Sanitation, Hygiene Education and Water Supply Bangladesh (SHEWA B) World Water Week Stockholm, Sweden 29 August 2012

Transcription

1 Sanitation, Hygiene Education and Water Supply Bangladesh (SHEWA B) World Water Week Stockholm, Sweden 29 August 2012

2 The WASH Situation in Bangladesh Estimated Population (2011) 1 149,772,364 Estimated population density 1015/km 2 Urban/Rural % % % / 76.7% % Access to improved water sources 2 81% (Urban 85%, Rural 80%) Access to improved sanitation sources 2 56% (Urban 57%, Rural 55%) Coverage of sanitation facilities in Primary schools 65% Extent of Arsenic contamination Household (sources > 0.05 mg/l) % Estimated number of people drinking water in excess of 0.05 mg/l Estimated number of people living in urban slums 22 million 7 million 1 Source: Bangladesh 2011 Census (Bangladesh Bureau of Statistics) 2 Source: JMP 2010 data 3 Source: National Drinking Water Quality Survey 2009 (part of MICS 2009)

3 ESHWSRA SHEWA-B (Development Phase) Environmental Sanitation, Hygiene and Water Supply in Rural Areas (ESHWSRA) (Implementation Phase) Sanitation, Hygiene Education and Water Supply - Bangladesh (SHEWA-B)

4 WORKING AT SCALE ESHWSRA SHEWA-B % CHANGE Development Phase Implementation Phase - 8 Million Beneficiaries 30 Million Beneficiaries 275% 10 Districts 31 Districts 210% 37 Sub-districts 114 Sub-districts 208% 37 Agencies 81 Agencies 119% 273 Local Government Institutions 2,909 Community Hygiene Promoters 708 (690 rural + 18 urban) Local Government Institutions 10,000 Community Hygiene Promoters 159% 243% 4,844 Primary Schools 13, 000 Primary Schools 168% 750,000 New Latrines Promoted 1.14 Million New Latrines Promoted 6,939 New Water Points 23,100 New Water Points 233% 52%

5 SANITATION ACTIVITIES Promotion and construction of low cost latrines at household level; Construction of demonstration latrines in urban and rural areas; Piloted latrines for the disabled; Piloted (EcoSan) Ecological Sanitation latrines; Targeted rural ultra-poor for government subsidies; Development of low cost sanitation guidelines;

6 HYGIENE PROMOTION ACTIVITIES Developed hygiene promotion training manuals and materials; Community hygiene promoters (CHP) trained and supported to assist communities; Facilitated development of Community Action Plans (CAP) and Community Maps; Mass-media campaign with radio, TV and multi-media messaging; Community level activities in tea stalls, mothers meetings, courtyard sessions, house-tohouse visits and interactive popular theater;

7 Construction of new wells; Rehabilitation of existing wells; Use of evidence-based appropriate technology; Water quality testing of all new wells; Training for Operation & Maintenance; Water Point Coding System established and implemented;

8 ARSENIC SITUATION Policy changes: Cease shallow well construction in arsenic areas; Construct only deep boreholes in arsenic areas; Advocate to change GoB admissible levels to WHO global standards; Focus new construction of deep wells in heavily contaminated areas; CHPs Trained on using Arsenic Field Testing Kits; Provide other water supply options if wells contaminated; Pilot testing of household arsenic filters; Painting of spigots: Red contaminated Green - safe

9 WASH IN SCHOOLS ACTIVITIES Ensuring running water with all latrines; Construction of new water points, latrines & hand washing stations; Rehabilitation of existing water points and latrines; Separate stalls for boys and girls, and urinals for boys; Lessons & Demonstrations; School Brigades Student involvement in school hygiene; Monitoring of catchment areas; Taking home hygiene messaging to family;

10 SHEWA B ACHIEVEMENTS Hygiene Promotion Sanitation (Latrines promoted) Water Supply WASH in Schools 1.5 Million mothers of children under 5 participated in BCC activities 1.14 Million new latrines constructed by communities 14,500 water points constructed & tested and 8,600 under construction 2,617 primary school facilities constructed/repaired 133,000 Community Maps & Community Action Plans Created 2,789 New latrines constructed in urban slums by project 29,000 caretakers trained on O&M 70,000 teachers/ school management committee members trained 11,000 urban adolescent girls active as peer change agents 300 EcoSan latrines constructed 1,600 CHPs trained to monitor using arsenic field-testing kits 1.08 Million Students in Brigades trained and functioning Trained 10,000 CHPs 6 Compost Plants Constructed MIS & geo-coding system developed and implemented National Standard facilitated and approved

11 SHEWA-B INTERIM RESULTS 1. The extent of the health impact is under evaluation final evaluation June 2013; 2. Due to the scale of the project, any slight % reduction in diarrhoeal cases would be significant in terms of population affected; 3. Significant knowledge increases were noted throughout the process and impact monitoring; 4. Open defecation reduced from 25% to 5%; 5. Reduction in the number of people drinking arsenic contaminated water;

12 Urban Sanitation and Hygiene: Baseline-Midline Findings Indicator Baseline 2009 Midline 2010 Intervention HHs have clean latrines (spot check) 12% 24% Intervention HHs have soap/ash and water at convenient place for hand washing after defecation (spot check) 24% 49% Mothers washing both hands with soap after cleaning baby s bottom (observation) 12% 33% Mothers washing both hands with soap before feeding baby (observation) 2% 7%

13 Interim School Findings 2011 Indicators Schools maintaining a functional water point and environmental sanitation around it. School latrines that are operational, accessible, clean and useable. Schools having soap/ash and water at a convenient hand washing place after defecation event. Schools having an appropriate solid waste disposal system Combined hardware and software intervention schools Software only intervention schools Control Schools 56% 42% 35% 66% 65% 56% 81% 79% 68% 61% 65% 54%

14 Mean diarrhea prevalence Prevalence of diarrhoea among children < 5 years First 8 quarters , Rural Bangladesh Intervention Control 20% 15% 10.1% 9.9% 10% 5% 0% Month

15 Mean diarrhea prevalence Prevalence of diarrhoea among children < 5 years , Rural and Urban Bangladesh 50% 45% 40% 35% 30% 25% 20% 15% 10% 5% Control(Rural) Control(Urban) Intervention(Rural) Intervention(Urban) Rural: 13% vs. 9% (p=0.02) Urban: 7% vs. 7% 0% Month

16 SHEWA-B LESSONS LEARNED Enormous scale of the project affected quality and sustainability Data should be consistently integrated/used for project management and corrective actions; Aspects of sustainability with all stakeholders should be integrated from the start of the project: payment versus volunteer status of field workers (CHPs); exit strategy should be agreed and initiated from the start; real ownership at the community level must be a priority; Enabling environment is critical to ensure sustainability; Development partnerships and working at a Ministerial level, across sectors; Opportunities to ensure pockets of innovation should be expanded throughout the project;

17 SHEWA-B - RECOMMENDATIONS Evaluate behavior change strategies to identify which activities are leading to changes in behaviour versus increased knowledge; Increase the focus on strengthening the enabling environment at all levels; Expand to a programme approach to encompass national and global trends; Projects of such a scale should be incorporated into long term (+ 25 years) sector planning; Support policy development and implementation at Ministerial levels, across sectors; Partnerships need to be nurtured in order to share risks, responsibilities, resources and benefits; Ensure expansion of innovations by documenting and disseminating all WASH innovations, both successes & failures;