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A Gender Study from Bhutan

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A Gender Study from Bhutan ROLE OF RURAL WOMEN IN SANITATION AND HYGIENE A Gender Study from Bhutan …………. Connected with ……………… Pema Cheizom, National Consultant and Ms. Tshering Choden, SNV Gender, Inclusion and Governance Advisor October 2014 …………. ………………… Page | 2 This research was undertaken with support from the Australian government as part of SNV Asia’s Sustainable Sanitation and Hygiene for All Programme. Page | 2 Page | 3 List of Abbreviations ADB Asian Development Bank BCC Behavior Change Communication BHU Basic Health Unit BNEW Bhutan Network for Empowering Women CDH Community Development for Health CSO Civil Society Organisation DHO Dzongkhag Health Officer ECCD Early Child Care Development ECB Election Commission of Bhutan FGD Focus Group Discussion GAO Gewog Administrative Officer GNHC Gross National Happiness Commission GSI Gender equality and Social Inclusion plan GTW Guided Transect Walk HA Health Assistant HH Household HHs Households HWWS Hand washing with soap IDI In-depth Interview KII Key Informant Interview KM Kilometres LNW Lhawang Norbu Wangyal, local consultant for RSAHP MDGs Millennium Development Goals MoH Ministry of Health NCWC National Commission of Women and Children NA National Assembly NC National Council NFE Non Formal Education OD Open defecation PHED Public Health Engineering Division PL Pit latrine RENEW Respect, Educate, Nature and Empower Women RGoB Royal Government of Bhutan RSAHP Rural Sanitation and Hygiene Programme RWSS Rural Water Supply and Sanitation SNV Netherlands Development Organisation SSH4A Sustainable Sanitation and Hygiene for All UNICEF United Nations Children’s Fund VHW Village Health Worker Wangdue Wangdue Phodrang Dzongkhag WASH Water, Sanitation and Hygiene WB World Bank Page | 3 Page | 4 Glossary of Bhutanese Terms Used Chupen Village messenger Dasho Honorary title for heads of Government agencies Dungkhags Sub-district Dzongdags District administrators Dzongkhag District Dzongkha National language of Bhutan Gewog Administrative Block consisting of several villages Gup Elected Head of the Gewog Lhotshampa HH Bhutanese people practicing Hindu culture living in the South Lyonpo Minister Mangmi Elected member of the Gewog Nepali Dialect spoken by the Lhotshampa people Sharchogpai-lo Dialect spoken by the people of Sharchop (easterners) Thayma Tshogpa Informal religious group Tshogpa Head of a village Zomdue Village meeting Zhi Sar Resettled Household Page | 4 Page | 5 TABLE OF CONTENTS EXECUTIVE SUMMARY ................................................................................................................................................ 8 1. BACKGROUND ....................................................................................................................................................... 15 1.1 GENDER SITUATION IN BHUTAN ................................................................................................................................. 15 1.2 GENDER AND WASH .............................................................................................................................................. 18 2. RURAL SANITATION AND HYGIENE PROGRAMME ................................................................................................. 19 3. OBJECTIVES OF THIS STUDY ................................................................................................................................... 20 4. STUDY DESIGN ...................................................................................................................................................... 20 4.1 THEMES ............................................................................................................................................................... 20 4.2 STUDY LOCATIONS ................................................................................................................................................ 20 Samtse ........................................................................................................................................................................ 21 Samdrup Jongkhar ....................................................................................................................................................... 22 Wangdue Phodrang ...................................................................................................................................................... 22 5. METHODS AND TOOLS .......................................................................................................................................... 23 5.1 METHODS ............................................................................................................................................................ 23 5.2 PARTICIPANT INCLUSION AND EXCLUSION CRITERIA ..................................................................................................... 24 5.3 DATA MANAGEMENT AND STATISTICAL ANALYSIS ......................................................................................................... 24 5.4 ETHICAL CONSIDERATIONS ...................................................................................................................................... 24 5.5 BARRIERS AND BRIDGES BETWEEN THE STUDY TEAM AND PARTICIPANTS ......................................................................... 24 5.6 INFORMED CONSENT .............................................................................................................................................. 24 5.7 RISKS ANTICIPATED ............................................................................................................................................... 24 5.8 METHOD LIMITATIONS ............................................................................................................................................. 24 6. FINDINGS & IMPLICATIONS: WHAT THE STUDY FINDINGS MEAN FOR RSAHP ....................................................... 25 6.1 DIVISION OF WASH-RELATED HH LABOUR ................................................................................................................. 25 6.2 DECISION-MAKING AT HH LEVEL ............................................................................................................................... 27 6.3 DECISION-MAKING AT COMMUNITY LEVEL ................................................................................................................... 28 6.4 ACCESS, PRIVACY AND SAFETY ISSUES ...................................................................................................................... 34 6.5 OTHER KEY FINDINGS FROM THIS STUDY IN ADDITION TO THE FINDINGS PER THEME ........................................................... 37 7. RECOMMENDATIONS ....................................................................................................................................... 39 7.1 RECOMMENDATIONS FOR THE GOVERNANCE COMPONENT ............................................................................................ 39 7.2 RECOMMENDATIONS FOR THE DEMAND CREATION COMPONENT ..................................................................................... 40 7.3 RECOMMENDATIONS FOR THE SUPPLY CHAIN COMPONENT ........................................................................................... 40 7.4 RECOMMENDATIONS FOR THE BEHAVIORAL CHANGE COMMUNICATIONS COMPONENT ......................................................... 41 7.5 RECOMMENDATIONS FOR THE RSAHP ...................................................................................................................... 41 7.6 GENERAL RECOMMENDATIONS FOR IMPROVED GENDER EQUALITY IN BHUTAN .................................................................. 44 8. CONCLUSION .................................................................................................................................................... 44 9. REFERENCES ...................................................................................................................................................... 46 Page | 5 Page | 6 ANNEXURES Annex 1: Study Team Annex 2: Work plan Annex 3: Guideline for Key Informant Interviews, In-depth Interviews, Focus Group Discussions and Guided Transect Walks Annex 4: Study protocol Annex 5: Photos Annex 6: Barriers and bridges between the study team and participants and risk analysis Annex 7: Sequencing of the interviews, discussions and participants/study team Annex 8: The NCWC’s National Strategy for 2014-2019 (selected priority areas only) Page | 6 Page | 7 Acknowledgments Foremost, the report authors would like to acknowledge the Research Ethics Board, Ministry of Health (MoH) for its approval of this study as well as the Public Health Engineering Division (PHED) team (Mr. Tshering Tashi, Ms. Karma Choden, Mr. Sonam Gyeltshen) and Ms. Kinley Zam (Policy and Planning Division of MoH) for their valuable coordination and assistance. Ms. Di Kilsby, the International Consultant who led the development of the study’s protocol and field tools to train the study team prior to fieldwork, provided important guidance and inputs during the analysis of field data and finalisation of this report. The contributions of Ms. Thinley Dem (Behavior Change Communication (BCC) Advisor of SNV), Ms. Choki (Consultant of LNW) as well as the three field study assistants (Ms. Che Chay, Ms. Dechen Wangmo and Mr. Sonam Phuntsho) are also acknowledged. Special thanks also goes to Mr. Rinchen Wangdi (Chief
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