Moving Beyond ODF to Safely Managed Sanitation for All

Transcription

1 Moving Beyond ODF to Safely Managed Sanitation for All South Asia Regional Learning Event Mark Ellery 8 th November, 2016 The CS WASH Fund is supported by the Australian Government and managed by Palladium International Pty Ltd.

2 Population Using Improved Sanitation (%) Sanitation MDG achieved by Pakistan, Sri Lanka & Maldives 120% Sanitation MDG Progress JMP % 80% 60% 40% 20% 0% 98%, Maldives 95%, Sri Lanka 71% 64%, Pakistan 68% 61%, Bangladesh 50%, Bhutan 46%, Nepal 34% 40%, India 32%, Afghanistan 24% 19% 17% 21% 4% Year Source: WHO and UNICEF (2015) Drinking Water Supply and Sanitation Joint Monitoring Programme (JMP) 2

3 Population Defecating in the Open (%) Open Defecation reduced most in Nepal, Pakistan, Bangladesh 100% Open Defecation Reduction JMP % 88% 75% 60% 40% 20% 0% 49% 34% 23% 13% 11% 44%, India 34% 32%, Nepal 13%, Afghanistan 13%, Pakistan 2%, Bhutan %, Bangladesh %, Sri Lanka 0%, Maldives Year Source: WHO and UNICEF (2015) Drinking Water Supply and Sanitation Joint Monitoring Programme (JMP) 3

4 Millions of People # people defecating in the open declined by 161 million while the # of people w/out improved latrines increased by 29.6 million 1, # People without Sanitation Facilities in SAR JMP 2015 Maldives Afghanistan Bhutan Sri Lanka Nepal Bangladesh Pakistan India -161 million million w/out any latrine (i.e. open defecation) w/out improved latrines Source: WHO and UNICEF (2015) Drinking Water Supply and Sanitation Joint Monitoring Programme 4

5 Child Height for Age Correlation of Open Defecation & Nutrition Reducing Open Defecation has significant health consequences Open Defecation Density vs Stunting vs # Open Defecators MDHS 2009 SDHS 1987 PDHS 2012 BDHS 2014 BDHS 2011 PDHS 1990 NDHS 2011 BDHS 2007 NDHS 2006 BDHS 2004 NDHS 2001 Bangladesh DHS Pakistan DHS Nepal DHS Sri Lanka DHS India DHS Maldives DHS IDHS 2005 BDHS 1999 IDHS 1999 BDHS Open Defecation per square km Source: ICF International, The DHS Program STATcompiler. Funded by USAID. 5

6 Significance of Fecal Ingestion on Nutrition Environmental Enteric Dysfunction (EED) Constant exposure to fecal bacteria Unhealthy villi Food Stop exposure to fecal bacteria Food Healthy villi Infected Intestine Poor absorption of nutrients No diarrhea Uninfected Intestine Good absorption of nutrients No diarrhea 6

7 % Access to Improved Sanitation The size & type of the sanitation challenge varies significantly from country to country in South Asia 100% # People w/out Improved Latrines JMP % 60% 40% Bangladesh 62,560,290 Nepal 15,358,140 Pakistan 67,731,840 Sri Lanka 1,080,600 Bhutan 388,000 Maldives 7,160 20% 0% Aghanistan 21,764,760 India, 769,434,000 Improved facilities Shared facilities Other unimproved Open defecation GDP per capita (current US$) Source: World Bank Data Bank, WHO and UNICEF (2015) Drinking Water Supply and Sanitation Joint Monitoring Programme (JMP) 7

8 The Challenge of the SDGs Millennium Development Goals (MDGs) Sustainable Development Goals (SDGs) Faecal sludge & menstrual hygiene management, handwashing & hygiene Safely managed Improved Shared Other unimproved Halving those without access is biased against the hard to reach (i.e. poor, disabled) Improved facilities are not necessarily safe Shared facilities are not necessarily unsafe Add a safely managed category Target the universal access to sanitation and the progressive elimination of all inequalities Basic Shared Other unimproved Open defecation No targets for open defecation Eradicate all open defecation Open defecation 8

9 Costs SDG Sanitation Ladder Response Need to change the approach at different stages in the ladder Open Defecation Public Regulation - Sanitary behaviour - Sanitary codes - Environmental standards - Quality tradespeople - Institutional separation Unimproved CLTS - Coordination - Behaviour Change - Informed Choice Shared Supply Chains - Poor/disable inclusive - Gender equitable - Access to finance - Appropriate technologies Basic Safely managed Public Services - Fecal effluent & sludge management - Handwashing facilities & hygiene behaviour - Menstrual hygiene management Health Benefits Adapted from: SNV (2016), Thinking Beyond the Finish Line: Sustainable Sanitation Services for All; Asia Regional Learning Event 9

10 What can we learn from achieving ODF status at the local level that helps us towards the SDGs and safely managed sanitation for all? 10

11 Private Good = Rival + Excludable Rival: A good or service is rival when consumption by one agent reduces the availability for others. Excludable: A good or service is excludable when it is possible to exclude access to these services. This means that latrines & soap, sewage networks and treatment plants, masons and pit emptiers are all private goods. Private goods are most efficiently delivered by commercial providers within a competitive market. 11

12 Public Good = Non-rival + Non-excludable Non-Rival: A good or service is rival when consumption by one agent does not reduce the availability for others. Non-Excludable:A good or service is non-excludable when it is impossible to exclude others from the consumption of that service. Clean air, street lighting, fire protection, defense, public information and open defecation free jurisdictions are all examples of pure public goods. The provision of public goods is the raison d être of government 12

13 CLTS: Untangling Public & Private Goods Sanitation Provision of an open defecation free jurisdiction Non-Rival + Non-excludable Public Good Government Provision of latrines, masons, sewers & emptiers Rival + Excludable Private Good Market Forces 13

14 CLTS Targeting of Open Defecation Free Areas Separate government s role of ensuring sanitation rights for all above all of the agents that provide services to the underserved Firms Companies Households Citizen Consumers CBOs NGOs Co-ops Joint Ventures Utilities Bidders Collect Store Transport Treat Test Protect Provide Gov t sets & evaluates, enables & enforces quality of service standards on all providers within its jurisdiction Gov t Ensure 14

15 CLTS: Don t subsidise household latrines! Keep asset ownership & financing liability together 1. If the responsible Government owns assets then let competitive contracts 2. If the responsible Government doesn t own assets then license the market Asset ownership Firms Companies Households CBOs NGOs Co-ops Joint Ventures Utilities Bidders Provide Market Licensing Social: Norms, public education, quid-pro-quo Legal: Planning Approval, NoC, O&M license Competitive Contracts Short: Lease, M/C, S/C, labour Long: BOOT, concession, staff Asset ownership Gov t sets & evaluates, enables & enforces quality of service standards on all providers within its jurisdiction Gov t Ensure 15

16 What we can learn from achieving ODF status to address the SDGs? 1. Need to change the approach as you move up the sanitation ladder 2. Remember the importance of targeting the public good in sanitation Be clear on the priority role of government (that no-one else can do) 3. Retain asset ownership & financing liability together Strengthen the social / legal instruments where government doesn t own sanitation assets 16

17 Thank you 17