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SUSTAINABLE SANITATION & HYGIENE FOR ALL (SSH4A) PROGRAMME Baseline Study Report, Nepal …………. ……………… July 2015 Netherlands Development SSH4A is supported by the Organization Australian Government and DGIS. Baseline Study Sustainable Sanitation & Hygiene for All (SSH4A) Programme Nepal (Project districts supported by Civil Society WASH Fund, DFAT) Submitted to: SNV/Netherlands Development Organisation Nepal Jawalakhel, Lalitpur, Nepal Submitted by: Surya Binod Pokharel (Team Leader) Deependra Kaji Thapa (Survey Coordinator) Research Centre for Integrated Development Nepal Gausala, Kathmandu [email protected] Acknowledgement RECID Nepal is grateful to SNV Nepal for offering the opportunity to conduct out the Baseline Survey of SSH4A Programme. We would like to express our deepest appreciation to Ms. Nadira Khawaja, WASH Sector Leader and Mr. Anup Regmi, Project Leader, from SNV Nepal for their continuous support and guidance in the finalization of study methodology, field plans as well as finalization of baseline study report. We are also grateful to Erick Batings from IRC for his invaluable guidance through training, and mentoring. RECID Nepal would like to thank a wide range of individuals who supported this baseline survey. We are grateful to the district advisors of SNV Nepal for supporting to commence the field work in the districts. Special gratitude goes to all the participants and respondents including the staff and representatives of DDC, DWASHCC, WSSDO, RMSO, VDCs and schools for their patience, cooperation and valuable time in sharing their insights and experiences. We express our deep appreciation to all the supervisors and enumerators for their hard work and timely completion of field levels. Surya Binod Pokharel Deependra Kaji Thapa Research Centre for Integrated Development (RECID) Nepal Executive Summary Introduction and Objectives SNV Nepal is implementing its Sustainable Sanitation and Hygiene for All (SSH4A) Programme in eight districts of Nepal with funding from the Civil Society WASH Fund of DFAT, Australian Government and the Ministry for Foreign Affairs (DGIS), The Netherlands. The districts include Jumla, Dolpa, Kalikot, Rukum, Rolpa, Salyan, Sarlahi and Mahottari. The major objective of the study was to establish the current status of sanitation and hygiene in the target districts as well as to understand the capacities of key stakeholders to steer processes and deliver services. Methodology The study was carried out to measure the existing status of pre-determined programme indicators. The SSH4A programme has four impact indicators measuring the status of sanitation and hygiene at the household level out of which three indicators are also used to measure the status in schools. Eight outcome indicators are being used to assess sector capacities including sector steering and implementation capacities, private sector engagement, sector alignment, and empowerment. The baseline survey used Qualitative Information System (QIS) tool assessing for impact indicators (which provides a progressive scale from level 0 to level 4 with benchmark being at level 2) and Scorecard tool for the outcome indicators as performance monitoring frameworks. Household survey: A total of 2,979 households from 47 sampled VDCs in eight project districts were surveyed using Akvo FLOW mobile application software. Data were collected by trained enumerators from the head of household and/or the adult member of the sampled households using structured questionnaire. Guided self-assessment: Outcome indicators were measured at district level through Focus Group Discussions (FGDs) and interaction with key district stakeholders using self-assessment scorecards. FGDs and interactions were made with persons from related authorities responsible for sanitation and hygiene activities in the districts (WSSDO, DWASHCC, and DDC etc.). Major Findings on Impact Indicators Socio-demographic Characteristics The socio-demographic data provides the context of the project area and an insight into potential factors that may influence the sanitation and hygiene situation. The findings confirmed that Nepal is a patriarchal society and 81.4% of the households were headed by men. The project area had an average household size of 6.7. The survey revealed that 13.8% of the households had at least one member living with a disability. The sampled households were distributed into one of five wealth quintiles relative to national wealth ranking: poorest, poor, medium, rich, or richest. The findings showed that the respondents belonged mostly to the poor wealth category followed by medium and poorest categories. Differentiation according to the ecological zones showed a clear distinction between the three zones with the mountain districts being the poorest, followed by the hills, and then the terai. Households with Access to a Sanitary Toilet (Indicator 1.1) Impact indicator 1.1 of the programme assesses access of households to a sanitary toilet. This indicator looks at the existence of toilets as well as the toilet structure. The infographic below shows that 42.8% of the housheolds did not have access to a toilet and a further 12.9% had access to a basic latrine or a shared facility. 44.3% of the households were at or above the benchmark of having an improved toilet. The majority of households that had an improved latrine had reached level 3 or 4 of the QIS scale for the indicator and therefore had an improved toilet in which excreta were contained and were also not accessible to flies. Notably, the terai, which was comparatively wealthier than the other ecological zones, had the highest proportion of households defecating in the open, 97%, as compared with the hills where 19% had no access to a toilet and the mountains where 29% had no access to a toilet. Kalikot, Rukum, Rolpa, and Salyan districts had between 41% to 62% of households with an environmentally safe toilet that was not polluting surface or groundwater sources. This can be attributed to the high prevalence of water-seal flush toilets and therefore excreta are contained and there is no access to flies. Also, the hill and mountain areas have permeable soils and in many locations the ground and surface water sources are far away; therefore, pits do not fill up or overflow easily and the chances of contaminating groundwater tend to be low. In the terai, on the other hand, environmental contamination is a high risk due to the flat land, high population densities, high groundwater table in many areas, and regular flooding events. Therefore, although currently the sanitation coverage in the terai is low, achieving level 4 with environmentally safe toilets is a considerable challenge for this area. Indicator #1 “Access to sanitary toilet” 44.3% of the 12.9% of the households households in the in the project area have a basic project area have an toilet or a shared latrine improved toilet (at or above of the households benchmark) 42.8% in the project area do not have access to a toilet Households with Use of Hygienic Toilet (Indicator 2.1) Impact indicator 2.1 of the programme assesses dual aspects of whether a toilet is being used and whether it is used and maintained in a hygienic condition. The infographic shows that 44.6% of the households in the project area were not using a toilet either because they did not have access to a toilet or because a toilet existed but it was not in use as a toilet. However, considering that 42.8% of households did not have access to a toilet (indicator 1.1), only a small number of households were not using a facility that existed as a toilet. This high usage rate can perhaps be attributed to the no-subsidy approach adopted by the Government of Nepal where households that were investing in making a toilet were also using that facility. The infographic also shows that 53.0% of the households were at or above benchmark and were using a toilet which was functioning as intended. As most of the facilities were flush toilets, this meant that the toilets had a functioning water seal. Results for indicator 2 showed that the overwhelming bottleneck in use of a hygienic toilet was cleanliness. The majority of households that were at or above benchmark for the indicator were at level 2 (benchmark level) itself indicating that the toilet was maintained in a functional condition. However, only 2.2% of the households were using a toilet that was clean (level 3 or higher). Notably, this trend was seen across ecological zones, individual districts, wealth quintiles, as well as gender of household head. Indicator #2 “Use of hygienic toilet” 53.0% of the 2.4% of the households households in the in the project area use a project area use a toilet toilet which is functioning as intended 44.6% of the households (at or above in the project area do not benchmark) have or do not use a toilet that exists Households with Hand Washing Facility In or Near Toilet (Indicator 3.1) Indicator 3.1 of the programme assesses the existence and quality of hand washing facilities in or near a toilet as a proxy indicator for the behaviour of safe practice of hand washing with soap after defecation. The infographic shows that a high proportion of households, 84.5%, did not have access to a hand washing facility, 7.5% of households had access to a hand washing facility but without soap, and that only 8.1% of household were at or above benchmark where a hand washing facility exists and soap (or soap substitute) is available. There was little difference in findings between the three ecological zones. So, even though in the terai most of the households had yet to construct a toilet and therefore would by default have no hand washing facility near a toilet (97%), notably even for the other two eco-zones, a high proportion of households had no hand washing facility (81% for mountains and 78% for hills).

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