Developing 40th International Conference knowledge and capacity in water and sanitation Loughborough University UK
LOCAL ACTION WITH INTERNATIONAL COOPERATION TO IMPROVE AND SUSTAIN WATER, SANITATION AND HYGIENE (WASH) SERVICES Conference Abstracts and the WEDC Publications Catalogue
A guide to what’s on your conference USB pen drive (DRAFT)
24–28 July 2017
40th WEDC INTERNATIONAL CONFERENCE
Local Action with International Cooperation to Improve and Sustain Water, Sanitation and Hygiene (WASH) Services
24–28 July 2017 Loughborough UK
Conference Abstracts and the WEDC Publications Catalogue
What’s on your conference USB pen drive
Conference, papers, posters and over a hundred WEDC publications listed in the catalogue are available free on your USB pen drive.
Please note: The printed edition of this document will include the publications catalogue. The USB pen drive will be given to you on arrival at the venue.
Developing knowledge and capacity in water and sanitation Developing knowledge and capacity in water and sanitation
Water, Engineering and Development Centre Loughborough University Leicestershire LE11 3TU UK
+44 (0) 1509 222885
wedc.lboro.ac.uk
© WEDC, Loughborough University, 2017
Designed and produced at WEDC
Cover illustration: Rod Shaw Contents
Review of organizational capacity in integrated water resources management in Accra, Ghana E. M. Abraham (Ghana)...... 1 WASH infrastructure and menstrual hygiene management in basic schools: a study in Kumasi, Ghana P. Acheampong, K. Akodwaa-Boadi, E. Appiah-Effah & K. B. Nyarko (Ghana)...... 1 Innovative sanitation social movement: experiences from Nepal K. Adhikari, H. N. Acharya, T. Ahmad & S. Shrestha (Nepal)...... 2 Case study on value for money assessment of a UNICEF assisted WASH programme in Nepal S. Adhikari, A. P. Gautam, S. B. Dhakal & T. Ahmad (Nepal)...... 2 Improving WASH services in Zimbabwe: experiences from a rural WASH project T. Ahmad, V. Kinyanjui, M. Jonga, H.R. Mashingaidze & A. Cole (Nepal)...... 3 Gender and empowerment through WASH based on cases from Bangladesh S. Ahrari & E. Van Galen (The Netherlands)...... 3 Addressing the sanitation crisis through a market-based approach N. Akwunwa (Nigeria) ...... 4 Co-composting of faecal sludge with solid waste to improve FSM practice in Sakhipur municipality Abdullah Al-Muyeed, Ada Oko-Williams, Khairul Islam, Liakath Ali, Suman Kanti Nath & Palash Ranjan Sanyal (Bangladesh)...... 4 Water sanitation and hygiene status in the neighbourhood of Bangladeshi Islamic schools and mosques Mahbub-Ul Alam, F. Yeasmin, S. Sarker, Abu Mohd. Naser, T. Md. N. Huda, H. Ahmed, A. Bucher, S. Ali, A. Khan, Md. M. Rahman & L. Unicomb (Bangladesh)...... 5
BACK TO CONTENTS v A socio-ecological analysis of barriers to sustained adoption of rural sanitation in Ethiopia, a qualitative study Fikralem Alemu, Abera Kumie, Girmay Medhin, Teshome Gebre & Phoebe Godfrey (Ethiopia)...... 5 From camps to communities: a review of 10 years of WASH programming by Concern Worldwide in Northern Uganda J. Aluba, E. Lenia & B. T. Harris (Uganda)...... 6 Resilient WASH: lessons learned from El Nino drought response in Ethiopia – a qualitative study Jorge Alvarez-Sala & Dr Samuel Godfrey (Ethiopia)...... 6 Market driven approach for faecal sludge treatment products N. Andriessen, L. Schoebitz, M. Bassan, S. Bollier & L. Strande (Switzerland)...... 7 Safi Sana business challenge on open defecation and plastic pollution in the beaches of Teshie, Ghana Kwabena Twumasi Ankrah (Ghana) ...... 7 Assessment of latrine technologies in selected communities after CLTS implementation in Ghana E. Appiah-Effah, K.B. Nyarko, R. Buamah & L. Roberts (Ghana)...... 8 Solar pumping for rural water supply: life-cycle costs from eight countries A. Armstrong, J. Mahan & J. Zapor (USA)...... 8 Community health volunteers’ capacity for hygiene behaviour change: evidence from urban Kenya E. Aseyo, D. Nelima. E. Davis, K. Baker, O. Cumming, J. Mumma & R. Dreibelbis (Kenya)...... 9 Menstrual hygiene management in Ghana: understanding the socio-cultural, economic, political factors, challenges and opportunities S.A. Asimah, P.Y. Diabene & S.N.L. Wellington (Ghana)...... 9
vi BACK TO CONTENTS Post-certification: an innovative post-project sustainability approach to maintain WASH rural services J. Aubriot & V. Tabu (Democratic Republic of the Congo)...... 10 Modelling chloride contamination due to the impact of pit latrine on shallow groundwater in Nigeria A. Bakari (Nigeria) ...... 10 Some lessons learned from engaging in WaSH participatory action research in Melanesian informal settlements D. J. Barrington, K. F. Shields, S. G. Saunders, S. Meo, S. Sridharan, R. T. Souter & J. Bartram (Australia & UK) ...... 11 LGBTI and sanitation: what we know and what the gaps are C. Benjamin & A. Hueso (UK)...... 11 Creating sustained usage of household water treatment: a case study from Kagera, Tanzania M.A. Besteman, L. Osterwalder & A. Kiniga (The Netherlands)...... 12 Cleansing in hidden spaces: the bathing needs of perimenopausal women A. Bhakta, B. J. Reed & J. Fisher (UK) ...... 12 Lessons from scaling up urban sanitation development in Indonesia and Mozambique I. Blackett, P. Hawkins, M. Listyasari & O. Muximpua (UK)...... 13 An island within an island: 19 years of rural WASH programmes implementation in La Gonave, Haiti B. Bourzac (Haiti)...... 13 Designing pit emptying technologies: combining lessons from the field with systems thinking C. Buckley, R. Sindall & F.L. de los Reyes III (South Africa) ...... 14
BACK TO CONTENTS vii What happens inside a pour-flush pit? insights from comprehensive characterization A. Byrne, R. Sindall, L. Wang, F. L. de los Reyes III & C. Buckley (South Africa)...... 14 Collection time inequalities: fetching water in Ethiopia A. Cassivi, E. O. D. Waygood & C. C. Dorea (Canada)...... 15 Understanding, respecting and including people with mental health conditions as part of the CLTS process S. Cavill, P. England, S. House & S. Ferron (UK) ...... 15 Water delivery configurations and CBOs in Dhaka’s slums, Bangladesh: lessons for WASH sustainability S. Cawood (UK)...... 16 Quality control in the decentralized production of biosand filters: a pilot workshop in Zambia N. Chan, L. Mitchell, T. Ngai & S. Li (Canada)...... 16 Operationalizing FSM regulations at city level: a case study of Warangal, India V. S. Chary, Y. M. Reddy & S. Ahmad (India)...... 17 Community health clubs growth monitoring: experience from Zimbabwe’s Small Towns WASH Programme A. Cole, T. Maja, P. Kaendesa, V. Kinyanjui & M. Munyaka (Zimbabwe) ...... 17 Improving Zimbabwe urban WASH service delivery through U-Report A. Cole, T. Maja, P. Kaendesa, V. Kinyanjui & M. Munyaka (Zimbabwe)...... 18 Wastewater management in developing countries: Bolivia case studies C. Cossio, J. McConville, S. Rauch & A. Mercado (Bolivia)...... 18 Moving forward: findings from menstrual hygiene management formative research in Bangladesh M. Coultas, J. Martin, C. Stephen & S. Warrington (UK)...... 19
viii BACK TO CONTENTS What drives political leaders to improve urban sanitation? C. Cummings, I. Langdown, T. Hart & M. Matoso (UK)...... 19 The role of information and communications technology in teal-time monitoring for quality WASH infrastructure P. K. Darko, E. S. Kogo, E. Yanyi-Akofur & J.P. Debus (Ghana)...... 20 Sanitation marketing in Nepal in support of open defecation free social movement S. B. Dhakal, T. Ahmad & S. Shrestha (Nepal)...... 20 Moving forward from humanitarian to sustainable WASH service: improving our work through evidence building data Anton Dharmalingam & Marielle Snel (Sri Lanka) ...... 21 Strengthening WASH sector monitoring through the use of ICTs: experiences from Zimbabwe’s Rural WASH Information Management System (RWIMS) L. Dhoba, A. Nyawasha & S. Nyamuranga (Zimbabwe) ...... 21 Adaptable drinking-water laboratory unit for decentralized testing in remote and alpine regions A. Diener, A. Schertenleib, D. Daniel, M. Kenea, I. Pratama, M. Bhatta, & S. Marks (Germany)...... 22 Water resource assessment of Karst Islands and the development of a freshwater lens assessment protocol R. DiFilippo, I. Smout & L. Bosher (USA)...... 22 Getting the message right: step by step behaviour change communication to guide change in Sanitation in Nepal K. Dishwa & S. L. Rautanen (Nepal)...... 23 WASH, violence and health: a quantitative analysis Reshma Dixit (India)...... 23
BACK TO CONTENTS ix Improving nutritional impact through the integration of WASH and nutrition interventions: a practical guidebook MPH. J. Dodos & Dr. J. Lapègue (Serbia) ...... 24 Planning approaches for sanitation systems in peri-urban areas: a case study from Tanzania M. Domini, S. Sorlini & G. Langergraber (Italy) ...... 24 Challenges of developing a peri-urban water supply strategy in Ghana Dotse F.M, Nii Odai Laryea, Christopher Sackeyfio & Gertrude Amissah Asokwah (Ghana) ...... 25 Optimisation of faecal sludge processing via vermifiltration Enrique Hernández, C. & Furlong, C. (Spain & The Netherlands)...... 25 Groundwater supply sustainability in fragile states: a case study examining challenges and approaches P. Evans & A. Bastable (UK)...... 26 Improved prioritisation tool for local decision-making in the water, sanitation and hygiene sector F. Ezbakhe & A. Pérez-Foguet (Spain) ...... 26 Improved functionality through solar powered water pumping system and solar lighting help villagers to be more resilient to the drought impact K. Farah (Somaliland) ...... 27 Pathways to improving sustainability of WASH services: influencing government planning and decisions, Indonesia H. Ferdian, R.R. Putra & L. Leong (Indonesia)...... 27 Hygiene promotion: Have we got the right answers to the knowledge behaviour gap? Franck Flachenberg (France)...... 28
x BACK TO CONTENTS Financial Flow Diagrams to promote policy-making, based on 20 community management case studies from India R. Franceys, T. Guinaldo, C. Leitner, O. J. Nyangoka, V. Thomas, J. Zeilinger & P. Hutchings (UK)...... 28 Financing access to improved water and sanitation, Public Works Loans Board, UK R. Franceys (UK)...... 29 Barriers and enablers to becoming and staying open defecation free in remote Timor-Leste N. Francis, M. Morrow, S. V. Nery, A. Clements & J. Black (Australia)...... 29 Learning from Oxfam’s Tiger Worm Toilets projects C. Furlong, J. Lamb & A. Bastable (The Netherlands & UK)...... 30 Promotion of manual drilling in Guinea Bissau: mapping suitable zones and estimating the potential F. Fussi, F. Asplund & M. Caruba (Italy)...... 30 Rapid Action Learning Unit: new Initiative to institutionalize learning under the National Sanitation Programme in India Sanchita Ghosh (India)...... 31 Improving sanitation in the Niger Delta N. Gilbert & L. King (Canada)...... 31 Rainwater harvesting and management in the semi-arid areas of Tigray region, Ethiopia Y. Girma & M. Aynalem (Ethiopia) ...... 32 Building local capacity to promote sanitation: Vietnam and Cambodia M. Goodwin-Kucinsky, Q. Nguyen & A. May (USA) ...... 32 Taking women’s ‘different’ bodily functions into account, particularly menstruation in sanitation provision C. Greed (UK)...... 33
BACK TO CONTENTS xi Real Time Emergent Learning (RTEL): a promising approach for adaptive programming Hadjel Hakim (Switzerland) ...... 33 Integrating WASH and nutrition to reduce stunting in Cambodia: from discourse to practice G. Halcrow, S. Lala, L. Sherburne, T. Tho & M. Griffiths (Australia)...... 34 Following-up on successful sanitation situations Suzanne Hanchett & Shireen Akhter (USA)...... 34 Sustainable water pumping in refugee camps: solar PV / diesel hybrid scenarios at Nyarugusu, Tanzania B. Harkness, P. Guthrie & M. Burt (New Zealand)...... 35 Sustainable water pumping in refugee camps: costs and benefits of over- sized solar PV systems B. Harkness, P. Guthrie & M. Burt (New Zealand) ...... 35 An innovative framework for embedding knowledge management in an organisation: a manager’s perspective K. Harries (Australia)...... 36 Individual water sourcing: understanding risks and resilience to groundwater resource abstraction in Nigeria A. Healy, S. Allan, G. Bristow, S. Capstick, K. Danert, I. Goni, A. MacDonald, M. Tijani, K. Upton & L. Whitmarsh (UK) ...... 36 Selling soap and latrines in Madagascar and Djibouti: results of marketing surveys T. Heath, H. Hafany & K. Mohamed (France)...... 37 Challenges of transboundary water management: the example of the Mekrou river basin (Benin, Burkina, Niger) J. Hedoin & M. Ouedraogo (France)...... 37
xii BACK TO CONTENTS Lessons learnt on the implementation of menstrual hygiene management in Karamoja D. Hekel, A. S. Irumba, M. Fitsum, R. Mabano & J.A. Akudago (UK)...... 38 Effectiveness of community dialogue in promoting hygiene and sanitation in Afghanistan Shafiqullah Hemat, Nasratullah Rasa & Sharifullah Alemi (Afghanistan)...... 38 Lessons from WaterAid’s multi-country WASH in schools programme R. Hinds & T. Keatman (UK) ...... 39 Approaches to safely manage drinking water in Port-Harcourt and Obio- Akpor in Rivers State Helen Charles Hosea (Nigeria)...... 39 Community Water Plus: results from an investigation into community- managed rural water supply in India P. Hutchings & R. Franceys (UK) ...... 40 Faecal sludge emptying services in Trinidad S. Ifill & S. Kayaga (Trinidad &Tobago & UK) ...... 40 Adjusting institutional arrangements: towards improved governance of self- supply water systems in Uyo, Nigeria I. J. Ikpeh, R. Soetanto, A. Anvuur & I. Smout (UK) ...... 41 Engagement of schools, media and healthcare professionals in improving menstrual hygiene management in Nigeria D. I. Iroegbu (Nigeria) ...... 41 Hybrid staffing structure: practical workforce knowledge management for restructuring a water utility S. Joel (Nigeria)...... 42 Hygiene practice and de-worming association with nutritional status of adolescent girls in rural Bangladesh S. P. Jolly & T. R. Chowdhury (Bangladesh) ...... 42
BACK TO CONTENTS xiii Lessons learnt from implementation of outcome linked community led total sanitation intervention in Busia Kenya M. Josphat & G. Kimathi (Kenya)...... 43 Menstrual hygiene management to improve the attendance of primary school-aged girls in Central North, Burkina Faso I. Kabore/Ilboudo, L. Z. P. Nikiema, J. P. Debus & C. McIntosh (Burkina Faso)...... 43 Lessons from cholera response in Kathmandu Valley, Nepal L. K. Kansakar, T. R. Teh, A. M. Shrestha, T. Ahmad, S. S. Rana & K. L. Shakya (Nepal) ...... 44 Study on sustainability of ecological sanitation: a case study of Darechowk Village Development Committee, Chitwan, Nepal P. Kattel, M. Thapa & B. Sharma (Nepal) ...... 44 Institutionalising WASH capacity development in South Sudan: moving from emergency response to development M. Keega (Kenya) ...... 45 Model village approach: case of Kamwenge District D. Keesiga, G. Kanweri, B. Achiro & C. Nimanya (Uganda) ...... 45 Local level skilled WASH human resource mapping: a case from Nepal G. Khatri & K. Subedi (Nepal) ...... 46 The need to have a multifaceted and mainstreamed approach to addressing menstrual hygiene management: a Kenyan case study Maria Kidney, Carol Galvin & Joan Syombua Nthusi (Kenya) ...... 46 Scaling up menstrual hygiene management S. Kiiza & J. Nyaketcho (Uganda) ...... 47 After the pit is full: understanding latrine emptying in Fort Dauphin, Madagascar K. Kirsch, & R. Hammersley-Mather (USA)...... 47
xiv BACK TO CONTENTS Evaluation of pour-flush latrines and pit management in Honduras C. Kostyla (USA) ...... 48 Achieving and sustaining open defecation free (ODF) villages: a study of four rural districts in Zimbabwe Z. Kugedera & J. T. Machikicho (Zimbabwe)...... 48 Sustainability of ODF status of selected communities in disaster prone areas in the Eastern Part of Indonesia Muhammad Afrianto Kurniawan (Indonesia) ...... 49 Barriers to shared sanitation cleaning and maintenance in Kampala Slums, Uganda Japheth Kwiringira (Uganda) ...... 49 WASH governance in support of NGO work: trends and differences from field studies A. Lerebours & N. Villeminot (France) ...... 50 Integrating WASH and nutrition in market-based interventions: principles and results from the field G. Lestikow, J. MacArthur, R. Chowdhury, J. Davis & Y. Wei (USA)...... 50 Global study on sustainable service delivery models for rural water: evidence from 16 countries H. Lockwood & G. Mansour, S. Smits & S. Smets (UK & The Netherlands) ...... 51 Survey of waste disposal and its perception among residents of Sokoto Metropolis, North-Western Nigeria Magami, I.M. & Shamaki, S.B. (Nigeria)...... 51 Formulation of water and sanitation policies and strategies: experiences from Rwanda M. Malik, M. Kayitesi, A. Muzola, E. Nuwamanya, F. Nteziyaremye, G. Musabyimana, E. Hategekimana & J. M. V. Rutaganda (Rwanda) ...... 52
BACK TO CONTENTS xv Rural WASH programming: experiences from Rwanda M. Malik, L. Karangwa, A. Muzola, J. Sano, E. Hategekimana, F. Nteziyaremye, G. Musabyimana & J. M. V. Rutaganda (Rwanda)...... 52 Self-supply solutions in Malawi Duncan Marsh & Tiyese Zumu-Mwale (UK & Malawi) ...... 53 Improving the fit between development and humanitarian WASH in protracted crises Mason, N., Mosello, B., Shah, J. & Grieve, T. (UK)...... 53 How to unlock the incentives to turn political will on sanitation into action N. Mason, A. Hueso & M. Matoso (UK) ...... 54 Understanding vulnerabilities and risk in the development of market based approaches L. Medland, J. Fullwood-Thomas & C. Brady (UK)...... 54 Membrane filtration reduces recontamination risk in chlorinated household water containers R. Meierhofer, P. Rubli, K. Dreyer, H. Ouma, K. Wanyama & M. Peter-Varbanets (Switzerland & Uganda)...... 55 Making WASH monitoring and evaluation work for everyone: the experience of the DRC WASH Consortium G. Melloni & S. Jones (Italy)...... 55 Matrix of strategies for achievement and sustaining open defecation free (ODF) communities in rural settings P. B. Mirirayi (Zimbabwe)...... 56 Impact of persistent drought in the community and coping mechanisms: a case of Bulilima district, Zimbabwe P. B. Mirirayi (Zimbabwe)...... 56 Rapid action towards ODF in Saharanpur District in India: stunting, menstruation and other innovations in CLTS Vinod K Mishra & Amarjeet Singh (India)...... 57 xvi BACK TO CONTENTS Key challenges of marginalised communities on sanitation and hygiene and recommendations to clean India Vinod Kumar Mishra (India)...... 57 Low-cost biomass as novel adsorbents for the removal of heavy metal ions from industrial wastewater used for crop irrigation in developing countries A. S. Mohammed, A. D. Wheatley, G. C. Sander, E. Danso-Boateng, E. Nyktari & I.C. Usen (Nigeria)...... 58 Practices and effects of menstrual hygiene management in rural Bangladesh B. K. Mondal, M. K. Ali, T. Dewan & T. Tasnim (Bangladesh)...... 58 The outcomes of community-based water, sanitation and hygiene interventions: a case of Bangladesh B. K. Mondal (Bangladesh)...... 59 Strengthening the enabling environment to accelerate rural sanitation in last mile territories: a case of Bihar, India Pravin More & Ashish Kumar (India)...... 59 Menstrual hygiene management compliance in primary schools in Uganda: a case of Lira Municipality Martin Mujjabi Mukasa & Alex Ojuka Jalameso (Uganda)...... 60 WASH 5 Star approach: addressing hygiene behaviour in schools of rural Bangladesh Mukherjee S, & Alam M (Bangladesh)...... 60 Sustaining open defecation free status: the vital role of validation exercise K. Nadar, F. Khan & S. Otusanya (Nigeria)...... 61 Asset creation versus sustaining services: institutionalizing VLOM to deliver SDG-6.1 target in Nigeria K. Nadar, F. Khan, M. Niang & G. Mahato (Nigeria)...... 61
BACK TO CONTENTS xvii Barefooted community consultants: an efficient way to deliver SDG-6.2 target in Nigeria K. Nadar, F. Khan, B. Ogunjobi & S. Otusanya (Nigeria)...... 62 Integrating value for money principles in WASH for affordable and sustainable WASH services in Nigeria Kannan Nadar & Xuechen Bao (Nigeria)...... 62 Smart-phone drives performance and enhances WASH services delivery in communities in Nigeria K. Nadar & R. Nwozor (Nigeria)...... 63 Water and sanitation competitions: an effective approach for promoting sustainable WASH services in schools and communities T. Namata & H. Mukasa (Uganda)...... 63 How to achieve improved WASH services’ sustainability D. W. Namiiro (Uganda)...... 64 Connecting the disconnected: a unique public-private-people-partnership (PPPP) sanitation model in Delhi, India M. Naved (India)...... 64 A tool for assessment of school WASH facilities Vishal Nayak (India)...... 65 A tool for improving people’s voices: Citizen Report Card on sanitation programme Nayak Vishal & Gupta Anurag (India)...... 65 Towards effective implementation of community-based water safety plans: stakeholders engagement process in Afghanistan S. K. Ngilambi & C. N. McCubbin (Afghanistan)...... 66 A less expensive toilet: the impact of targeted subsidies on latrine purchases in Cambodia C. Nicoletti, R. Macaranas, G. Lestikow & D. Hudner (USA)...... 66 xviii BACK TO CONTENTS Community engagement - a paradigm shift to WASH programming in emergencies Eva Niederberger (UK)...... 67 Performance of community health clubs in transforming sanitation and hygiene conditions A. Ntakarutimana & N. Ekane (Rwanda)...... 67 Investigating the relationship of rainwater harvesting tank technology and safe water coverage in Uganda: a case study of Mbarara District A. Odongo (Uganda)...... 68 Locally responsive intervention to improve municipal solid waste collection coverage in Accra, Ghana K. Oduro-Appiah, A. Scheinberg, A. Mensah, V. Kotey, A. Afful & N. de Vries (Ghana)...... 68 Scaling-up sanitation and hygiene promotion through grant-making Ouma Vincent & Muhuri Jackson (Kenya)...... 69 WASH financing – the missing link: initial lessons from Sinapi Aba’s pilot in Ghana J. Owusu-Dabo (Ghana)...... 69 The influence of real time learning in WASH programming A. Padilla & J. Dumpert (Cambodia)...... 70 Host and refugee population cooperation: case of Dumse water supply and sanitation project, Damak-5, Nepal Prabesh Paudyal & Murray Burt (Nepal)...... 70 Seawater desalination transforming the Gaza Strip Mohanlal Peiris, Gregor von Medeazza & Zaidan AbuZuhry (State of Palestine)...... 71 Simplified sampling method for household-based surveys with reduced populations in the water and sanitation sector A. Pérez-Foguet & R. Giné-Garriga (Spain)...... 71
BACK TO CONTENTS xix Evaluating novel gravity-driven membrane (GDM) water kiosks in schools M. Peter-Varbanets, K. Dreyer, N. McFadden, H. Ouma, K. Wanyama, C. Etenu & R. Meierhofer (Switzerland)...... 72 Sanitation marketing in rural Zambia, a replicable business model J. Pinfold, A. Mungamelo, J. Ng’ambi & J. Anscombe (UK)...... 72 Groundwater faecal contamination in Kalpitiya Peninsula of Sri Lanka Ranjana Piyadasa & Sonali D. Herath (UK & Sri Lanka)...... 73 Impact of community-led total sanitation on women’s health in urban slums of Kalyani Municipality Preetha Prabhakaran, Kamal Kar & Lyla Mehta (India)...... 73 Research alternatives for the knowledge gap C. Print & I. Smout (UK)...... 74 Towards decentralized biogas generation: building community scale biogas reactor T. Radu, V. Smedley & R. Blanchard (UK)...... 74 Linking relief, rehabilitation and development (LRRD): examples and lessons learned for the WASH sector Martina Rama (France)...... 75 Why do women in India not use public toilets? Patterns and determinants of usage by women in Warangal City Y. M. Reddy, V. S. Chary & R. Srividya (India)...... 75 Research into policy: a literature review R. Renouf (UK)...... 76 Supporting partnerships with local actors to improve water supply services for the sustainable prevention of cholera in Kalemie, Democratic Republic of Congo (DRC) B. Saga (France)...... 76
xx BACK TO CONTENTS Community-led integrated model for sustainable and inclusive faecal management and WASH services Guruprasad Sahu (India)...... 77 The role of human-centred design in implementing ICT solutions in WASH projects David Schaub-Jones & Jessica Kaliski (South Africa)...... 77 Urban sanitation: where to next? P. Scott, R. E. Scott & A. P. Cotton (UK)...... 78 Urination needs and practices away from home: where do women go? P. Scott, M. Sohail & S. Cavill (UK)...... 78 Diagnostic and decision-support tools for effective faecal sludge management (FSM) services Rebecca Scott, Ian Ross & Michael Smith (UK)...... 79 Establishing district service centre to improve functionality of rural supplies in Uganda A. Sentumbwe & R. Mutiibwa (Uganda)...... 79 Water desalination in the Gaza Strip: Al Salam RO brackish water desalination plant case study Mahmoud Shatat, Karen Arakelyan, Omar Shatat, Tim Forster & Ashraf Mushtaha (Palestinian Territory, Occupied)...... 80 WASH in health care facilities: initiatives, challenges and lessons from Nepal post emergencies A. M. Shrestha, D. S. Malla, & T. Ahmad (Nepal)...... 80 Rheology of sludge in pour-flush toilets: understanding the requirements for pit emptying technology design R.C. Sindall, A. Byrne & C.A. Buckley (South Africa)...... 81 Android application turning trash into cash: an innovative approach on solid waste management in urban areas M. Sirait (Indonesia)...... 81
BACK TO CONTENTS xxi Faecal sludge management and technology justice: promoting sustained and scalable solutions L. Stevens, N. de la Brosse & J. Casey (UK)...... 82 A cross-sectional study on water access within the Healthy Villages and Schools (VEA) program in the DRC G. String, P.N. Mirindi, J.M. Sangira & D. Lantagne (USA)...... 82 Operational research on water safety plans: implementations in India, DRC, Fiji, and Vanuatu G. String, R. Singleton, P. N. Mirindi, F. Polo & D. Lantagne (USA)...... 83 Making universal access to water affordable in Zambia and Zimbabwe Sally Sutton & Peter Harvey (UK)...... 83 Health, food security and equity, socio-economic factors in self-supply investment Sally Sutton (UK)...... 84 An analysis of potential performance improvement in Freetown’s water utility using the AquaRating system A. Swarray, A. Bangura & M. Dillon (Sierra Leone)...... 84 Supporting Swaziland’s first water and sanitation joint sector review: lessons learned W. Tillett, N. D. Ntshalintshali & C. Kapupu (UK & Swaziland)...... 85 WASH in health care set ups in Uttar Pradesh Anjali Tripathy (India)...... 85 Customer perceptions and implementation of pro-poor safe water interventions in Uganda’s urban areas I. K. Tumwebaze & S. A. Ayugi (Uganda)...... 86 Mobile-based tracking system to ensure sustainability of a sanitation programme: experiences from four Indian states Asad Umar, Prasann Thatte & Satviki Varma (India)...... 86 xxii BACK TO CONTENTS Regional capacity for WASH sector knowledge management and learning in West and Central Africa E. Uytewaal, K.A. Naylor, R. van Lieshout & D. Jawara (The Netherlands)...... 87 A comparative analysis of the impact of hygiene promotion and sanitation marketing in rural Ethiopia K. Vrana, C. Garbutt, M. Wubshet, M. Yasin-Jemal, B. Getachew & M. Gizaw (Czech Republic)...... 87 Improving water point functionality in Malawi: making the case for minimum financing for direct support J. Wahba, S. Byrns & T. Smith (Malawi)...... 88 Reporting the condition of South Africa’s water sector infrastructure Kevin Wall & Chris Rust (South Africa)...... 88 Evolution of the social franchising approach to watsan maintenance in South Africa Kevin Wall & Oliver Ive (South Africa)...... 89 SEEK (Sludge to Energy Enterprises in Kampala): co-processing faecal sludge for fuel production B. J. Ward, M. Gold, D. Turyasiima, F. Studer, W. Getkate, J. M. Maiteki, C. B. Niwagaba & L. Strande (Switzerland)...... 89 Applying a community scorecard for rural water services in Timor-Leste M. Whalen, A. Grumbley & J. da Silva (Australia)...... 90 Rural water system functionality and its determinants: a twelve-country study J. Wiles & N. Mallonee (USA)...... 90 Capacity building in Cambodia’s rural local governments for the sanitation market K. Worsham, B. Powell & C. Chan (USA)...... 91
BACK TO CONTENTS xxiii Landlords/compound managers: change makers to improve and sustain communal latrine use and maintenance Farzana Yeasmin, Farzana Begum, Fosiul A. Nizame, Guy Norman, Sam Drabble, Md. Khobair Hossain, Dalia Yeasmin, Abdus Shaheen, Habibur Rahman, Mahbub Ul Alam1, Leanne Unicomb & Peter J. Winch (Bangladesh)...... 91
xxiv BACK TO CONTENTS Review of organizational capacity in integrated water resources management in Accra, Ghana E. M. Abraham (Ghana)
PAPER 2619
The study was to review organizational capacity for integrated water and other environmental management. Meetings were arranged with key informants within ten priority organizations based on specific criteria. The discussions with the priority organizations centred on various levels of capacity. The issues discussed included organizational strategic planning and programme implementation; quality assurance; external relationships; human resource management; financial management; communication and information management; feedback from the public; and complaints procedure and staff code of conduct. Focus group discussions were held in selected locations in Accra in which participants indicated their knowledge of the selected organizations and the extent to which they were involved in decisions on water and environmental management. Organizations had different capacity suited for their specific role in integrated water resources management in the city. The review showed that organizations can collaborate more among themselves and also with other stakeholders, especially local communities in the city.
WASH infrastructure and menstrual hygiene management in basic schools: a study in Kumasi, Ghana P. Acheampong, K. Akodwaa-Boadi, E. Appiah-Effah & K. B. Nyarko (Ghana)
PAPER 2693
Understanding the role of Water, Sanitation and Hygiene (WASH) services on menstrual hygiene behaviors and practices and ultimately on school absenteeism is important to inform policy and practice. This study focused on how the schools’ WASH infrastructure affects Menstrual Hygiene Management. The study was based on data from seven schools in the Weweso circuit, Kumasi– Ghana collected through Focus Group Discussions, key informant interviews and observation of water, sanitation and hygiene (WASH) facilities in the selected schools. The schools did not have adequate provision for menstrual hygiene management and the private schools had better WASH infrastructure/services that provide a better environment for menstrual hygiene management compared to the public schools. The poor WASH infrastructure in basic schools constrain school girls from maintaining good menstrual hygiene practices. The study recommends education on menstrual hygiene management and the incorporation of adequate consideration for menstrual hygiene management infrastructure in basic schools.
BACK TO CONTENTS 1 Innovative sanitation social movement: experiences from Nepal K. Adhikari, H. N. Acharya, T. Ahmad & S. Shrestha (Nepal)
PAPER 2592
Sanitation sector in Nepal remained a low priority till 2010. From 2010, the Government of Nepal prioritized sanitation and hygiene through creating enabling policy environment, inclusive planning, decentralized service delivery arrangement, and transforming sanitation promotion to social movement. The sanitation and hygiene master plan developed in 2011 provided a clear road map as well as set a national target of achieving universal access to improved sanitation by 2017. Social sanitation movement included triggering through school and community led interventions, socio-cultural festivals, sector triggering, decentralized governance, multi-sector collaboration and pro-active engagement of grass-root level actors. As a result access to improved sanitation increased dramatically from 43% in 2010 to 87% in 2016. Despite the huge progress, Nepal has to address a number of issues related to disparity in sanitation coverage and poor hygiene behaviors. There is a strong need of social norms for eliminating certain cultural dogmas especially around menstrual hygiene.
Case study on value for money assessment of a UNICEF assisted WASH programme in Nepal S. Adhikari, A. P. Gautam, S. B. Dhakal & T. Ahmad (Nepal)
PAPER 2700
A value for money (VfM) tool was used to better understand the input to process and output to results chain, to enable evidence based programming and to improve performance in terms of economy, efficiency, equity, and effectiveness of UNICEF assisted WASH programme in Nepal. This was motivated by result based budget allocation, planning and monitoring approach to enhance result based management of WASH programme. The VfM tool used in the case study is mainly based on comparing Cost Performance Ratios for consecutive years of implementation. The recommendations of VfM study conducted in 2014 provided basis for improvement and maximizing results in 2015 and also led to improved VfM analysis in 2015. This was achieved through revisiting the physical targets, readjusting the unit cost and reviewing its partnership strategies. The performances and associated expenditure so far made substantiates good value for money.
2 BACK TO CONTENTS Improving WASH services in Zimbabwe: experiences from a rural WASH project T. Ahmad, V. Kinyanjui, M. Jonga, H.R. Mashingaidze & A. Cole (Nepal)
PAPER 2620
Rural WASH Project (2012-2016) was implemented in rural areas of Zimbabwe covering 33 of 60 rural districts in five provinces aiming at improving WASH services. This project was built over four thematic areas of WASH infrastructure, demand led sanitation & hygiene promotion, Public Private Partnership for Operation & Maintenance, and WASH sector governance. The project achieved almost of all the planned results by end of October 2016. The project resulted in massive capacity development of government and community based structures for sustainable delivery and management of WASH services. For the first time in the history of Zimbabwe, demand led sanitation mainly without subsidy was successfully implemented resulting in construction of over 107,048 latrines, and achieving 2,555 Open Defecation Free villages. The project is now being scaled up in other districts and provinces under the 2nd Phase of the Project.
Gender and empowerment through WASH based on cases from Bangladesh S. Ahrari & E. Van Galen (The Netherlands)
PAPER 2777
It is often assumed that participation and representation of women in Water Sanitation and Hygiene (WASH) committees will lead to their empowerment .In order to get a better insight into “How” participation in the WASH committees can lead to empowerment of women, Simavi1 with support from the Gender and Water Alliance2 conducted a study to get a better insight on “If”, “How” and “Why” women’s empowerment has taken place as a result of participation in the WASH committees or other WASH interventions in our programme in Bangladesh. The results of this study and recommendation for WASH interventions are presented in this paper.
BACK TO CONTENTS 3 Addressing the sanitation crisis through a market-based approach N. Akwunwa (Nigeria)
PAPER 2820
In Nigeria, population growth and insufficient progress on sanitation have meant that the portion of the population with access to improved sanitation dropped between 1990 and 2015, and the number of people open defecating actually increased.1 This paper presents a market-based approach to sanitation that focuses on increasing the availability, affordability and sustainability of rural sanitation options in two states of Nigeria with large rural populations and low rates of access to improved sanitation. Key components of this initiative include developing a product line based on consumer preferences, working with motivated sanitation entrepreneurs, and establishing community-based sales agents. Challenges include difficulties changing cultural norms around open defaecation, and lack of affordable financing options.
Co-composting of faecal sludge with solid waste to improve FSM practice in Sakhipur municipality Abdullah Al-Muyeed, Ada Oko-Williams, Khairul Islam, Liakath Ali, Suman Kanti Nath & Palash Ranjan Sanyal (Bangladesh)
PAPER 2684
Sakhipur municipality with 32,000 inhabitants mostly comprise of onsite septic tank and pit toilet of different types. When the pit or septic tank is full, the usual practice is to engage professional sweepers are employed to manually empty them and deposit the wastes in mostly the nearby water bodies. A co-compost plant was designed by the Sakhipur municipality and partners and it’s been in operation since 2016 to tackle faecal sludge generated from pit toilets and septic tanks, and solid waste from households exploring sanitation service chain. This study provides a description of an innovative co-composting system which improves current FSM practice in municipality regime. The generated lessons against tackling the operational challenges of sanitation service chain will provide good learnings for replicating similar practice in other municipalities.
4 BACK TO CONTENTS Water sanitation and hygiene status in the neighbourhood of Bangladeshi Islamic schools and mosques Mahbub-Ul Alam, F. Yeasmin, S. Sarker, Abu Mohd. Naser, T. Md. N. Huda, H. Ahmed, A. Bucher, S. Ali, A. Khan, Md. M. Rahman & L. Unicomb (Bangladesh)
PAPER 2699
Faith based interventions have been underutilized to improve water, sanitation and hygiene status and offers promise to promote behaviour in the community. Prior to delivering a faith based WASH intervention, we conducted a survey among the neighbouring households of eight Bangladeshi Islamic schools and associated mosques. We randomly selected 192 families from where any male attend mosque and interviewed adult women from that family. At baseline, almost all households used improved water sources and improved toilets. However, toilet cleanliness was poor. Faecal matter was disposed into the environment after emptying the pit/septic tank. Defecation and disposal among children <3years mostly occurred directly in the open which should be improved using behaviour change recommendations. Presence of hand washing agent in the hand washing place was low. Islamic faith based intervention should be designed and delivered in way that can promote hand washing, safe sanitation practices and safe disposal of child faeces.
A socio-ecological analysis of barriers to sustained adoption of rural sanitation in Ethiopia, a qualitative study Fikralem Alemu, Abera Kumie, Girmay Medhin, Teshome Gebre & Phoebe Godfrey (Ethiopia)
PAPER 2676
The objective of the study was to explore barriers influencing the sustained adoption and use of sanitation facilities. A qualitative study was conducted in rural Ethiopia using in-depth interview and focus group discussion techniques. A social-ecological model and IBM-WASH framework were employed for the designing and analysis. Barriers for sustained adoption and use of sanitation facilities were categorized into1)individual level (past latrine experience, lack of demand to improved latrine), 2) household level factors (unaffordability, lack of space and, absence of physically strong family member), 3) community level factors (lack of access to public latrine, lack of shared rules against open defecation, lack of financial access for the poor) and, 4) societal level factors (lack of strong local leadership, flooding, soil condition, lack of appropriate sanitation technology, lack of promotion and demand creation on improved latrine). Hence, there is a need to consider multi-level intervention to address the identified barriers.
BACK TO CONTENTS 5 From camps to communities: a review of 10 years of WASH programming by Concern Worldwide in Northern Uganda J. Aluba, E. Lenia & B. T. Harris (Uganda)
PAPER 2633
There is a tendency for WASH interventions in emergency settings to be spontaneous and they frequently conclude before the emergency is over. Similarly, organisations may respond to emergencies not as part of their longer term country strategies, but rather as rapid responses to request for emergency calls. Whereas such emergency programming is characteristic of refugee- type humanitarian programmes that might culminate in voluntary repatriation, in emergency situations, like the case of the Internally Displaced Persons (IDPs) programme in Northern Uganda, there is need to adopt a Linking Relief, Rehabilitation and Development (LRRD) approach that entails planning for post - emergency recovery and development programmes as well. This paper details Concern Worldwide’s Water, Sanitation and Hygiene (WASH) intervention in Northern Uganda spanning a 10 year period, bridging emergency and development phases
Resilient WASH: lessons learned from El Nino drought response in Ethiopia – a qualitative study Jorge Alvarez-Sala & Dr Samuel Godfrey (Ethiopia)
During 2015/2016, Ethiopia suffered its worst drought in 50 years, triggering the largest-ever drought emergency response. Under the leadership of the Government of Ethiopia, and with support of UNICEF as co-chair of the WASH cluster, a well-coordinated and well-funded response provided support to 13 million people, exceeding the initial target of 9.6 million. The response included a variety of interventions, from short-term interventions such as water trucking and distribution of water treatment chemicals, to longer-term solutions such as construction of multi- village schemes and drilling deep wells in areas affected by chronic lack of water. The lessons learned from that response shall orient future WASH investments in the country and lead to better mainstreaming of the concept of resilience in both emergency and development interventions.
6 BACK TO CONTENTS Market driven approach for faecal sludge treatment products N. Andriessen, L. Schoebitz, M. Bassan, S. Bollier & L. Strande (Switzerland)
PAPER 2807
Inadequate management and treatment of faecal sludge continues to pose risks for public and environmental health. Given the variability of faecal sludge and location-specific nature of solutions, it is difficult to decide on treatment objectives and performance goals for treatment. The Market Driven Approach was developed as a quantitative methodology to determine which faecal sludge treatment products have the highest market potential in a defined location. This methodology provides a way to compare treatment products based on their real value for resource recovery. This paper discusses the results and lessons learned from field-testing in five cities across Africa and South-East Asia.
Safi Sana business challenge on open defecation and plastic pollution in the beaches of Teshie, Ghana Kwabena Twumasi Ankrah (Ghana)
PAPER 2763
This research paper is about Safi Sana’s public toilet business challenge in Teshie, Acrra. It examines the fundamental reasons why majority of the inhabitants within this coastal community choose to openly defecate in the sea rather than patronize the highly subsidized toilet facility. It also looks at the sanitation situation in Teshie with regards to the degree of plastic waste pollution along the sea shores and how this sub-consciously promotes open defecation within the area. Ethnographic research methods such as observational shadowing and in-depth interviews were employed in obtaining data. Through the process of Design Thinking, the obtained data was analysed, then used to create 2 prototype solutions that merged what the people loved to do, with what they had to do. They were then tested in the community through Market surveys and focus group discussions. The feedback was very positive and recommendations were made to the company to do well to roll over those plans to be able to simultaneously reduce plastic pollution, open defecation and increased patronage of their toilet block.
BACK TO CONTENTS 7 Assessment of latrine technologies in selected communities after CLTS implementation in Ghana E. Appiah-Effah, K.B. Nyarko, R. Buamah & L. Roberts (Ghana)
PAPER 2683
In Ghana, rural sanitation delivery has been based on CLTS since the past six years. This paper assessed the latrines delivered as part of CLTS implementation in six districts of Ghana namely Asunafo North, Pru, Builsa North, Garu Tempane, Ketu North and Kadjebi. The specific objectives were to (1) identify the types of latrines in the selected districts (2) establish the reasons for the choice of latrine and (3) technological challenges encountered during latrine construction. Sampling was purposive and covered a total of 515 households. The types of latrines recorded were traditional pit latrines with and without slabs, flush to septic tanks and VIP latrines. The key considerations in the selection of latrine types for construction were affordability and availability of component materials. Householders should be encouraged to use locally available materials for latrine construction to reduce latrine cost.
Solar pumping for rural water supply: life-cycle costs from eight countries A. Armstrong, J. Mahan & J. Zapor (USA)
PAPER 2654
Although interest in solar water pumping has been steadily growing, misconceptions persist about the applicability and cost-effectiveness of such systems in remote settings. The primary barrier to wide scale adoption of solar water pumping is that policy makers and practitioners at the local, national and international levels lack valid and transparent information on performance in a broad range of contexts and of the full life-cycle costs. In an attempt to fill this information gap, this paper presents upfront and recurring costs from 85 rural solar water pumping schemes of various sizes that have been designed, constructed and supported by Water Mission in eight countries. The average life-cycle costs associated with the reviewed schemes were within and on the lower end of IRC WASHCost benchmark ranges for both piped water schemes and boreholes fitted with handpumps. These findings indicate solar pumping is a viable and cost-effective intervention for rural water supply.
8 BACK TO CONTENTS Community health volunteers’ capacity for hygiene behaviour change: evidence from urban Kenya E. Aseyo, D. Nelima. E. Davis, K. Baker, O. Cumming, J. Mumma & R. Dreibelbis (Kenya)
PAPER 2667
Community health volunteers (CHVs) play an important role in health service delivery and are increasingly involved in water, sanitation and hygiene (WASH) behaviour change promotion. However, the realities of CHVs work, engagement with the health sector, and daily challenges remain undocumented. This mixed-methods study explored CHVs capacity to deliver an infant hygiene intervention in an urban informal settlement in Kenya. Findings suggest that CHVs are overburdened, receive inconsistent training, and forced to compromise their commitments in order to sustain their own livelihood. Sustained efforts in appreciating the work of CHVs, sustained supplies for CHVs, operational training in communication behaviour change methods and notable efforts in breaking the vicious circle of poverty in informal settlements would go a long way in promoting healthy seeking behaviours.
Menstrual hygiene management in Ghana: understanding the socio-cultural, economic, political factors, challenges and opportunities S.A. Asimah, P.Y. Diabene & S.N.L. Wellington (Ghana)
PAPER 2775
WaterAid Ghana conducted a study to guide its implementation of a Menstrual Hygiene Management (MHM) Programme in its areas of operation. The study explored existing MHM practices, identifying the endogenous, socio-cultural beliefs, behaviours and practices related to Water Sanitation and Hygiene (WASH) and focussed on the school environment. 319 pupils from 15 schools and 333 households at the community level were engaged across eight Metropolitan, Municipal and District Assemblies. This paper presents some of the key findings of the study.
BACK TO CONTENTS 9 Post-certification: an innovative post-project sustainability approach to maintain WASH rural services J. Aubriot & V. Tabu (Democratic Republic of the Congo)
PAPER 2701
The Democratic Republic of Congo is one of the sub-Saharan African countries that have not reached the Millennium Development Goals (MDGs) in water and sanitation despite massive efforts undertaken over the last fifteen years. To accelerate access to WASH services, UNICEF and government partners have been implementing the National ‘Healthy Villages and Schools’ Programme since 2008. It underwent a major reshaping in 2013 following a sustainability study that demonstrated that only 2% of villages had maintained their healthy status. A new post- certification support and monitoring component was put in place, including ‘catch up’ activities, which would allow the programme to re-certify villages and schools where the healthy status has been lost. This innovative approach continuously monitors WASH status, assuring the long- term sustainability of outcomes. Lessons learned, both in terms of results and methodology, can be identified from this critical sustainability measure and shared with the WASH community.
Modelling chloride contamination due to the impact of pit latrine on shallow groundwater in Nigeria A. Bakari (Nigeria)
PAPER 2591
Pit latrines are the most widely used forms of onsite sanitation facilities in Nigeria. Majority of the households in low income areas use pit latrines in the country. The concern for the potential of groundwater contamination by pit latrines necessitates this study. This paper is aimed at modelling the impact of pit latrines due to chloride contamination of shallow groundwater in Birnin Kebbi North-western Nigeria. The predictive modelling of chloride contamination is carried out using the MODFLOW/MT3DMS modelling codes. All the results are presented and discussed in this paper. The outcome of the paper will be useful to policy and decision makers in the Water and Sanitation Sector (WASH) in Nigeria.
10 BACK TO CONTENTS Some lessons learned from engaging in WaSH participatory action research in Melanesian informal settlements D. J. Barrington, K. F. Shields, S. G. Saunders, S. Meo, S. Sridharan, R. T. Souter & J. Bartram (Australia & UK)
PAPER 2643
In Melanesian countries there has been a large flux of people from rural to urban and peri-urban areas, resulting an in increased number living in informal settlements. These settlements often lack connections to mains water and sewerage lines and formal solid waste collection. Our project used a participatory action research (PAR) approach to work in partnership with informal settlement communities and enabling actors to achieve the self-determined WaSH conditions which participants felt would improve the well-being of those living in informal settlements. Because the PAR approach encourages reflection and adaptation, we learned lessons that were incorporated into the design of ongoing and future processes, and this paper presents five such lessons which we judge to be of practical use for WaSH enabling actors.
LGBTI and sanitation: what we know and what the gaps are C. Benjamin & A. Hueso (UK)
PAPER 2649
Discussions on gender and WASH typically ignore non-normative gender identities. To address this, we reviewed the existing literature on the interrelation of LGBTI and sanitation. The evidence is scanty, and mostly focused on developed countries, although there is a growing body of evidence looking at South and South-East Asia. Most of the publications focus on the challenges transgender people face when accessing public toilets or other communal facilities, which include verbal abuse, physical and sexual assault, denial of access, arrest and expulsion. Almost nothing was found on LGBI people (not including transgender). Solutions range from ‘gender-neutral’ public toilets, to ‘third gender’ ones, as well as ensuring transgender people can access toilets matching their gender identity. But there is no clear consensus. Overwhelmingly, the review reinforced how little is known about the challenges LGBTI face in relation to sanitation, a gap academics and practitioners alike could help address.
BACK TO CONTENTS 11 Creating sustained usage of household water treatment: a case study from Kagera, Tanzania M.A. Besteman, L. Osterwalder & A. Kiniga (The Netherlands)
PAPER 2822
In 2014 Basic Water Needs B.V. and South Pole Group, together with the Tanzanian NGO KADERES, developed a safe drinking water project in the Kagera region in Tanzania. The focus of the project was on sustained usage of household water treatment products. The project partners decided not to invest in the products, but in the creation of sustainable supply chain for a household water filter. This meant that filters were sold through local retailers and end-users were asked to invest the expected commercial retail price. By the end of 2016 an analysis of all monitoring data showed the percentage of households still using the household water treatment product exceeded expectations. 93,1% of households owning the product between 0-1 year were still using the product and 82,7% was still using it after 1-2 years. It seems probable that the project set up has influenced the high usage rates.
Cleansing in hidden spaces: the bathing needs of perimenopausal women A. Bhakta, B. J. Reed & J. Fisher (UK)
PAPER 2827
An increasing proportion of the world’s women will pass through the transition to menopause, or perimenopause, as the global population ages. Drawing on the experiences of perimenopausal women in Ghana, this paper highlights bathing as a hidden but important need which has been neglected by the WASH sector. Data gathered in two urban communities through participative methodologies reveal that increased bathing is a vital hygiene practice to manage various perimenopausal symptoms. Bathing experiences of perimenopausal women in Ghana are shaped by symptoms of ageing, and infrastructural, economic, social and environmental factors. Setting the bathing needs of perimenopausal women in the context of socio-cultural perspectives of bathing, this paper calls for an increased examination of bathing in the WASH sector, with an emphasis upon providing user friendly infrastructure through a gender-sensitive approach.
12 BACK TO CONTENTS Lessons from scaling up urban sanitation development in Indonesia and Mozambique I. Blackett, P. Hawkins, M. Listyasari & O. Muximpua (UK)
PAPER 2600
Indonesia and Mozambique are very different in terms of geography, culture, income, population and the type of sanitation used – and other aspects of development. This paper looks at urban sanitation development over the last 10 years in both countries – and the similar aspects of their development. In particular it looks at what lead to achieving national leadership: the role played by gating solid data and evidence; sanitation development models and how the critical role of effective advocacy. It ends with an overview of unresolved shared challenges and asks if these important issues provide lessons learned for other countries too?
An island within an island: 19 years of rural WASH programmes implementation in La Gonave, Haiti B. Bourzac (Haiti)
PAPER 2656
With harsh environmental conditions and isolation, the island of La Gonave, in Haiti, offers a rare opportunity for studying the impact of long term support in sustainable WASH services .After 19 years of WASH programmes implementation, Concern Worldwide was willing to document different experiences held in this particular context. Moreover, La Gonave suffers from a relative lack of investment from the government, which increases its vulnerability in terms of access to safe water and sanitation. This isolation piles up many challenges, endangering population health and well-being: dry and tough environmental conditions underlying scarce water resources and logistical issues, a constraining governmental policy on water and sanitation leading the NGOs to adapt and create new strategies, and complex social and cultural aspects affecting the expected outcomes. The situation of La Gonave requires creative programmes and innovative techniques to address these factors. This paper aims to outline some examples.
BACK TO CONTENTS 13 Designing pit emptying technologies: combining lessons from the field with systems thinking C. Buckley, R. Sindall & F.L. de los Reyes III (South Africa)
PAPER 2826
The ideal pit emptying machine has been envisioned to be safe, hygienic, and economical, while being mobile and lightweight, allowing access to pits located away from main roads. The machine should be robust, should be amenable to easy operation by a few personnel, and can be maintained using local expertise and supplies. Using the insights from a recent workshop and our own field experience, we discuss the challenges of designing such a machine, and broaden the discussion to include the entire system of pit emptying, collection, and transport. We classify pit emptying technologies according to the type of pit (e.g., wet pits with little trash, wet pits with lots of trash, and dry pits with lots of trash), and argue that designing technologies accordingly should be the focus in the future. A systems approach that includes transport optimisation, sustainability of small businesses, and operator safety and training is advocated.
What happens inside a pour-flush pit? insights from comprehensive characterization A. Byrne, R. Sindall, L. Wang, F. L. de los Reyes III & C. Buckley (South Africa)
PAPER 2823
The pour-flush toilet is extensively used in many countries, but the biodegradation within pour- flush leach pits has not been fully characterised. We present a comprehensive physical, chemical, and microbiological analysis of pour-flush active and standing leach pits in South Africa. Four household toilet sites were sampled four times over 11 months. The pour-flush pit filling rate was estimated to be 0.11m3/y, which is lower than those of other sanitation technologies. Faecal sludge in active leach pits had similar ash, VS, CODT and TKN as other onsite technologies, but higher moisture content. The CODT in pour-flush sludge decreased 85% in 27 days in a short-term laboratory test. Microbial DNA sequencing showed that both aerobic and anaerobic degradation occurred in active and standing pits. Specific microorganisms were identified and differences in microbial communities in active, standing, and single pits were described, providing important insights into processes occurring within pour-flush pits.
14 BACK TO CONTENTS Collection time inequalities: fetching water in Ethiopia A. Cassivi, E. O. D. Waygood & C. C. Dorea (Canada)
PAPER 2772
In 2015, WHO and UNICEF reported that only 12% of Ethiopia’s population have access to water on premises. High proportion of the population thus needs to fetch water for their survival. Considering the importance of time to fetch water on an individual’s health and well-being, we aim to demonstrate where water fetching issues are the most prevalent. This study highlights the widespread burden of fetching water and the significant disparities in terms of accessibility with regards to the location of the source within population groups. Characterization of collection time by regions, type of source, education level and water fetcher illustrated where work mostly remains to reach universal access to drinking water.
Understanding, respecting and including people with mental health conditions as part of the CLTS process S. Cavill, P. England, S. House & S. Ferron (UK)
PAPER 2604
Mental health conditions affect large numbers of people globally, in a variety of ways and people often face extreme stigma and marginalization as a result. Appropriately implemented, Community Led Total Sanitation (CLTS) can contribute to physical, mental and social health by helping to build pride and contribute to the inclusion and empowerment of people with mental health conditions; but there are also risks that people with mental health conditions may be mistreated, or have their rights abused, if they have difficulty in changing their sanitation and hygiene behaviour. This paper calls for all those engaged in sanitation programmes to: increase their learning on this issue; increase their awareness of the specific vulnerabilities of this group in sanitation programmes; build the capacity of stakeholders on acceptable and unacceptable practices in working with people with mental health conditions; and develop a Code of Conduct.
BACK TO CONTENTS 15 Water delivery configurations and CBOs in Dhaka’s slums, Bangladesh: lessons for WASH sustainability S. Cawood (UK)
PAPER 2647
In Dhaka, Bangladesh over five million bustee (slum) dwellers access water via self-help, Non- Governmental Organisations (NGOs), Community-Based Organisations (CBOs), donors, samity’s (cooperative societies), illegal vendors, local leaders, politicians, private landowners and some government agencies. These diverse ‘delivery configurations’ (Olivier de Sardan 2010; 2011; Jaglin 2014) have implications for WASH sustainability, the terms and cost of access. Drawing on in-depth fieldwork in three bustees, and citywide interviews with NGO and government officials, this paper outlines how NGO-initiated CBOs access legal water connections. Whilst CBOs play an increasingly important role, the extent to which supply (and associated hardware) remains functional, affordable and equitable in this context, is disputed. Findings highlight the importance of a more coordinated and integrated approach to water, sanitation, hygiene and land tenure security, for enhanced WASH sustainability in urban low-income settlements.
Quality control in the decentralized production of biosand filters: a pilot workshop in Zambia N. Chan, L. Mitchell, T. Ngai & S. Li (Canada)
PAPER 2785
The locally produced, concrete biosand filter is a household water treatment option for improving water quality. As of December 2015, over 830,000 biosand filters had been implemented in 60 countries around the world. Local, decentralized production is an advantage of the technology but also creates challenges with quality control. This paper describes the development, piloting and evaluation of a quality control workshop in Zambia. The overall reaction to the workshop was positive. Based on results from the pilot, CAWST will revise the workshop to better achieve learning outcomes and improve the efficacy of the workshop.
16 BACK TO CONTENTS Operationalizing FSM regulations at city level: a case study of Warangal, India V. S. Chary, Y. M. Reddy & S. Ahmad (India)
PAPER 2803
Warangal is the first city in India to introduce and operationalize Faecal Sludge Management (FSM) regulation. Evidence based advocacy, leadership at city level, citizen awareness campaigns, capacity building of stakeholders particularly the mechanised desludging operators, extensive use of information and communication technology (ICT) tools for monitoring have played an important role in operationalizing the regulation. The City government through FSM regulation has successfully introduced : a) empanelment and training of masons (as toilet builders) to ensure toilets are built as per design principles, b) site inspection by the sanitation team prior to issuance of building plan approval, c) licences to operate mechanised desludging and service level agreement with private operators d) usage of personal protective equipment by the desludging operators e) a mobile app in vernacular language for record keeping on desludging f) a dedicated helpline for citizens to seek support on FSM operations and g) awareness campaigns on safe FSM and scheduled desludging. Lessons from Warangal are being scaled up through introduction of State level FSM regulation and operational guidelines. Community health clubs growth monitoring: experience from Zimbabwe’s Small Towns WASH Programme A. Cole, T. Maja, P. Kaendesa, V. Kinyanjui & M. Munyaka (Zimbabwe)
PAPER 2612
The Government of Zimbabwe and UNICEF are implementing a Small Towns WASH Programme in 14 towns of Zimbabwe. Hygiene Promotion is one of the key programme components and activities are being delivered through community, school and market health clubs. An adaptation of a tool, known as the Group Maturity Index for tracking the development and growth of the health clubs by measuring progress of the clubs across five domains of objectives, governance, systems, resourcing and impact has been developed; two assessments of clubs have been done in October 2015 and May 2016 respectively. This paper compares the results of the two assessments and looks at the usefulness of the tool for programming. It provides a basis for development workers to adapt and obtain an objective means of tracking areas of weakness and strengths when working with health clubs and community based groups.
BACK TO CONTENTS 17 Improving Zimbabwe urban WASH service delivery through U-Report A. Cole, T. Maja, P. Kaendesa, V. Kinyanjui & M. Munyaka (Zimbabwe)
PAPER 2642
The Government of Zimbabwe and UNICEF are implementing a Small Towns WASH Programme (STWP) in 14 towns of Zimbabwe. Hygiene Promotion is one of the key programme components and related activities are being delivered through community, school and market health clubs. UNICEF in partnership with the Government of Zimbabwe is piloting the use of mobile SMS based service delivery case management system known as U-Report under the STWP. U-Report is a free SMS social monitoring tool for community participation, designed to address issues that the population cares about. U-Report started out as a local innovation to help young Ugandans engage on issues that affect their lives and futures. This paper details the experience of piloting the U-Report system in strengthening community participation in WASH service delivery, in Zimbabwe’s Small Towns WASH Programme.
Wastewater management in developing countries: Bolivia case studies C. Cossio, J. McConville, S. Rauch & A. Mercado (Bolivia)
PAPER 2776
Wastewater management in developing countries still is a challenge, especially in small towns. The aim of this study is to understand technical and social factors related to management. Thus, the context surrounding the performance of six treatment plants in rural areas of Cochabamba, Bolivia were investigated: three small treatment plants (2000-10000 p.e.; flow>5L/s) and three very small treatment plants (<2000 p.e.; flow<5L/s). Performance of the plants was measured based on the removal of TSS, BOD5 and Fecal Coliforms. Management data was collected through semi-structured interviews with water association managers and users. Results found that inappropriate design and type of technology, lack of operational expertise and lack of financial resources were the main factors related to low performance. Moreover, lack of financial resources is linked to the awareness of users on the importance of having the service and willingness to pay for their adequate functioning.
18 BACK TO CONTENTS Moving forward: findings from menstrual hygiene management formative research in Bangladesh M. Coultas, J. Martin, C. Stephen & S. Warrington (UK)
PAPER 2783
Menstruation is a fact of life for 2 billion women and girls of reproductive age and yet in many places girls face serious barriers to managing their periods. These barriers impact on their rights to education, health, dignity and participation in society. Plan International is implementing menstrual hygiene management activities in 12 countries across Africa and Asia. In 2016, Plan International contracted Oral Testimony Works and Creative Social Change to conduct formative research in Bangladesh on menstrual hygiene management, using human centred design and other participatory methods. This paper presents some of the primary participatory research findings: on practice, motivators and barriers to managing menstruation safely, privately and hygienically. The paper also includes some of the programme recommendations and suggested approaches for Plan International to use in the re-design and implementation of current and future menstrual hygiene management work in Bangladesh.
What drives political leaders to improve urban sanitation? C. Cummings, I. Langdown, T. Hart & M. Matoso (UK)
PAPER 2635
This report analyses the political challenge of improving access to sanitation in rapidly growing and developing secondary cities. We look at examples throughout history and across the world, and argue that while sanitation problems may appear to be technical in nature, without political incentives to solve them, progress cannot be made. Drawing on lessons from historical progress, we formulate a framework for understanding how improvements in urban sanitation take place. We then apply these principles to current sanitation challenges in two secondary Tanzanian cities, Mwanza and Arusha, to assess what could drive improvements there, and potentially elsewhere.
BACK TO CONTENTS 19 The role of information and communications technology in teal-time monitoring for quality WASH infrastructure P. K. Darko, E. S. Kogo, E. Yanyi-Akofur & J.P. Debus (Ghana)
PAPER 2610
The risk of inefficiencies in quality of WASH infrastructure construction is higher in places where monitoring is less or absent or when monitoring is only limited to persons directly involved with the business processes and transactions. To address system deficiencies and constraints in the monitoring of latrine construction in WASH in schools’ project, CRS Ghana explored innovative technology solutions that allow access to quick, cost-effective quality data on progress of construction activities. The solution involves the use of Tablets, GPS, Iformbuilder Platform and BarTender software to develop a simple system to track and certify construction results in real- time. This approach prevents construction defects, supports cost-effective delivery of quality infrastructure, promotes transparency and allows decision making on payments, contracts and WASH programming.
Sanitation marketing in Nepal in support of open defecation free social movement S. B. Dhakal, T. Ahmad & S. Shrestha (Nepal)
PAPER 2606
Nepal’s Sanitation achievement been accelerated by the sanitation social movementl that prioritizes the elimination of Open Defaecation (OD) in line with the Sanitation and Hygiene Master Plan launched in 2011 by the Government of Nepal. UNICEF partnered with International Development Enterprises (iDE) Nepal to develop a market-based approach for sanitation for strengthening the sanitation supply chain in eight Terai districts with high rates of OD. A product named “Easy Latrine” was promoted as a major component of the programme that could all be purchased from one retailer in a ‘one-stop shop’ manner to enable an efficient purchasing experience for the consumer. In a period of 18 months, total of 33,730 easy latrines were sold in 56 villages and 6 villages were declared Open Defecation Free. This paper aimed at sharing the experience from implementation of sanitation marketing model.
20 BACK TO CONTENTS Moving forward from humanitarian to sustainable WASH service: improving our work through evidence building data Anton Dharmalingam & Marielle Snel (Sri Lanka)
PAPER 2797
There are currently around 45 million people in need of WASH humanitarian assistance. The objective of this paper is to reflect on some of the data on proven practices of water, sanitation and hygiene (WASH) schemes that have been undertaken by World Vision, in the countries that are part of Syria Crisis Response namely Lebanon, Jordan, Kurdish region of Iraq and Northern Syria. This data is to provide some initial evidence on how World Vision is moving forward in understanding the impact of its WASH schemes over time. The rationale behind this paper is to show that WASH in fragile areas is increasingly being recognised as a priority in line with achieving sustainable WASH through the urgent need for stakeholders, ranging from donors to development experts to take WASH efforts in this region more seriously in terms of long term sustainability through better stakeholder coordination in the region. This paper aspires to bring to light the impact of World Vision WASH schemes in the region and how it can potentially move forward.
Strengthening WASH sector monitoring through the use of ICTs: experiences from Zimbabwe’s Rural WASH Information Management System (RWIMS) L. Dhoba, A. Nyawasha & S. Nyamuranga (Zimbabwe)
PAPER 2769
A rural WASH database is under development in Zimbabwe where anecdotal information continues to be a major constraint to sector planning. Without a firm evidence base, the sector has not been able to institute policy changes and provide a framework through which interventions can be designed. Performance tracking, transparency and accountability remain weak without compelling cases based on credible information. This paper explores opportunities created by RWIMS, a mobile to web based database, which brought reforms in the management of sector information and attempted to address the practical issues that sector practioners grapple with in their quest to provide services that last. Specifically, it lays out the opportunities that the system has created in addressing a perennial national challenge of improving O&M of rural water points riding on the penetration of mobile technology in rural Zimbabwe.
BACK TO CONTENTS 21 Adaptable drinking-water laboratory unit for decentralized testing in remote and alpine regions A. Diener, A. Schertenleib, D. Daniel, M. Kenea, I. Pratama, M. Bhatta, & S. Marks (Germany)
PAPER 2743
Our project introduces an adaptable drinking-water laboratory unit to promote decentralised drinking-water quality testing in remote and alpine regions. We outline product-design and handling requirements for analyses in remote areas as a basis for the development of do-it- yourself setups that fill the gap between field test-kits and professional laboratory facilities. In a collaborative effort between international researchers and local water experts, a setup was developed in the alpine region of Mid-Western Nepal. The unit’s main element, a solar-powered incubation system proved technically reliable, suitable for cold climates and easy-to-handle in mobile and stationary application. The setup can support the extension of water safety planning and water quality surveillance to so-far underserved rural or unreached remote regions. Long- term implementation will require a careful look at effective solutions for training, supervision, supply chains and integration into existing structures.
Water resource assessment of Karst Islands and the development of a freshwater lens assessment protocol R. DiFilippo, I. Smout & L. Bosher (USA)
PAPER 2829
Karst islands like those found in the Philippine Archipelago present extreme challenges for stakeholders to manage their water resources in a sustainable manner. Anthropogenic Climate Change, land development, point source pollution and increased population have all combined to alter the water balance on these fragile islands. Karst features, shallow depth to groundwater and the potential for dissolution, contribute greatly to these challenges. Combined, these factors pose an array of complex research questions. A field reconnaissance and semi-structured interviews were completed on Bantayan Island in 2016. Drawing upon current groundwater characterization practices the research posits a novel approach for these hydrogeologic environs. With the application of the Freshwater Lens Assessment Protocol (FLAP) credible output for the characterization of the islands groundwater resources will be determined and integrated into an Adaptive Water Resource Management framework, empowering stakeholders to make informed decisions on sustainable abstraction strategies.
22 BACK TO CONTENTS Getting the message right: step by step behaviour change communication to guide change in Sanitation in Nepal K. Dishwa & S. L. Rautanen (Nepal)
PAPER 2605
Nepal has been using the Community-Led Total Sanitation (CLTS) approach since 2003/04. However, success has been varied. In some cases, the emphasis has slipped back to hardware (constructing toilets) rather than behaviour change (using toilets). Where behaviour change has occurred, it has not always been sustained. The Rural Water Supply and Sanitation Project in Western Nepal Phase II, a bilateral project of the Governments of Nepal and Finland, has developed a Step-By-Step approach to behaviour change to guide local staff, local governments and community to implement CLTS approaches sustainably. The framework strengthens pre- triggering and triggering through identifying barriers and supporting factors, and stimulates site-specific thinking on priorities to achieve true behaviour change at scale. Mobile phones are used to ensure accurate up-to-date data for the purpose.
WASH, violence and health: a quantitative analysis Reshma Dixit (India)
PAPER 2738
In India out of the 246,692,667 households there are 53.1% having no latrines. Similarly in the urban areas out of 78,865,937 there are 18.6% without latrines. Two thirds of Indian homes are devoid of a drinking water facility from a treated tap source. Inadequate water and sanitation impacts women as they face challenges and are widely exposed to vulnerable situation posing a threat to their dignity and safety. To understand the challenges in accessing water and sanitation provisions a PhD study was conducted in the urban slums of Bhopal, Madhya Pradesh. The findings indicate that 89.5% respondents did not feel safe defecating in the open. 96% women and 40% men controlled the urge to defecate. A key finding of the study was that 68% of the women had experienced violence in some or the other form.
BACK TO CONTENTS 23 Improving nutritional impact through the integration of WASH and nutrition interventions: a practical guidebook MPH. J. Dodos & Dr. J. Lapègue (Serbia)
PAPER 2653
Undernutrition is a multi-sectoral problem with multi-sectoral solutions. By applying integrated approaches, the impact, coherence and efficiency of the action can be improved. The international humanitarian organization Action Against Hunger has published a new guidebook for improving nutrition through the integration of water, sanitation, and hygiene (WASH) and nutrition interventions. The “WASH’ Nutrition Practical Guidebook” demonstrates the importance of both supplementing nutrition programmes with WASH activities and adapting WASH interventions to include nutritional considerations i.e. making them more nutrition-sensitive and impactful on nutrition. It has been developed to provide practitioners with usable information and tools so that they can design and implement effective WASH and nutrition programmes. Apart from encouraging the design of new integrated projects, the guidebook provides support for reinforcing existing integrated interventions.
Planning approaches for sanitation systems in peri-urban areas: a case study from Tanzania M. Domini, S. Sorlini & G. Langergraber (Italy)
PAPER 2639
The planning and improvement of sanitation systems represents a critical problem for low- income countries, in particular in rapid growing peri-urban areas. This paper illustrates the assessment of the Community-Led Urban Environmental Sanitation (CLUES) and the Sanitation Safety Planning (SSP) approaches, tested for the design of an improved sanitation system in peri-urban areas of Iringa Municipality, in Tanzania. The application in field of the two approaches permitted to evidence and analyse their strengths and weaknesses, and possibilities to increase their potentials with an integrated use. The experience, applied to a case study, aims to be an example of application for practitioners dealing with sanitation planning in context showing similar characteristics.
24 BACK TO CONTENTS Challenges of developing a peri-urban water supply strategy in Ghana Dotse F.M, Nii Odai Laryea, Christopher Sackeyfio & Gertrude Amissah Asokwah (Ghana)
PAPER 2593
This paper discusses the efforts to fashion a strategy for peri-urban water supply in Ghana with financial support from Agence Francaise de Developpment. It posits that the institutional weakness of the Water Directorate of the erstwhile Ministry of Water Resources, Works and Housing as the policy formulation unit for the water sector created too much space for the Ghana Water Company Limited to abort the process for the successful implementation of the pilot project and the replication of an appropriate model. The paper however sees the creation of a new Ministry for Sanitation and Water Resources as an opportunity to strengthen the Water Directorate and the eventual development of an appropriate strategy for the peri- urban areas so as to minimise the problem of the missing middle.
Optimisation of faecal sludge processing via vermifiltration Enrique Hernández, C. & Furlong, C. (Spain & The Netherlands)
PAPER 2833
Faecal sludge requires treatment before it can be safely discharged. Novel treatment technologies, such as vermifiltration need to be explored. This study aims to determine if a simple vermifilter containing Eisenia fetida can process sludge and explores the effect of bedding materials (woodchip, granular activated carbon (GAC) + woodchip, and clay pebbles + woodchip) on nitrogen reduction in the effluent. All bedding materials performed well for general effluent quality, but nitrification was not found to occur. This was thought to be due to sampling and analysis techniques. The GAC bedding was unsuitable as worm density decreased. The optimum bedding material was woodchip which yielded the highest worm and cocoon densities, vermicompost production and solids conversion. This study proves that E. fetida have the ability to process sludge in a simple vermifilter and adds to the debate on nitrification in these systems.
BACK TO CONTENTS 25 Groundwater supply sustainability in fragile states: a case study examining challenges and approaches P. Evans & A. Bastable (UK)
PAPER 2638
Sustainable groundwater supply development in developing countries remains an ongoing challenge due to a range of technical and community related factors. The challenge in fragile states becomes increasingly difficult due to often adverse operational environments and rapid NGO interventions. Such challenging conditions reduce the likelihood of achieving sustainable supplies in the long term. Recent practical experiences in Wau, South Sudan are presented and used to examine groundwater supply sustainability challenges and potential solutions that can be applied in wider fragile state contexts. It should be recognised that groundwater supply sustainability cannot always be realistically achieved in fragile state environments; however, long term financial and developmental incentives exist to maximise sustainability potential wherever the context allows. A combination of preparedness and informed early-phase decision making in collaboration with capable local partners can maximise groundwater supply sustainability potential in challenging fragile state working environments.
Improved prioritisation tool for local decision-making in the water, sanitation and hygiene sector F. Ezbakhe & A. Pérez-Foguet (Spain)
PAPER 2705
The provision of sustainable water, sanitation and hygiene (WaSH) services is essential for human health and development. In order to achieve this sustainability, reliable data is needed to support planning, and improved prioritisation tools are required to evaluate sector performance and promote decision-making. In this context, the present paper introduces to the WaSH sector the ELECTRE-III model, which has proved successful for multi-criteria ranking in water resources management. This article presents 1,600 communities in Nicaragua as case study and evaluates the method’s suitability to rank the performance of a large number of communities on multiple criteria. Results indicate that ELECTRE-III is effective at assessing communities at a large-scale and targeting the neediest areas for WaSH improvements.
26 BACK TO CONTENTS Improved functionality through solar powered water pumping system and solar lighting help villagers to be more resilient to the drought impact K. Farah (Somaliland)
PAPER 2816
Despite the quarter century of donor investment through small scale projects the rural water supply in Somaliland suffers high rates of dysfunctional and unreliable water supply, where over 54% of the rural water points have fallen into disrepair at any given time. Little effort has been put into improving the sustainability of rural water supply over that period of time, especially during the dry season. This paper analyses the challenges, lessons learnt and the success of the the Quenching the Thirst project which CARE International implemented 2013-2016 in Somaliland with a close partnership of the Ministry of Water Resources (MoWR). The main interventions were capacity building, steps towards sustainable water policy and the use of the solar powered water pumping technology and village lighting business. This has ensured reliable & safe to drink rural water supply and enabled the villagers to be more resilient to the current severe drought prompted by El Nino in Somaliland.
Pathways to improving sustainability of WASH services: influencing government planning and decisions, Indonesia H. Ferdian, R.R. Putra & L. Leong (Indonesia)
PAPER 2669
The Indonesian Government estimates that it will cost US$21.6 million to achieve the country’s 2019 Universal Sanitation Access goal. However, an assessment, by Plan in ten districts found that district governments were allocating under 1% of their annual budget to WASH. A key pathway to achieving the Universal Sanitation goal and to improving WASH service sustainability is through enabling local governments to independently and sustainably resource and support WASH improvements. This is critical for improving services sustainably for the poor, who are most affected by government resource decisions. Within a project context, Plan and local government partners developed and applied a series of successful strategies to influence government decision making processes. The combination of these strategies had not been undertaken previously in Indonesia. In only three years, these strategies have resulted in the project’s five district governments securing funding for sanitation and hygiene implementation for 363,000 people in 242 villages.
BACK TO CONTENTS 27 Hygiene promotion: Have we got the right answers to the knowledge behaviour gap? Franck Flachenberg (France)
PAPER 2729
Obtaining effective hygiene behaviour change through Hygiene Promotion (HP) remains a challenge. A discrepancy exists between the scientific knowledge now available about human behaviour and the HP interventions implemented by aid agencies. Quality standards need to be defined and applied to ensure minimum quality of HP interventions. This paper presents some insights and practical recommendations for closing the knowledge behaviour gap.
Financial Flow Diagrams to promote policy-making, based on 20 community management case studies from India R. Franceys, T. Guinaldo, C. Leitner, O. J. Nyangoka, V. Thomas, J. Zeilinger & P. Hutchings (UK)
PAPER 2710
This paper reports the development of ‘Financial Flow Diagrams’ as a means of better communicating complex financial information, directly inspired by the development of ‘Shit Flow Diagrams’, in this case highlighting, for policy-makers, donors and service providers financial challenges. We describe the design considerations investigated during the preparation of visual oriented financial communications. This includes arguments about the merits and limitations of visuals and associated tools/software that best display flows of resources (in our case financial). We then present visuals that were submitted for testing across a panel of informants, some closely related to the Community Water Plus project, a 20 case study, 17 States research project of ‘successful’ community managed water schemes in India, which provided the source financial information. Finally, we provide a critical analysis and feedback on the limitations of using Financial Flow Diagrams as a mean to convey messages on funding distribution in the context rural water supply.
28 BACK TO CONTENTS Financing access to improved water and sanitation, Public Works Loans Board, UK R. Franceys (UK)
PAPER 2711
The challenge of funding the SDG’s has led to considerable interest in ‘innovative financing’. This paper reports on an analysis of sector lending, capital expenditure, and resulting, consumer paid, interest rates, during the rapid expansion of water and sewerage services in England and Wales over a 150 year period. Government minimised the cost to consumers by establishing a Public Works Loans Board (PWLB) which on-lent national borrowing to local municipal service providers at the lowest possible interest rate so as to accelerate access to improved services. With the cost of achieving basic WASH services for all now estimated at $28.4bn per year (Hutton & Varughese, 2016) and tariffs and taxes being insufficient to meet the needs, repayable finance becomes critical to achieve the desired SDG benefits. PWLB long-term average ‘real’ interest rates of 1.95% (5% nominal) made a significant difference to affordability in Britain as compared to some present ‘innovative financing’ reports of 15-20% per year nominal interest costs.
Barriers and enablers to becoming and staying open defecation free in remote Timor-Leste N. Francis, M. Morrow, S. V. Nery, A. Clements & J. Black (Australia)
PAPER 2636
The barriers and enablers to becoming and staying open-defecation-free (ODF) following interventions which include Community-Led Total Sanitation (CLTS) are not well documented for remote communities in Manufahi District, Timor-Leste. This case study sought to address this gap in knowledge through a thematic analysis of interviews (which took place in 2014) with 21 participants affiliated with two communities which underwent the WaterAid program between 2012 and 2013. Whilst the cost and effort of constructing toilets was cited as a significant barrier, competing priorities for resources is likely to be more important. Trust in the implementing organisation as well as being able to acquire the household’s preferred toilet are important enablers to becoming and staying ODF. There is a perception among participants that vulnerable households face specific challenges to becoming and staying ODF. Including vulnerable households, especially those with people with disabilities, in both interventions and research remains challenging.
BACK TO CONTENTS 29 Learning from Oxfam’s Tiger Worm Toilets projects C. Furlong, J. Lamb & A. Bastable (The Netherlands & UK)
PAPER 2835
The world is witnessing the highest levels of forced human displacement on record, leading to people being housed in urban centres and camps. Generally the sanitation needs of these people are initially met by external agencies. The long-term costs of operating and maintaining traditional sanitation systems can be unviable when communities or local authorities take over their management. Therefore Oxfam has been trialling the Tiger Worm Toilet (TWT) in peri-urban and camp settings. The aim of this paper is to review Oxfam’s TWT projects and to share the learnings, together with the innovations that have occurred. The learnings are that TWTs are not the solution to all sanitation problems, but they have been proven to work well at household level. Monitoring and documenting the trials has been an ongoing problem due to a number of issues, which are linked to short term funding, and the use of project rather than program approaches.
Promotion of manual drilling in Guinea Bissau: mapping suitable zones and estimating the potential F. Fussi, F. Asplund & M. Caruba (Italy)
PAPER 2760
Guinea Bissau has made large strides in water supply, but still 35% of villages have no access to safe water. UNICEF is promoting alternative solutions to ensure a proper water supply in these small communities, for example manual drilling. For these reason a mapping study to identify suitable zones for these techniques has been carried out in 2016, using existing groundwater data and the experience from local experts. 88% of Guinea Bissau is considered with feasible hydrologeogical conditions for manual drilling. In 63% of the regions where this technique is applicable, it is adequate for villages of small-medium size. Taking into consideration the results of this study, it seems evident that the promotion of manual drilling could be a valid alternative to improve the situation of access to safe water especially in rural areas.
30 BACK TO CONTENTS Rapid Action Learning Unit: new Initiative to institutionalize learning under the National Sanitation Programme in India Sanchita Ghosh (India)
PAPER 2672
This paper presents the highlights and insights from regional consultative workshops, which were run by the Water Supply and Sanitation Collaborative Council (WSSCC) in June, 2016 across five regions of India with the support of the Government of India. This initiative was organised with the objective of developing a better understanding of Rapid Action Learning Units under the Swachh Bharat Mission (Gramin) / Clean India campaign, and for supporting and institutionalising cross-learning and sharing at different levels of implementation to accelerate progress. This paper discusses the current learning and sharing mechanisms, the challenges, the concept of rapid action learning and institutional structures for learning under the programme. The paper seeks to highlight the critical elements and key recommendations for creating strong rapid learning and sharing units.
Improving sanitation in the Niger Delta N. Gilbert & L. King (Canada)
PAPER 2626
Little WASH progress has been made in the Niger Delta. Using the exploratory case study method, including quantitative and qualitative data collection, the authors examined current sanitation practices, efforts made to improve sanitation, the extent to which those efforts have succeeded and what else is needed to improve sanitation sustainably. The results show the immediate need for development of low-cost, durable, and appropriate sanitation technology options, as none currently exist that address consumer needs, high water table and rainfall, shortage of land, and access issues, followed by supply chain development. The only formal behaviour change framework tried in the region is CLTS with limited results, possibly due to the proximity to water. Other frameworks such as the RANAS model (with adaptations of the questionnaires), IBM-WASH and Nudge Theory should be tested. Other recommendations include improved government services, access to capacity building and education about technology options, and opportunities to encourage knowledge-into-practice.
BACK TO CONTENTS 31 Rainwater harvesting and management in the semi-arid areas of Tigray region, Ethiopia Y. Girma & M. Aynalem (Ethiopia)
PAPER 2602
Located in the eastern part of Tigray Region, Ethiopia, Saesie-Tsaeda district has a total population of 30,829 people, most of whom are dependent on rain-fed subsistence agriculture. Access to adequate quantities of safe water in this semi-arid region is a consistent challenge. To provide an alternative source of water, local NGO ECC-SADCO constructed rain water harvesting structures and set up a sustainable operation and management system in the district. This paper highlights the key lessons from this project activity, specifically regarding rain water harvesting cisterns in semi-dry areas.
Building local capacity to promote sanitation: Vietnam and Cambodia M. Goodwin-Kucinsky, Q. Nguyen & A. May (USA)
PAPER 2754
Drawing on experience implementing market-based sanitation programs in seven countries, this paper describes iDE’s insights into building local capacity to promote sanitation in two different contexts: the increasingly market-oriented planned economy of Vietnam and open market Cambodia. In both countries, iDE leverages an understanding of partner and stakeholder barriers and motivations, applies continuous coaching, and uses a variety of incentives to convert learning into practical action. With an emphasis on creating sustainable, scalable change and adapting to ever-changing market conditions, to date these two programs have facilitated the sale of almost 300,000 improved latrines to rural households.
32 BACK TO CONTENTS Taking women’s ‘different’ bodily functions into account, particularly menstruation in sanitation provision C. Greed (UK)
PAPER 2601
Whilst over two billion people lack adequate toilet provision, water supply, and sanitation, women are particularly badly affected. Women have fewer facilities to start with, but more toileting needs caused by biological differences particularly menstruation, pregnancy, and menopause. For example, 50% of school girls in Africa leave school when menstruation starts because of lack of suitable school toilets. Over 50% of the world’s population is urbanized and of those, over 50% of urban dwellers live in shanty towns and unregulated settlements, most of which lack adequate sanitation provision, especially for women and girls travelling by public transport, working away from home, or going to school. Comparisons are made with the toilet situation in Western countries. Toilet provision is one of the last frontiers of gender inequality. Female toilet provision needs to be recognised as a key component of urban planning policy, in order to create sustainable, accessible and equitable cities.
Real Time Emergent Learning (RTEL): a promising approach for adaptive programming Hadjel Hakim (Switzerland)
PAPER 2733
In the WASH sector, learning is too often an afterthought in programme design and insufficient in practice. The Real Time Emergent Learning (RTEL) approach is a framework that has been used to help set up systematic learning and nurture a culture of learning collectively for rapid programmatic adaptations. RTEL is characterised by 4 principles and a focus on making learning: real-time, networked, evolving and reflexive’. When facilitated and nurtured, this approach has the potential to create the conditions for learning to emerge from practice and help inform operational and strategic decision making. So far, the shift to a real-time learning mode in two of GSF supported programmes (Kenya and Cambodia) has resulted in significant changes. The aim of this paper is to present the conceptual framework, how some of the concepts are applied in practice, the challenges, and some reflections points.
BACK TO CONTENTS 33 Integrating WASH and nutrition to reduce stunting in Cambodia: from discourse to practice G. Halcrow, S. Lala, L. Sherburne, T. Tho & M. Griffiths (Australia)
PAPER 2687
A growing body of evidence on the contribution of water, sanitation and hygiene (WASH) in improving young children’s growth in the critical “first 1,000 days” window, from pregnancy through the age of two years, means that efforts to integrate WASH and dietary improvement activities to improve nutritional outcomes are gaining momentum. Integration, while offering additional benefits of program efficiencies, cost-effectiveness and mobilization for sustained local action presents challenges of focus and scope. How programmes integrate in practice for nutritional benefit for young children is critical. In Cambodia, international cooperation through the NOURISH Project supports the Royal Government of Cambodia to accelerate efforts to reduce chronic malnutrition in children through an integrated WASH and nutrition approach. This paper discusses the conceptual framework for integration, gives practical examples of integrated activities and reflects on the challenges from a WASH practitioner’s perspective to improve WASH services within this framework at project mid- point.
Following-up on successful sanitation situations Suzanne Hanchett & Shireen Akhter (USA)
PAPER 2810
This paper summarises the findings from a ten-year follow-up study of nine unions that achieved 100 percent sanitation coverage during a 2003-2006 Bangladesh national sanitation campaign. The unions all had been studied in 2009-2010, and four of them also in 2000 and 2001. Follow-up interviews with union chairmen were done in 2015. Some of the places had experienced multiple waves of sanitation promotion programming since the early 1990s. The authors recommend follow-up research (using RRA methods) as a way to learn from experience and gain insight into the social and technical forces affecting long-term sustainability of sanitation practices. In these cases technical quality of products was important, as were several social factors, especially family division, seasonal migration, and demographic changes, such as urbanisation and crowding. The nine unions are ranked in terms of their levels of institutional and social support for sanitation improvement.
34 BACK TO CONTENTS Sustainable water pumping in refugee camps: solar PV / diesel hybrid scenarios at Nyarugusu, Tanzania B. Harkness, P. Guthrie & M. Burt (New Zealand)
PAPER 2622
Globally, refugee numbers have reached unprecedented levels, with the average length of protracted refugee situations now 26 years. UNHCR is seeking solutions for refugee water supply with low long-term operational costs and reduced environmental impact. Solar PV energy provides the ideal solution to efficiently power water pumps in remote locations with high solar irradiation. This paper describes valuable learning from a solar PV diesel hybrid water pumping system installed at Nyarugusu refugee camp in Tanzania, and analyses economic and environmental benefits. A sustainability assessment framework is developed to optimise performance, derive local future fuel price projections, and apply life-cycle environmental impact to simulated generation scenarios. Results show fuel combustion as the dominant recurring component of cost and impact, while the embedded impact of module and inverter manufacture was also significant. Hybrid scenarios provided economic, energy and CO2e emissions payback in 5 years; and a hybrid with a 20% oversized PV array provided 45% lower discounted levelised cost of electricity (LCOE) and impact than a diesel generator. The success ...... Sustainable water pumping in refugee camps: costs and benefits of over-sized solar PV systems B. Harkness, P. Guthrie & M. Burt (New Zealand)
PAPER 2623
Residents of refugee camps often face challenges to accessing efficient energy for domestic needs and livelihoods. This paper presents a case study from Nyarugusu Refugee Camp in Tanzania, where a water pumping system was powered by a solar PV / diesel hybrid system, and considers optimising energy generation and valuing surplus energy, so the surplus can be utilised to provide social benefits to residents. The results provide validation of solar energy data sources and projected PV installation costs, and show the marginal capital cost/kWh of over-sizing a solar PV system is attractive beyond 50% surplus capacity where cost/kWh levels slightly below $0.10/kWh. The proposed sustainability assessment framework includes new parameters; Gross Productive Energy (GPe) and Productive Energy Index (PeI), which provide a means of quantifying surplus energy utilisation, and examples successfully assessed included school computers, mobile handset charging, and an ‘enterprise hub’ building which could support social cohesion, knowledge transfer and income generation initiatives.
BACK TO CONTENTS 35 An innovative framework for embedding knowledge management in an organisation: a manager’s perspective K. Harries (Australia)
PAPER 2664
This paper recommends moving beyond the form of knowledge management which relies on individuals taking responsibility to learn and improve practice, to implementing a more comprehensive approach where knowledge is at the core of business, so that the sector more effectively, efficiently and sustainably meets the needs of target populations. It provides a valuable framework for managers and leaders to consistently support local action in order to improve and sustain water, sanitation and hygiene (WASH) services. Alternatively, the framework can be used by local actors to strengthen their organisations. The paper is based on experience, case studies and a literature review. The author is a WASH and Integrated Management System specialist, who has developed, implemented and reviewed successful ‘bottom-up’ management systems that focus on empowering local teams in corporate, development, and humanitarian settings.
Individual water sourcing: understanding risks and resilience to groundwater resource abstraction in Nigeria A. Healy, S. Allan, G. Bristow, S. Capstick, K. Danert, I. Goni, A. MacDonald, M. Tijani, K. Upton & L. Whitmarsh (UK)
PAPER 2690
Across much of Africa, domestic water supplies are increasingly dependent on groundwater reserves. As the cost of accessing these reserves fall, expertise becomes more widely available and incomes rise there is a rising trend towards the private commissioning of boreholes and wells. This nascent shift towards a distributed and increasingly individualised water supply may have many implications for the resilience of communities to future environmental shocks, which are, as yet, under-explored. Drawing on the case of Nigeria and new interdisciplinary research, this paper addresses this gap, through a specific focus on understanding the behaviour and choices of individuals and other key stakeholders which underpin this trend. It also seeks to understand the possible implications of this for the resilience of associated social and ecological systems.
36 BACK TO CONTENTS Selling soap and latrines in Madagascar and Djibouti: results of marketing surveys T. Heath, H. Hafany & K. Mohamed (France)
PAPER 2674
Action Contre la Faim is implementing a social marketing project in Madagascar and Djibouti. The project aims to facilitate the construction of latrines and hand washing devices with soap without the use of subsidies. This paper outlines the social marketing process used in the project and provides detail on implementation and results of its early stages. The results include information on the barriers, motivations, drivers and requested features for latrines and hand washing devices. It then summarises how these are being developed into marketable products. The paper concludes with the current lessons learnt from the project and the main recommendations.
Challenges of transboundary water management: the example of the Mekrou river basin (Benin, Burkina, Niger) J. Hedoin & M. Ouedraogo (France)
PAPER 2746
The aim of the Mekrou pilot project is to improve water resource management in the transboundary basin of the Mekrou River. Appointed to produce the baseline study, Hydroconseil witnessed the implementation of this transboundary project first-hand. Hydroconseil observed internal problems, such as confusion over definition of the study area, which is based on hydrological boundaries but also needs to consider administrative and political aspects. There were also difficulties encountered during implementation of IWRM activities for the project. The project’s institutional framework is interesting as it involves stakeholders from the global South (the executing agency, the Niger Basin Authority, etc.); however, it perhaps lacks objectivity when it comes to local political issues. Overall, it appears that such projects are not particularly cost- effective and may require an intensive soft component in order to increase trust and dialogue among stakeholders and build consensus.
BACK TO CONTENTS 37 Lessons learnt on the implementation of menstrual hygiene management in Karamoja D. Hekel, A. S. Irumba, M. Fitsum, R. Mabano & J.A. Akudago (UK)
PAPER 2757
Around 57% of Uganda girls miss school over the year due to their inability to manage menstruation (SNV and IRC, 2012). Samaritan’s Purse (SP) is implementing a comprehensive WASH project in two districts of Karamoja to improve the health of the local communities. This project includes a Menstrual Hygiene Management component which is teaching young girls and women about menstruation. Samaritan’s Purse staff are working with Days for Girl to give young girls and women the knowledge and resources to effectively manage menstruation. The research concludes that it is important to focus on practical teaching for girls and women who have low levels of literacy but to also engage with men in the discussion on MHM due to their important role in local society.
Effectiveness of community dialogue in promoting hygiene and sanitation in Afghanistan Shafiqullah Hemat, Nasratullah Rasa & Sharifullah Alemi (Afghanistan)
PAPER 2793
Poor hygiene and sanitation practices lead to increased burden of diarrhoeal diseases which is a leading cause of death among children under five years of age. According to the Afghanistan Demographic and Health Survey the under-five mortality rate is 55 deaths per 1,000 live births in Afghanistan and diarrhoea prevalence rate is 29% among children under age of five. Considering the importance of sustained hygiene and sanitation in reduction of diarrhoea, community dialogue approach was designed and implemented in six districts of three provinces in Afghanistan. This study revealed that installation of hand washing facilities, availability of soap and safe storage of water are improved 71.6, 75.3 and 41.9 percentage points respectively and entire target communities are declared open defecation free through implementation of community dialogue approach during a year.
38 BACK TO CONTENTS Lessons from WaterAid’s multi-country WASH in schools programme R. Hinds & T. Keatman (UK)
PAPER 2739
WaterAid conducted a School Water, Sanitation and Hygiene (WASH) programme funded by the H&M Foundation from 2013-16. The programme launch gave an opportunity to test the school WASH approaches and provided space for the WaterAid’s Country Programmes to innovate and integrate successes into programme design. WaterAid capitalised its experience from this programme through learning workshops and end of programme evaluation. This paper summarises the key lessons and recommendations to enhance the quality of the programme design. The key learning from the programme focusses on deepening partnership within the sector, cross-sector engagement, translating policy into practice, sustaining hygiene behaviour change, and increased capacity of government to support sustainability of the intervention. These lessons have influenced our programme design including WaterAid’s new Guidelines for Sustainable and Inclusive School WASH.
Approaches to safely manage drinking water in Port-Harcourt and Obio-Akpor in Rivers State Helen Charles Hosea (Nigeria)
PAPER 2809
Port-Harcourt and Obio-Akpor in Rivers State, south of the Niger Delta region in Nigeria with no centralised water distribution systems, hence the citizens rely on boreholes, satchet and bottled water for drinking. Lack of access to potable water has become a threat to the people’s health. A survey of the water quality was done to ascertain the quality of water consumed as well as strategies to improve drinking water quality. The storage vessels play a significant role in the management of drinking water. The most common form of storage is in buckets/drums which showed highest faecal contamination. Water treatment is mostly by boiling and filtration. To safely manage drinking water, water treatment at point of use, narrow neck or mouthed storage vessels should be in practice.
BACK TO CONTENTS 39 Community Water Plus: results from an investigation into community-managed rural water supply in India P. Hutchings & R. Franceys (UK)
PAPER 2634
This paper reports on the outcomes from the ‘Community Water Plus’ (2013-2016) project that was designed to give donors, IFIs and low-income country governments the evidence base to determine and justify the ongoing resources needed to support community rural water services. The research demonstrated that significant recurrent financing from government and other sources subsidised the costs of services in successful community management programmes in India. The Gram Panchayat, the local-self government institution, also provided on-going support and carried out everyday operation, maintenance and administrative functions. The implications of the Indian experience are that successful rural water service delivery requires such significant on-going support, including funding and the delivery of key functions, that it is better to conceive of it as a form of coproduction between state and citizens, rather than community management, and governments should allocate resources accordingly.
Faecal sludge emptying services in Trinidad S. Ifill & S. Kayaga (Trinidad &Tobago & UK)
PAPER 2813
Onsite sanitation facilities meet the sanitation needs of 2.7 billion people worldwide. In Trinidad and Tobago (T&T) 70% of the population needs are met by on-site sanitation facilities which are predominantly toilets draining to septic tanks. Using a case study methodology, a study was conducted in 2016 to explore how faecal sludge emptying services are conducted in T&T. Main findings included (i) both public and private emptying providers’ had an equal chance of being hired in Trinidad; (ii) lack of safe/adequate faecal sludge disposal facilities and frequent truck downtime were the main challenges for public FS emptying providers; and (iii) the two main factors for customer satisfaction are clean-up after the emptying operation, and ability to completely empty the tank. A vital recommendation is the need to identify and commission a sector leading organisation which will champion sanitation policies and strategies; and provide an enabling environment for other stakeholders.
40 BACK TO CONTENTS Adjusting institutional arrangements: towards improved governance of self-supply water systems in Uyo, Nigeria I. J. Ikpeh, R. Soetanto, A. Anvuur & I. Smout (UK)
PAPER 2836
Improved access to water supply in sub-Saharan Africa is increasing. However, the driver for this increase is not water supplied by water utility companies but alternative sources of supply. As the trend continues, there is need to move beyond clamour for access to address water governance in order to contribute to sustainable supply of water to water users. To scrutinise the water governance concerns, a case study of institutional arrangements in water supply in Uyo, Nigeria was assessed using interviews, documentary reviews and observations. The key findings are discussed in relation to eight institutional arrangements for water supply and are related to effect on improved water governance. This paper concludes with potential implications for self supply water systems in Uyo, all the major cities in Nigeria and in most cities in sub-Saharan Africa, and recommends areas where further research could focus.
Engagement of schools, media and healthcare professionals in improving menstrual hygiene management in Nigeria D. I. Iroegbu (Nigeria)
PAPER 2611
This paper examines how active engagement of schools, media and healthcare professionals in breaking the silent on menstruation will help improve menstrual hygiene management (MHM) among girls and young women in South- East - Nigeria. Despite the effort of some UN agencies such as Water Supply and Sanitation Collaborative Council (WSSCC), UNICEF’s WASH in school initiatives and civil society organizations such as WaterAid in developing a comprehensive approach to manage menstruation with respect and dignity, the schools, media and healthcare professional inclusion have been lacking.
BACK TO CONTENTS 41 Hybrid staffing structure: practical workforce knowledge management for restructuring a water utility S. Joel (Nigeria)
PAPER 2697
Skill challenge in the water industry varies throughout the globe and for Water Utilities in developing countries such as Port Harcourt Water Corporation (PHWC), Nigeria, the challenge of managing capacity gap, improving skill competences and knowledge base designed its Hybrid Staffing Structure Initiative. It is a unique mix of workforce combining different skills and experiences from an old water utility company (Water Board) and the Ministry of water Resource; Private sector organisations and young graduates. Along with a strategic variety of mentorship platforms of Project Management Consults, and a GWOP arrangement with sustainable utilities in Africa. This paper explores the hybrid staff structure and how it has influenced the workforce Knowledge management at PHWC.
Hygiene practice and de-worming association with nutritional status of adolescent girls in rural Bangladesh S. P. Jolly & T. R. Chowdhury (Bangladesh)
PAPER 2770
The objective of this study was to explore the underlying factors associated with nutritional status, iron deficiency anaemia among adolescent girls under the BRAC nutrition programme area to improve their existing intervention package. Multistage cluster random sampling was used to select 1620 adolescent girls from rural Bangladesh. We observed that using sanitary latrine and hand washing were associated with better nutritional status of adolescent girls while intake of de-worming tablet and being exposed to media were positively associated with higher serum haemoglobin level. Integration of WASH components into the nutrition education programme of BRAC could be helpful to achieve the programme goal for reduction of malnutrition and iron deficiency anaemia among adolescent girls.
42 BACK TO CONTENTS Lessons learnt from implementation of outcome linked community led total sanitation intervention in Busia Kenya M. Josphat & G. Kimathi (Kenya)
PAPER 2646
The financial inclusion improves health in Kenya (FINISH INK) is a public private partnership project funded by the Dutch Government implemented in Busia and Kilifi Counties of Kenya. The aim is to increase access to sustainable sanitation for rural communities through micro-credit initiatives. The project has three components namely: sanitation demand through community led total sanitation plus (CLTS+), sanitation supply side development and financial inclusion. The project has decomposed demand creation into two social marketing strategies namely; community led total sanitation (CLTS) and direct sanitation marketing all which are which linked to sanitation loaning.
In Busia, an intensive CLTS intervention was implemented based on three key innovations namely: targeted capacity building schemes; harnessing the existing local social and administrative governance structures; and development ...
Menstrual hygiene management to improve the attendance of primary school-aged girls in Central North, Burkina Faso I. Kabore/Ilboudo, L. Z. P. Nikiema, J. P. Debus & C. McIntosh (Burkina Faso)
PAPER 2637
How to improve the conditions for girls to attend school, to reduce failure and drop-out rates of adolescent girls, while ensuring their dignity and protection? This was the consideration that motivated the Kom-Yilma project, implemented by Catholic Relief Services in Burkina Faso and financed by the Leona M. and Harry B. Helmsley Charitable Trust, to undertake a behavior-change strategy for menstrual-hygiene management in 118 schools in Bam and Sanmatenga Provinces. Discussions and behavior-change communication activities, providing an appropriate space for girls and the active participation of women leaders have already demonstrated positive results for a subject generally considered taboo in the intervention zone.
BACK TO CONTENTS 43 Lessons from cholera response in Kathmandu Valley, Nepal L. K. Kansakar, T. R. Teh, A. M. Shrestha, T. Ahmad, S. S. Rana & K. L. Shakya (Nepal)
PAPER 2740
The first recorded cholera epidemic in Nepal took place in 1823, followed by a series of epidemics occurring in the Kathmandu Valley in 1831, 1843, 1856, 1862 and 1887. Kathmandu Valley still witnesses cholera and other water borne disease cases almost every year. In 2015 and 2016, cholera cases for the valley was highest with 76 and 150 confirmed cases respectively along is with huge caseload on Acute Watery Diarrhoea (AWD). WASH Situation of the Valley especially of City Centres comes with lots of challenges owing to the complexities of urban set-up and thus the city centres are the potential hotspots in context to outbreak vulnerabilities. Based on lesson learned in 2016 cholera response, this paper presents a way forward for minimizing the occurrence of cholera and AWD which includes developing a system for cholera prevention and outbreak response.
Study on sustainability of ecological sanitation: a case study of Darechowk Village Development Committee, Chitwan, Nepal P. Kattel, M. Thapa & B. Sharma (Nepal)
PAPER 2586
Eco-san is the concept to solve the sanitation related issues with multiple benefits. The objective of the research is to analyse the sustainability of eco-san toilet in Darechowk Village Development Committee (VDC). Qualitative as well as quantitative methods were adopted among the eco-san user as well as non-user group. From analysis, 84 percent of eco-san users are continuously reaping multiple benefit of eco-san toilet via utilization of fertilizer produced from eco-san toilet. From comparative analysis among sample from field with chemical fertilizer and field with urine as fertilizer, it is found that pH value of soil sample from field with chemical fertilizer is higher than that of sample from field with urine as fertilizer. Study is inclined towards the sustainability of eco-san toilet from communal ownership, their increasing willingness to install the eco-san toilet among current non-user groups, increment in agricultural productivity and soil fertility boosting financial ability.
44 BACK TO CONTENTS Institutionalising WASH capacity development in South Sudan: moving from emergency response to development M. Keega (Kenya)
PAPER 2584
South Sudan has experienced decades of civil war and gained independence in July 2011 and more recent outbreak of conflicts has been experienced in December, 2013 and July, 2016. The Water Policy (2007) has stipulated human resource development and capacity building as key issues of priority. The policy indicates the government’s intention to reverse the effects of decades of conflict and long term political and economic marginalisation in the south, where water sector strategies would be established for human resource development and training through technical collaboration with relevant institutions in other countries. WASH strategic framework (2011) was developed by Ministry of Water Resources and Irrigation (MWRI) with a rationale to attract investment, formulate priority action plans and create capacity in the WASH sector at all levels. The framework has been the basis of the transformation from ad-hoc emergency relief interventions to a holistic, government-led planning and implementation of well-targeted interventions.
Model village approach: case of Kamwenge District D. Keesiga, G. Kanweri, B. Achiro & C. Nimanya (Uganda)
PAPER 2778
A model African country is made up of model villages. Every home in a village should have all the requirements of hygiene and sanitation and also; the line community should have a water source that has all the requirements of appropriate O&M as safe water is a key complimentary element of ideal hygiene and sanitation and vice versa. This has been done through village hygiene and sanitation improvement campaigns in Kamwenge District through District and Sub County Health Inspectorate teams through the model village approach. The key elements contributing to the success of the approach are; strong engagement with the local government leaders, inclusiveness of the sanitation committees, political willingness and continuous monitoring. This has resulted in increased access to sanitation and presence and use of handwashing facilities.
BACK TO CONTENTS 45 Local level skilled WASH human resource mapping: a case from Nepal G. Khatri & K. Subedi (Nepal)
PAPER 2732
Improved WASH services are not just for dignity of people but also human rights and Nepal constitution has also endorsed it as a fundamental human right. Despite of hard hit by earthquake 2015, WASH sector in Nepal is moving ahead to achieve the national universal coverage target by 2017 and SDGs; however, sustainability and functionality of WASH facilities are not materialized as envisaged. People want to improve their ladder from basic service to improved service level in water supply and sanitation and seek support from service providers at local level. This study was conducted in 4 districts of Nepal to explore the present status of WASH skilled human resources; resulted that only 30% trained people were working professionally and there was remarkable drop out of trained people. Key reasons behind dropping out are less demand and income, financial constraints for establishing business and lack of updated knowledge and skills.
The need to have a multifaceted and mainstreamed approach to addressing menstrual hygiene management: a Kenyan case study Maria Kidney, Carol Galvin & Joan Syombua Nthusi (Kenya)
PAPER 2648
Brighter Communities Worldwide (formally known as Friends of Londiani – rebranded in January 2017) has been working with communities in Kericho County, Kenya for the past fifteen years. We began working on Menstrual Hygiene Management (MHM) in schools in 2010 when the need was identified by the community. Approximately 90% of teachers in schools were the programme has been implemented reported an improvement in girl’s school attendance and 77% of the girls involved in the programme have seen a change of attitude and understanding towards menstruation among their families and communities. Feedback from the programme has enhanced our view that MHM requires a multidimensional approach and that improved MHM will have benefits for all sectors of the community. This paper goes through our experience in the field of running one programme on MHM to mainstreaming MHM across all of Brighter Communities Worldwide’s programmes.
46 BACK TO CONTENTS Scaling up menstrual hygiene management S. Kiiza & J. Nyaketcho (Uganda)
PAPER 2657
Good menstrual hygiene is crucial for the health, education and the dignity of girls and women. The knowledge and ability of women and girls to manage their menstruation both hygienically and with dignity is fundamental to achieving gender equality. Improvements in Menstrual Hygiene Management (MHM) contribute to sustainable development goals 3, 4 and 6 specifically and are associated intricately to Water, Sanitation and Hygiene (WASH) facilities, knowledge and behaviors. The lack of information and gender friendly facilities at school, coupled with negative attitudes contributes to girls missing out on approximately 11% of school time in Uganda (IRC, 2013). Plan International Uganda utilizes multi-dimensional approach to galvanizing menstrual hygiene management focusing on private partnership to improve access to pads, income generation and improved MHM related knowledge, attitudes and practices. This paper aims to explain the project’s theory of change, implementation strategy and the ongoing evolution towards an MHM sustainable model.
After the pit is full: understanding latrine emptying in Fort Dauphin, Madagascar K. Kirsch, & R. Hammersley-Mather (USA)
PAPER 2594
Faecal sludge management (FSM) remains a challenge for developing countries, particularly in urban areas. This study investigated the barriers to pit latrine emptying in the urban commune of Fort Dauphin, Madagascar through household surveys, focus groups, and key informant interviews. On average, three households were sharing each of the latrines in the study and 20.4% of observed latrines were full. This research established that while no cultural barriers to latrine emptying appear to exist, other challenges include space, finding an emptier, and cost. The rapidity of shared latrine filling, lack of hygienic emptying services, and the absence of faecal sludge disposal or management sites will hinder public health in Fort Dauphin. Affordable access to hygienic emptying and FSM are the forthcoming challenges for sanitation projects in high-density urban communes.
BACK TO CONTENTS 47 Evaluation of pour-flush latrines and pit management in Honduras C. Kostyla (USA)
PAPER 2668
In order to meet the Sustainable Development Goals criteria for sustainable sanitation, sanitation solutions must safely separate humans from waste and include safe disposal in situ or treatment off-site of excreta. In 2016, Water Mission conducted a cross-sectional evaluation assessing the function, use, and pit management of 15,644 pour-flush latrines installed in Colón, Honduras between 2007 and 2015. Continued function of 85% of latrines and continued use of 82% demonstrated viability of the latrines, at least up until the point of pit fill. Of the 15% of pits that had filled at the time of survey, nearly 77% of households had not taken any action to enable ongoing pit functionality, likely attributable to a lack of planning. Increased education and programming on pit management and the training of a local mason are now integrated into the employed approach in efforts to improve the longer-term viability of this sanitation solution.
Achieving and sustaining open defecation free (ODF) villages: a study of four rural districts in Zimbabwe Z. Kugedera & J. T. Machikicho (Zimbabwe)
PAPER 2590
Community led total sanitation was adopted and implemented in 33 rural districts of Zimbabwe with the majority of communities failing to achieve Open Defecation Free (ODF) within the lifespan of the project. Africare initiated a study to determine the determinants of attaining ODF in four rural districts where it implemented the project. Findings will be used by government and developmental partners to achieve improved and sustained outcomes in future. Green and Kreuter`s PRECEDE MODEL was the theoretical framework used to guide the study. Expecting subsidies from the project, having and enforcing community constitutions, existence of income savings and landings (ISALs), having active sanitation action groups and community health clubs were found to be statistically significant factors associated with attainment of ODF status.
48 BACK TO CONTENTS Sustainability of ODF status of selected communities in disaster prone areas in the Eastern Part of Indonesia Muhammad Afrianto Kurniawan (Indonesia)
PAPER 2598
Community Based Total Sanitation (STBM) has successfully contributed to the acceleration of sustainable rural sanitation progress in Indonesia. The fact that many communities in Indonesia live in disaster prone areas may affect that progress. The study aimed to review the sustainability of Open Defecation Free (ODF) status of selected communities in the eastern part of Indonesia. These communities have experienced disasters during and after STBM implementation. Despite the study finding that the selected communities have not fully achieved ODF, the majority of households have proven that they could maintain their ODF behaviour even after experiencing the disasters (27 out of 30 respondents in each communities). The factors that enable sustainability of ODF behaviour, in regards to disaster resilient community, are disaster risk awareness of communities, having coping mechanism in place and the ability of the communities to build back better and reduce vulnerability.
Barriers to shared sanitation cleaning and maintenance in Kampala Slums, Uganda Japheth Kwiringira (Uganda)
PAPER 2618
While shared sanitation is the most viable sanitation option for slums, evidence shows that slum sanitation facilities are poorly used, not properly cleaned and poorly maintained. A cleaning observation was undertaken among households sharing latrines in Kampala slums over a period of six months. Results showed that non-compliance with cleaning schedules, many users, defaulting on shared cleaning commitments, abuse of user fees, dirty and unpaved surroundings, lack of water and cleaning materials; slum house owners and tenants wanting more rent and cheap housing respectively with none having interest in sustainable sanitation are key barriers in shared sanitation cleaning. Sustainable sanitation implies; affordability, improved welfare, poverty alleviation, shared values, norms, regulation and enforcement as well as improved service delivery. This paper explores barriers to effective shared latrine cleaning and maintenance in slums of Kampala city.
BACK TO CONTENTS 49 WASH governance in support of NGO work: trends and differences from field studies A. Lerebours & N. Villeminot (France)
PAPER 2677
Action Against Hunger commissioned five studies on WASH governance in the Philippines, Pakistan, Djibouti, South Sudan and Kenya in order to better inform its strategic planning and operations. Similar trends were found across the countries, such as the fragmentation of the WASH sector, the limited capacities at local level, and the lack of data or limited community engagement. Differences were also noted between legal frameworks, the maturity of national level institutions, and the inclusion of disaster risk management. This abstract provides a snapshot of the main findings and how it translated into operational recommendations for the organization. A practical manual to apply a governance lens into humanitarian and development programs was published by Action Against Hunger based on these experiences.
Integrating WASH and nutrition in market-based interventions: principles and results from the field G. Lestikow, J. MacArthur, R. Chowdhury, J. Davis & Y. Wei (USA)
PAPER 2719
This paper outlines principles for integrating market-based approaches for improving WASH and nutrition. It draws on iDE’s experience implementing such programs, and specifically highlights learnings from iDE Bangladesh’s program Profitable Opportunities for Food Security (PROOFS), implemented in partnership with ICCO Cooperation, BoP Inc., and Edukans. PROOFS leverages market forces to increase food security, nutrition, and water and sanitation for smallholder farmers and base-of-pyramid consumers. The program recently concluded a pilot in which Nutrition Sales Agents added a set of WASH products to their existing “basket” of nutrition-related goods. The paper highlights principles for leveraging markets to achieve outcomes in WASH and nutrition. Specific insights involve aligning sales cycles, managing different sales and distribution channels, and ensuring that product margins provide profit opportunity for businesses and sales agents. These principles are underscored by observations from the WASH-Nutrition pilot, the final results of which will be available for the WEDC Conference.
50 BACK TO CONTENTS Global study on sustainable service delivery models for rural water: evidence from 16 countries H. Lockwood & G. Mansour, S. Smits & S. Smets (UK & The Netherlands)
PAPER 2583
An assessment of rural water supply sustainability was commissioned by the World Bank in 16 countries utilizing five building blocks and a taxonomy of prevailing service delivery models. Results show a mixed picture in progress towards establishing optimum conditions for sustainability. Institutional capacity has advanced most markedly. Financing and monitoring score second highest, with good examples in countries such as Nicaragua and the Philippines. Consistently lower scores are found for asset management and water resource management. Community-based management is still the predominant management model, often formalized in policy, but not systematically supported or regulated. A greater differentiation of other service delivery models is found, with a trend - especially in urbanizing, middle-income countries - towards the delivery of services by utilities, private operators and/or through the aggregation of multiple rural schemes under one management entity. Dispersed rural populations continue to rely on either poorly supported community-based management or self-supply.
Survey of waste disposal and its perception among residents of Sokoto Metropolis, North-Western Nigeria Magami, I.M. & Shamaki, S.B. (Nigeria)
PAPER 2573
Sokoto metropolis is located at extreme Northern Nigeria with a population of 4,244,399 people. This survey was conducted to evaluate the pattern of waste disposal and regularity of sanitation. Waste samples from the five LGAs that makeup the metropolis was collected for analysis and questionnaire was distributed to residents around the collected waste dumpsites. Biodegradables waste dominated the categories of waste collected. There was lack of waste collecting centres in the metropolis. Majority of the residents disposed off waste at any available space or inside drainages around their houses. Respondents were also aware of diseases associated with waste disposed around their residential area. The government of the State is aware of this environmental problem and willing to take corrective measures. There is need for proper enlightenment on the efficient waste disposal and management system.
BACK TO CONTENTS 51 Formulation of water and sanitation policies and strategies: experiences from Rwanda M. Malik, M. Kayitesi, A. Muzola, E. Nuwamanya, F. Nteziyaremye, G. Musabyimana, E. Hategekimana & J. M. V. Rutaganda (Rwanda)
PAPER 2715
This paper describes the process of formulation of Rwanda’s National Water Supply and Sanitation Policies and Strategies, which were approved by the Cabinet in December 2016. The major steps in the process included conceptualisation (preparation of a concept note and work plan); constitution of a dedicated task force to oversee the process; engagement of international consultants; literature review and information collection; preparation of background papers; stakeholders’ consultations; preparation of draft polices and strategies; review and quality assurance by the sector working group and the task force; consensus building; finalisation and approval. The process spanned almost two years and cost approximately US$ 170,000, including the cost of external consultants and stakeholders’ consultations. The case of Rwanda provides valuable lessons for other countries that plan to update their national water and sanitation policies and strategies in view of changes in the context and emerging issues and to ensure alignment with the SDGs. Rural WASH programming: experiences from Rwanda M. Malik, L. Karangwa, A. Muzola, J. Sano, E. Hategekimana, F. Nteziyaremye, G. Musabyimana & J. M. V. Rutaganda (Rwanda)
PAPER 2717
Rwanda WASH Project was implemented in rural areas of four low-WASH access districts during 2009 -2015 by the Government of Rwanda with support from UNICEF and the Government of the Netherlands. This project had four key components i.e. community water supply, sanitation and hygiene promotion, institutional WASH and capacity building. The project, which benefitted over 500,000 people, resulted in increase in average access to improved water supply and sanitation in the target districts from 47 per cent to 85 per cent and from 34 per cent to 70 per cent, respectively. A project sustainability assessment carried out in 2016 showed that the infrastructure built under the project was fully functional. The experiences of the project underline the importance of establishment of effective project coordination mechanism, use of existing government structures, capacity building, strong monitoring and evaluation framework and public-private partnership for management of water supply systems.
52 BACK TO CONTENTS Self-supply solutions in Malawi Duncan Marsh & Tiyese Zumu-Mwale (UK & Malawi)
PAPER 2727
Self-supply in the WASH context refers to incremental improvement in products and services paid for by the user themselves. Self-supply plays a significant role in the supply of water to people across the globe in both developed and developing countries. For countries like Malawi, where self-supply exists in most rural communities, but is not formally recognized nor support offered to improve its efficacy, a system of supported or accelerated self-supply could offer a means to reverse low access at household level for multi-use purposes, including irrigation and significantly improve the current appalling functionality of community supplies. Studies suggest that supported or accelerated self-supply have significantly better Life Cycle Costing results than standard community managed water point schemes (Olschenski et al, 2015). Simple low cost rope and washer technology is appropriate for much of Malawi given the high levels of shallow water.
Improving the fit between development and humanitarian WASH in protracted crises Mason, N., Mosello, B., Shah, J. & Grieve, T. (UK)
PAPER 2609
The worlds of humanitarian and development WASH (water supply, sanitation and hygiene) too often operate separately, increasing the vulnerability of poor and marginalised people to disease and missed socio-economic opportunities. This is especially the case in protracted crises marked by weak governance and conflict. Research undertaken at global level and in South Sudan and the Democratic Republic of Congo identifies the challenges but also positive stories of where and how WASH service providers are overcoming the separation. While a hierarchy of perceived and real differences act as a wedge to drive the humanitarian and development communities apart, action is possible and can be led from the ground up by WASH agencies working at the operational level.
BACK TO CONTENTS 53 How to unlock the incentives to turn political will on sanitation into action N. Mason, A. Hueso & M. Matoso (UK)
PAPER 2580
More and more governments are committing to achieving universal access to sanitation, but rhetoric alone will not be enough. High-level expressions of political will need to be turned into prioritisation of sanitation, across different levels and departments in government, and into course correction systems that can identify and adapt to implementation challenges. Research, carried out by the Overseas Development Institute and commissioned by WaterAid, investigates the underlying incentives that encourage these processes, drawing on case studies in India (Chhattisgarh State), Ethiopia and Indonesia. We find that organisations championing sanitation can tap into personal values as well as career aspirations and ambitions, to get different levels of government to prioritise sanitation. To enable timely course correction, it is important to build a culture of learning and trust, which means investing in reliable verification, enabling informal information sharing, and securing participation of people with power to make and follow up on decisions.
Understanding vulnerabilities and risk in the development of market based approaches L. Medland, J. Fullwood-Thomas & C. Brady (UK)
PAPER 2644
Progress towards resilient and sustainable development is continuous and constantly shifting as circumstances, contextual experiences and systems change. In many countries there are humanitarian and development activities taking place at the same time, yet our approaches within these areas can still be quite separated in terms of planning, implementation and monitoring. Yet traditionally quite different populations benefit from humanitarian and development interventions. Interest in the role of markets in both humanitarian and development contexts continues to grow based on the understanding that markets need to work for marginalised and vulnerable populations. Vulnerability will have an impact on the way that people can interact with market systems and trying to understand markets in relation to both personal vulnerabilities and vulnerable and fragile contexts requires a new approach, linking humanitarian and development actions more systematically.
54 BACK TO CONTENTS Membrane filtration reduces recontamination risk in chlorinated household water containers R. Meierhofer, P. Rubli, K. Dreyer, H. Ouma, K. Wanyama & M. Peter-Varbanets (Switzerland & Uganda)
PAPER 2595
The study was conducted in the catchment area of two Gravity Driven Membrane Filtration (GDM) water kiosks in Uganda. It assessed if the cleaning and disinfection of jerrycans with chlorine can reduce risks for regrowth and recontamination of treated water during storage in undisturbed containers, as well as at the household level. In addition, the impact of water handling, household hygiene and safe storage determinants on water quality was evaluated. Results indicate that the cleanliness of the water storage container has a critical impact on water quality changes during storage. Safe drinking water at the point of consumption after 24 hours of storage at the household level can be achieved with a combination of ultrafiltration and subsequent chlorination.
Making WASH monitoring and evaluation work for everyone: the experience of the DRC WASH Consortium G. Melloni & S. Jones (Italy / DRC)
PAPER 2607
The DRC WASH Consortium, comprised of five international NGOs led by Concern Worldwide, has been active in DRC since 2013 with a rural WASH programme reaching nearly 750,000 people. One of the Consortium’s key goals is complementarity with DRC’s national rural WASH programme, therefore harmonising the Consortium’s monitoring & evaluation framework with the national programme’s standards has been a strategic requirement. In addition, the Consortium needs to comply with its donor’s global WASH indicators (UKaid) and to measure the success of its own programme approach according to key indicators. The process of defining those multiple sets of requirements and of integrating them in a consistent whole has resulted in a multidimensional monitoring & evaluation framework. This paper describes this process and highlights the challenges and potential of monitoring WASH in similar contexts.
BACK TO CONTENTS 55 Matrix of strategies for achievement and sustaining open defecation free (ODF) communities in rural settings P. B. Mirirayi (Zimbabwe)
PAPER 2815
The paper documents implementation experiences of the Rural WASH Project in one (Matabeleland South) of the 5 Provinces of Zimbabwe .The project was supported by DFID-UK and SDC for the period 2012-2016.Unicef was the fund manager with various NGOs engaged as implementing partners. The paper concentrates on one of the thematic areas of the project - demand led sanitation- which adopted the community led total sanitation approach to some extent. Communities were expected to achieve and sustain Open defecation free (ODF) villages. Data was collected during monitoring visits to the implementing villages over a period of 4 years. There was notable variation on the rate of achievement of ODF amongst the villages in the Province. The major point of note was that in as much as hygiene promotion is the key for achievement of ODF status, adoption of various innovative strategies chosen mostly at community level with relevant support makes the process a success.
Impact of persistent drought in the community and coping mechanisms: a case of Bulilima district, Zimbabwe P. B. Mirirayi (Zimbabwe)
PAPER 2841
Climate change induced droughts are causing persistent droughts in Zimbabwe, something which was not common years back. Reviewed literature agree that most studies dwell on the impact of droughts associated with water and food shortages in a generalised manner without going deeper into other hidden aspects of life. The full spectrum of drought effects and coping mechanisms not fully documented in Zimbabwe. A qualitative study was conducted in October 2016 in a randomly selected village in Bulilima district. Data was collected through focus group discussions and interviews with community members, health centre staff and school health personnel. The researcher found that the drought was having negative effects on health, WASH, education, livelihoods and general social lifestyle. The study concluded that communities were failing to cope with drought and there are no drought mitigation strategies. There is need to develop drought risk management plans to respond to future drought.
56 BACK TO CONTENTS Rapid action towards ODF in Saharanpur District in India: stunting, menstruation and other innovations in CLTS Vinod K Mishra & Amarjeet Singh (India)
PAPER 2652
In 2016, the Ministry of Drinking Water and Sanitation(MDWS), Government of India (GoI) empanelled competent organizations and individuals to offer on-demand capacity building support and guidance on community wide approaches for sanitation to different districts and states in India. The Water Supply & Sanitation Collaborative Council (WSSCC) is an UN agency and as an empanelled organization for training works closely with the district of Saharanpur towards making it an ODF district. Constantly looking for innovative ways to influence behaviour change, WSSCC deployed new tools of stunting and menstruation to galvanize communities to make Saharanpur an open defecation free district of Uttar Pradesh. It showed startling success in the district within few months without using cash incentive to propel behaviour change. This paper outlines the new methods and tools adopted for community wide approaches, its challenges and outcomes.
Key challenges of marginalised communities on sanitation and hygiene and recommendations to clean India Vinod Kumar Mishra (India)
PAPER 2615
The Ministry of Drinking Water and Sanitation, Government of India recognizes that equity and inclusion are key to ensuring that everyone’s sanitation needs are met and that no one is left behind. A priority concern of the SBM guidelines is providing access to different categories of people who are not able to use safe sanitation facilities. The guidelines mention the need to take safety and dignity issues into account and provide facilities that are sensitive to the needs of people with disabilities. It also recognizes the specific needs of women and adolescent girls, such as menstrual hygiene management, and allocates resources for awareness and disposal of menstrual hygiene waste. These guidelines are now in the process of being operationalized and rolled out in practice. This paper discusses key challenges and issues of marginalised communities in India regarding sanitation and hygiene and recommendations under Swachh Bharat Mission.
BACK TO CONTENTS 57 Low-cost biomass as novel adsorbents for the removal of heavy metal ions from industrial wastewater used for crop irrigation in developing countries A. S. Mohammed, A. D. Wheatley, G. C. Sander, E. Danso-Boateng, E. Nyktari & I.C. Usen (Nigeria)
PAPER 2796
Freshwater scarcity has prompted farmers in developing countries to rely on wastewater for agriculture. However, the concentrations of heavy metals in the wastewaters are found to be above the WHO/FAO recommended thresholds. This inherently presents concern particularly as it relates human health. Although, several conventional wastewater treatment technologies exist; their applications are limited by high procurement, operation and maintenance costs. Currently, studies on biomass wastes as low cost adsorbents are gaining momentum. In this study, coco-peat was considered for heavy metals removal. In this context, batch experiments were carried out in triplicates at 3 different contact times and pH. After 2hr of contact time at pH9, the coco-peat was proven to have Cr removal efficiency of 91.6% against 73.2% using an activated bone char; and 95.0% for Pb(II) against 91.2% for the bone char. This suggests that ...
Practices and effects of menstrual hygiene management in rural Bangladesh B. K. Mondal, M. K. Ali, T. Dewan & T. Tasnim (Bangladesh)
PAPER 2578
This study explored the existing practices on menstrual hygiene management of the girls and women in rural Bangladesh. It has also depicted the associated effects against existing practices linking with school attendance, performance, affordability of menstrual products etc. The results of the study are retrieved using both quantitative and qualitative research methods i.e. questionnaire survey, focus group discussion, key informant interviews etc. Study revalued that 91% school girls use old unhygienic cloths while 9% use improved products. Above 90% girls dispose pads un-hygienically which is not environment friendly. Among the girls, 48% miss 3 or more days causing bad performance on their results. And, 86% girls reported that improved menstrual items are not affordable for them. Improper menstrual management is identified a barrier of women empowerment. For a way forward, integrating menstrual hygiene management interventions with relevant development programmes are recommended to improve the exiting state.
58 BACK TO CONTENTS The outcomes of community-based water, sanitation and hygiene interventions: a case of Bangladesh B. K. Mondal (Bangladesh)
PAPER 2576
The study explores the outcomes of integrated water, sanitation and hygiene interventions, implemented under community-based development initiative program at 8 communities in Magura, Kustia, Nator and Nilphamary districts of Bangladesh. Installing and implementing appropriate interventions, hygiene behaviours and practices were improved significantly among the communities. The coverage of using improved latrine reached 100% in 2012 as compared to 67% in 2010. Open defecation rate declined at zero. Diarrheal and vector-borne diseases reduced by 48% in 15 rural villages through adopting good practices i.e. avoiding open defecation, using improved latrines, washing hand with soap before taking meal and after using toilet etc. Such results were achieved by the active engagement and participation of change agents and community people in planning, implementation and monitoring stages. The integrated approach with other components like disaster risk reduction, health, education and livelihood in the program triggered to achieve such results.
Strengthening the enabling environment to accelerate rural sanitation in last mile territories: a case of Bihar, India Pravin More & Ashish Kumar (India)
PAPER 2786
Between 1990 & 2015, India registered 31% reduction in open defecation, significantly influencing the global and regional estimates. However, India still has the highest global share of the population practising open defecation. Within India, the open defecation prevalence varies widely across territories. States like Kerala and Sikkim have declared themselves open defecation free, whereas Bihar, Jharkhand, Madhya Pradesh, Odisha & Uttar Pradesh (UP) continue to lag behind with more than 70% population still practising open defecation. Until these last mile territories gear up, the national and global sanitation goals will remain unfulfilled. This paper analyses the role of enabling environment to accelerate rural sanitation in one of the low performing states - Bihar, by addressing policy, implementation and supply side bottlenecks. The paper also presents the recommendations for rapid scale-up based on the acquired insights.
BACK TO CONTENTS 59 Menstrual hygiene management compliance in primary schools in Uganda: a case of Lira Municipality Martin Mujjabi Mukasa & Alex Ojuka Jalameso (Uganda)
PAPER 2761
The main objective of the study was to determine the influence of Menstrual Hygiene Management on school absenteeism of adolescent girls in 10 primary schools in Lira municipality. Our findings highlighted that; majority of the rrespondent’s onset of the menstruation was at 13 years of age, 60% of the participants used disposable pads. Most respondents changed their pads at least twice a day.Two-fifth of the primary girls reported missing school for about 3 days during menstrual periods pointing to the lack of menstrual hygiene products. However, presence of senior women teachers was found to increase the number of girls attending school during their menstruation periods.
WASH 5 Star approach: addressing hygiene behaviour in schools of rural Bangladesh Mukherjee S, & Alam M (Bangladesh)
PAPER 2630
Every child has basic rights to safe drinking water, sanitation and hygiene (WASH). School are essential institutions to children’s welfare, and a place where lifelong behaviours are inculcated.. The National Hygiene Baseline Survey [1] and recent WASH bottleneck analysis of Bangladesh [2] reflected the worrying state of hygiene behaviour in schools. WaterAid Bangladesh has developed an approach called ‘WASH 5 Star’ based on the five behavioural domains articulated in the National Hygiene Promotion Strategy (NHPS) 2012 in Bangladesh [3] to raise awareness at the individual, household and institutional level on proper hygiene practices . The WASH 5 Star approach was introduced in 2500 schools in rural Bangladesh and yielded encouraging results within a short span of time. This approach can to be introduced at a large scale to achieve wider health benefits.
60 BACK TO CONTENTS Sustaining open defecation free status: the vital role of validation exercise K. Nadar, F. Khan & S. Otusanya (Nigeria)
PAPER 2597
UNICEF-Nigeria in collaboration with the Federal Ministry of Water Resources (FMWR) and key stakeholders is implementing Community-Led Total sanitation (CLTS) to accelerate sanitation coverage in rural areas with good success. Over 8,400 communities have been certified Open Defecation Free (ODF) across 21 States. Sustaining ODF status has never been so important to consolidate the initial success and moving up the sanitation ladder. 10% of randomly selected ODF certified communities are considered for the validation exercise. This exercise has reduced ODF relapse rates from 44% in 2014 to 11% in 2016. This has further improved the quality of CLTS facilitation and an increase in improved latrines. The resources spent on the validation exercise (US$ 6.4 per community) is much less than the funds (US$ 197) required to get the relapsed communities back to ODF.
Asset creation versus sustaining services: institutionalizing VLOM to deliver SDG-6.1 target in Nigeria K. Nadar, F. Khan, M. Niang & G. Mahato (Nigeria)
PAPER 2834
Despite investments in water supply infrastructure, functionality remains low owing to a variety of factors including poor Operation & Maintenance regime and low community ownership. To overcome these challenges, a robust Village Level Operation and Maintenance (VLOM) approach was piloted. The approach is institutionalized within the State Rural Water Supply and Sanitation Agencies (RUWASSAs) by shifting agencies’ focus from mere asset creation towards sustained service delivery. The VLOM units established in the twelve RUWASSAs work with trained local area mechanics (LAMs), parts dealers and community caretakers towards ensuring 100% functionality of schemes. The LAMs charge communities for their services against agreed rates. This is linked to the Facility Tracking System resulting in 11% increase in functionality since inception of the pilot project. Once scaled up and sustained, this approach will optimize investments needed to achieve WASH SDG-6.1 target in Nigeria.
BACK TO CONTENTS 61 Barefooted community consultants: an efficient way to deliver SDG-6.2 target in Nigeria K. Nadar, F. Khan, B. Ogunjobi & S. Otusanya (Nigeria)
PAPER 2750
Sanitation, Hygiene & Water in Nigeria (SHAWN) is a UNICEF/UKAid assisted project aimed at achieving 11,600 Open Defecation Free (ODF) communities in six states of Nigeria by 2018. The delivery of an ODF communities through local governments costs $190per community requiring a minimum of five follow up visits by the staff over 3-6 months. This was the experience prior to the engagement of “barefooted Community consultants” for delivering ODF communities. Under a pilot, formal contracts were signed with community “consultants” for delivering ODF communities in return for fixed payment. Consultant is paid $32 per ODF community after certification. At present 65 communities have been delivered in 14 LGAs of Katsina & Bauchi States reducing the average cost of ODF village by $158 per community. The approach is effective, demonstrates a very good value for money and should be adopted for achieving ODF Nigeria by 2025 Roadmap targets.
Integrating value for money principles in WASH for affordable and sustainable WASH services in Nigeria Kannan Nadar & Xuechen Bao (Nigeria)
PAPER 2651
Value for Money (VfM) is a way of thinking and working aimed at achieving cost savings, improved efficiency of services, sustainability and equity of the WASH services delivered. Under the UKAid funded SHAWN-II project in 6 states, UNICEF has embedded the VfM approach in the implementation of WASH interventions. This includes activity-based cost management, harmonized procurement process, revised protocol for Open Defecation Free (ODF) certification, and real-time monitoring of WASH Information Management System (WASHIMS). WASH program has demonstrated good VfM across the four dimensions—Economy, Efficiency, Effectiveness and Equity. The plan is to scale up this VfM framework to 20 states. Given the huge costs for attaining SDG-6.1 and 6.2 targets, VfM will play an important role in maximizing the value of every US dollar invested in the WASH sector.
62 BACK TO CONTENTS Smart-phone drives performance and enhances WASH services delivery in communities in Nigeria K. Nadar & R. Nwozor (Nigeria)
PAPER 2650
The deployment of mobile technology has helped to transform data/evidence gathering in programme management and tracking results under the “Federal Government of Nigeria – UNICEF” Water, Sanitation & Hygiene (WASH) programme in Nigeria. UNICEF has demonstrated the use of smartphone-based real-time reporting to incite improved programme performance management and accountability. Smart-reporting involved Local Government Area (LGA) level coordinated planning, implementation, monitoring and reporting of results by field facilitators using mobile-app supported templates and online tools. This system, within the short time has improved the quality of planning and target setting; fostered greater accountability amongst team members; improved performance of staff and effective use of financial resources and other logistics and demonstrated greater attainment of results. The results so far clearly demonstrate the viability of the Smart-reporting system to improve accountability, advance the management and delivery of WASH programme results with potential for wider scale-up across the country.
Water and sanitation competitions: an effective approach for promoting sustainable WASH services in schools and communities T. Namata & H. Mukasa (Uganda)
PAPER 2572
Whilst several approaches have been undertaken to improve water, sanitation and hygiene (WASH) services, very little work has been carried out and documented on water and sanitation competitions. The use of WASH competitions is one of the effective and low cost approaches to improving WASH services both in schools and surrounding communities. This paper is based on practical experience from the recently conducted WASH competition in 52 targeted schools in Gulu, Kitgum, Lamwo and Pader of Northern Uganda.
BACK TO CONTENTS 63 How to achieve improved WASH services’ sustainability D. W. Namiiro (Uganda)
PAPER 2629
WASH stands for “Water, Sanitation and Hygiene”. In developing countries WASH services (Safe water, proper hygiene education and adequate sanitation) have proved to be a key public health issue and that’s why many funding organizations such as Water Aid have identified WASH as an area with significant potential to achieve a strong positive impact on public health. Due to lack of access to safe clean drinking water, approximately 2,300 people die every day from diarrhea and this prevents students from attending school which has a negative effect on child development and decline in performance. Improvement in WASH reduction of diseases associated with drinking dirty unsafe water, and improving the hygiene/sanitation environment of the communities.
Connecting the disconnected: a unique public-private- people-partnership (PPPP) sanitation model in Delhi, India M. Naved (India)
PAPER 2665
Delhi is a home to around 2 million people living in 675 unauthorised settlements. These settlements have no or inadequate access to sustainable water & sanitation services due to lack of tenure rights and space crunch. For sanitation needs people have to depend on poorly managed & unsafe community toilet complexes or resorting to open defecation. The Safeda Basti pilot project attempts to demonstrate that synergy in the approach and work of the government, community, non-profit and private financial institutions can lead to a sustainable sanitation solution even for the poor living in unauthorised urban slums. This project demonstrates a unique Public- Private-People Partnership (PPPP) model in sanitation, wherein community participation was intrinsic throughout the project life cycle, resulting into a complete and sustainable sanitation to the targeted marginalized community.
64 BACK TO CONTENTS A tool for assessment of school WASH facilities Vishal Nayak (India)
PAPER 2768
Schools are among the most important place where adequate and safe WASH facilities can improve percentage of girl child higher education. Indian constitutions and Right to Education Act given it as fundamental rights of every child in India. The paper is based on the School WASH assessment study conducted in Madhya Pradesh state in India. This paper will give key findings, which indicates that 399 (55%) toilet units are not in use and attached urinals are not available in 89 (12%) toilet units. Out of available urinals, 258 are not functional. The availability of water for users after using toilets in an issue of concern. About 487 (76%) toilet units did not have any arrangement of water for sanitation. In fact drinking water facilities was also not functional in every school.
A tool for improving people’s voices: Citizen Report Card on sanitation programme Nayak Vishal & Gupta Anurag (India)
PAPER 2762
Feedback of community is one of the most important tools for tracking the impact of various programmes being implemented and highlighting the gaps in implementation. The paper is based on the learnings of the Citizen Report Card (CRC), which is a tool to get the feedbacks from the citizens regarding implementation of flagship programme of Government of India, Swacch Bharat Mission (Clean India Mission), in the state of Chhattisgarh. A network of civil society organisations called “Chhattisgarh Citizen WASH Forum has carried out two rounds of CRC.
The paper analyses feedbacks of the citizen on awareness, access, quality, usage, technical aspect of sanitation facilities and their level of satisfaction. Paper also highlights key process of CRC and the use of mWater- android based mobile application for data collection.
BACK TO CONTENTS 65 Towards effective implementation of community-based water safety plans: stakeholders engagement process in Afghanistan S. K. Ngilambi & C. N. McCubbin (Afghanistan / UK)
PAPER 2795
The Rural Water Supply, Sanitation & Irrigation Programme (Ru-WatSIP) intends to implement a simplified community-based Water Safety Plan (WSP) approach in the rural water supply programme in Afghanistan. Such an approach is new to Afghanistan and faces some unique challenges. Alhough the main challenges reside in obtaining a common understanding on a simplified community-based WSP concept and agree on a minimum package of activities under the rural water supply program, there are other underlying factors such as the structure of community leadership and stakeholder participation which has hampered the process since its inception.
A less expensive toilet: the impact of targeted subsidies on latrine purchases in Cambodia C. Nicoletti, R. Macaranas, G. Lestikow & D. Hudner (USA)
PAPER 2658 iDE’s sanitation marketing efforts in Cambodia have resulted in over 250,000 sales of improved pour-flush latrines. Despite the overall efficacy of this approach, iDE recognizes that market actors are not necessarily incentivized to reach the poorest segments of the market. iDE and Causal Design utilized a randomized controlled trial, in which poor households in treatment villages were offered partial subsidies, financing and cash-only options, while control-village households were offered only financing or cash-only purchase options, to test which financing mechanism leads to the greatest coverage change among poor households, while having the least distortionary effect on the market. The study finds uptake rates among poor households increased by 14-16 percent compared to the control group, while there was no significant effect on non-poor households. This study provides compelling evidence for the impact, as well as increased cost-effectiveness, of well-targeted subsidies on latrine uptake among lower-income households in a market-based approach.
66 BACK TO CONTENTS Community engagement - a paradigm shift to WASH programming in emergencies Eva Niederberger (UK)
PAPER 2771
Community Participation is the backbone of Oxfam’s approach to public health and one of its core strengths when responding to diseases outbreaks. The Ebola crisis in West Africa however revealed that public health programming is often adopting instructive approaches rather than building on the local expertise of affected communities. Oxfam’s public health promotion team therefore revised current approaches to community mobilisation in WASH which prompted a paradigm shift towards greater community engagement. This paper provides an overview of the learning, adopted approach, and how this has shaped Oxfam’s overall public health promotion strategy.
Performance of community health clubs in transforming sanitation and hygiene conditions A. Ntakarutimana & N. Ekane (Rwanda)
PAPER 2798
A case - control study was conducted in Rwanda on the performance of the Community Health Club (CHC) approach in transforming household sanitation and hygiene conditions. We selected two villages from a rural setting (Rusizi) and two villages from peri urban setting (Kicukiro). In both settings, we had one intervention village (case) with CHC approach as exposure, and one control village with no CHC approach exposure. We conducted household surveys in 798 households (95%) with spot observations. Focus group discussions and interviews with village members, local leaders, sanitation professionals and opinion leaders were conducted too in both settings 3 years after CHC implementation (2015). The baseline data on sanitation and hygiene collected from local offices (2012) helped to assess the contribution of the approach. The results show that CHC approach implementation is associated with households’ sanitation and hygiene practices improvement 3 years after the intervention in Kicukiro and Rusizi districts.
BACK TO CONTENTS 67 Investigating the relationship of rainwater harvesting tank technology and safe water coverage in Uganda: a case study of Mbarara District A. Odongo (Uganda)
PAPER 2737
Countries worldwide have recently improved water and sanitation facilities in their rural communities to achieve the Sustainable Development Goal. However the assessement of population served by rain water harvesting tank technology have not been considering months of dry spell where the technology were not in use, this have been a challenge to estimating safe water coverage in Uganda leading to inaccurate safe water coverage estimation. All the dry months were identified, a formula derived incorperating the dry months and a model developed to improve safe water coverage estimation. The case study was done in Mbarara District where rain water harvesting tanks technology was studied to adequately assess their reliability to users. This method is better than the current one because all the months of dry spell were considered and the result reflected logical safe water coverage value.
Locally responsive intervention to improve municipal solid waste collection coverage in Accra, Ghana K. Oduro-Appiah, A. Scheinberg, A. Mensah, V. Kotey, A. Afful & N. de Vries (Ghana)
PAPER 2713
The paper reports on a process that engaged stakeholders to assess the strengths and weaknesses of the city of Accra’s approach to raising solid waste collection coverage. Stakeholders, working with researchers, have made the evaluation using a combination of benchmark indicators, analysis of franchise agreements, process flow diagramming of collection trends, and statistical analysis of user answers to a survey. Informal services are growing while formal services are shrinking. A logistic regression model suggests that regular collection and affordable user charges significantly increases the levels of user satisfaction. The use of a participatory approach has led to an unusual alliance: formal service providers have agreed to work with informal providers as subcontractors and support them to formalize and increase collection coverage. The positive experience of participation leads the authors to advocate institutionalizing the use of a participatory approach through stakeholder platforms to evaluate interventions and develop plans for service improvement.
68 BACK TO CONTENTS Scaling-up sanitation and hygiene promotion through grant-making Ouma Vincent & Muhuri Jackson (Kenya)
PAPER 2752
Kenya losses USD 324 million per year due to poor sanitation (World Bank, 2012), and 19,500 Kenyans, including 17,100 children under 5 die each year due to diarrhoea. This paper aims to demonstrate how the Kenya Sanitation and Hygiene Improvement Programme (K-SHIP) is scaling up Sanitation & Hygiene promotion through grant-making while contributing to the country’s target of being Open Defecation Free (ODF) by the year 2020. KSHIP is funded by Water Supply & Sanitation Collaborative Council (WSSCC) through Global Sanitation Fund (GSF) and implemented by Amref Health Africa in Kenya. In 2016, K-SHIP competitively contracted 17 sub-grantees(SGs) who implemented sanitation and hygiene activities in 11 counties reaching over 235,663 people with S&H services. The capacity of the SGs was built and the model can be used as an advocacy tool for resource mobilization. 149 villages have been certified ODF which is associated with reduced sanitation related morbidity.
WASH financing – the missing link: initial lessons from Sinapi Aba’s pilot in Ghana J. Owusu-Dabo (Ghana)
PAPER 2688
Sinapi Aba Trust WASH programme seeks to enhance livelihood of the poor through the provision of WASH loans to fill the gap of non-existence or limited access to WASH financing to the poor. A market study conducted in 2016 revealed the existence of demand for improved WASH facilities among the poor. But they are faced with the challenge of raising the required upfront payment for WASH investments. It was also found that the poor are already paying 10 to 20 times what the rich pay; therefore they could pay off a loan over time. Hence, Sinapi Aba with technical and financial support from Water.org and Opportunity International-UK developed loan products to provide WASH financial services to the poor. From August 2016 to February 2017 we have disbursed 76 WASH loans at USD197,666. One important lesson learnt is education for behavioural change and affordable loan capital is key to success.
BACK TO CONTENTS 69 The influence of real time learning in WASH programming A. Padilla & J. Dumpert (Cambodia)
PAPER 2681
In an effort to improve programme outcomes, particularly in ensuring sanitation for all, the Cambodia Rural Sanitation and Hygiene Improvement Programme (CRSHIP) has introduced tools to strengthen the programme’s ability to adjust interventions to the specific local conditions, priorities, and opportunities. In 2016, CRSHIP introduced Real Time Learning (RTL), providing an opportunity for continuous reflection and learning leading to context adaptive programming. Using RTL, programme partners are able to report on activities, invite feedback and request support, or offer insight reflecting their experiences. RTL is still an emerging practice with some challenges in implementation, including introducing adaptations throughout institutional arrangements, and limited quantitative findings to date, however current empirical evidence suggests it may carry significant potential to enhance knowledge management, quality of implementation, support inclusive and equitable programming, and expand the breadth and impact of programme works.
Host and refugee population cooperation: case of Dumse water supply and sanitation project, Damak-5, Nepal Prabesh Paudyal & Murray Burt (Nepal)
PAPER 2695
UNHCR promotes the use of technology and solutions with low long term operational cost and in line with the Sustainable Development Goals. UNHCR advocates for refugees’ access to local services, and mainstreaming the management of refugee WASH services into local structures. In Nepal, Bhutanese refugees have been hosted in settlements in the forest areas of Jhapa and Morang for more than 24 years. In the past, water was provided from boreholes equipped with electric pumps powered by diesel generators. The cost of operating the diesel generators was high and unsustainable without ongoing support from UNHCR. This paper presents a ‘best practice’ case study describing the development of a new sustainable, low cost gravity flow water system, shared by refugees and host community, and mainstreamed into local structures.
70 BACK TO CONTENTS Seawater desalination transforming the Gaza Strip Mohanlal Peiris, Gregor von Medeazza & Zaidan AbuZuhry (State of Palestine)
PAPER 2671
There are no easy conventional solution to Gaza’s chronic water crisis and impending environmental catastrophe. Seawater desalination is one of the key transformative interventions strategically considered to address both these issues. UNICEF, with European Union funding, therefore initiated the implementation of a seawater desalination programme in late 2012. The first phase of the seawater desalination plant producing 6,000 m3/d, is the largest to be completed in Gaza and is to be extended to produce 20,000 m3/d to ultimately serve a population of 250,000 people. Seawater desalination remaining an energy intensive process, focus has been on identifying innovative means of generating and conserving energy to tackle the energy-water nexus, given the limited availability of electricity within Gaza. Advance renewable energy and energy recovery technologies have been incorporated to maximise the plant’s viability. Such transformative technologies is essential to ensure that Gaza remains a liveable place in the years to come.
Simplified sampling method for household-based surveys with reduced populations in the water and sanitation sector A. Pérez-Foguet & R. Giné-Garriga (Spain)
PAPER 2640
In order to make decisions efficiently and equitably, up-to-date information is required. In developing countries, with limited resources, such information should be provided by means of cost-effective methodologies, in which sampling issues are of primary importance. Different sampling strategies are currently in use. At local level with reduced populations, standard approaches prove expensive and time consuming. In this paper, we opt for simple linear piecewise approximations to calculate the sample size in terms of given precision, confidence level and population size. To support the applicability of the proposed approach by practitioners in the field, easy-to-use tables are elaborated. In terms of sampling, easy-to-follow practical guidelines for household selection and transect walk planning are also provided. The article presents six rural communities in Honduras as initial case study to illustrate the validity and applicability of the approach adopted herein for sampling design and sample size determination.
BACK TO CONTENTS 71 Evaluating novel gravity-driven membrane (GDM) water kiosks in schools M. Peter-Varbanets, K. Dreyer, N. McFadden, H. Ouma, K. Wanyama, C. Etenu & R. Meierhofer (Switzerland)
PAPER 2735
This paper presents results of the field evaluation of three gravity driven membrane (GDM) water kiosks purifying Victoria lake water in schools in Uganda. The study evaluated the technical performance of the systems and the feasibility of the operation and maintenance concepts over two years of operation, as well as the financial viability of the business model and management concept and overall system sustainability. The results show that GDM water kiosks are a simple technology capable of treating turbid surface water and can autonomously supply good quality water to schools and communities. They require little maintenance, are simple to operate and maintain, and with trained local O&M team support, they offer sustainability of operation in remote low-income areas. The business and management model evaluation has not yet been completed and is ongoing.
Sanitation marketing in rural Zambia, a replicable business model J. Pinfold, A. Mungamelo, J. Ng’ambi & J. Anscombe (UK)
PAPER 2766
This paper describes a successful sanitation marketing project implemented by Government of Zambia and UNICEF that is part of a larger sanitation programme in rural Zambia. The aim of the sanitation marketing component is to build the capacity of the private sector, such as individual artisans, to provide sanitation services that fulfil a need for stronger, longer lasting toilets at affordable prices, particularly in areas with sandy/waterlogged soils. Innovation has centered on developing substructure designs that use locally available materials keeping the costs as low as possible in order to reach a larger market segment. Introduction of large heavy mass produced products is often limited due to high transport costs for sparsely populated rural areas. At time of writing 291 “entrepreneurs” have been trained and around half have been confirmed active achieving over 1,300 sales to households and institution.
72 BACK TO CONTENTS Groundwater faecal contamination in Kalpitiya Peninsula of Sri Lanka Ranjana Piyadasa & Sonali D. Herath (UK & Sri Lanka)
PAPER 2589
Ground water table of Coastal dry zone areas in Sri Lanka is exposed to fecal contamination due to the typically used human excreta disposal method of pit – latrines. Though there available standards and commonly accepted factors regulating the construction of shallow wells in the proximity of pit latrines, fecal contamination continuously been a burden to the dry zone coastal areas. This research consider ‘depth of the water table’, ‘gap of infiltration layer’, ‘depth of the latrine pit’ and ‘the distance between dug well and latrine pit’ on preventing ground water fecal contamination, taking Kalpitiya Peninsula of Sri Lanka as the case study. On the derived results the paper concludes that the considered commonly accepted factors are not the determining factors of fecal contamination in coastal land strips alike the case study area. The results suggest more attention on site specific reasons on developing standards to prevent ground water fecal contamination.
Impact of community-led total sanitation on women’s health in urban slums of Kalyani Municipality Preetha Prabhakaran, Kamal Kar & Lyla Mehta (India)
PAPER 2756
This paper documents the impact of Community led Total Sanitation (CLTS) on women’s health in urban slums of Kalyani Municipality the first open defecation free (ODF) town in India. Women’s health was viewed not only in terms of their physical health status but also their social and psychological well-being. The study also looked at how the process had empowered women and the role of the external environment in stimulating and supporting the change process. The study findings indicate that improved sanitation reduced the disease burden on women and their families, increased their safety and enhanced their social status. It was found that women played a lead role in initiating and driving sanitation and hygiene behaviour change in their communities, placing them in leadership roles and involving them in the decision- making process. This enabled woman to exercise agency in achieving gains beyond sanitation to improve their lives.
BACK TO CONTENTS 73 Research alternatives for the knowledge gap C. Print & I. Smout (UK)
PAPER 2765
The world may be headed for a perfect storm in the coming years that will stretch human ability to manage the combined pressures of population, climate change and unsustainable economic growth. Despite global progress in WASH significant poverty traps are likely to remain and may worsen in the mega-cities and rural remote areas. Least income Fragile and Conflict Affected States in Africa currently remain the areas of most concern. They exhibit the weakest service delivery pathways but are typically highly complex and challenging operational environments. Lack of hard data inhibits research in this area, which can result in major challenges for WASH programming. This paper presents analysis, reviews probabilistic methods for engineering, and presents a paradigmatic framework for research and knowledge generation, demonstrating that methods and tools exist to underpin judgments and decisions under uncertainty.
Towards decentralized biogas generation: building community scale biogas reactor T. Radu, V. Smedley & R. Blanchard (UK)
PAPER 2817
This paper describes effort on the newly funded British Council project “Community Scale, decentralised Anaerobic Digestion for energy and resource recovery”. The aim of the project is to establish a network of small, community scale digesters both in Thailand and UK, for decentralised biogas generation from locally available wastes. We are especially focusing on food waste. The pilot digesters are paired with instruments for remote autonomous monitoring of biogas quality and conditions within the reactor (pressure, humidity). The data from networked reactors are collected on a single web portal, enabling remote monitoring. This reduces the need for trained personnel to be present at all times at each site. Reactor design is also described and the potential benefits and challenges are discussed.
74 BACK TO CONTENTS Linking relief, rehabilitation and development (LRRD): examples and lessons learned for the WASH sector Martina Rama (France)
PAPER 2828
The concept of linking relief, rehabilitation and development (LRRD) aims at improving integration and coordination between humanitarian actors and development actors in transitional contexts. Notwithstanding large popularity of the concept, its application in the field is challenged by many obstacles, especially in the WASH sector. This article describes HYDROCONSEIL experience in this area and lessons learnt in various countries. It provides examples of challenges faced in unstable settings and areas of recurrent or protracted crises, such as trade-offs between providing quick disposable infrastructure and more expensive long-lasting equipment, difficulties in involving stakeholders, and complex achievement of cost-recovery of services. Three main recommendations are provided to help aid practitioners face such challenges: The need to invest significant time and resources in the initial needs assessment, the need to choose water or sanitation infrastructure/equipment which is both ambitious and pragmatic, and the need to allow for flexibility in the project’s methodologies.
Why do women in India not use public toilets? Patterns and determinants of usage by women in Warangal City Y. M. Reddy, V. S. Chary & R. Srividya (India)
PAPER 2794
This paper is part of an extended study to assess the needs of women for public toilets (PT) and sanitation facilities in the city of Warangal, Telangana, India. A quantitative dip-stick study with a sample size of 197 women followed by 21 in-depth interviews was undertaken among a cross- section of women from various walks of life, different ages and qualifications. From the content analysis of the interviews and network analysis of the most commonly co-occurring words, the broad themes that emerged as sanitation needs of women in public spaces were related to high demand for exclusive toilets for women with specific facilities and caretakers who collect money and keep the toilets clean, with particular need for women caretakers to add to the feeling of security. A strong need greater number of well-maintained sanitation facilities in places such as bus stops and railway stations and access to the toilets from main roads rather from interior roads were other aspects that emerged.
BACK TO CONTENTS 75 Research into policy: a literature review R. Renouf (UK)
PAPER 2742
Water & Sanitation for the Urban Poor (WSUP) is embarking on a new research programme dedicated to improving urban sanitation in Ghana, Kenya and Bangladesh. The driving aim of the programme is not only to produce rigorous research, but research that can drive sector change in each of the three focus countries. For this to be achieved, research must be timely, relevant and communicated in a manner that is useful to those who are in a position to drive change in urban sanitation policy on all levels. This paper presents a broad overview of the literature produced on research uptake and the actions recommended for researchers seeking to ensure that their work makes a sustained impact where it is most needed. This will inform WSUP’s sector influencing strategies and guide its development of a research uptake strategy.
Supporting partnerships with local actors to improve water supply services for the sustainable prevention of cholera in Kalemie, Democratic Republic of Congo (DRC) B. Saga (France)
PAPER 2730
SOLIDARITÉS INTERNATIONAL (SI), as part of its program “Improving access to safe water for sustainable prevention of Cholera in Kalemie, DRC”, supported local actors to establish a partnership in order to ensure efficient management of standpipes. The lack of safe water, which is mainly provided through the piped water scheme, is one of the main causes of the recurrent Cholera outbreaks and standpipes are the main water access points for the most vulnerable communities of the affected areas. The partnership was formally established through a Memorandum of Understanding (MoU) binding Civil Society Organizations (CSO), Water Service Provider (WSP) and the representative of Government in charge of water regulations at local level. The partnership arrangement resulted in an improvement of the management of the standpipes and led to targeted communities having access to piped water; this improved safe water supply services in Kalemie and certainly contributed to the reduction of Cholera cases.
76 BACK TO CONTENTS Community-led integrated model for sustainable and inclusive faecal management and WASH services Guruprasad Sahu (India)
PAPER 2724
For better WASH services, we need infrastructure, energy to clean water, incentives to ensure community participation and funds to make WASH services sustainable. An integrated model, which is a combination of a community biogas plant (CBP), a reverse osmosis (RO) plant and community toilets, provides a one stop solution for quality WASH services. In this model the sceptic tank is attached to the CBP, which produces biogas used to generate electricity to power the RO plant. Slurry, from CBP, is converted to vermicompost and the increasing demand for organic manure makes it a community led sustainable business model. Profits can be used to build community infrastructure so the community no longer has to depend on outside funds. It enhances the capacity of the community to work together, augments income and reduces disease. Community participation in this model addresses the major challenge of WASH professionals - community ownership of WASH services.
The role of human-centred design in implementing ICT solutions in WASH projects David Schaub-Jones & Jessica Kaliski (South Africa)
PAPER 2734
Over the past decade in many parts of Sub-Saharan Africa, there has been a continual rise in the advancement of telecommunications, as well as a continual rise in urbanisation. Within this context, a number of sector professionals have acknowledged the potential for the rapid growth in information and communication technologies (ICT) to offer new opportunities to water providers to address some of their enduring challenges. Desille and Faggianelli (2013) emphasise the importance of those both collecting and analysing information to ensure data collected is relevant and regularly updated. Unfortunately, little attention is initially given to catering these systems towards those collecting data. This paper uses lessons learned regarding appropriate and inappropriate design approaches in ICT projects in the WASH sector to showcase two case studies implemented by the social enterprise, SeeSaw. Despite SeeSaw’s attempt to incorporate the personalities, incentivise, and motivations of the reporters at the onset of the project, some challenges still remain. These results suggest both the challenges avoided when design considerations incorporate those collecting information, but also the challenges ...
BACK TO CONTENTS 77 Urban sanitation: where to next? P. Scott, R. E. Scott & A. P. Cotton (UK)
PAPER 2832
This paper sets the current research-related innovations in urban sanitation of low to middle income countries within a broader historic context. It highlights the key threads of urban sanitation discourse over the past four decades; from putting the last first, to a more nuanced understanding of household demand and uptake, and a focus on faecal sludge management (FSM). Particularly since 2008 the International Year of Sanitation, there has been increasing specialisation around the sanitation value chain and FSM, producing deeper knowledge and several diagnostic / decision support tools. Whist the sector has, in no doubt, made great progress, the paper suggests that there is a risk of (over)simplification. Now is the time, armed with a better understanding and decision support tools, to embrace urban complexity; to place sanitation back into the wider human-technology-environment systems of the city; and to plan for integrated basic services in the domestic and peri-domestic domains.
Urination needs and practices away from home: where do women go? P. Scott, M. Sohail & S. Cavill (UK)
PAPER 2596
This paper places the sanitation spotlight on urination. Open urination is a cause of concern for various reasons including: public decency, public nuisance, smell, health and hygiene. Measures aimed to stop the practice focus on: 1) creating and enforcing laws; 2) changing social norms; and 3) making more urinals available. For gendered reasons, women are less likely to practice open urination, instead becoming practised at withholding urination when away from home. This paper argues that attention to urination can help cast light on gendered needs, norms and behaviours (and how these change along the human life course) in a way that the sanitation focus on defecation hasn’t. This paper is presented in conjunction with a side event at the WEDC conference titled: “Need to Wee?” Please join us there to continue the conversation.
78 BACK TO CONTENTS Diagnostic and decision-support tools for effective faecal sludge management (FSM) services Rebecca Scott, Ian Ross & Michael Smith (UK)
PAPER 2608
Achieving effective faecal sludge management (FSM) from on-site sanitation systems is critical to improving sanitation in urban settlements. Research conducted in 2014-16 by OPM Ltd and WEDC, on behalf of and with the World Bank WSP, used extensive primary data from five cities in the global South to develop a comprehensive suite of FSM diagnostic and decision-support tools. This paper describes the development and use of the tools, while illustrating two key tools. The resulting suite of tools, together with associated resources, provides a comprehensive and usable basis to help guide FSM intervention options, informed by an understanding of existing FSM services, within the context of the enabling environment and political economy realities of the city.
Establishing district service centre to improve functionality of rural supplies in Uganda A. Sentumbwe & R. Mutiibwa (Uganda)
PAPER 2702
According to the sector performance report 2016, the functionality of rural water facilities was at 86% by June 2016. The functionality of wells with hand pumps was low at 70% compared to other rural water supply facilities. Meanwhile, in the hygiene and sanitation (H&S) field, toilet access rate was at just 70% and the access rate to hand washing facilities just 27%. The paper outlines a new approach of establishing District Service Centre to support operation and maintenance in order to improve functionality of rural water supplies. The pilot project is a technical cooperation between the Government of Uganda and that of Japan through its development arm of Japan International Cooperation Agency (JICA). The project covers four districts of Mubende, Kiboga, Mpigi and Butambala in central Uganda and its outcome is expected to be up scaled in other districts.
BACK TO CONTENTS 79 Water desalination in the Gaza Strip: Al Salam RO brackish water desalination plant case study Mahmoud Shatat, Karen Arakelyan, Omar Shatat, Tim Forster & Ashraf Mushtaha (The Gaza Strip, Palestine)
PAPER 2821
Ongoing deterioration of the water supply of the Gaza strip poses a difficult challenge for water planners and sustainable management of the coastal aquifer. The aquifer is currently overexploited, with total pumping exceeding total recharge. In addition, anthropogenic sources of pollution threaten the water supplies in major urban centres. Many water quality parameters presently exceed World Health Organisation (WHO) drinking water standards. The major documented water quality problems are elevated chloride (salinity) and nitrate concentrations in the aquifer. Up to 95 per cent of Gaza’s population source their drinking water from 154 public or private producers, whose production and supply chain result in the potential contamination of up to 68% of drinking water supplies, exposing nearly 60% of the population to severe public health risks. This paper presents the details of the implementation of a medium scale brackish water desalination plant constructed in eastern Rafah – Gaza by Oxfam and its partner the Coastal Municipalities Water Utility. WASH in health care facilities: initiatives, challenges and lessons from Nepal post emergencies A. M. Shrestha, D. S. Malla, & T. Ahmad (Nepal)
PAPER 2662
Almost one-fifth of health care facilities (HFCs) in Nepal do not have access to WASH services posing serious threat to patients and staff while jeopardising the dignity of vulnerable population seeking health services including pregnant women and the disable. Though Nepal has been able to reach many hard to reach areas with health services, ensuring infection prevention from health facilities is still a challenge. The 2015 Earthquake further devastated the situation. Under various initiatives in the last five years, significant efforts were undertaken to assess and improve the situation. Over 600 HCFs mostly in the earthquake affected districts were supported for improved WASH services while development of guidelines on WASH in HFCs is in progress. Incorporating indicators on WASH services in HFCs into the Health Management Information System and putting in place a viable mechanism for operation and maintenance of WASH facilities are few of the priority areas.
80 BACK TO CONTENTS Rheology of sludge in pour-flush toilets: understanding the requirements for pit emptying technology design R.C. Sindall, A. Byrne & C.A. Buckley (South Africa)
PAPER 2825
Pour-flush (PF) toilets are seen as bridging the gap between basic on-site sanitation and the water-borne sewerage systems that people aspire to. Limited studies have been conducted on the rheological properties of PF sludge, which are a key component in designing and selecting appropriate pit emptying equipment. Samples from active and standing PF leach pits were tested for moisture content and viscosity. The two variables were linked using the fresh faeces viscosity model (Woolley et al., 2014). A second model was used to demonstrate how the volume and moisture of material in standing PF leach pits changed over time. This showed that PF leach pits could be emptied using a pump within two months of active use. Alternatively, PF leach pits can be left for up to five years after which the volume will have reduced to 45 % of the original volume and can be dug out manually.
Android application turning trash into cash: an innovative approach on solid waste management in urban areas M. Sirait (Indonesia)
PAPER 2704
Sesama is an android based application to help urban communities to connect to a waste bank nearby to gain more benefits from their waste. It allows users to order the waste bank to pick up their recyclables from their place, to monitor transactions with the waste bank and to decide what to do with the money deposit in the waste bank. A waste bank is a community-based recycling centre where solid waste collected, sorted and temporarily deposited before sold to recycling agent and factory. The application help the waste bank connected to its customers by responding to picking-up order, providing real time transaction information, and also helping the waste bank in creating reports and database which previously conducted traditionally on paper. This innovation has helped the community in increasing their interest on separating their waste, assisted the waste bank in its administrative works and helped government in monitoring the amount of solid waste recycled and delivered to landfill.
BACK TO CONTENTS 81 Faecal sludge management and technology justice: promoting sustained and scalable solutions L. Stevens, N. de la Brosse & J. Casey (UK)
PAPER 2712
In this paper we use Practical Action’s framework of Technology Justice and apply it to faecal sludge management. The framework analyses FSM from the perspectives of access, use and innovation. It encourages a wider systems-based approach to the issue. We illustrate the ideas by discussing how we are trying to create long-lasting change through a positive enabling environment in Bangladesh which encompasses empowerment of informal pit emptiers, engagement with Municipalities, and work to establish a new set of national guidelines.
A cross-sectional study on water access within the Healthy Villages and Schools (VEA) program in the DRC G. String, P.N. Mirindi, J.M. Sangira & D. Lantagne (USA)
PAPER 2728
In DRC, the Healthy Villages and Schools (VEA) National Program consists of a community participatory process towards sustainable access to improved water services, hygiene and sanitation where villages and schools are certified “healthy” once they comply with 7 WASH specific norms. Through a mixed-methods survey of household questionnaires, water quality testing of source and stored water samples, mapping of water sources, and discussions with key informants, this study looked at VEA implementation in the Katana health zone, South Kivu province, to ascertain lessons learnt from the program. From 206 household surveys and 71 focus group discussions, it was determined that there are two primary barriers to effective water supply coverage: accessibility to a source within 30 minutes and delivery of water that conforms to WHO guidelines of <1 E. coli CFU/100mL. Additional demographic and WASH knowledge, attitudes, and practices outcomes as well as challenges associated with the VEA are discussed.
82 BACK TO CONTENTS Operational research on water safety plans: implementations in India, DRC, Fiji, and Vanuatu G. String, R. Singleton, P. N. Mirindi, F. Polo & D. Lantagne (USA)
PAPER 2721
Despite the promotion of Water Safety Plans (WSPs) as a comprehensive risk assessment and management strategy for water delivery, there is a lack of documented outcomes and impacts from this approach, particularly for community-managed supplies. Through a mixed-methods protocol of household surveys, water quality testing of source and stored water samples, key informant interviews, and focus group discussions, this study looked at WSP implementation in four countries to ascertain lessons learnt from these programs. From 817 household surveys and 256 key informant discussions, it was determined that there was no clear evidence linking WSPs to improvements in water quality. However, interviews indicated improved capacity of local committees in understanding their water supply systems and in identifying key risks to the delivery of safe water. Additional outcomes of WSPs and challenges associated with their implementation are discussed.
Making universal access to water affordable in Zambia and Zimbabwe Sally Sutton & Peter Harvey (UK)
PAPER 2706
As per capita costs of rural water supply escalate, and donor funding cannot keep pace, it will be necessary to look at alternative solutions to achieve universal access in sub-Saharan Africa. Leveraging funds from new sources and minimising costs to government may help to avoid a slow-down in progress to 2030. Results from UNICEF-funded reviews of Accelerated Self-supply in Zambia and Zimbabwe suggest Self-supply is an essential strategy to achieve universal access, especially in remote areas with low population density where many of the remaining unserved reside. Government must adopt complementary or hybrid strategies, incorporating Community Water Supply and Self-supply, if the SDG target of universal and equitable access to safe and affordable drinking water is to be met. Including self-financing in rural water supply strategies will require development of new affordable standards for smaller communities, but could save the two governments almost $400,000,000, cutting the necessary budget by 35-40%.
BACK TO CONTENTS 83 Health, food security and equity, socio-economic factors in self-supply investment Sally Sutton (UK)
PAPER 2585
International research into household investment in water supply and sanitation has led to a growing awareness of the significance of household investment (Self-supply) to the local WASH sector. This paper looks at some lessons learnt from baseline surveys of self-financed water supplies in Ethiopia, Malawi and Zambia. The surveys explored some impacts of on-plot Self- supply, which could influence future efforts to support self-supply services to reach new groups and improve existing supplies. The prime motivation for investors is convenience of domestic supply. A closer water source is perceived to improve family health and save time and energy, and so to lead to greater food security, even where the water is not directly used for productive purposes. In equity terms investment is not limited by wealth or education. Sharing of supplies extends many of the benefits of proximity of access to those who have been unable to develop their own.
An analysis of potential performance improvement in Freetown’s water utility using the AquaRating system A. Swarray, A. Bangura & M. Dillon (Sierra Leone)
PAPER 2698
The water utility serving the capital of Sierra Leone, Guma Valley Water Company (GVWC) faces significant challenges delivering sustainable services. To determine the potential scope within GVWC for performance improvement and to identify areas of focus for the planned investment from international partners the AquaRating (AR) system was used for the first time in Africa. The final AR score of 9.62 has underscored the challenges GVWC is presently facing in the management and delivery of quality services. However, analysis at thematic and sub-thematic levels have highlighted some positive practices in corporate governance and stressed other areas, such as customer care and water treatment processes, where efforts should be focused over the next three years. Additionally, the AR results provide an objective baseline to measure improvements over time while GVWC aims to reach the global benchmark of what a ‘well performing’ utility does.
84 BACK TO CONTENTS Supporting Swaziland’s first water and sanitation joint sector review: lessons learned W. Tillett, N. D. Ntshalintshali & C. Kapupu (UK & Swaziland)
PAPER 2753
Joint Sector Reviews (JSRs) are being undertaken in a growing number of countries, and are considered features of good practice for strengthening sector governance, accountability, and harmonisation. Some guidance on JSRs has been developed by Danert et al (2016), and this paper seeks to add to the growing body of evidence with a practical experience from the first water and sanitation JSR in Swaziland. The learning and recommendations in this paper are particularly relevant for countries undergoing JSRs for the first time, and also for countries looking to strengthen existing JSR processes. Key findings relate to; using the first JSR to develop sector building blocks and institutionalise the JSR process into sector processes; the role of technical assistance to mentor the process and develop capacity for future JSRs; and the importance of sustained support after the first JSR event, to ensure momentum is not lost.
WASH in health care set ups in Uttar Pradesh Anjali Tripathy (India)
PAPER 2790
Under the Swachh Bharat Abhiyaan that focuses on promoting cleanliness in public spaces, Swachhta Guidelines for Public Health Facilities are being issued separately to maintain cleanliness and hygiene in the health care facilities. As the first principle of healthcare is “to do no harm”, it is essential to have our health care facilities clean and adherence to infection control practices. Maintenance of the hygiene and cleanliness of health facilities is not only related to aesthetics and patient satisfaction, but it also reduces the incidence of Hospital Acquired Infections (HAI). Maintaining cleanliness in a health care facility differs from the conventional cleaning. Public health facilities are generally perceived to be unpleasant and unhygienic with poorly maintained buildings, over-flowing drains, grazing cattle within the campus, presence of rodents inside the hospital, often dirty /non-functional toilets. This paper is trying to present the scenario in UP and urgency to see wash in heath sector aspect and finding solutions.
BACK TO CONTENTS 85 Customer perceptions and implementation of pro-poor safe water interventions in Uganda’s urban areas I. K. Tumwebaze & S. A. Ayugi (Uganda)
PAPER 2791
This paper presents findings from the study on water user customer perceptions and the implantation of pro-poor safe water interventions in Uganda’s urban areas. It was a cross- sectional study conducted in six urban towns. A total of 341 household respondents, mostly buying water from public water points participated. Most water consumers from public water points were satisfied with the sources and quality of water. Some perceived the water as safe to drink without first boiling it. However, some consumers believed their water was contaminated and others it being hard. Most water customers never participated in establishment of the sources and neither were they consulted in setting water tariffs. With regard to the pro-poor water and sanitation strategy, key informant respondents such as the private water operators were unaware of its existence while those who were knowledgeable were blunt about its content due to inadequate dissemination and clearly defined concepts. This study recommends that to any pro-poor strategies be well disseminated to all service providers and have clear implementation frameworks to track performance. In addition, of all service users ... Mobile-based tracking system to ensure sustainability of a sanitation programme: experiences from four Indian states Asad Umar, Prasann Thatte & Satviki Varma (India)
PAPER 2696
India’s goal of achieving 100% sanitation coverage has been a long-standing one. While the recent push to eliminate open defecation has made significant progress taking India to a level of 61% coverage, the functionality of sanitary latrines and sustainability of open defecation free villages remain major challenges mainly due to the absence of a strong mechanism to track the progress of infrastructure and improvement in hygiene behaviours. The benefits of significant public investment made in the sanitation sector hence remain only partially realized. Against this backdrop, the Aga Khan Development Network (AKDN) under its ambitious multi-state sanitation initiative spread across Bihar, Madhya Pradesh, Uttar Pradesh and Gujarat has introduced GPS enabled mobile-based monitoring system to track the progress of sanitation infrastructure and hygiene behaviours. The initiative with the help of AKVO flow has so far tracked 19400 units till January 2017 to get the completion status, quality of construction and awareness levels and behaviour pattern of targeted communities.
86 BACK TO CONTENTS Regional capacity for WASH sector knowledge management and learning in West and Central Africa E. Uytewaal, K.A. Naylor, R. van Lieshout & D. Jawara (The Netherlands)
PAPER 2703
This paper assesses regional capacity for supporting governments in West and Central Africa in the development of their respective WASH sectors through knowledge management and learning. The assessment is based on a survey of relevant institutions and individuals in the region and takes into account assessments of the sector knowledge management and learning initiatives in eleven countries in the region. The main finding is that existing capacity at regional level is fragmented and not utilized to its full potential. Central to this is the absence of a clear link between the “supply” of knowledge products and the “demand” by users. Key conclusions include the need to (i) adapt the WASH learning agenda to the specific regional and national contexts, (ii) make better use of contributions from academia and the private sector and (iii) reinforce leadership roles of relevant continent-wide, regional and national bodies for knowledge management and sector learning.
A comparative analysis of the impact of hygiene promotion and sanitation marketing in rural Ethiopia K. Vrana, C. Garbutt, M. Wubshet, M. Yasin-Jemal, B. Getachew & M. Gizaw (Czech Republic)
PAPER 2755
Access to good quality, safe-to-use sanitation in rural Ethiopia remains low. Implementation by WASH actors of sanitation marketing in rural Ethiopia is limited. Over four years, People In Need, in cooperation with government partners implemented a WASH project using a “local system-strengthening” approach. This study compares two types of intervention to improve sanitation and hygiene behaviours: hygiene promotion and hygiene promotion in combination with sanitation marketing. The study found that the additional sanitation marketing component was associated with improved latrine quality and presence of a handwashing facility near to the latrine, compared to a hygiene promotion intervention alone. This demonstrates that sanitation marketing can add significant value to rural WASH programs.
BACK TO CONTENTS 87 Improving water point functionality in Malawi: making the case for minimum financing for direct support J. Wahba, S. Byrns & T. Smith (Malawi)
PAPER 2779
Due to decentralization policy in Malawi, district government water offices responsible for providing direct support for water service delivery find themselves with an increase in devolved responsibilities but without the corresponding funds to carry them out. EWB has been implementing a strategy to advocate for a realistic devolution of funds to district level government to carry out the minimum direct support necessary to improve water point functionality. This approach is focused on the generation of specific evidence, as well as mapping and coordination of sector stakeholders to generate a feasible plan for an increase in devolved funds. This case study highlights the key lessons learned in advocating for more resources to an underfunded sector in a competitive resource constrained context where most sectors remain severely underfunded.
Reporting the condition of South Africa’s water sector infrastructure Kevin Wall & Chris Rust (South Africa)
PAPER 2830
The purpose of the “national infrastructure report cards” of the condition of engineering infrastructure in South Africa has been to draw the attention of government, and of the South African public at large to the importance of maintenance, and to factors underlying the state of repair of infrastructure. The success of these report cards, published in 2006 and 2011, has been such that a new report card is currently being prepared. Whereas completion of this, the third report card, will not take place until around mid-year, the objective of this paper is to briefly describe the background to and purpose of infrastructure report cards and the process by which the South African report cards are compiled, to discuss key findings of the previous report cards, and to describe the third report card’s preliminary findings for the water sector.
88 BACK TO CONTENTS Evolution of the social franchising approach to watsan maintenance in South Africa Kevin Wall & Oliver Ive (South Africa)
PAPER 2806
The paper describes how the innovative social franchising partnership approach to the routine maintenance of sanitation and water infrastructure has evolved over a period of 15 years, from its origins in research into the condition of infrastructure, through three successive research projects including pilots on the maintenance of low-technology sanitation facilities, to implementation. The paper also describes the business procedures, the lessons learned from these pilots, and the first large-scale implementation contracts. Whereas other approaches to improve service delivery have also built capacity and developed skills, many of them have had limited success because they have not enjoyed sufficiently strong incentive structures and support systems. In contrast, the very practical social franchising partnership approach is built on a robust foundation of mutual support and incentives.
SEEK (Sludge to Energy Enterprises in Kampala): co-processing faecal sludge for fuel production B. J. Ward, M. Gold, D. Turyasiima, F. Studer, W. Getkate, J. M. Maiteki, C. B. Niwagaba & L. Strande (Switzerland)
PAPER 2808
The goal of this project was to improve the resource-recovery value of faecal sludge treatment products. A market assessment identified coffee husks, spent grain, and sawdust as optimal organic wastes to co-process with faecal sludge to increase its fuel value. Drying times of faecal sludge to 90% solids were reduced by half with co-pelletizing with these organic wastes. Briquettes produced with char had comparable heating value, fuel performance, and emissions to charcoal briquettes currently being sold. Use of pellets as a fuel was tested in a gasifier and in several industrial clay kilns (after crushing). High ash content led to clinker formation in the gasifier, but performed well in kilns. The potential market for co-processed faecal sludge fuels is high in Kampala, Uganda, especially among industries, however, the market for pellets needs to be developed.
BACK TO CONTENTS 89 Applying a community scorecard for rural water services in Timor-Leste M. Whalen, A. Grumbley & J. da Silva (Australia)
PAPER 2661
Accountability of service providers to their clients/users is an essential condition for sustainability of water services. Social audit, Citizen Report Card and Community Scorecard have been widely utilised tools enabling citizens and communities to hold government to account for the delivery of basic services. WaterAid introduced a Community Scorecard Tool to Timor-Leste in 2012 to allow communities to assess the performance of WaterAid and their implementing partners. This tool was adapted in 2016 to enable communities to assess and improve the performance of the community based water management group and government frontline staff to deliver water services in their rural communities. The methodology includes provision of an immediate feedback loop and action planning component that involves government authorities, formal village leadership, service providers and water users. The tool was tested in eight locations by WaterAid and local NGO facilitators and to date has shown promise in motivating communities to improve their water services.
Rural water system functionality and its determinants: a twelve-country study J. Wiles & N. Mallonee (USA)
PAPER 2780
This paper presents results from a 12-country study of water systems installed by Living Water International from 2001-2014. Results from a random, representative sample of 3,815 water systems indicate that 77.1% were functional, with an additional 5.8% having limited functionality. These results fall in the upper end of an expected range based on similar studies. Several factors increased the odds of water system functionality, including when water users made financial contributions to the system and whether a community used a management structure. Any type of management increased the odds of functionality, but village water committees had the largest effect. Additionally, Afridev pumps were associated with higher odds of functionality than India Mark II pumps.
90 BACK TO CONTENTS Capacity building in Cambodia’s rural local governments for the sanitation market K. Worsham, B. Powell & C. Chan (USA)
PAPER 2587
Approximately 72% of Cambodians practice open defecation. The government has implemented strategies and policies to improve access to sanitation and decentralized roles and responsibilities to the local rural district and commune governments so that it can be more effective in supporting rural sanitation marketing (SanMark). Semi-structured informal interviews with local stakeholders were analysed to understand the role of rural local governments (LGs) in SanMark and what capacities they possess – and need. The different roles perceived for LGs to fill include monitoring, regulation, and demand creation, however are not specific as to the details of how these roles can be implemented. The research found that capacity of LGs is very weak and needs to accommodate older personnel with lower levels of education. The capacities identified to support roles given to LGs are often general and unclear, such as “coordination” and “monitoring”, though the key basic capacities in need are effective communication.
Landlords/compound managers: change makers to improve and sustain communal latrine use and maintenance Farzana Yeasmin, Farzana Begum, Fosiul A. Nizame, Guy Norman, Sam Drabble, Md. Khobair Hossain, Dalia Yeasmin, Abdus Shaheen, Habibur Rahman, Mahbub Ul Alam1, Leanne Unicomb & Peter J. Winch (Bangladesh)
PAPER 2663
Shared latrines are the most common primary means of sanitation in the high-density slums in Dhaka city where maintaining cleanliness and functionality is difficult. We developed a cleanliness and maintenance intervention package that included behaviour change materials and interpersonal communication sessions with slum residents, landlords/compound managers, waste bin emptiers regarding flushing, latrine waste disposal in waste bins and safe child feces disposal. We evaluated the role of landlord/ compound managers and explored the mechanism by which they contributed to this intervention. We conducted focus group discussions with landlords/ compound managers, community health promoters (CHPs) and tenants, group discussions with CHP supervisors and key informant interviews with the staff member of implementing agency. CHPs and their supervisors said landlords/compound managers supported their efforts to implement this intervention. We found landlords/compound managers play a reinforcing role in the intervention.
BACK TO CONTENTS 91
Developing knowledge and capacity in water and sanitation
WEDC – The Water, Engineering and Development Centre is one of the world’s leading education and research institutes for developing knowledge and capacity in water and sanitation for sustainable development and emergency relief. We are committed to the provision of effective, evidence-based and appropriate solutions for the improvement of basic infrastructure and essential services for people living in low- and middle-income countries. With over 45 years of experience, we offer expert advice and quality learning opportunities for sector professionals. Founded in 1971, WEDC is based in the School of Civil and Building Engineering at Loughborough University, one of the top UK universities. Our approach promotes the integration of social, technical, economic, institutional and environmental activities as foundations for sustainable development.
WEDC engages in three main activities:
• education and training, at postgraduate level and for professional development;
• applied research and consultancy; and • outreach – providing access to high quality technical information and support through our international conferences and publications available in print or to download free of charge.
Water, Engineering and Development Centre Loughborough University Leicestershire LE11 3TU UK T: + 44 (0) 1509 222885 E: [email protected] W: wedc.lboro.ac.uk 92 BACK TO CONTENTS