Volume : 4 | Issue : 5 | May 2015 ISSN - 2250-1991 Research Paper Social Work

Promotion of Sustainable Sanitation in Six Villages of Banka District,

Mr. Pritam Bhattacharyya Mr. Mukesh Kr. Shukla

Now a day, “WASH” is a burning issue which needs better attention in the 12th five year plan where engagement of civil society organization can boost up the implementation process in collaboration with existing line departments. More concentration is required in community awareness on ‘WASH’ component through Community mobilization and behavioural change communication instead of installation the subsidiary latrine. A long experience in related field, Research team has able to contribute & raise community awareness in order to make people recognize where health problems originate and how to better sanitation by their own action with a wide range of activities in a collaborative effort with many partners including families, communities, government and like-minded organizations. The Government already adopted a “demand driven” approach with the name “Total Sanitation Campaign” (TSC) with effect from 1999. Now, the concept of sanitation has been expanded to include personal hygiene, home sanitation, safe water, garbage disposal, excreta disposal and waste water disposal named as Nirmal Bharat Abhijan (NBA). This revised approach emphasized more on Information, Education and Communication (IEC) to increase awareness among the rural people and generation of demand for sanitary facilities. The involvement of Ngo will add an extra value for making the programme ‘community led’ and ‘people centered’. But, intensive awareness generation of VWSC, Sahiya and other service providers will be helpful to enhance their knowledge & skill as community level as Motivator and Mobilizer. Involvement of subject matter specialist will definitely penetrate into the grass root level for greater community participation.Commitment on water and sanitation: MDG 7, which aims to halve, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation. But those who die are by no means the only children affected. Many millions more

ABSTRACT have their development disrupted and their health undermined by diarrhea or water-related disease. Water and sanitation are vital in themselves, but they are also key prerequisites for reducing child and maternal mortality (MDG 4 and 5) and combating diseases (MDG 6). And they are key to reducing child under nutrition (MDG 1) and achieving universal primary education (MDG 2). Girls, especially, are likely to spend more time in school when they spend less time fetching water and when adequate sanitation facilities are available on school grounds. Water and sanitation programs is to prevent diarrheal diseases, especially in children and adolescent, mitigate environmental factors that contribute to negative health effects and improving quality and quantity of water, in addition to improve hygiene practices. Research goal of this component is to increase access to portable water and sanitation by access to hardware and promoting better hygiene behavior. Access to hardware refers to core equipment and supplies that are provided either at the household level or within communities. Hardware includes community water systems, sanitation facilities and household level technologies and materials. Hygiene promotion relates to the software that accompanies the supplied hardware. Hygiene promotion includes behavioral/social change methods for achieving success such as: community mobilization and communication strategies, social marketing, school programs and community participation in problem identification and solutions. KEYWORDS

ACRONYM: MGNREGS Mahatma Gandhi National Rural Employ ANM Auxiliary Nurse Mid-Wife ment Guarantee Scheme ASHA Accredited Social Health Activist MHM Menstrual Hygiene Management AWW Anganwari Worker MOIC Medical Officer In-charge BC Block Coordinator NBA Nirmal Bharat Abhijan BDO Block Development Officer NGO Non Government Organization BWSC Block Water & Sanitation Committee NRMC NR management Consultant Pvt. Ltd CDPO Child Development & Protection Officer ODF Open Defecation Free CLTS Community Led Total Sanitation PHED Public Health Engineering Department DC District Coordinator PO Programme Officer DDC Deputy Development Commissioner PRI Panchayati Raj Institution DM District Magistrate PRS Panchayat Rojgar Sevak DWSC District Water & Sanitation Committee PS Panchayat Samiti DWSM District Water Sanitation Mission RSM Rural Sanitary Mart EE Executive Engineer SC Schedule Caste GP Gram Panchayat SHG Self Help Group GSF Global Sanitation Fund SMC School Management Committee HDI Human Development Index ST Schedule Tribe JMP Joint Monitoring Programme SWSM State Water Sanitation Mission MDG Millennium Development Goal VWSC Village Water & Sanitation Committee

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WASH Water Sanitation & Hygiene level. Involvement of School Management Committee in san- ZP Zilla Parishad itation promotion in schools and utilization of school untied fund in Sanitation purpose definitely will increase the attend- Executive Summary ance rate among girl students. Sanitation and hygiene challenges is a burning issue now a day all over . There is a need to re-focus on stopping Overall, it was an Action Research for developing a sustainable open defecation rather than the building of facilities alone, model on Sanitation promotion utilizing the maximum benefit investing heavily in hygiene promotion and social intermedia- of the scheme for the beneficiaries and involving all the stake- tion, particularly at household level, and providing improved holders at each & every stair of planning, Execution & mon- and affordable design options for the poor. Supply and de- itoring for its sustainability. District can adopt this model for mand must be linked. To date the focus has been on BPL fam- greater coverage in a stipulated time frame and endorse the ilies. But there are huge numbers of families above poverty scheme decentralized and people centric. line who don’t follow adequate or any sanitation and hygiene practices. These families also need to be covered under a com- CONTENT prehensive communications, advocacy and marketing strate- Topic Page gies. The link needs to be made with improved sanitation and Abstract hygiene impact on overall health. Practicing open defecation Acknowledgement creates an environment in which diseases can transmit rapidly. Acronym Executive Summary The other problem of proper hygiene and sanitation has in- ______creased manifold due to higher rates of population growth Chapter I: Introduction leading to insanitary conditions. The other limitations in pro- Chapter II: Review Of Literature viding the adequate sanitation condition are lack of trained Chapter III: Methodology personnel, lack of knowledge, improper need based area spe- Chapter IV : Area and the People cific planning to disseminate information and constantly mon- Chapter V : Key Study Element itor the changes. Keeping it in the mind and depending upon Chapter VI : Activity & Result Area the present situation (above 80% HH in Bihar still practicing Chapter VII : Sustainability Assessment open defecation), Global Sanitation Fund has been provided Chapter VIII : Model Adopted for Execution support in Banka district of Bihar for sustainable promotion of Chapter IX: Success Story Sanitation through technical executing agency NEEDS. Chapter X : Challenges Chapter XI : Glimpse In the present study, main focus shifted in to Behavioural Chapter XII : Way Ahead change rather installation of Latrine in H.H. level. The trans- ______formation from TSC to NBA was a paradigm of change that is List Of Tables being carried out in communitization mode with incorporation Annexure of IEC and strengthening Public Private Partnership approach. Reference

State like Bihar is still striving a lot that has been shown in 1. Introduction: Human Development Index (HDI) and Banka is among most Sanitation is the hygienic means of promoting health through neglected & poverty alleviated district of Bihar due to its ge- prevention of human contact with the hazards of wastes as ographical isolation, border surroundings and dense tribal well as the treatment and proper disposal of sewage waste- population. Hence, district authority still believe in tradition- water. Hazards can be physical, microbiological, biological al CLTS approach to bring ODF under Nirmal Bharat Abhijan. or chemical agents of disease. World Health Organiza- But, huge advertisement of NBA subsidiary approach develops tion (WHO) defines sanitation as group of methods to a negative mind set of vulnerable sections to invest money in collect human excreta and urine as well as communi- this sector and expand a dependency on Govt. support even ty waste waters in a hygienic way, where human and in APL families. community health is not altered. Sanitation methods aim to decrease spreading of diseases by adequate Critical Fund Management process in NBA & MGNREGS schemes waste water, excreta and other waste treatment and creates greater confusion among functionaries in all level that re- proper handling of water and food by restricting the sults non disbursement of fund up to the beneficiaries in grass occurrence of causes of diseases. root level and non submission of Utilization Certificate in the state via district restrict further disbursement of fund. Sanitation is a system to increase and maintain healthy life and environment. Its purpose is also to assure peo- From 2012, involvement of NGO in Sanitation promotion un- ple enough clean water for washing and drinking pur- der the flagship of NBA was a immense step towards success poses. Typically health and hygiene awareness is con- but their unorganized vision and movement pushed NBA pro- nected to sanitation in order to make people recognize gramme further backward. where health problems originate and how to access better sanitation by their own actions. Based on these situation, this study has shown a path to carry the flagship programme by lend in hand with community and According to the WHO-UNICEF Joint Monitoring Programme the model scanned that can be replicated in other places also for Water Supply and Sanitation (JMP), 37% per cent of the for unique and rapid execution in a mode of convergence. developing world’s population have lack improved sanitation facilities, and over 780 million people still use unsafe drinking Though term “ODF” is a simple abbreviation but it consists of water sources. Inadequate access to safe water and sanitation several approaches and components. Availability of toilet in services, coupled with poor hygiene practices, kills and sickens H.H level does not mean it use in day to day basis. This study thousands of children every day, and leads to impoverishment has shown the way to merge toilet availability with its acces- and diminished opportunities for thousands more. sibility by promoting community awareness and demand and plotted it in a single line. With support from District, block & Poor sanitation, water and hygiene have many other serious GP level functionaries, community basically adopted improved repercussions. Children and particularly girls are denied their latrine in their H.H. but, lack of concurrent monitoring and right to education because their schools lack private and de- comprehensive awareness hinder the practice level irrespec- cent sanitation facilities. Women, who are using open air tive of Caste, Creed and location. Functionalization of VWSC everyday for defecation, lose the dignity of life and social sta- and separate peer educator training for Adolescent, Women & tus. Poor farmers and wage earners are less productive due School students generate that sustainability in the community to illness, health systems are overwhelmed and national econ-

53 | PARIPEX - INDIAN JOURNAL OF RESEARCH Volume : 4 | Issue : 5 | May 2015 ISSN - 2250-1991 omies suffer. Without WASH (water, sanitation and hygiene), is a personal and private matter and thus is the responsibility sustainable development is impossible. It needs a wide range of individuals. of activities and work with many partners, including families, communities, governments and like-minded organizations. Women tend to attach more importance to sanitation than do men, but hitherto female priorities carry less weight in house- 1.1 Sanitation and Human health- A close association: hold budgeting. Sanitation and human health are closely connected to each other. Therefore it is very important to safeguard adequate A combination of multiplicity of institutional homes, weak na- sanitation and hygiene awareness to reduce the amounts of tional planning and low political status –a root cause of many infections and access to water borne diseases. A common ex- failures in sanitation service delivery. ample is diarrhoea which is the most important and common excreta related diseases. It is an acute malfunction of diges- Lack of (or inadequacy of) coordination and dialogue among tive system which causes watery excrement and continuous the multiple agencies and institutions -non-optimal interaction need for excretion. It creates rapid weakening of liquid and with societies on sanitation issues salt balance and the body starts to dehydrate. Main factors in transmitting of diarrhoea are inadequate personal and food Inadequate information on the interface between: service pro- hygiene and lack of safe drinking water. Interestingly this dis- viders (supply) and consumers (demand); different types of ease can be prevented by maintaining the following areas at service providers operating within the same program household level: Societal perceptions, cultural norms and religious beliefs -does • Increase of access and use of safe water and sani- not help provide a welcoming platform for the demand of tation services sanitation services by communities • Using adequate toilet and paying attention on proper handling and disposal of excrement. Poverty -poorest households often lack the financing capacity • Promoting hygiene education to purchase sanitation facilities • Encouraging breast-feeding • Proper washing of vegetables, utensils and boiling 1.4 Objective of NBA Programme: of water a) Bring about an improvement in the general quality of life • Washing hands (both adult and children) before in the rural areas. and after having food and defecation b) Accelerate sanitation coverage in rural areas to achieve the vision of Nirmal Bharat by 2022 with all gram Panchayats The problem of proper hygiene and sanitation has increased in the country attaining Nirmal status. manifold due to higher rates of population growth leading to c) Motivate communities and Panchayati Raj Institutions pro- insanitary conditions. The other limitations in providing the ade- moting sustainable sanitation facilities through awareness quate sanitation condition are lack of trained personnel, lack of creation and health education. knowledge, improper need based area specific planning to dis- d) To cover the remaining schools not covered under Sar- seminate information and constantly monitor the changes. All va Shiksha Abhiyan (SSA) and Anganwadi Centres in the these factors contribute in unsatisfactory sanitation service level. rural areas with proper sanitation facilities and undertake proactive promotion of hygiene education and sanitary 1.2 Hand Washing- A vital component of Sustainable San- habits among students. itation: e) Encourage cost effective and appropriate technologies for Human feces are the main source of diarrheal pathogens. ecologically safe and sustainable sanitation. They are the source of shigellosis, typhoid, cholera, all other f) Develop community managed environmental sanitation common endemic gastro-enteric infections and some respira- systems focusing on solid & liquid waste management for tory infections such as influenza and pneumonia. A single overall cleanliness in the rural areas. gram of human feces can contain 10 million viruses and one million bacteria. 1.5 Components of NBA The Programme components and activities for NBA implemen- These pathogens are passed from an infected host to a new tation are as follows: one via various routes but all of these illnesses emanate from feces. Removing excreta and cleaning hands with soap after (a) Start-Up Activities contact with fecal material –from using the toilet or cleaning a. Conducting of preliminary survey to assess the status of a child – prevents the transmission of the bacteria, viruses and sanitation and hygiene practices b. Base line survey protozoa that cause diarrheal diseases. c. Orientation of key personnel at the district/GP level d. Preparation of State Plan. Other measures (food handling, water purification, and fly control) have an impact on these diseases as well, but sani- The cost of Start-up activities will be met from the IEC funds tation and hand washing provide the necessary protection up to Rs. 10 Lakh. Additional fund requirement, if any, shall against fecal contact. They start by creating initial barriers to be met by the State. fecal pathogens from reaching the domestic environment. Hand washing with soap stops the transmission of disease (b) IEC Activities agents and so can significantly reduce diarrhea and respiratory Information, Education and Communication (IEC) are impor- infections, and may impact skin and eye infections. tant components of the Programme. These intend to trig- ger the demand for sanitary facilities in the rural areas for Research shows that children living in households exposed households, schools, Anganwadis and Community Sanitary to hand washing promotion and soap had half the diarrheal Complexes through behavioural change. The activities car- rates of children living in control neighborhoods. Because ried out under these components should be area specific and hand washing can prevent the transmission of a variety of should also involve all sections of the rural population. IEC is pathogens, it may be more effective than any single vaccine. not a one-time activity. IEC strategy and plan to be drawn Promoted on a wide enough scale, hand washing with soap to include creation of demand leading to construction and can be thought of as a “do-it-yourself” vaccine. Ingraining the use in a sustained manner. IEC should be conducted at all habit of hand washing could save more lives than any single tiers i.e Districts, Blocks and Gram Panchayat. National com- vaccine or medical intervention. munication strategy framework has been developed by Gov- ernment of India giving emphasis on Inter Personal Com- 1.3 Reason for dire situation:- munication (IPC) at the grassroots level. The states are to Leadership or rather its absence –consideration that sanitation evolve their own strategy using folk media, mass media and

54 | PARIPEX - INDIAN JOURNAL OF RESEARCH Volume : 4 | Issue : 5 | May 2015 ISSN - 2250-1991 also outdoor media like wall painting, hoarding etc. The IEC (d) Construction of Individual Household Latrines should also focus on health and hygiene practices and envi- A duly completed household sanitary latrine shall comprise ronmental sanitation aspects. of a Toilet Unit including a super structure. The programme is aimed to cover all the rural families. Incentive as provided Interpersonal communication and door to door to door con- under the scheme may be extended to all Below Poverty Line tact are recognised as the most significant tools for attaining (BPL) Households and Above Poverty Line Households (APL) the programme goals. In order to strengthen communication restricted to SCs/STs, small and marginal farmers, landless la- machinery at the village level with participatory social mobili- bourers with homestead, zation, guidelines for engagement of village level motivators (Swachchhata Doot / Sanitation Messengers) have been is- physically handicapped and women headed households. The sued separately. As part of this strategy, in addition to Swa- construction of household toilets should be undertaken by chchhata Doots, field functionaries like Bharat Nirman Vol- the household itself and on completion and use of the toilet; unteers, ASHA, Anganwadi workers, School Teachers etc can the cash incentive can be given to the household in recogni- also be engaged at the village level for demand creation tion of its achievement. and taking up behaviour change communication. The motiva- The incentive amount to Below Poverty Line (BPL) house- tor can be given suitable incentive from funds earmarked for hold/identified APLs for construction of one unit of IHHL IEC. The incentive will be performance based i.e. in terms shall be Rs.4600.00 (Rs.5100.00 for difficult and hilly areas). of motivating the number of households and schools/ Angan- The central share out of this shall be Rs.3200.00 (Rs.3700.00 wadis to construct latrines and use them. in case of hilly and difficult areas) and State Government share shall be Rs.1400.00. Minimum beneficiary share shall Each project district should prepare a detailed IEC plan be Rs.900.00 in cash or labour. State Governments are al- along with the Annual Action Plan with defined strategies lowed the flexibility to provide higher incentive for a house- to reach all sections of the community. The aim of such a hold toilet, of the same or higher unit costs from their own communication plan is to motivate rural people to adopt hy- funds. All houses constructed with the central or/and state giene behaviour as a way of life and thereby develop and assistance should invariably have suitable sanitation facility as maintain all facilities created under the programme. an integral part. However, All houses constructed by the ben- eficiaries under Indira Awas Yojana (IAY) or any other state The Annual IEC Action Plan should be duly approved by the rural housing scheme which did not have toilets shall also be DWSC/DWSM. The Communication and Capacity Develop- eligible for the incentive as above for creation of sanitation ment Units (CCDUs) / Water and Sanitation Support Organ- facilities for the targeted groups under NBA. isations (WSSOs) set up at the state level must support the districts in developing a good IEC plan and also in imple- APL families not covered by the above incentives will take menting it. Observance of Sanitation Day/ Sanitation Week up construction of the household latrines on their own / Sanitation Fortnight should be essential component of the through motivation. The IEC activities will provide compre- Annual Action Plan. hensive coverage to all the families in the GP without excep- tions. APL families facing cash crunch may access the revolv- For effective dissemination of the IEC material, funds may ing fund as outlined in the guidelines. also be provided under this component to blocks and gram Panchayats for execution of works. They may take up such Construction of bucket latrines is not permitted in the rural activities by engaging local NGOs for interpersonal communi- areas. The existing bucket latrines, if any, should be convert- cation; selecting motivators; executing works like wall paint- ed to sanitary latrines and the sharing pattern for incen- ings, street plays etc. The development of such material exe- tive for the targeted beneficiaries shall be identical to that of cuted by the Panchayats may be standardized by the district construction of individual house hold latrines. or the CCDU. Ministry of Rural Development notification Number S.O.l022(E) The IEC funds should be broadly divided into pre Nirmal dated 04.05.2012 regarding convergence of TSC with MN- and Post- Nirmal phase so as to have funds for sustaining REGS will be mutatis mutandis applicable for convergence the movement. The project districts, however, shall have the with NBA. flexibility of deciding thisdivision depending on the baseline survey reports and rate of acceleration of sanitation coverage. (e) Rural Sanitary Marts and Production Centers The Rural Sanitary Mart is an outlet dealing with the mate- Funds available under IEC may be used for imparting hygiene rials, hardware and designs required for the construction of education to the rural communities, general public, as well sanitary latrines, soakage and compost pits, vermi-compost- as children in schools. The IEC plan should include a com- ing, washing platforms, certified domestic water filters and ponent for raising awareness among school going children, other sanitation & hygiene accessories required. RSMs should teachers and PTAs. ensure that a variety of pans (ceramic, mosaic, HDP, fiberglass) are available for choice by the beneficiaries. RSM should nec- IEC funding will be in the ratio of 80:20 between GOI and essarily have those items, which are required as a part of the State Governments and the total IEC cost including start the sanitation package. It is a commercial venture with a so- up grant will be limited to 15% of the total project cost. cial objective. The main aim of having a RSM is to provide materials, services and guidance needed for constructing dif- (c) Capacity Building ferent types of latrines and other sanitary facilities for a clean This component is for training of VWSC and PRI members, environment. Production Centers are the means to produce block and district functionaries and grass root functionaries cost effective affordable sanitary materials at the local level. like ASHA and other health, education and related func- They could be independent or part of the RSMs. tionaries, Anganwadi workers etc. SHGs can be trained in trades such as masonry work, brick-making, toilet pan mak- The Production Centers/Rural Sanitary Marts could be opened ing and plumbing etc as also for awareness raising activities. and operated by SHGs / women Organizations/Panchayats/ NGOs/CBOs of repute can be engaged for this activity. State NGOs etc. Support of private entrepreneurs may also be tak- Resource Centres and Regional / District Resource Centres en for ensuring an effective supply chain. should be identified for conducting such trainings. DWSM/DWSC should have a Memorandum of Understanding Capacity building funding will be in the ratio of 80:20 be- (MoU) with the RSMs/PCs along with a system of joint mon- tween GOI and the State Governments and will be limited to itoring evolved to ensure that the RSMs & PCs are on track 2% of the IEC budget. with production plans as per requirement. RSMs should have

55 | PARIPEX - INDIAN JOURNAL OF RESEARCH Volume : 4 | Issue : 5 | May 2015 ISSN - 2250-1991 a method of quality certification of its products and a band to be treated as two separate units and each unit is entitled of trained masons and motivators. to Central assistance. The number of toilet units to be con- structed should be adequate to meet the requirements of Quality standards (where notified by BIS or by MoDWS) for the school as per the strength of the students attending each of the items of purchase should be strictly adhered to. the school. State/UT Governments, Parent-Teachers Associ- ation and Panchayats are free to contribute from their own An interest free loan up to Rs.3.5 lakh can be given for es- resources over and above the prescribed amount. In addition tablishing RSM/PC out of revolving fund available with the to creation of hardware in the schools, it is essential that hy- district. In case more RSMs are required, a maximum of up giene education is imparted to the children on all aspects to Rs.35 Lakh from the Revolving Fund can be utilized for of hygiene. For this purpose, at least one teacher in each this purpose. Loans from the revolving fund for RSM/PC school must be trained in hygiene education who in turn shall be recovered in 12-18 installments after one year from should train the children through interesting activities and the date of receiving the loan. community projects that emphasize hygiene behaviour. The expenditure for this purpose can be met from the IEC fund (f) Provision of Revolving Fund in the District earmarked for the project. The district and Panchayat imple- The revolving fund may be given to Cooperative Societies or Self menting agencies should ensure good coordination with De- Help Groups whose creditworthiness is established, for pro- partment of Education and Health & other partners in order viding cheap finance to their members. Loan from this fund to fulfill the objective of SSHE i.e. to provide a safe, healthy should be recovered in 12-18 installments. NBA projects will learning environment to all children. have the flexibility to decide the other termsand conditions for sanction of the revolving fund. This revolving fund can The Central assistance per unit will be restricted to 70 be accessed by APL households not covered for incentives un- percent for a unit cost of Rs.35,000/- (Rs.38,500 in case der the guidelines. Loan can also be given to the owner of the of hilly and difficult areas). Funding for School Sanitation in a household where Anganwadi center is located for construction NBA Project is provided by the Central and State Government of baby friendly toilet provided the ICDS authorities agree to re- in the ratio of 70:30. fund the loan from the rent paid to the house owner. 5% of the District project outlay subject to a sum of up to Rs.50 Lakh, Anganwadi Toilets can be used as revolving fund. The revolving fund is shared be- In order to instill the practice of using a toilet in children tween Centre and State on an 80:20 basis. from very early stage in life, it is essential that Anganwadis are used as a platform of behaviour change for the children (g) Community Sanitary Complex as well as the mothers. For this purpose, each Anganwadi Community Sanitary Complex is an integral component of should be provided with a baby friendly toilet. Since there the NBA. These Complexes, comprising an appropriate num- are a large number of Anganwadis operating from private ber of toilet seats, bathing cubicles, washing platforms, Wash premises, following strategy may be adopted; basins etc, can be set up in a place in the village acceptable and accessible to all. Ordinarily such complexes should be con- (a) In all the Anganwadis, which are in Government build- structed only when there is lack of space in the village for ings, baby friendly toilets should be constructed from the construction of household toilets and the community owns NBA funds provided. up the responsibility of their operation and maintenance. The ultimate aim is to ensure construction of maximum IHHLs (b) In those Anganwadis, which are in private buildings, the and construction of community complexes will be restricted owner must be asked to construct the toilet as per design, to only when IHHLs cannot be constructed, for whatever rea- and, he/she may be allowed to charge enhanced rent for son, and also teach the community of “Hygiene practices”. the building to recover the cost of construction. The maintenance of such complexes is very essential for which Gram Panchayat should own the ultimate responsibil- (c) Alternatively, the toilet may be constructed from revolving ity. User families may be asked to contribute a reasonable fund component under the NBA and, suitable deductions monthly user charge for cleaning & maintenance. The pro- made from the monthly rental paid to the owner to recover posal for putting up CSC will be approved by the National the cost over a period of time. Scheme Sanctioning Committee (NSSC). Such complexes can also be made at public places, markets, etc. where large Unit cost of a toilet shall be up to Rs.8,000 (Rs.10,000 in case scale congregation of people takes place. Suitable mainte- of hilly and difficult areas) foreach Anganwadi in the rural nance guidelines may be adopted by the community to en- areas. Financial assistance to be given by Government of In- sure proper maintenance of the complex. Maximum unit cost dia will be restricted to Rs.5,600 (Rs.7,000 in case of hilly prescribed for a community sanitary complex is up to Rs.2 and difficult areas). Additional expenses can be met by the lakh. Sharing pattern amongst Central Government, State State Government, Panchayats or funds from Thirteenth Fi- Government and the community is in the ratio of 60:30:10. nance Commission, MPLADS, MLALADS, MNREGS etc. The community contribution, however, can be made by the Panchayat out of its own resources, from grants of the Thir- Construction of Anganwadi toilets is to be prioritised in the teenth Finance Commission or from any other fund of the 200 high focused districts to assist in tackling the issue of State duly permitted by it. malnutrition.

(h) Institutional Toilets All government buildings constructed with financial support Children could be a good channel to influence parents to of the Centre must have appropriate sanitation facilities un- adopt proper sanitary habits. Children are more receptive to der the respective schemes as an integral component of the new ideas. Schools/Anganwadis are appropriate institutions scheme. This is considered essential to achieve the vision of for changing the behaviour, mindset and habits of children ‘NIRMAL BHARAT’. from open defecation to the use of lavatory through motiva- tion and education. (i) Solid and Liquid Waste Management The objective of NBA is to bring about improvement in the School Toilets general quality of life in rural areas. Solid and Liquid Waste Toilets in all types of Government Schools should be con- Management (SLWM) is one of the key components to ad- structed. Emphasis should be given to toilets for Girls in dress this. SLWM is to be taken up in project mode for each Schools. Toilet should provide access opportunity to children Gram Panchayat (GP) with financial assistance capped for a with special needs. A toilet unit consists of a toilet and min- GP on number of household basis to enable all GPs to imple- imum of two urinals. Separate toilet units for girls and boys ment sustainable SLWM projects. should be provided in all co-educational schools, which are

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Under this component, activities like compost pits, vermin 1.6 Study Goal: composting, common and individual biogas plants, low cost Sustainable promotion of sanitation among rural communities drainage, soakage channels/ pits, reuse of waste water and through better access of improved latrine and safe hygienic system for collection, segregation and disposal of household practices garbage etc can be taken up. Projects should be approved by State Scheme Sanctioning Committee (SSSC). Assistance 1.7 Study Objective: of professional agencies/NGOs may be sought to develop/ Objective 1:To Provide sustainable and integrated WASH ser- test/ implement such projects. Projects will be prioritized in vices in the targeted areas identified GPs targeted for Nirmalstatus and those that have already been awarded Nirmal Gram Puraskar (NGP). SLWM Provide hygiene promotion and education through multi- can also be implemented by dovetailing funds from other Ru- ple channels (interpersonal communication in household and ral Development programmes like MNREGS etc. group settings

The total assistance under NBA for SLWM projects shall be Raise the sanitation coverage to 80% in the targeted area worked out on the basis of total number of households in each GP, subject to a maximum of Rs.7 lakh for a GP hav- Provide safe water and sanitary latrines inputs to all mid schools ing up to 150 households, Rs.12 lakh up to 300 households, with a specific focus on the personal & community hygiene Rs.15 lakh up to 500 households and Rs.20 lakh for GPs having more than 500 households. Funding for SLWM project Advocate for and facilitate additional sanitation coverage of under NBA is provided by the Central and State Government the remaining 20% of the population through government in the ratio of 70:30. Any additional cost requirement is to projects and funding be met with funds from the State/GP. Objective-2: To induce safe hygienic behavior to break (j) Maintenance of facilities created under NBA contamination cycle of unsanitary latrines, contaminated It is essential to train the community, particularly all the mem- water & unsafe hygienic behavior bers of the family in the proper upkeep and maintenance of Implement awareness campaign at block & GP level with sup- the sanitation facilities created. The IEC activities should include port from block NBA cell & other private organization through awareness of the community on how to maintain the sanitation gender sensitive, inter-personal & mass communication ap- facilities. The maintenance expenses of individual household san- proach itary latrines should be met by the households. Objective 3: Ensure sustainability and scaling-up WASH services The maintenance cost of community sanitary complexes may by: be met by the PRIs through appropriate mechanisms like user Involving all stakeholders at all levels, irrespective of gender charges etc. The concerned departments should provide ad- and social status and strengthening their capacities to effec- equate funds for maintenance of school/Anganwadi toilets. tively participate in all convergence platforms Any other appropriate funds made available by the state government to the PRIs/districts may be utilized. Ensure effective management & planning of WASH by Village Monitoring Committees with greater participation of women

1.8 Probable Impact: Improvement Primary Impact Economic Impact latrine access & more latrine per capita Less open defecation Better living standard Personal, domestic & environmental Improved health status due to less hygiene practices exposure of pathogen School participation Improved quality of ground & surface Isolation & treatment of human excreta water Higher labor productivity

Improved quality of land & external living Reduce the rate of premature mortality area Reduce health cost

Productivity Adoption of safe sanitary practices Improved domestic use of water Reuse of human excreta

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2. Review of Literature tor while allowing for broad variation in the way programmes The researcher has gone through different books, Journals are applied and translated locally. and articles to consolidate relevant information for his re- search. To do so, he studied few national & international The Essential Elements of Community Approaches to Total project evaluation reports and research works done by many Sanitation (CATS) private organization like UNICEF, WSP, WSSCC etc. In this par- ticular portion, he has tried to highlight relevant portion of 1 CATS aim to achieve 100 per cent open defecation free those work with which the entire study has been structured (ODF) communities through affordable, ap- propriate tech- and assisted researcher time to time in the field as a ready ref- nology and behaviour change. The emphasis of CATS is erence. the sustainable use of sanita- tion facilities rather than the construction of infrastructure. The safe disposal of infant 2.1 FACILITATING “HANDS-ON” TRAINING WORKSHOPS and young children’s faeces in toilets is essential to achiev- FOR COMMUNITY-LED TOTAL SANITATION- A Trainers’ ing ODF status. Training Guide by Kamal Kar published in “Water Supply 2 CATS depend on broad engagement with diverse members & Sanitation Collaborative Council” (WSSCC), Geneva, of the community, including house- holds, schools, health Switzerland in the year of 2010 centres and traditional leadership structures. This Trainers’ Training Guide on Community-Led Total San- 3 Communities lead the change process and use their own itation (CLTS) has primarily developed from experiences of capacities to attain their objectives. Their role is central in facilitating over one hundred national, regional and interna- planning and implementing improved sanitation, taking tional ‘hands-on’ training workshops designed specifically into account the needs of diverse community members, for the trainers and users of CLTS in more than 25 countries. including vulnerable groups, people with disabilities, and The methods described here are not the only ways of train- women and girls. ing trainers on CLTS. Trainers are encouraged to use their own 4 Subsidies – whether funds, hardware or other forms – best judgments at all times and innovate with locally appro- should not be given directly to households. Community re- priate and effective approaches to enhance participation and wards, subsidies and incentives are acceptable only where commitment and develop trainers whose work would eventu- they encourage collec- tive action in support of total sani- ally determine the standard of empowerment of local commu- tation and where they facilitate the sustainable use of sani- nities, leading to total sanitation and beyond. tation facilities. 5 CATS support communities to determine for themselves This Handbook on CLTS described the basics of CLTS facilita- what design and materials work best for sani- tation infra- tion and is essential and useful material for the field facilita- structure rather than imposing standards. External agencies tors. This guideline, on the other hand, is written with a focus provide guidance rather than regulation. Thus, households to meet the requirements of the trainers of CLTS facilitators, build toilets based on locally available materials using the and of future CLTS trainers who are not yet experienced CLTS skills of local technicians and artisans. facilitators. The guide can also be used by trainers who wish 6 CATS focus on building local capacities to enable sustaina- to train trainers of CLTS facilitators, but not all parts of the bility. This includes the training of com- munity facilitators guidelines will be equally applicable, and trainers of trainers and local artisans, and the encouragement of local champi- will need to use their own common sense and experience to ons for community- led programmes. pull together elements of the training described in this guide- 7 Government participation from the outset – at the local line and elements from other training of trainers guidelines, and national levels – ensures the effectiveness of CATS and for instance on the Experiential Learning Cycle (ELC). the potential for scaling up. 8 CATS have the greatest impact when they integrate hy- 2.2 “Community-Led Total Sanitation in Rural Areas An giene promotion into programme design. The definition, Approach that Works” - Published by ‘Water & Sanitation scope and sequencing of hygiene components should al- Program’ (WSP) 2007 ways be based on the local context. This book emphasized a paradigm shift to collective behavior 9 CATS are an entry point for social change and a potential change in creating open defecation-free environments. The catalyst for wider community mobilization. practice of open defecation by the majority of people in this region is one of the most serious environmental threats to The CATS Essential Elements were articulated by UNICEF san- public health. Open defecation and the failure to confine ex- itation specialists in July 2008 as the ‘non-negotiable aspects creta safely are primary factors that contribute to the spread of community-based sanitation programmes. of disease and infection through the bacteriological contam- ination of water sources and the transmission of pathogens 2.4 Community-Led Total Sanitation and Hygiene (CLTSH) through the fecal-oral route. Improved hygiene practices by published by Ministry of Health of Federal Democratic Re- entire communities, including the use of sanitary toilets, can public of Ethiopia, January, 2011 effectively break this cycle of disease transmission. Policy in- This training guide book helped the canvasser in following tervention to help achieve this objective could reduce the dis- ways: ease burden by as much as 50 percent. It has shown the path to merge CLTS approach with Govt. subsidiary program for 1. Facilitate in community ignition, post ignition and commu- its sustainable as well as its area specific modification of ap- nity empowerment tools proaches with underlying factors. It would help researcher to 2. Guide toward understanding of the need to foster commu- cope up with existing situation in the field and greater respon- nity ownership of the CLTSH process, sive in ever changing challenging environment. 3. Enable to successfully generate enthusiasm among com- munities and develop common ground and collective ac- 2.3 COMMUNITY APPROACHES to TOTAL SANITATION- tions Based on case studies from India, Nepal, Sierra Leone, 4. Enable him to develop a plan for initiating, monitoring and Zambia published by United Nations Children’s Fund up scaling improved sanitation and hygiene in their respec- (UNICEF), Newyork, 2009 tive areas. Community Approaches to Total Sanitation (cats) is an umbrel- la term used by UNICEF sanitation practitioners to en- com- 2.5 Achieving and Sustaining Open Defecation Free Com- pass a wide range of community-based sanitation program- munities: Learning from East Java- Published by WSP, ming. CATS shared the goal of eliminating open defecation; March 2012 they are rooted in community demand and leadership, fo- This book has provided a fair idea on cost effective sustaina- cused on behaviour and social change, and committed to lo- ble sanitation behaviour change at large scale. It was a WSP’s cal innovation. the cats essential elements are a framework for Scaling Up Rural Sanitation initiative, a learning-by-doing initi- action, pro- viding a common foundation for work in the sec- ative implemented in partnership with local and national gov-

58 | PARIPEX - INDIAN JOURNAL OF RESEARCH Volume : 4 | Issue : 5 | May 2015 ISSN - 2250-1991 ernments in Indonesia, India, and Tanzania,8 sought answers -Hygiene and sanitation is connected to environment, educa- by working at scale from the beginning and by testing a com- tion, gender equality and the reduction of child mortality and bination of two relatively new and promising approaches. The poverty and has project combined three components: Community-Led Total Sanitation (CLTS) and sanitation marketing (SM) to generate •great advantages for public health, livelihoods and dignity demand and increase supply of sanitation goods and servic- es, and efforts to strengthen the enabling environment (EE) so •economic benefits generated that engender positive impact that demand and supply improvements could grow and sus- and can be a catalyst for development in India. tain each other with supportive—and ultimately institutional- ized and sustained—policies and practices. -Hygiene awareness may have increased in , howev- er translation into behavior change is still lagging 3. Study Design & Methodology: 3.1 METHODOLOGY Communication to promote hygiene and sanitation It is the procedure for conducting a research work, collecting -Communication -crucial in processes that seek to get differ- data from the fields and interpreting it for the right result. It ent stakeholder groups and individuals together to act based is the modus operandi of some methods and techniques ap- on consensus and in a concerted manner plied in the specific context to collect the information from the respondents. The present research has been of a mixed -Information and knowledge -becomes effective and practical approach as far as methodological considerations are con- only when it is properly communicated. cerned. It has endeavoured in some distinct ways of describing research outcomes. For example, both qualitative and quan- -Communication and content of messages on hygiene and titative approach has been used in the study; some compari- sanitation -must necessarily carry specific information for sons have merged with quantitative data generated from the groups with often divergent interests, perceptions, religious field but in most occasions presented researcher concentrated and cultural norms in qualitative data analysis method as in the case of ‘Decen- tralization of Power’ and ‘Women Empowerment’. Training approach:- In intervention area women and girl suffers of white discharge 3.2 METHODS OF DATA COLLECTION and problem facing in the in time menstruation period, so 3.2.1 SECONDARY SOURCE that condition training provided to women and girl for adop- A good literature review is characterized by: a logical flow of tion of clean and hygienic method and making of low cost ideas; current and relevant references with consistent, appro- sanitary pad also in medical check up camp women and girl priate referencing style; proper use of terminology; and an are consult with doctor for remedy their problem. unbiased and comprehensive view of the previous research on the topic. It helps with all types of assignments as well. 3.3.2. Demand Creation:- Various water and sanitation programmes have failed in the In the present study records kept with local Panchayats and past because they were supply driven. It is of prime importance NGOs, record of Statistical Bureau, , and to understand that people will only apply those sustainable wa- previous thesis on ‘Panchayati Raj and Natural Resource Man- ter and sanitation practices and technologies properly that they agement’ are used as literature review. really want themselves (demand driven). Furthermore, communi- ties will only accept solutions when they understand them and 3.2.2 PRIMARY INFORMATION & Key Message Sharing: see their benefits. Demand for sustainable sanitation and water Community Trigerring: management systems is only created when end-users have mo- It is the prime approach to motivate & mobilize community in tivation, opportunity and ability to invest in sanitation and water Community Led Total Sanitation Programme. Depending upon systems, which suits their needs and aspirations. Improving sani- the situation, lot of tools were used like Sanitation mapping tation and water conditions of an area cannot be done only by & Transact walk to identify comfortable & dirty places in the implementing hardware such as constructing toilets or wastewa- locality, how to spread disease from shit, spiritual connectiv- ter treatment plants. Many water and sanitation programs have ity with shit, prestige related to open defecation, shit calcu- failed in the past because they were supply driven (organizations lation etc. After successful completion of this exercise, com- wanted something, not the people!). Even when there is impe- munity has realized the worst effect of open defecation and tus for sanitation and water improvement among the municipal motivated enough to construct toilet by their own investment. authorities, the level of demand within the general population Facilitation was necessary to build technically sound low cost may be much lower. People will only use systems properly when sustainable toilet as well as few basic behavioral change mes- they really want them themselves (demand driven). Furthermore, sages for prevention of water borne diseases. people will only accept solutions when they understand them and see their benefits. Since sanitation and water management Basic Principle: improvements require intervention at both household and com- munity levels, raising the demand for such services from individu- als is of paramount importance for the project’s success. Demand for sanitation and water systems is only created when end-users have motivation, opportunity and ability to invest in a sanitation and water system which suits their needs and aspirations.

Motivation: not by health messages but direct benefits; in- creased convenience, comfort, privacy, safety, avoidance of sexual harassment, prestige etc.

Opportunity: access to good product, information, builders and materials,

Ability: resources needed to make use of opportunities, such as money, skill, transportation, and control over decisions. 3.3 Strategy Adopted: 3.3.1. Awareness Generation & Capacity Building 3.3.3 Advocacy: - Awareness Raising :- At any one time, more than half the Advocacy is the action of delivering an argument to gain com- developing world’s poor are ill from causes related to hygiene, mitment from political and social leaders and to prepare a so- sanitation and water supply ciety for a particular issue. Advocacy involves the selection and

59 | PARIPEX - INDIAN JOURNAL OF RESEARCH Volume : 4 | Issue : 5 | May 2015 ISSN - 2250-1991 organization of information to create a convincing argument, Present Researcher focused his study in Banka depending and its delivery through various interpersonal and media chan- upon the backwardness of the district among other four nels. Advocacy includes organizing and building alliances (Betia, , , ) in human Development In- across various stakeholders. Advocacy as part of a wider con- dex. He used random sampling method to choose the dis- tinuum of a communication process that includes social mobi- trict. Out of 11 blocks, he has chosen three blocks namely lization and program communication. Chandan, katoria & Rajoun using stratified random sam- pling method ( district has already initiated few BCC activ- Lobbying to influence the policy process by working closely ity but progress was extremely poor in the Quarterly San- with key individuals in itation report mentioned in PHED- Banka). Due to paucity of time & lack of human resource he has further chosen political and governmental structures; three Gram Panchayats (one in each block) and 6 villages • Meetings, usually as part of a lobbying strategy; (2 villages in each GP) by using purposive sampling method • Negotiation, to reach a common position; based on following criteria:

Three message of Advocacy:- Proposed NGP panchayats in district AIP 1. The silent emergency:- Many people are suffering with- 3 ST populated village, 1 SC populated village, 1 General out adequate sanitation. Resulting in unnecessary deaths every caste village & 1 General & SC mixed populated village for a year. comparative study of behavioral change by same agent in the stipulated time frame 2. Women and children suffer the most:- There are many people around the Jharkhand without access to adequate Supportiveness of PRI members sanitation facilities, with devastating consequences for wom- No fund availability of NBA, LGSY & MGNREGS for toilet en and children. Where there are no latrines girls commonly construction or as reward money for promoting CLTS and to avoid school. Without latrines women and girls wait until dark make it people centric. Hence, the process can be replicated in other places involving them as change agent to defecate, exposing themselves to harassment and sexual assault. Infectious diseases associated with lack of water and Accessibility of the researcher despite of it geographical re- sanitation put women’s reproductive health at risk. Diarrhea moteness resulting from poor sanitation and hygiene is responsible for the death of more than two million impoverished children Mason availability each year.

3.4 The approach framework:

3.6 Logical Frame Work of the Study:

3.5 Sampling Scheme:

Project Outcome: People achieve better hygiene results through changed sanitation behavior Objective-1 Key Activities Measurable Indicators Means of Verification Potential Impact Provide sustain- Triggering the community to stop increase in requisition rate Govt. Orders Improved equitable able and integrat- open defecation and follow up of latrine installation access and coverage ed WASH services Sub-Center, AWC, GP MPR of basic sanitation, in the targeted % of access to & use of improved sanitation Promote acceptance among com- areas safe drinking water and hygiene prac- munity on improved sanitation and VWSC meeting minutes tice in rural house- hygiene Increase in % of receiving holds and schools “Nirmal Gram Puroskar’ School report in districts with the award least investment Sanitary Mart report reduce the rate of Wa- List of Sanitary mart or ter-borne diseases other supplier

Establishing Market linkage for Increase the rate of strengthening supply chain issue installation

Objective-2 Key Activities Measurable Indicators Means of Verification Potential Impact

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Project Outcome: People achieve better hygiene results through changed sanitation behavior Objective-1 Key Activities Measurable Indicators Means of Verification Potential Impact Induce safe hy- GP level VWSC orientation on No. of training conducted Training Report Improved awareness gienic behavior to Sanitation and promotion WASH at GP level of community mem- break contamina- component & Sanitation based Submitted copy of SoE bers, school goers tion cycle of un- micro planning and adolescents on sanitary latrines, Meeting register proper hygiene and Increased capacity of School No. of students & teach- contaminated of VWSC meeting sanitation practices Management Committee on Safe ers trained water & unsafe Hygiene behavior hygienic behavior Sansad & GP level micro Facilitate in Formation & Sansad % of regularization of plan level meetings to develop capacity meeting Submitted copy of UC of the beneficiaries for sustainable use of hygiene and sanitation services

Capacity Building of the Stake- % of micro plan prepared holders in Sanitation based micro & % of utilization done planning and its execution Develop village adolescent girls as No. of Peer Educator School & VWSC register peer educator & school peer edu- selected & oriented cator for sanitation promotion Organize GP level awareness No. of camps organized GP SoE camps at schools and other public Photograph places No. of Camps organized utilizing GP’s fund Develop & Use different IEC mate- No. of IEC developed Photograph rials & Wall Writing in schools and village involving local youth Objective-3 Key Activities Measurable Indicators Means of Verification Potential Impact

Ensure sustainabil- Formation of Village level monitor- No. of VMC formed VWSC register Improved capacity ity and scaling-up ing committee of local Govern- WASH services ment, other service Facilitate in Grass root level Sanita- % of Micro Plan prepared Sansad, GP & District Mas- providers and ben- tion planning and its utilization ter Plan eficiaries to plan, implement and Support District Water & Sanita- MIS developed MIS copy manage activities tion Committee by developing a that will result in centralized tracking mechanism of improved sanitation ODF villages coverage Develop a model of execution in Result based Process Process Documentation the intervening area that can be documentation Report adopted & replicated by District Water & Sanitation Committee in other places

Support to the WASH networks to advocate for increased profile of sanitation and hygiene

3.7 Key Study Result Indicators: interface meetings organized with DWSM resulting in 1. Village Action Plan on becoming ODF developed by GPs. leveraging of funds for sanitation and hygiene promotion 2. Village Health and Sanitation Committees formed and 7. School have committees on Sanitation and Hygiene and Trained Children participate in awareness creation and informa- 3. Household visits made and awareness created on sanita- tion sharing on sanitation and hygiene tion promotion and hygiene practices improved 8. All households have their own or shared sanitary latrine 4. Wall writings and culturally appropriate wall paintings 9. Dispose of infant/child excreta in latrines undertaken to promote sanitation and hygiene by com- 10. Water for personal cleaning is in or near latrine munity 11. Hand washing and personal hygiene practice by every- 5. Elected Representatives made visits to intervention GPs body after defecation and before taking food. and participated in Gram Sabhas and mobilized people 12. Safe water sources are used for all cooking and drinking for sanitation and hygiene improvement 13. Safe water storage 6. Panchayats made aware of entitlements under NBA and 14. Maintain water source

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3.8 Sustainability Assessment: SERIAL BLOCK NUMBER OF The study activities were initiated from September’13 and pro- NO. NAME LATTITUDE LONGITUDE PANCHAYATS cess ended in the month of March’14. After active community involvement in all phases of the work, it was vital to assess 2 BANKA 24o52’47’’ North 86o55’12’’ East 16 sustainability of improved facilities & practices. Keeping it in the mind, after six months of execution, a Sustainability As- 25.2222918’ 87.358287’ sessment has been taken place with Standard KAP question- 3 BARAHAT North East 15 naire on WASH developed by UNICEF in the year 2010 for the study on “current community access to and practices on 4 BELHAR 25o55’00’’ North 86o36’00’’ East 18 Water, Sanitation and Hygiene in select rural and urban settle- 24.8020627o 87.0236941o ments in Liberia”. Present Researcher just jotted out few key 5 BOUNSI North East 16 questions from it just to know communities sanitation prac- tices, Hand Washing practices, Hygiene Messages & its Source 6 CHANDAN 24o38’00’’ North 86o40’00’’ East 17 and communities motivation to uphold the changes. 30 peo- 7 DHORAIYA 24.8833o North 86.9167o East 20 ple (10 adult male, 10 adult female, 5 adolescent girls and 5 adolescent boys) from each village have been interviewed o o 8 FULLIDUM- 25.9768873 86.7603421 11 separately. Opinion and views of Mukhiya and Block Coordi- ER North East nator-NBA were captured on sustainability issue. 24.7475346o 86.718373o 9 KATORIA North East 16 3.9 Activity Time Frame Sl. 10 RAJOUN 25o01’00’’ North 86o59’00’’ East 18 Activity Month No. SAMBHU- o ’ ’’ o ’ ’’ Study Planning, Selection 11 GANJ 25 05 00 North 86 44 00 East 19 1. September’13 of Area Literature Review, Govt. & September’13 to 2. 4.1 Profile of Chandan & Katoria Block: Community Acceptance October’13 Chandan & katoria are situated in southern part of Banka Finalization of Process & September’13 to district of Bihar. It is absolutely adjust cent to Jharkhand. 3. Tools October’13 Due to its geographic isolation and scattered population type, this block is searching the light of development in 4. Community level Execution November’13 to March’14 the sphere of economy, education & health. Bounding by October’14 to the traditional rituals and taboos coupled with some una- 5. Sustainability Assessment December’14 voidable social evils like early marriage, domestic violence is pushing villagers constantly in the gloomy state. Lack 6. Data Analysis January’15 of govt. facilities in health, education created pessimism 7. Development of Report February’15 among villagers and resulting low institutional delivery and high dropouts in immunization and education sector. Children are mostly engaged in bidi making for supporting their families. Above 90% population are still practicing open defecation and some improvement has been observed after the involvement of NEEDS in sanitation & Hygiene promotion program from August’13 in collaboration with NBA & NREGS. Infrastructure and service delivery in BPHC is noticeable and key health outcome indicators such as institutional delivery, weighing of children within 48 hours of birth and full immunization of children up to one year of age witnessed a positive trend. Infrastructure of Sub centers & AWCs need to be improved and effective moni- toring system has to be emerged for strengthening VHND 4. AREA AND THE PEOPLE and for steady reduction of LO/DO in primary immuniza- Present Researcher has focused his study in 6 villages of Ban- tion. Most of the cases, it has been seen that no growth ka district. The main reason for choosing this particular district monitoring has measured and plotted in MCPC. VHSNC was to do something better for those uncared, unprotected, is formed in most of the panchayat but, not yet function- poverty alleviated, vulnerable tribal people of a backward dis- al. After long involvement of NEEDS & PRADAN in SHG trict in HDI. The profile of the district has mentioned below: strengthening, large number of capacitate SHG can be seen in this block. NEEDS has initiated training on personal & The district of Banka is situated in far south - east of the State menstrual hygiene with these groups under GSF flagship. Bihar. The eastern and southern border of the district coin- The women SHG participants are hopeful that the processes cides with district of the state - Jharkhand. In west of change that has been initiated would bring greater ben- and north east it touches Jamui and respec- efits in time. It also explores opportunities for strengthening tively. The old district is situated in the north side SHG engagement in addressing a range of health determi- of Banka. nants (including early marriage and child bearing, gender, water, sanitation and hygiene) that have a direct bearing The geographical area of the district is 305621 hectare i.e. on key health outcomes. Now, main challenge lies on func- 3019.3465 Sq Km. and total rural house hold is 367997. tionalization of VHSNC and regularization of convergence meetings at sub center & Panchayat level. The district head quarter of Banka is situated in Banka town. The district has been established on 21st, February, 1991. Ear- 4.2 Block Profile of Rajoun: lier it was a Sub-Division of a the district Bhagalpur. Rajoun block is situated in the southern part of banka and adjustcent to bhagalpur. This block is famous for business & market areas. NEEDS has started working getting support of SERIAL BLOCK LATTITUDE LONGITUDE NUMBER OF NO. NAME PANCHAYATS MLA- Mr. Manish Kumar. There are 18 Panchayats in Rajoun having 38409 H.H. (Census 2011). In the financial year 14-15, 1 AMARPUR 25o02’00’’ North 86o54’00’’ East 19 two panchayats have been selected for NGP namely Tilakpur & Signan. NEEDS has taken these two panchayat in priority.

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4.3 Demographic Profile of Villages(Before Intervention) Block GP Village Village Type Total HH Population Male Female HH With Toilet Sukhaniya Tribal 35 215 111 104 02 Chandan Siljori Trigunadih Mahadalit 24 148 77 71 0 Tetaria Tribal 29 184 95 89 0 Katoriya Lakrama Mandeva Tribal 12 89 49 40 0 Rampur General 60 380 196 184 4 Rajaun Signan Mohanpur Mixed 66 427 219 208 3

5. KEY STUDY ELEMENT: for various options. at this stage CLTS facilitators encourage 5.1 Different Tools of Community Led Total Sanitation: early starters and appreciate their urgent action against OD. • Defecating Area Mapping Facilitators ask the entire community if anyone else would be • Calculation of Shit interested to see the technique of construction of a latrine • Calculation of household medical expenses by their fellow villagers or would be interested to start con- • Defecation area transect struction. outsiders facilitate the process of planning by the • Diagramming faecal-oral contamination route community for achieving oDF status. This includes a week- • Food and shit by- week listing of families willing to start constructing latrines • Water and shit on their own, the formation of a sanitation committee or strengthening of an existing one, the identification and invita- 5.2 ODF planning: tion of Natural Leaders for presentation of their plans the next Immediately after triggering some members of the community day/after two days, and a decision on the final date of decla- spring up and decide to start digging a pit on the same day or ration of the ODF Community and a celebration. the next morning. Many others join the discussion and look

5.3 The F-Diagram: It is an illustration which describes the feco-oral transmission cycle. The “F” refers to the five main transmission routes or agents: fluids, fields, fingers, food and flies.

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5.4 Community bylaws 5.6.7 Phases of certification Once successful ignition is done in a community, is the com- • Primary phase: ODF certification munity should typically set bylaws to show solidarity to the • Secondary phase: Improved hygiene and sanitation cause and to punish offenders. These bylaws are enforced through tradition/social structures and mainly aimed at putting 5.6.8 Key variables for verification and certification collective pressure on wrongdoers to adhere to the commonly • ODF free status agreed norms and practices. Commonly used bylaws include: • Hand washing practices • Safe water chain • Casting the offender out of social support networks • Denying labor support 5.6.9 CLTSH monitoring and motivation mechanisms • Refusing to share food and drink • Yellow flag for latrine construction • Shaming by shouting at the offender • Green flag for latrine construction and use o • White flag for latrine construction and use, including wa- 5.5 Coffee for Health Club ter sources protection Establishing a “Coffee for Health Club” for neighborhoods is another community support mechanism to enable neighbors to 5.6.10 ODF celebration and certification discuss their hygiene and sanitation behaviors and design and • Administrative level for ODF status celebration can be de- action plan comprising “doable” behaviors. Such “clubs” help cided by the and CLTS team maintain peer support and peer pressure, and promote a com- • Certification starts at village level; external stakeholders petitive spirit among neighborhoods in a village. They also help invited to certification ceremony to identify early (behavior change) adopters and eager pioneers from the group who model and inspire new behaviors. The club 5.6.11 Awards and Motivation could, for example, meet every two weeks and facilitated by • Certificate volunteer community health promoters. This program prepares • Institutional rather than individual neighborhoods to compete with each other to improve hygiene and sanitation in their houses and neighborhoods. 6. ACTIVITY & RESULT AREA: 6.1 Accessibility to Intervening Area: 5.6 Verification, Certification and Motivation at a Glance It was essential for the present researcher to ensure permis- 5.6.1 Rationale for verification sion from district PHED cell for conducting the entire study. To motivate and encourage communities to lead their own de- With the view of this objective, a small presentation ses- velopment beyond creating an ODF environment sion has been held in District Water & Sanitation Committee monthly meeting in presence of DDC, Chair-person(ZP), Exec- 5.6.2 Objectives of the verification and certification pro- utive Engineer, District Coordinator-NBA. Key agenda of that tocol meeting were as follow: • To standardize the verification and certification process • Self Introduction and objective sharing • To develop simple verification and certification reports/ • Brief about course and purpose of Dissertation work templates • Objective, Area, Methodology and Hypothesis of the study • To provide guidance in motivating and encouraging the communities Study Activities Required Support from Elected bodies and Govt. functionaries 5.6.3 Concepts of verification, celebration and certifica- tion DWSC members assured for maximum cooperation and guid- • Motivate and award sustainable sanitation and hygiene ance during the study and conveyed information up to con- improvements cerned block authority. • Acknowledge achievements and create healthy competi- tion 6.2 Orientation of Staff on CLTS: Before penetrating in the field, Reasearcher got the opportu- 5.6.4 Methods of verification and certification nity to attend three days residential orientation on Communi- • Review reports of Village, ty Led Total Sanitation with staff of NEEDS at madhubani. NR • CLTSH committee reports Management Consultant Pvt. Ltd has facilitated the training. • Reports on celebration of intermediate results captured Under mentioned key issues was discussed during orientation: with video, photographs, etc. • Overview & Working principle of CLTS Observation • Community Triggering process with hands on practice • Transect walk through pre-defined routes • Behavioral change in hygienic practices, sanitation and • Household visits water use

Discussions/interviews with Gender sensitivity • Family members • The general community • Key informants, using semi-structured questionnaires • Village CLTSH committee • Discussion/celebration of achievements with both inter- nal and external WASH stakeholders

5.6.5 How to organize verification teams • Village: CLTSH team and natural leaders • WASH offices, CLTSH team, NGOs, community-based or- ganizations (CBOs) • governmental offices, CBOs, • Donors, bilateral and multilateral organizations and • Integration of hygiene, sanitation, and water (WASH 5.6.6 Process of Verification starts from internal verifica- component) tion process and invite externals for endorsement Mini- • Strengthening convergence meetings (Sansad, GP, Block) mum units of verification and certification • Intensification of Coordination & Linkage among various • Minimum unit of verification: village department & schemes

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6.3 Gram Panchayat level Orientation: 6.5 Defecation area mapping:

NEEDS is working in Banka district for promotion of sustain- able rural Sanitation. As it was extremely difficult to organize orientation session without any financial support, Researcher has participated being a part of NEEDS and shared the pur- pose to the ASHA, AWW, ANM, SHG members, WARD mem- bers including Mukhiya. Three separate orientation have been organized before penetrating directly in the field. Major dis- cussion were done on following issues to make them aware and strengthen Community Led Total Sanitation:

• Programme activity & role of various stakeholders • Micro Planning & Triggering • Demand Generation • Convergence of GP level line departments • NBA & MGNREGS convergence and role of Mukhiya • Other GP specific issues

6.4 Community Level Trigger exercise: It is a process of facilitating participatory exercises using dif- ferent tools of CLTS, where a local community realizes the bad effects of open defecation and decides to stop it through collective analysis of its own sanitation situation and profile, is called ”triggering”. Triggering exercises are facilitated sepa- In a defecation area mapping exercise, members of the local rately for the adults, children and wherever necessary for the community join together and draw a large ground map of women. their village/neighbourhood using different colour powders, chalk, saw dust, ash, rice husk or other local materials. While 6 separate trigger exercises have been organized by the can- indicating the outer boundary of the village, on the ground vasser to know community perception and to motivate them map they indicate their houses (using cards), main landmarks for eradication of insanitary situation. People from Sukhunia like schools, churches, temples, mosques, main roads, bushes, responded spontaneously and started pit digging next day forest, water sources, etc. Finally, they show places of open onwards. In case of Mandeba, a inspired Mason named Bikha defecation using yellow powder on the map and draw lines to Roy has taken the initiative to mobilize community in toilet connect those areas with their respective homes. This indicates construction & its use. Rajoun has been chosen as proposed clearly who goes where for OD. Defecation area mapping is NGP panchayat and Mukhiya cooperated in high note with facilitated separately for the women and children. interest- empowered community participation to make Rampur & Mo- ing patterns of adult men, women and children emerge from hanpur Open Defecation Free village. well- facilitated maps. Separate exercises have been conduct- ed in six villages to aware people about the ways of contam- ination & spread of diseases directly and indirectly related to shit.

Sukhunia people has taken loan from SHG. After triggering, community have done an economical ranking exercise to jot down list of beneficiaries who were really unable to construct toilet. SHG has given loan to them.

6.6 Demand Generation Camp: Few documentation that includes filling up NBA & MGNREGS demand form, submission in photocopy of Job Card, Bank passbook, Land acquisition certificate and voter ID, were es- sential from beneficiaries end for getting reward money of Rs. 9100 (Rs. 900 was beneficiary contribution) after construction Figure Error! No text of specified style in document.1 of toilet. But, it takes time to collect all these as few of them Community Triggering before & after have all the required document.

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A Demand generation camp in village in presence of Bank representative for open zero balance bank account, Panchayat Rojgar Sevak for job card preparation, Block Coordinator -NBA for filling up NBA form and Mukhiya to certify those forms and to monitor the total process. After submission of all doc- uments along with demand form, district PHED cell engaged Researcher has organized Three Mason trainings in collabora- to process the advance NBA fund based on those documents tion with Gram Jyoti, in three Panchayats namely Siljori, Sig- and request letter of Mukhiya. Alongside, beneficiaries started nan & Lakrama. BDO in Rajoun & Mukhiya President in Chan- to dig the leach pit by their own effort. dan has inaugurated the training. Total 75 Masons have been trained during the 5 days training training each phase where Present Researcher tried to link up this process in six villages 1st two days have been kept for theory and in rest three days, earning cooperation of elected members & Govt. functionaries they have worked in the villages to construct toilet in the vil- followed by mason & volunteer training to accelerate the con- lages. struction in rapid phase. Entire village celebrated Open Defe- cation Free status within three months of triggering. Sukhunia 6.9 School Sanitation Awareness: of Siljori Panchayat was the first ODF village in Banka district of Bihar who celebrated ODF status on 17th Nov’13 in the auspicious occasion of World Toilet Day.

6.7 Construction of Model Toilet:

Two separate training in each Panchayat was organized by mobilizing GP untied fund one was for Peer school students and one was for School Management Committee. The con- cept was that the peer educators will teach other students in the schools and SMC will monitor all the thing and utilized the school untied fund in Sanitation purpose. Students partici- In the convergence scheme, rewarded toilet amount has to be pated in School Clean Mission and students monitoring team come from two schemes named NBA (Rs. 4600/-) & NREGS have been formed one in each three Gram Panchayat. In the (Rs. 4500/-). Beneficiaries will contribute Rs. 900/- . By mobiliz- auspicious occasion of National Campaign, a rally of school ing BDO & PO, present researcher facilitated in construction students has been commenced in Siljori Panchayat that was process of three Model Toilets with estimate for demonstra- inaugurated by Chandan block Pramukh. tion purpose in the Chandan, Katoria, Rajoun block premises. 6.10 Celebration of Global Hand Washing Day in Lakrama: 6.8 Mason Training:

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Even, She has visited six ODF villages and shared positive feed- back to villagers during time of interaction.

is a campaign to motivate and mobilize millions around the world to wash their hands with soap. It takes place on Octo- ber 15 of each year. Hand washing with soap is one of the easiest tasks a child can learn. It’s also one of the most impor- tant “do-it-yourself” vaccine for the children. Being a part of 6.13 School Peer Educator Training on Menstrual Hygiene this programme, Canvasser participated in Lakrama Panchayat Management: of Katoria block where Mukhiya distributed Soap, Mug and NEEDS NGO has conducted a two days menstrual Hygiene Bucket in each AWC and organized Street Play in Lakrama Management training for 30 school students of Chandan. High school premises. Block Coordinator-NBA participated in Main objective was to develop school peer educator who will the event and spreaded a huge impact in the community on teach safe menstrual hygiene behaviour to other students. Fol- Hand washing before taking the food and after using toilet. lowing topics have been covered in the training: Even children in AWC asked for soap few occasion for hand wash before taking Mid Day Meal. Basic Sanitation & Hygiene behaviour Gender Equality

6.11 Celebration of World Toilet Day: Last year, Researcher has organized World Toilet Day celebra- tion in Sukhunia village of Siljori Panchayat with villagers from Sukhunia, Trigunahadi, Lamatia, Heth Chandan & Siljori for • Changes (Physical & Mental) in Puberty enjoying a merriment moment as Sukhunia was declared 1st • Female reproductive organ & its function ODF village in Banka district. Villagers were rewarded by Block • Menstruation Hygiene Medical Officer in Charge. • Superstition related to Menstruation • Home Made Sanitary Pad preparation 6.12 Visit of Chairperson- Banka: • Safe Disposal of Sanitary Pad

7. Sustainability Assessment:

In the three tier district Panchayati Raj Institution, Chairperson is called as District Chief and point person of any programme planning & execution. Ms. Sweta Kumari, Honorable Chairper- son-Banka has shown cooperation from the early stage of the study with her valuable guidance on current field situation and by mobilizing concerned Gram Panchayat Mukhiayas. Figure 7.1: No. of Families own Toilet (n-180)

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Figure 7.2: Latrine Type (n-172)

Figure-7.7: Disposal of Household Waste (n-180)

Figure 7.3: Facilitation provided for construction of La- trine (n-172)

Figure 7.4: Key Motivation for construction of Toilet (n- 172)

Figure-7.8: Baby’s/ infant’s faces usually being thrown (n- 180)

Figure-7.5: Hand Washing Station available around the Latrine (n-172)

Figure-7.9: Key Times of Hand washing (n-180)

Figure-7.6: Distance of Latrine from House (n-172)

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Figure-7.10: Commonly used material for

Figure-7.13: Activities carried out to keep water source safe & maintained (n-180)

Figure-7.11: Most commonly uttered Hand Washing (n- 180) Hygiene Message (n-180)

Figure-7.14: Activities carried out to keep drinking water safe from contamination (n-180)

7.15 Major Findings in Sustainability Assessment: • Out of 180 families, only 8 families have not able to construct toilet till date but they are sharing toilet with neighbor • All latrines are sustainable. Some TSC toilet are renovat- ed but no over the pit structure was entertained • After Community Triggering, 8 families in the target group have constructed their latrine with self initiative. Figure-7.12: Most common receiving source of Hygiene But, 89% families have constructed with the support of related Message (n-180) facilitating groups by adopting the model of execution. • During Community Triggering and follow up activity in village & schools, many motivational tools have been demonstrated & shared with villagers. People adopted two result areas (Disease Prevention -56%; Safety, Securi- ty & Prestige-31%) as key motivation for construction of toilet. It reflects the utility of Community Led Total Sani- tation (CLTS) tool in community mobilization on Sustaina- ble behavioral change in Sanitation • During the process, one of the main taboo i.e. “Toilet

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should be outside of the house” has not been eradicated conducted in presence of Mukhiya, Health & nutrition service as 60% people have constructed their toilet outside their providers, teachers, SHGs and ward members from each reve- house. nue village where essentialities of toilet & hygiene were well • Hand Washing with Soap in critical times and disposal of demonstrated by TEAM facilitators. Some gender based issues baby’s faces in toilet are two prime behavioral change in- were highlighted which motivated SHG members to take the dicators that are showing positive trend. baton for individual toilet construction. But, non availability of • People are using ladle (34%) and keep vessel in some financial resources hindered the entire initiative. Some move- height from ground (41%) for keeping drinking water ment was planned to block office and bank by SHG members safe from contamination. They have also dug soak pit for monetary support. It was noticed that construction of H.H (48%) and drainage(34%) for carrying out waste water toilet became their prime agenda and participation was also in Kitchen garden. appreciable. Keeping it in the mind, TEAM conducted another meeting with SHG members who were associated with the or- 8. Ideal Model Adopted for Execution: ganization from 2010 in livelihood program. After receiving a small orientation, they have conducted community level meet- ing and made a ranking of households as per their econom- ic condition and provided portion amount of RS. 36,000 to most needy households and motivated others to build toilets by there on effort. TEAM supervised total procedure and facil- itated in demand generation process. All the toilets were con- structed under the NBA & MGNREGS convergence scheme.

What is Now?

9. SUCCESS STORY 9.1 Sukhania SHG carrying the Yardstick- Another sign- post of women empowerment Name of the village-Sukhania of siljori panchayat Name of the SHG: Bajarangbali Block-Chandan District- Banka Facilitated By: Pritam Bhattacharyya

What was Before? In the auspicious occasion of world toilet day, Sukhania has Sukhania is a tribal village of Siljori panchayat . Due to its been declared as first ODF village in Banka District. SHG mem- geographical isolation, this village was searching the light of bers were awarded by block MOIC, member of ZP & Mukhiya development in the sphere of economy, education & health. on that day. A recent survey has been conducted to assess the Bounding by the traditional rituals and taboos coupled with practice level that shows 99% uses. some unavoidable social evils like early marriage, domestic vi- olence was pushing villagers constantly in the gloomy state. 9.2 Village Mason develops into Village Motivator -An in- Lack of govt. facilities in health, education created pessimism stance of behavior change among villagers and resulting low institutional delivery and Performer: Mr. Bikha Roy high dropouts in immunization and education sector. Children Age: 65 (Male) were mostly engaged in bidi making for supporting their fam- Name of the Village: Mandeba ilies. Out of 35H.H, no toilet was constructed under TSC or Name of the Panchayat: Lakrama NBA supervision. In schools, Sub-Center & AWC, no difference Block: Katoria was seen up to August’13, when team started to promote District: Banka sanitation & safe hygiene in that village. During the meeting Facilitated By: Mukesh Kr. Shukla in AWC, adolescent girls acknowledged their wretchedness in Menstruation time as no usable toilet was there in the school Village Mandeba is located 25 km away from katoria block premises. VHSNC & SMC were formed but was not functional. under Lakrama Panchayat. It is geographically isolated small revenue village having just 12 Households. Morning sun- How SHG played a role? shine brings a range of new challenges and Villagers start Before penetrating in the village, a GP level orientation was the fight of survival against hunger every day. Open defeca-

70 | PARIPEX - INDIAN JOURNAL OF RESEARCH Volume : 4 | Issue : 5 | May 2015 ISSN - 2250-1991 tion, unhygienic condition in & outside of house, stagnant experience or critical fund management process, most of the water & contaminated water bodies had made the village elected representatives are still not providing the support in as den of water borne diseases. Due to lack of financial the programme. resources, proper treatment was also lacking. When TEAM has started working in neighboring village named Teteria Researcher has established a healthy working relationship with under same Panchayat, Mr. Bikha Roy got the opportunity district authority and advocacy workshops are going on in to work as Mason & has learnt the possible effects of open block & GP level in presence of district & block level officials defecation. He has taken the initiative to call a meeting in and some supportive elected members. DDC has already tak- his village with facilitation of TEAM where Community mo- en the initiative to call block level convergence meeting that bilizer shared some models of low cost sustainable toilets creates a favorable environment in few blocks and definitely among villagers. Mr. Bikha Roy first started to build his toi- make the impact of sustainability and acceptance of the pro- let in JMP mode having two leach pit, concrete grounded gramme in coming days. structure with rural pan and built the super structure with locally available material. Observing the entire procedure, 10.3 Commercialization of NBA hinders the process of other villagers have made mostly same low cost sustainable CLTS: toilets & now use rate is 100%. Mr. Roy is now working as Community Led Total Sanitation seeks the community owner- volunteer for motivating other villages and taken the active ship to accelerate the process without depending on external role in demand generation process. resources. But, due to well advertised NBA scheme, everybody aware about their entitlement amount and non disbursement of fund in ODF villages creates a off-putting impact in mind set of the community to invest finance & other resources in the process.

Researcher has focused on sustainable toilet based on eco- nomic condition of the particular beneficiary. Hence, well rec- ognized NBA model have been constructed in few village as well as UNICEF approved JMP toilet can be seen in few vil- lages. But, acceleration in fund flow will definitely work as al- ternative trigger tool in effective execution of Nirmal Bharat Abhijan.

10.4 Lack of common understanding in NBA & NREGS con- vergence at various level of execution: Now, the amount of Rs. 9100/- ( excluding the beneficiar- ies contribution of Rs.900) will be disbursed from joint initi- ative of NBA (Rs. 4600/-) & NREGS (Rs. 4500/-). Here exists confusion and misinterpretation among block & GP level stakeholders in process of disbursement of fund. As a result, beneficiaries from only two villages (Mohanpur in Signan GP & Muradpur in Tilakpur GP) have received NBA & NREGS amount respectively. NEEDS is playing the role of catalyst to bridge up the gap and hopefully, this problem will be mitigat- ed soon as DDC has taken the initiative to sit together with block and GP level stakeholders in a common platform to solve the issue. The reflection has been seen in Signan & Tilak- pur Panchayat of Rajoun block.

10.5 Supply Chain Issue: Non availability of “Rural Pan” is definitely hindering the achievement. NEEDS has supplied rural pan in few villages and Mukhiyas have brought it from Bhagalpur in few GPs. But, due to non availability of it, Urban Pans have been installed in some cases. Actually, the problem lies in case of water scarci- ty in the villages. The 45° angle in rural pan easily clean with 10. CHALLENGES: minimum water use. 10.1 Community Acceptance: During TSC & NBA intervention, few NGOs have already 11. GLIMPSE OF BEHAVIORAL CHANGE: worked in Banka & constructed number of toilets. Most of the toilets either were not technically sound or defunct. They has been created a negative impact in the community. Hence, in initial few months, it was absolutely difficult to mobilize local human resources for stepping forward in toilet construction as prime means of healthy survival.

NEEDS has a strong SHG base in Chandan block during the livelihood programme. For earning the community accept- ance, NEEDS started working with those SHGs with present researcher as assigned resource person and Sukhnia became the 1st ODF village in Banka and interestingly, They have tak- en the loan from SHG fund for toilet construction without de- pending NBA or MGNREGS fund.

10.2 PRI Negligence: In bottom up approach of planning and execution, involve- ment of PRI members is only way to carry the sustainable behavior change in the community. Due to previous awful

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Annexure-I Sustainability Assessment Questionnaire on WASH at H.H level

Section A: RESPONDENT’S PROFILE 1. Block 2. GP 3. Village

4. Gender of the respondent:

[ ] Female [ ] Male

5. How many people living in the household?

6. Male Female Total 0-5 years old 12. WAY AHEAD: Sanitation remains one of the biggest development chal- 7. Educational background of the respondent: lenges in all developing countries. Improving sanitation is the key to achieving the health-related Millennium Devel- [ ] Can’t read/write [ ] Elementary (level 1-6) [ ]Junior High (lev- opment Goals (MDGs) of reducing child mortality and com- el 7-9) [ ] Senior High (level 10-12) [ ] College and above bating disease. A focus on appropriate outcome-oriented approaches to rural sanitation is critical, given that a major- Section B: SANITATION PRACTICES ity of poor households continue to live in rural areas. Con- 8 . Do your family own a latrine? ventional approaches that Bihar has attempted to tackle the issue of poor sanitation by trying to improve coverage and [ ] Yes [ ] No access with financial support for constructing toilets. How- ever, for many years it has been evident that providing sub- 9 . If YES, who helped you construct the latrine? sidies for construction of individual toilets alone does not necessarily translate into usage. Behavior change is a key [ ] Not applicable [ ] Self [ ] Local authority/Govt [ ] NGO [ ] ingredient for this to occur. Sanitation programs have, for Others: some time now, incorporated the need to raise awareness and emphasize the benefits of toilet usage. Even this mar- 10. If YES, which type of latrine? keting of sanitation, in order to create individual demand (often combined with subsidies linked to toilet construction [ ] 1 leach Pit [ ] 2 leach Pit [ ] over the pit [ ] Septic by households) has not necessarily resulted in significant progress in securing the desired outcomes from sanitation 11 . How far is the latrine from your house? programs in the region. [ ] Within the House [ ] Within 50 m [ ] More than 50 m It is in this background that the significant results demonstrat- ed by a recent approach adopted in Bihar has drawn atten- 12 . If NO Latrine, where your family members go for defeca- tion. At the heart of this approach is a shift away from the tion? ( Tick one which the family usually practices ) provision of subsidy-led toilets for individual households and emphasizing not merely behavior change by individuals in [ ] Neighbour’s latrine [ ] Dig a hole/cat h ole [ ] Bush/back- general but of an entire collective, to achieve ‘open defeca- yard/field [ ] Public latrine tion-free’ villages. The objective is to reduce incidence of diseases related to poor sanitation and manage the public 13 . Where is baby’s/infant’s feces usually being thrown? risks—posed by the failure to safely confine the excreta of some individuals—at the community level. This has been most [ ] Toilet [ ] Bury [ ] thrown anywhere [ ] Garbage pit effectively undertaken by empowered communities motivat- ed to take collective action, with the government and other 14 . Where do you dispose your household waste/garbage? ( agencies performing at best a facilitating role. Tick one which is most common ) [ ] Garbage pit [ ] Burn [ ] low ground [ ] Composting [ ] River [ ] thrown anywhere With the formulation of appropriate guidelines, demand-re- sponsive strategies, and inclusion of fiscal incentives, the foun- 15. What is your motivation for construction of Toilet dation has been laid for achieving overall sanitation goals in the district. Policy decisions by central and state governments [ ] Disease Prevention [ ] Safety, Privacy & Security [ ] clean En- on adopting outcome-focused approaches are a positive step vironment [ ] Improved Social Status towards scaling up and sustaining behavior change for meet- ing sanitation outcomes. However, policy makers need to be Section C: HANDWASHING PRACTICES continuously informed to ensure that policies and strategies 16 . Kindly tell me the key times you usually wash your remain on track. The logic of focusing on behavior change of hands? an entire collective, if the public health objective that underlies the search for improved sanitation is to be secured, is easy to [ ] Before eating [ ] After latrine use [ ] After handling baby’s grasp. The CLTS approach has demonstrated the ability to best diaper/feces [ ] After eating meet this objective. [ ] Before feeding child [ ] Before food preparation [ ] After However, enough ground has been covered in the study and defecation [ ] After handling rubbish [ ] After handling animals success demonstrated to be able to send out a strong mes- sage about the promise that CLTS holds. Devising appropriate 17 . What do you usually use in washing hands? ( Tick the institutional frameworks by keeping the local government at most commonly practiced ) centre-stage, formulation of effective information, education and communication strategies, providing of technology know- [ ] Water only [ ] Water & Soap [ ] Water and ash how and choices, ensuring monitoring mechanisms and devel- oping the capacity of a cadre of motivators to trigger mindset 18 . OBSERVATION ONLY: Is there any hand washing facility change in different settings could go a long way in meeting available around the home? the health- and sanitation-related Millennium Development Goals. [ ] No available washing facility [ ] There are water an d soap near or within the latrine (ONLY in households with latrine fa-

72 | PARIPEX - INDIAN JOURNAL OF RESEARCH Volume : 4 | Issue : 5 | May 2015 ISSN - 2250-1991 cility) [ ] There is ONLY water near or within the latrine (ONLY duty. Throughout the study, his association was true learning in household with latrine facility) [ ] There are water and soap experience for me; means of words to acknowledge would be at a designated hand washing area. [ ] There is ONLY water at too mean to express gratitude. a designated hand washing area I acknowledge with thanks the help I received from Mr. Murari Section D: HYGIENE MESSAGES & SOURCES Choudhury, ‘Executive Director- NEEDS for extending academ- 19 . Have you heard any health/hygiene messages for the last ic, intellectual and emotional input, valuable suggestions and 3 months? intensive encouragement in entire tenure of the study.

[ ] Yes [ ] No I express my profound indebtedness to Mr. Pradip kumar (DDC, Banka) and Ms. Sweta Kumari( Chair-person, ZP-Banka) 20 . If YES, can you tell me which hygiene messages you can for their help, guidance, repeated review of drafts and critical recall comments throughout the study period.

21 . From where you heard this/these message/s? With profound sense of gratitude I express my heartfelt re- spect to Mr. Monaj Choudhury (Executive Engineer), Mr. San- [ ] Government’s health workers [ ] Community Health Volun- jay Singh (District Coordinator- NBA) & Mr. Subhas Kr. Singh teers [ ] School children [ ] NGO staff [ ] Church/Mosque [ ] (Block Coordinator- NBA) for intellectual insights regarding Poster/flyer/leaflets [ ] Audio- Visual Aid [ ] Community events methodological issues in practical field situation and for pro- [ ] Private groups [ ] SMS/Phone [ ] Clinic/hospital [ ] Traditional viding me all the support services throughout my field. I owe leader [ ]Others: much to them.

22. How can you rank the process adopted to make your vil- Many colleagues have given freely of their ideas, advice and lage ODF ( Not good Excellent) activity during the research work and development of the manuscript their association have been enlightening. [ ] 1 [ ] 2 [ ] 3 [ ]4 [ ] 5 I must extend my sincere thanks to Mr. Basant yadav (Mukhi- 23. How do you keep your water source safe and maintained? ya- Siljori), Ms. Geeta Hansdak (mukhiya- Lakrama), Mr. Chan- drasekhar Singh (Mukhiya- Signan) who have provided me 24. How you keep the drinking water safe from contamina- with differential supports time to time. tion at household level? I extend my earnest thanks to all the villagers of the study vil- Acknowledgements lages, elected members and the government personnel at the The journey now poises to complete a circle, a full circle. local level of respective areas. Looking back is never easy; there comes a mix of soothing and agonizing experience that one had had. I, however, stop Finally, I owe my encompassing debt to my parents and life to reminisce and stoop to pick up the happier side of the partner whose silent blessings and love were the source of my walks that will perhaps sound anecdotal someday. Remem- strength. brance is fine, but taking record of every responsible person is something arduous, especially for someone having a poor Dated: 20.4.15 retrieval system like me. I beg pardon in advance. Place: Jharkhand (Pritam Bhattacha- I will cherish for long the day-to-day tutelage received from ryya) Dr.Premendra Kumar, Program Officer- NRMC during the peri- od of my study. His benevolent services transcended the call of

REFERENCES

Kamal Kar; 2010; “A Trainers’ Training Guide on CLTS” published in “Water Supply & Sanitation Collaborative Council” (WSSCC), Geneva, Switzerland | 2. Evaluation report on WASH; 2007; “Community-Led Total Sanitation in Rural Areas An Approach that Works”; Published by ‘Water & Sanitation Program’ (WSP) | 3. COMMUNITY APPROACHES to TOTAL SANITATION- Based on case studies from India, Nepal, Sierra Leone, Zambia published by United Nations Children’s Fund (UNICEF), Newyork, 2009 | 4. Training Guide book on Community-Led Total Sanitation and Hygiene (CLTSH) published by Ministry of Health of Federal Democratic Republic of Ethiopia, January, 2011 | 5. “Achieving and Sustaining Open Defecation Free Communities: Learning from East Java”- Published by WSP, March 2012 | 6. McIntosh, A. C. 2003 Asian Water Supplies. IWA Publishing, London | 7. Benoît MIRIBEL; 2005; “Water, sanitation and hygiene for populations at risk”; HERMANN ÉDITEURS DES SCIENCES ET DES ARTS, Paris | 8. Hazel Jones; 2011; “ Water Sanitation & Hygiene- Improving Access for All”; Loughborough University |

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