Danielle Pedi 5 June 2008

Transcription

1 Sharing Experiences: Lessons in sustainable sanitation in South East Asia and the Pacific Danielle Pedi 5 June 2008

2 Health Why do we need to promote sanitation? Diarrhoeal diseases (3 rd leading cause of death globally, 1.8 million deaths per year (WHO 2004)) Intestinal worms, trachoma, ARIs? Financial Costs Global cost for water and sanitation = US$38 billion sanitation accounts for 92% of this value (Hutton et al. 2006) Sanitation losses estimated at US$9 billion in Cambodia, Indonesia, Philippines and Vietnam alone ($4.8b health-related) (Hutton et al. 2007) Safety - especially for women Dignity

3 Effectiveness of Water & Sanitation Interventions for Reducing Diarrhoea Morbidity 50 in Diarrhoeal Incidence % Reduction i Latrine Water Quantity Water Quality Hygiene Promotion Handwash with Soap Effects are independent and additive Source: Esrey et al. 1991; Huttly et al. 1997; Curtis & Cairncross 2003; From Cairncross, 2007 Aspire Workshop

4 Cost effectiveness of water, sanitation & hygiene as health interventions (US$ per DALY averted) Intervention Water supply Hand pump or standpost House connection Water sector regulation & advocacy Basic sanitation Construction & promotion Promotion only Hygiene promotion Cost-effectiveness Source: Cairncross & Valdmanis, 2006 In Disease Control Priorities in Developing Countries, 2nd edition (Chapter 41)

5 Why do people want sanitation? Source: Mukherjee 2001

6 Why is there a sanitation gap? Demand is low, not fully expressed or ignored Households consider cost of investment too high Sanitation is intensely personal & difficult to discuss Interventions focus on building toilets, not changing behaviours. Success = # of toilets Political and institutional barriers

7 What have we learned? How to build toilets & finance their construction How to support household investment & behaviour change Shift from top-down supply driven to bottom-up demand led approaches Far greater emphasis on software elements A range of choices Understanding household practices, needs & preferences Better designed hygiene education Better marketing & promotion

8 Why this book? There are no one-size-fits-all solutions Experience and lessons go undocumented or buried in unpublished reports Focuses on practical implementation issues- plenty of options & approaches, but how do they make sense in context? Looks at dimensions of sustainable sanitation: health, financial, environmental, technology, socio-cultural Building a reflexive community of practice

9 CLTS in Indonsia WSLIC 2/MoH Focus on stopping open defecation Collective action No toilet subsidy Promotion of low-cost home made toilets Jan 05-Aug 07: coverage for 31,400 households 33 villages & 2 sub-districts declared Open Defecation Free

10 CLTS in Timor Leste WaterAid AU 5 pilot villages ODF in 42 days Compare: 7 villages in 1.5 years w/ subsidy

11 UD double double--pit composting latrines in Vietnam Plan in Vietnam Over 8,000 DVC latrines since % of households using & maintaining 63% use compost, 61% use urine

12 Biogas in Indonesia Demonstration biogas plant and french drain filter in public park Ecosan short course training Awareness raising about failing septic tanks Enough biogas to cook for 2 hours per day

13 Composting toilets in the Pacific Practical hands-on training in composting toilet construction in Tonga, Vanuatu, Tuvalu and Kiribati

14 School Sanitation in PNG ATloos constructed in 140 schools 91% girls & 80% boys using toilets Household demand for new Round Loo

15 PHAST in Vanuatu World Vision PHAST used as health education sessions, not as a participatory tool Evaluation and discussion Project redesign & more training in PHAST

16 Microfinance in Vietnam AusAID 3DT May 03-Aug 07: 144,00 in loans for 4,387 septic tanks (no default) Direct grants = 770 Extensive 1 year training in fund mgmt

17 Sanitation Park in Fiji - SOPAC Demonstration of systems (pour flush, septic tank, VIP, CT) Hands-on training in composting toilet construction Community Workshops & Action Plans

18 Sustainable SanitationSanitation- Drawing out some common lessons Health Environment and natural resources Technology and operations Financial and economic issues Socio-cultural and institutional aspects

19 Health Knowledge of good hygiene behaviour does not always translate into hygiene behaviour in practice Plan in Vietnam: 90% of householders had knowledge of good hygiene like washing with soap. 41% did not have cleaning agents near handwashing facilities School sanitation in PNG: observed toilet usage increase not accompanied by hand-washing (only 24% boys, 34% girls) Can not rely solely on self-reported data better monitoring & verification needed Clearer hygiene messages; more targeted, better designed hygiene campaigns

20 Environment & Natural Resources High water tables & frequent flooding limits technology options. Septic tanks promoted as most appropriate technology More emphasis on ensuring households maintain systems and are aware of environmental health risks Ecological Sanitation A range of sustainable alternatives BUT Cultural issues around reuse of sanitation products- may be resistance Must ensure appropriate and safe handling and use Promotion and marketing to change public perceptions (In Vietnam, 78% of DVC latrine users want to upgrade to septic tank) Training and education needed

21 Technology & Operations Hands-on training in design, construction, operation & maintenance is essential Once people have chance to see system first hand & experience its benefits, they are more likely to commit their own resources and time Local innovation in latrine design & construction can produce cheaper and more appropriate options ATLoo : From 16 toilets to 9 toilets per school cost savings of K9,000 Round Loo : 500 people tested Granito pan: US$ 4.30 vs. US$10 for Hanoi-manufactured pans CLTS drives local innovation

22 Key Lessons: Financial & Economic Issues Microfinance schemes require a good deal of startup support to build human and financial capacity Financial management, loan parameters, borrower assessment, training suppliers Ensure demand can be matched by supply Scaling up CLTS (links to sanitation marketing?) Training local suppliers can help promote sanitation and generate income Local producers become active promoters (PNG, Vietnam, Indonesia, Pacific)

23 Socio--cultural and institutional Socio Local champions are the key to uptake and sustainability Village chiefs, school headmasters, government officials, natural leaders Critical role of women Emerge as natural leaders in sanitation promotion Responsible for cleaning and maintenance Women value sanitation- when their voices are not heard, potential is reduced Essential to maintain the quality and integrity of facilitator training CLTS and PHAST rely on skilled facilitators

24 Implementation It takes time. Longer time horizons to first stimulate demand & engage in training of suppliers before beginning construction. It takes flexibility. Sanitation initiatives need to be able to respond to what works (and doesn t work), and adapt accordingly.

25 Summing Up: Policy Implications Move away from infrastructure towards people Stimulate demand, secure supply Business models that work: supply chains, skills, public/private sector roles, microfinance, subsidies?? Range of technology options that are affordable, sustainable, easy to maintain/repair Taking sanitation to scale: policies that support onground work (incentive schemes, different options) Monitoring & evaluation Disseminating lessons & sharing experience

26 Thank You! To the authors of the case studies for sharing their stories: Le Thi Hao, AusAID 3DT Penny Dutton, AusAID 3DT Geoff Bridger, AusAID 3DT Gabrielle Halcrow, World Vision AU John Donnelly, World Vision AU R.S. Arun Kumar, WTO Ben Cole, Consultant Pham Duc Phuc, Plan in Vietnam John Collett, Plan in Vietnam Rhonda Bower, SOPAC Kamal Khatri, SOPAC Leonie Crennan, Institute for Uncertain Futures Nina Shatifan, WSLIC 2 Dinesh Bajracharya, WaterAid AU Steve Layton, ATprojects