A study of drivers for latrine take-up in rural Cambodia Analysis from two sanitation marketing programs

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A study of drivers for latrine take-up in rural Cambodia Analysis from two sanitation marketing programs Claire Chase, Economist Water and Health Conference, University of North Carolina www.wsp.org www.worldbank.org/water www.blogs.worldbank.org/water @WorldBankWater

Sanitation marketing results show variety in sales across communes in Cambodia Cambodia has the lowest rural sanitation coverage in South East Asia region Open defecation nearly 70% in rural areas Annual rate of increase in rural sanitation coverage 1% per year, among the lowest in the region Sanitation marketing introduced in 2009, but little is known as to why sales are rapid in some communes and slow in others Among others, WaterSHED and ide are implementing sanitation marketing in Cambodia 1

Research Methodology Research Question What are the factors/drivers contributing to latrine take-up in communes where sanitation marketing activities have been carried out? Level of analysis Rural communes where latrine sales took place as part of sanitation marketing program Research technique Quantitative analysis: multiple regression using monitoring data of sanitation marketing implementers and government administrative data Qualitative analysis: semi-structured interview with commune cadre (commune councillors, village chiefs, latrine businesses) 2

Data characteristics Latrine sales and business characteristics: WaterSHED and ide Commune socioeconomic characteristics: Govt admin data (Commune Database & Identification of the poor database) Data timeframe: January December 2012 Sample size: 381 communes 10 communes randomly selected for in-depth qualitative research 3

Constructing hypothesis: Various factors could determine latrine take-up in a commune Supply-level factors Demand-level factors Enterprise/private sector capacity Demand generation Latrine take-up in a commune Enabling environment Commune socio-economy Commune-level factors 4

Independent Variables Commune-level factors Dependency ratio Illiteracy rate Level of poverty Occupation structure of commune Migration patterns. Population density Percentage of households with a toilet in 2011 Proportion of women in the commune council. Demand-level factors Presence of sanitation sales agents Number of latrine businesses visiting commune Supply-level factors Ownership of transportation assets Ownership of production assets Distance from latrine business to commune Number of markets in commune Number of construction enterprises 5

How latrine take-up rate is defined Latrine take-up rate: Sales per month per 100 households lacking sanitation at baseline Sanitation marketing HH without toilets at baseline (by Dec 2011) All HH in commune in 2012 Total annual number latrines sold in 2012 Latrine take-up rate = Number of HH without toilet by Dec 2011 /100 x 12 (months) 6

Limitation of the study Combining dataset: Combining data from different organizations with separate monitoring framework leads to only few data used for the study Data quality: Administrative data of the government faces some quality issue Data availability did not match hypothesized drivers 7

Nearly 3 latrines sold per month for every 1000 households without a toilet Average take-up rate is 0.28% 8

On average, the road distance of latrine business to commune is 8.8 km Average distance 8.8 km WaterSHED data ide data Average= 6.6 km Average= 12.8 km > 40km!

Communes have different level of sanitation market exposure On average, each commune exposed to sanitation market at about 7 months prior to 2012 (year of analysis) Early exposure ~ 1.5 month Longer exposure ~ 1 year Number of months for sanitation market exposure 10

Key commune characteristics that have an effect on latrine take-up rate Model with fixed effects B SE B Constant 0.06 0.16 Total Area in the commune 2.8E-07 1.2E-07 Total Area for resident in the commune 0.002 0.001 Density of population compare to resident area 2.3E-04 1.2E-04 % poor households category 1 *-0.006 0.003 % population > 18 migration out country *-0.026 0.013 % Primary occupation 0.001 0.001 % Secondary occupation -0.001 0.001 % Primary occupation in Agriculture fishery 0.001 0.002 % Primary occupation in craft and production ***0.032 0.010 Has a microfinance intervention 0.032 0.046 % female commune council ***0.004 0.001 Illiteracy rate -0.008 0.005 Total dependency ratio 0.001 0.001 11

Key demand-level variable that affects the latrine take-up rate Model with fixed effects B SE B Constant *0.43 0.21 Number of sales agents ***0.091 0.022 Number of village sold by latrine businesses -2.9E-03 0.01 Total number latrine businesses come to sell latrine per 0.02 0.02 commune Market maturity -0.001 0.010 Illiteracy rate -0.021 0.011 Total dependency ratio -3.E-03 3.E-03 12

Key supply-level variables that affect latrine takeup rate Model with fixed effects B SE B Constant ***0.359 0.042 Distance from latrine business to commune in KM ***-0.004 0.001 Has mould size 1 meter ****-0.13 0.04 Has mould size 0.8 meter 0.07 0.03 Has a motorcart -0.02 0.04 Has a truck 0.02 0.04 Has a Kouyon -0.03 0.05 Has a Chamberboxmold 0.07 0.05 Has other tools -0.04 0.04 Number of market in the commune *0.023 0.012 Number of construction material shop in the commune 0.01 0.01 13

Combining the variables together, only few maintain their significance Model with fixed effects B SE B Constant *0.8 0.347 Total dependency ratio -0.002 0.003 % poor households category 1-0.01 0.01 % population > 18 migration out country -0.03 0.02 Employment rate -0.004 0.003 % secondary occupations 0.000 0.002 % Primary occupation in craft and production ***0.04 0.01 % female commune council 0.002 0.002 Number of sales agents ***0.09 0.02 Distance from latrine business to commune in KM -1.2E-04 1.9E-03 Number of market in the commune *0.055 0.028 Has mould size 1 meter -0.13 0.06 14

Key findings from quantitative analysis Presence of households with diverse sources of income is positively correlated with latrine take-up The number of latrine sales agents visiting the commune had the strongest positive correlation with latrine take-up rate Community s exposure to the market also plays significant role in latrine take-up, i.e. sales is easier where there is an already functioning market place in the community Latrine business s ownership of production assets such as mold is not strongly correlated with latrine take-up 15

Key findings from qualitative analysis Communes with high latrine take-up often have the following features: Commune chiefs who care about commune reputation in relation to sanitation Strong commune leadership in setting sanitation shared vision and strategies for the commune Existence of demand creation activities in the commune Regular follow-up activities by the commune in sanitation activities 16 I don t want my commune to be called shit commune

Key findings from qualitative analysis (cont.) Good coordination among other partners such as NGO and private sector by local government Well established relationship of private sector and local government Reliability and quality of the latrine enterprise in producing and delivering latrine Active involvement of Commune Committee for Women and Children in sanitation 17 building relationships with the village chiefs and community people is very important for my business. When people have money to buy latrine, they will remember me.

Programming Implications Strengthening sales function in sanitation marketing program could be key to improve the latrine sales and take-up in a commune. Capitalizing on female members of commune council, such as the focal point for Commune Committee for Women and Children, is also key to increase the latrine take-up rate. Reducing cash constraint at household level could increase latrine take-up Need to understand better what role the capacity of enterprise plays in take-up 18

Programming Implications (Qualitative) Having strong local government leadership in enabling the private sector to operate in the communes is also necessary in enhancing sales function. Establishing good relationship with local government is key for private latrine business to be successful in a commune Capitalizing on or coordinating with other demand creation activities could be key success for sanitation marketing program Building competition mindset for commune reputation could optimize commune leadership to support sanitation program 19

Thank you Team members: Phyrum Kov, Priya Lall, Susanna Smets, Yeng Lun, Virak Chan, Sophea Pouv, Veasna Toeur Special thanks to WaterSHED and ide www.wsp.org www.worldbank.org/water www.blogs.worldbank.org/water @WorldBankWater