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Rethinking Sustainable Latrine Use Through Human Behaviour Change and Local Capacity Development an Assessment of the District Approach in Ethiopia (A Case Study)

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Rethinking Sustainable Latrine Use Through Human Behaviour Change and Local Capacity Development an Assessment of the District Approach in Ethiopia (A Case Study) Rethinking Sustainable Latrine Use through Human Behaviour Change and Local Capacity Development An Assessment of the District Approach in Ethiopia (A Case Study) By Addise Amado Dube A research project submitted in partial fulfilment of the requirements for the award of the degree of Master of Science in Water and Environmental Management Loughborough University MSc. © 2012 Addise Amado Dube September 2012 Supervisor: Dr Andrew Cotton BSc, PhD, CEng, MCIWEM Water, Engineering and Development Centre (WEDC) School of Civil and Building Engineering Loughborough University Leicestershire, UK, LE11 3TU Tel: +44 (0) 1509 222885 Abstract Sustainable latrine use is the headline of sanitation discussions. Despite the efforts, progress lags behind its targets in developing countries. The aim of this study focuses on understanding key motivators of sanitation behaviour change, capacity development and intersectoral integration to advance sustainable use of latrines. A mixed methodological approach comprising of survey, interview, focus group discussion and observation is applied to collect evidences. However, research on sanitation behaviour change and capacity development is scanty and at lower stage compared to other health sectors such as on diabetics, HIV/AIDS, obesity or alcoholism. The existing literature indicates that human behaviour change is a crucial factor in achieving sanitation targets and it is vital to work in interdisciplinary manner to achieve such goals. Sociological and historical approaches to sanitation research can contribute immensely to reflect on social facts and lessons from the past and the current practices. This case study discovered that social factors that focus on awareness creation and education is a strong reason in motivating sustainable latrine use followed by emotional layers such as cleanliness and decency as important driving forces. As the result of using latrines community members feel confident for getting dignity and convenience in their daily agricultural activities and homestead tasks which in turn motivates them to maintain their toilets. Although the qualities of the latrines in the study communities are poor and its utilization rate is very low, the latrine culture is progressing slowly but with a pressure to be ODF at the expense of sustainability. Based on such lessons, empowering stakeholders at the household and Kebele levels is crucial. Such capacity development includes enhancing the skills of service providers, facilitating sanitation products and promotion as well as providing supportive supervision and monitoring. On the other hand, the challenges of integrating intersectoral collaboration are complex and massive. Except for its lack of quality, regular follow up and monitoring, the coordination mechanisms are functioning properly at district level whereas the Kebele coordination can benefit if it mobilizes all the existing structures including political organizations, government civil service structures and social institutions such as religious, self help and other groups. If the current defects get corrected with an emphasis on quality, the evolution of sustainable latrine use in Ethiopia is positive. Key words: sustainable latrine use, behaviour change, capacity development, intersectoral integration, Kebele, district, Ethiopia i Dedication To my late father, Amado Dube, who enabled my studies possible and To my mother, Woelame Ayano, who work hard throughout to realize my goals. Rethinking Sustainable Latrine Use through Human Behaviour Change and Local Capacity Development ii Acknowledgments An educational journey begins with God’s help and an involvement of many people and institutions who deserve due acknowledgements for their contributions. My sincere thanks to Dr Andrew Cotton, Director of WEDC and project supervisor, for shaping the research process, offering inspirational and constructive comments and demonstrating the directions for the completion of the research project. My gratitude to Dr Julie Fisher for commenting on the draft, Dr Frank Odhiambo, Research Project Tutor, for his overall research project guidance and Tricia Jackson for support in the WEDC Resource Centre. My study was possible due to the facilitation arranged by the current EKHCDP Integrated Water and Sanitation Program (IWSP) supporting partners and the EKHCDP management. I extend my deepest gratitude to all particularly to Caspar Waalwjin, Tear NL and Keith Etherington, Tear fund UK for their close follow up. IWSP staff has encouraged me throughout my study and challenged me during my field data collection phase for which I am indebted to all for the comments. Thanks to Yohannes Demissie for arranging the briefing sessions and Dirk Wolff for the comments. The Gibe District Administration and WASH sectoral offices and Olawa Kebele officials have facilitated my data collection process for which I am grateful. Dr Azage Gebre Mariam has been encouraging me throughout my stay in Loughborough University and also for reading, commenting and sharing experience. Much appreciated. I am grateful to Emmanuel Church Open House for receiving in the House of God. It was part of an immense legacy of the churches around Loughborough! Thank you. My deepest gratitude to my wife Sara, my daughters Elon and Erlande and my son Biko for allowing me to study abroad which has challenging moments. Grand father and mother with all the family members took care of them while I was away and many thanks to all. Lidia Larebo, Betsega Wondimu ,Tsegaye Getahun and Abate Issa assisted me in field data collection while Biniam Haile and Zelalam Yohannes partially supported me in data coding and I would like to appreciate their efforts. My gratitude to all those who get involved in this research directly or indirectly and contributed for its success. Many thanks. Addise Amado Dube September 2012, Loughborough University, UK Rethinking Sustainable Latrine Use through Human Behaviour Change and Local Capacity Development iii List of Abbreviations AMCOW African Ministerial Council on Water BPR Business Process Re-engineering BSC Balanced Score Card CBO Community Based Organization CFT Community Facilitation Team CLTS Community Led Total Sanitation EKHCDP Ethiopian Kale Heywet Church Development Program ETB Ethiopian Birr FDRE Federal Democratic Republic of Ethiopia FGD Focus Group Discussion GTP Growth and Transformation Program HSDP Health Sector Development Program HEP Health Extension Program HEW Health Extension Worker HH House Hold HIV/AIDS Human Immune Virus /Acquired Immune Deficiency Syndrome HSP Hygiene and Sanitation Promotion INGO International Non-Governmental Organization IWSP Integrated Water and Sanitation Program IRC International Water and Sanitation Research Centre JMP Joint Monitoring Program Rethinking Sustainable Latrine Use through Human Behaviour Change and Local Capacity Development vi KABP Knowledge, Attitude, Beliefs, Practices KWT Kebele WASH Team MDG Millennium Development Goals MOU Memorandum of Understanding NGO Non-Governmental Organization OD Open Defecation ODF Open Defecation Free PHC Primary Health Care SC Steering Committee SHTEFIE Socio-cultural, Health/Hygiene, Technical, Economic, Financial, Institutional, Environmental SNNPRS Southern Nations, Nationalities’ and Peoples’ Regional State SUSANA Sustainable Sanitation Alliance TVET Technical and Vocational Education and Training UAP Universal Access Program UNDP United Nations Development Program UNICEF United Nations Children’s Fund VHP Volunteer Health Promoter WASH Water, Sanitation and Hygiene WASHCom Water, Sanitation and Hygiene Committee WEDC Water, Engineering and Development Centre WHO World Health Organization WIF WASH Implementation Framework WSSCC Water Supply and Sanitation Collaborative Council WWT Woreda WASH Team Rethinking Sustainable Latrine Use through Human Behaviour Change and Local Capacity Development vii Table of Contents ABSTRACT ............................................................................................................................................... I DEDICATION ............................................................................................................................................ II ACKNOWLEDGMENTS ......................................................................................................................... III INDIVIDUAL PROJECT ACCESS FORM ............................................................................................. IV CERTIFICATE OF AUTHORSHIP .......................................................................................................... V LIST OF ABBREVIATIONS ................................................................................................................... VI TABLE OF CONTENTS ....................................................................................................................... VIII LIST OF ILLUSTRATIONS ..................................................................................................................... X LIST OF TABLES .............................................................................................................................................. X LIST OF FIGURES ............................................................................................................................................ X CHAPTER 1 INTRODUCTION ................................................................................................................ 1 1.1. THE CONTEXT .......................................................................................................................................
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