

• 88 of global diarrhoeal disease is attributed to
  safe water supply, inadequate sanitation, and
  hygiene

2.6 Billion people (almost 40 of global
population) lack access to basic sanitation
That's just the health outcome...
5,000 children under 5 die each day due to
diarrhoeal diseases routed in inadequate water
sanitation deaths which are preventable
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Objective of IY of S is to put the global
community on track to achieve the sanitation MDG
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• 5 key messages of the I Y of S are
• Sanitation is vital for health weve seen the
  statistics
• Sanitation is a good economic investment
• 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
• Good sanitation practice protects the environment
  
• Improved sanitation is achievable
• 9.5 billion annual cost to reach the MDG

443 million school days lost each year due 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

Easy to use and maintain
Privacy
Less embarrassment for visitors
Dignity!
Status
Asset
Safety (especially for women)
Comfort convenience
Less flies around compound
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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
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Social (or Sanitation-) Marketing
Social marketing offers a more promising
approach to promoting positive hygiene behaviours
compared to traditional, health education-based
approaches
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

• Applying a marketing approach to sanitation is
  not just about advertising it is also about
  ensuring that appropriate sanitation options are
  made available and that suppliers have the
  necessary capacity to provide the desired
  services.

Sanitation marketing is about ensuring a balance
between demand (user) and supply (products,
provider)
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How do you market sanitation?
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Whos 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

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Sanitation marketing does NOT mean neglecting
hygiene education
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!
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Case StudiesDar es Salaam, TanzaniaWest
Bengal, IndiaSulabh, Bihar State, India
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• Advocacy in promoting demand-led approach
• Hygiene education often left to NGOs, with
  government coming in on structural phase gt
  Limited buy-in by govts.
• Hook sanitation on health, and promote
  politically through citizens rights approach
  (ODI)
• gt 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 Sanitation(CLTS)
Focuses on igniting a change in sanitation
behaviour rather than constructing toilets.
Achieved through a social awakening, stimulated
by facilitators.
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Community Led Total Sanitation
CLTS does not identify standards or designs
for latrines, but encourages local creativeness.
This leads to greater ownership, affordability
and therefore sustainability.
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Key components and methodology

• Begins with a community-based appraisal of
  current sanitation practices, including open
  defecation. Methodology includes
• Mapping defecation areas,
• Transect walks
• Calculations of faecal load
• Action planning

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Difference between traditional approach and CLTS
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Film clip

• Community-Led Total Sanitation, by Kamal Kar
• Produced by Plan International with the Institute
  of Development Studies

Friday 19 Sept., 9.30 am, Room A
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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 urbanisation by next generation, of
  which 60 will be unofficial settlement!
• Consider schools and churches as demonstration /
  entry points (Resources...)

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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