Demand-led approaches to Sanitation

Demand-led approaches to Sanitation

What is the greatest medical milestone of the last 150 years? Sanitation Poll carried out for the British Medical Journal, 2007 That s 2076 where I live! MDG 7, Target 10: To halve, by 2015, the proportion of people without access to safe drinking water and sanitation

The Awful Truth 2.6 Billion people (almost 40% of global population) lack access to basic sanitation 88% of global diarrhoeal disease is attributed to safe water supply, inadequate sanitation, and hygiene 5,000 children under 5 die each day due to diarrhoeal diseases routed in inadequate water & sanitation deaths which are preventable 3

Objective of IY of S is to put the global community on track to achieve the sanitation MDG

5 key messages of the I Y of S are: 1. Sanitation is vital for health we ve seen the statistics 2. Sanitation is a good economic investment 3. Sanitation contributes to social development - Less illness; improved 443 million nutrition school among days children; lost each increased year learning and retention among due pupils; to diarrhoea: higher work 4 productivity in 10 children among will adults; more dignity and privacy for not all reach their full educational potential 4. Good sanitation practice protects the environment 5. Improved sanitation is achievable - $9.5 billion annual cost to reach the MDG 5

How would you approach the following need? Poor beneficiary community c.700 homes (4,200 pop.) High incidence of diarrhoea, especially in under 5s, and worms amongst school-age children Very low proportion of latrine ownership, with prevailing evidence of poor use and maintenance Open defecation is prolific 6

The problem with supply-driven approaches Coverage may increase but take-up of proper latrine use is low, and mis-use is common Inappropriate technology (standardised approaches) often used No focus on cultural and social considerations Sanitation remains the poor relative in WASH or Watsan 7

Demand-led (Demand-responsive) approaches Although improved sanitation leads to improved health, people associate toilets with other benefits: Privacy Asset Status Comfort & convenience Easy to use and maintain Less embarrassment for visitors Less flies around compound Dignity! Safety (especially for women)

Rationale to a marketing approach: Many people, including the poor, are willing to pay for good sanitation that will satisfy their requirements if the technology is packaged and marketed appropriately, and the supply mechanism is easily accessible Apply a marketing approach to sanitation

Social (or Sanitation-) Marketing Social marketing offers a more promising approach to promoting positive hygiene behaviours compared to traditional, health education-based approaches Definition of Social Marketing 'The use of commercial marketing techniques to promote the adoption of behaviour that will improve the health or wellbeing of the target audience or of society as a whole' (Weinreich, 1999) 10

Demand & Supply: Applying a marketing approach to sanitation is not just about advertising; it is also about ensuring that appropriate sanitation options are made available and that suppliers have the necessary capacity to provide the desired services. Sanitation marketing is about ensuring a balance between demand (user) and supply (products, provider) 11

How do you market sanitation? Market Research Programme aims and objectives Product identification and development Set up supply mechanism Message and material development Identify market research expertise Establish and train the research team Conduct consumer research Conduct producer research Develop preliminary marketing mix (Product, Price, Place, Promotion) Identify and develop marketable sanitation facilities & services (e.g. latrine technologies /options, latrine information service, latrine centre) Identify potential suppliers of latrines & other related services Assess and develop their capacity to provide desired services Identify and/or set place(s) where consumers can access the sanitation services being marketed (eg toilet centres) Work with the public sector to establish strategy for disposal of sludge from toilets Identify partners with expertise for the design and development of marketing concepts Develop marketing concepts and creative design Pre-test and refine creative design Develop promotion strategy Implement promotion campaign Monitor and feedback Produce promotion materials (e.g. posters, flyers, radio jingle, billboard) Launch a campaign (e.g. road show, launch event) Run a promotion campaign for about 3 months Monitor the programme (spread/ response to the campaign, quality of services provided etc) Feedback and modify the programme as appropriate

Who s involved in sanitation marketing? SM creates opportunity for users, public sector, private sector, and NGOs all to get involved / to work together; A partnership for sanitation marketing could be made up of the following groups: - Households - Informal toilet builders - Pit emptying truck operators - Market research agencies - Communication/advertising agencies - NGOs - Government agencies - Financial institutions

Sanitation marketing does NOT mean neglecting hygiene education: Meeting social aspirations does not make a toilet a sanitary facility. That can only happen when the sanitation system is combined with hygienic behaviour based on an understanding of the effect on health of good hygiene practice and safe excreta disposal. Personal and public hygiene and care for even the simplest sanitary facility are at the core of good sanitation! 14

Case Studies Dar es Salaam, Tanzania West Bengal, India Sulabh, Bihar State, India

Advocacy in promoting demand-led approach Hygiene education often left to NGOs, with government coming in on structural phase > Limited buy-in by govts. Hook sanitation on health, and promote politically through citizen s rights approach (ODI) > Sanitation as a public right, not just a private good: governments to take more responsibility Acknowledge sanitation in the wider development agenda * Use notion that sanitation is a good investment Discrete budgets for sanitation are needed Government incentives to stimulate private sector development Long-term commitments: government planning processes must allow for this 16

Community Led Total Sanitation (CLTS) Focuses on igniting a change in sanitation behaviour rather than constructing toilets. Achieved through a social awakening, stimulated by facilitators. 17

Community Led Total Sanitation CLTS does not identify standards or designs for latrines, but encourages local creativeness. This leads to greater ownership, affordability and therefore sustainability. 18

Key components and methodology: Begins with a community-based appraisal of current sanitation practices, including open defecation. Methodology includes: Mapping defecation areas, Transect walks Calculations of faecal load Action planning 19

Difference between traditional approach and CLTS 20

Film clip Community-Led Total Sanitation, by Kamal Kar Produced by Plan International with the Institute of Development Studies

Impact on our sanitation programming? Adopt demand-led approach wherever possible, and consider sanitation in respect of development outcomes generally, not just as a WASH component Avoid straight subsidies on sanitation hardware Let every latrine be a wanted latrine (and therefore used) * Re. advocacy, linkage of sanitation with water is often unhelpful sanitation usually loses out to water (policy, strategy, budgets). Consider approaches such as CLTS, but support with longterm hygiene education programmes (e.g. PHAST), and ensure hard sanitation outputs (latrines, disposal sites) are included in sanitary surveys. 22

Impact on our sanitation programming? continued Public sector still has important role: - creating the right policy environment: incl. regulation (for price, quality, environmental impact, protection of water resources, etc.) - incorporating subsidies for hygiene promotion, sanitation marketing, supporting small-scale-providers, school sanitation, institutional sanitation, etc. Consider urban & peri-urban (e.g. squatter, slum) projects: 60% urbanisation by next generation, of which 60% will be unofficial settlement! Consider schools and churches as demonstration / entry points (Resources...)

Global Sanitation Fund (Launched March 2008) Run by the Water Supply and Sanitation Collaborative Council (WSSCC) of the UN Financing mechanism established to boost expenditure on sanitation and hygiene: Goal is to help large numbers of poor people attain safe and sustainable sanitation services and adopt good hygiene practices GSF supports other organisations (NGOs, CBOs, Local Govt.) implementation work by giving grants from a pooled global fund to selected organisations in eligible countries Must be linked to national sanitation policies/strategies Demand-led approaches, NOT supply- or subsidy-driven First round countries: India, Pakistan, Nepal, Senegal, Burkina Faso, Uganda, Madagascar. Second round of countries to be announced in 2009