WASHplus with local implementing partner ABMS/PSI improves hygiene conditions through behavior change and community mobilization in two peri-urban neighborhoods of Cotonou, the largest city of Benin. Wedged between the Atlantic Ocean and lagoons, Cotonou is floodprone and its slum neighborhoods experience cholera outbreaks during the rainy season. After promoting handwashing with soap and chlorination of household drinking water in 1,700 households, the pressing issue of open defecation came up time and again. The few public latrines are rickety structures built over the lagoons, but most residents prefer open defecation to these unsafe facilities. WASHplus connected with the provincial office of the Ministry of Health (MOH) responsible for sanitation in these zones to join in a first-ever (for Benin) experiment in community-led total sanitation (CLTS) adapted for peri-urban settings.
After adapting and testing CLTS tools for this new setting, all decision making and influential (social, religious, and governmental) persons from the two target neighborhoods were invited for an institutional “pre-triggering” prior to involving the entire community. They saw results of a simple survey situating the open defecation spots and public and household toilets. Community triggering was carried out on May 13. About 75 residents assembled in an open space, and two trained MOH facilitators led the group through the mapping exercise and a calculation of health-related household expenses. The Walk of Shame was not carried out as the event was far from the open defecation place. The result in urban areas is not necessarily a decision to construct latrines, and in this case, the group decided to create a special task force to follow up the decisions to destroy the open defecation places and work with the rest of the community to come up with solutions, especially concerning work with managers for the improvement of public latrines. The residents expressed a desire for modern toilets and said they were prepared to pay for them.
CLTS in this setting is different from rural settings, where the local chief has the power to convene and order people to implement decisions. These neighborhoods are extremely heterogeneous. Also, open defecation is forbidden by law, and the residents were reluctant to admit to the practice or to identify the open defecation places, thus the pre-survey came in handy. The participation of the “chef quartier,” the highest ranking local official, provided assurances that the decisions will receive strict follow-up. Plans are underway to replicate the triggering in the other zones of this very extensive neighborhood.
In its Year Five Annual Report, WASHplus has stories to tell, results to share, events to celebrate, and studies that add to the evidence base. WASHplus activities serve as the backdrop for many stories: the Zambian school girl who has access to privacy and menstrual supplies when she needs them, the Malian household that can now build an improved latrine on their rocky soil, the mother in Bangladesh who understands the importance of a feces-free environment, the Nepali home breathing cleaner air as it trials an improved cookstove. And perhaps more compelling than the individual stories are the results the project is beginning to record through endline data collection in Kenya and formative research on school enrollment and in Zambia. Providing water, sanitation, and hygiene (WASH) infrastructure to schools is having a notable impact on enrollment. Community-led total sanitation (CLTS) may be inoculating communities exposed to cholera. Numbers also tell the story of the project’s impact. Look for a snapshot of those figures throughout the report.
The conclusion of field activities in Uganda and Zambia this year provided opportunities to reflect, celebrate accomplishments through end-of-project (EOP) events, and share lessons learned. Several articles were published this year in peer-reviewed journals and others submitted on topics ranging from consumer preferences and willingness to pay for improved cookstoves to habit formation and costing of handwashing. WASHplus also played a key role in preparing the joint document on WASH and nutrition for publication and distribution.
WASHplus’s focus on integrating WASH into other development initiatives enabled the project to get in on the ground floor on subjects that are gaining traction at USAID and globally, such as WASH and nutrition, neglected tropical diseases, and MHM. This integration focus dovetailed nicely with the project’s mandate to serve a technical leadership role, and project staff had many opportunities this year to share its work and lessons from the field on a global stage, strategize with partners on important advocacy issues, inform policy, and develop guidance in multiple countries. Also toward that end, WASHplus launched its first two learning briefs on small doable actions and WASH and nutrition. This series details the variety of approaches WASHplus uses to improve WASH and household air pollution (HAP) across its portfolio of countries.
And finally, it’s been an exciting year for innovation with pilot projects underway in Ethiopia and Bangladesh focusing on sanitation marketing and sand envelopment. These two efforts will add to WASHplus’s body of knowledge on sanitation innovation and aligns closely with USAID’s global interest on the topic. WASHplus is also documenting its fecal sludge management work in Madagascar to tell the next chapter in that story.
Integrating basic science insights from psychology, cognitive science, and behavior change research, “The Science of Habit: Creating Disruptive and Sticky Behavior Change in Handwashing Behavior” presents six principles for creating greater initiation and maintenance of handwashing change. Read the new WASHplus report here.
@wasplusinfo’s Renu Bery presents a poster on integrating into at 2015 ASTMH Meeting!
In October 2015, WASHplus presented a poster at the American Society of Tropical Medicine and Hygiene Annual Meeting on the current situation, intervention design, behavior change plan, and expected results of its Burkina Faso WASH and neglected tropical disease (NTD) pilot activity, called “How Can Integrating Sanitation and Hygiene into an NTD Control Program Accelerate Reduction in NTDs?” View the poster here.
A mother is interviewed as part of the model moms contest.WASHplus implementing partner in Benin ABMS/PSI conducted an informal assessment via simple questionnaire and observations of any hygiene behavior changes in the two peri-urban pilot neighborhoods of Cotonou. This allowed outreach workers to observe improvements in hygiene practices the project is advocating, such as handwashing and point-of-use water treatment, and to select candidates for “Model Mother.” Of the 300 mothers assessed, 123 had perfect scores on a scale of one to 10, with 72 others close behind. Winners will be announced soon with much fanfare to continue to motivate others.
In August 2015, months of collaborative planning bore fruit as WASHplus carried out a training of master trainers with WASH and nutrition partner SHIKHA. The training for project managers responsible for community and household level outreach focused on Why WASH Matters for Child Growth, and provided new information and skills for safe feces management in USAID Feed the Future areas. Workshop sessions focused on breaking the fecal-oral cycle through latrine improvements and introduced WASHplus’s small doable action (SDA) approach to safe disposal of infant feces. Through this training and subsequent field visits, WASHplus was able to finalize a menu of SDAs for various infant and young child age cohorts. Workshop participants also provided input into job aids to help implement the SDA approach in the field. A second training was held in October. A poster on the subject of infant feces disposal was presented at the Integrated Nutrition Conference, Nairobi, Kenya, in September. In addition, WASHplus has published flipcharts, flashcards, and other materials in Bangladeshi on topics ranging from latrine improvement to tube well construction to menstrual hygiene management. Access the tools here.
A SPLASH staffer displays MHM materials at the end of project event. Hygiene Behavior Change Technician Mayombo Mandevu displays SPLASH menstrual hygiene management products, accomplishments, and stories at the end-of-project event.
WASHplus’s Schools Promoting Learning Achievement through Sanitation and Hygiene (SPLASH) project ended its four-year program with an event held on August 20 in Lusaka. The half-day event was designed to showcase the different activities that SPLASH carried out to deliver a truly comprehensive school WASH program, what was learned in the process, and most importantly, to advocate for WASH (water, sanitation, and hygiene) to be adopted nationally by the Ministry of Education (MOE) as a key element of quality education. To this end, SPLASH invited every provincial chief of the MOE to attend, along with a range of stakeholders from the WASH and education sectors. The 80 attendees were divided into groups and made the rounds to eight themed stations designed and manned by SPLASH and Government of Zambia partner staff. Each booth showcased a SPLASH intervention with its key activities, achievements, and lessons learned displayed on a poster. A flurry of publications were finalized for the event, including A Teacher’s Guide to Integrating WASH in Schools, School WASH Facilities Operations and Maintenance Guidelines, and two new stories from the field on integrating WASH into existing government programs and infrastructure and school enrollment.
To respond to the project objective of improving learning outcomes, SPLASH undertook a longitudinal study for three terms in 124 intervention and control schools. Results of this analysis by school term indicate a statistically significant effect of the intervention for all indicators tracked: student absenteeism (roll call and two-week recall), teacher absenteeism, and student-teacher contact time. It shows that WASH improvements in schools can reduce student absenteeism by up to 50 percent.