Identifying the last 10% of households practising open defecation in rural Tanzania

Since 2017, SNV and the Government of Tanzania have been implementing the Sustainable Sanitation and Hygiene for All (SSH4A) programme in eight Tanzanian districts. To date, the number of households that use toilets has increased to 90%. In the period March–April 2019, SNV Tanzania undertook a household survey in the eight project districts to identify the 10% of households still practising open defecation or sharing toilets despite the concerted government and SNV sanitation interventions. The findings show the majority of the households still practising open defecation and sharing latrines in the rural districts of Tanzania are not those commonly cited by the literature and sanitation programming – the people in poverty, the elderly people, people with disabilities, and those with other specific vulnerabilities. The majority in ‘the last mile’ are: 1) the ‘defiant’ households that have the socio-economic resources to build themselves latrines but prefer to practise open defecation or share toilets; 2) the socially isolated households that do not have a financially able family member who can support them; and 3) the geographically isolated households that are far from information centres. The SNV study also revealed a relatively high percentage of households headed by single mothers and those living in difficult terrains as part of the last mile. Furthermore, the study identified opportunities to increase access to sanitation among the last mile groups. These are: 1) introduction of behaviour change re-enforcement interventions tailored to different target groups; 2) promotion of context-specific sanitation technologies; and 3) introduction of community-led ‘social exclusion’ strategies.

Read the full report. Rieiro, M.F., 2019. Identifying the last 10% of households practising open defecation in rural Tanzania. Dar es Salaam, Tanzania: SNV Tanzania. 14 p.

Peri-Urban Sanitation – Water Currents, June 11, 2019

Peri-Urban Sanitation – Water Currents, June 11, 2019.

This issue of Water Currents highlights recent studies and resources on fecal sludge management, container-based sanitation, shared sanitation, and other topics. As noted in USAID’s Water and Development Plan included in the U.S. Global Water Strategy, separating individuals and communities from human waste, properly treating fecal waste, and promoting key behaviors that lessen the risk of illness are critical sanitation and hygiene interventions that reduce diarrheal disease, child mortality, malnutrition, neglected tropical diseases, and other waterborne illnesses, such as cholera. sanergy.png

The first six studies are from the Creating Demand for Peri-Urban Sanitation (SanDem) project, which aims to better understand how to improve the quality of peri-urban sanitation using demand-side/behavior change approaches in Lusaka, Zambia.

We would like to thank staff from Sanitation and Hygiene Applied Research for Equity (SHARE) for contributing content to this issue. SHARE generates evidence to improve policy and practice worldwide to achieve universal access to effective, sustainable, and equitable sanitation and hygiene.

Read the complete issue.

Emergency WASH update – recent webinars and research

If you and your organization would be interested in collaborating with the USAID CKM project on organizing an Emergency WASH-related webinar or Water Currents enewsletter, please let us know. emergencies

These links give examples of CKM webinars and the enewsletter issues. Also, please share any recent studies, reports or upcoming events by your organization that can be featured in the Emergency WASH updates.


Water as a Tool for Resilience in Times of Crisis. In this webinar, the Environmental Change and Security Program, USAID’s Sustainable Water Partnership, and Winrock International hold a discussion on where the challenges lie and what practitioners and policymakers can do to bolster effective water management for the world’s most vulnerable communities.


Rapid Review of Disability and Older Age Inclusion in Humanitarian WASH Interventions. Elrha, May 2019. The information presented in this review intended to provide an overview of the level of disability and older age inclusion in WASH interventions in humanitarian action. The review highlighted important gaps in available literature on inclusive WASH interventions in humanitarian contexts.

Rethinking Faecal Sludge Management in Emergency Settings: Decision Support Tools and Smart Technology Applications for Emergency Sanitation. CRC Press / Balkema – Taylor & Francis Group, June 2019. This study focused on the development of a smart emergency toilet termed the eSOS (emergency sanitation operation system) smart toilet to address the limitation in technical options. This toilet is based on the eSOS concept that takes into account the entire sanitation chain, which is the required processing of human excreta from toilet until safe disposal (downstream process).


Barriers and Facilitators to Chlorine Tablet Distribution and Use in Emergencies: A Qualitative Assessment. Water, May 29, 2019. We found: (1) chlorine tablets are regarded as one of the most effective water treatment methods and are often considered appropriate in emergency response, (2) dosing confusion and taste and odor rejection are perceived as the main problems limiting effectiveness, and (3) the primary solutions suggested for these problems were social and behavioral.

The Impact of Various Promotional Activities on Ebola Prevention Behaviors and Psychosocial Factors Predicting Ebola Prevention Behaviors in the Gambia Evaluation of Ebola Prevention Promotions. Int. J. Environ. Res. Public Health, June 2019. Three promotional activities were significantly associated with psychosocial factors of handwashing and, thus, with increased handwashing behavior: the home visit, posters, and info sheets. Health behavior change programs should rely on evidence to target the right psychosocial factors and to maximize their effects on prevention behaviors, especially in emergency contexts.

Evaluation of an Emergency Bulk Chlorination Project Targeting Drinking Water Vendors in Cholera-Affected Wards of Dar es Salaam and Morogoro, Tanzania. The American Society of Tropical Medicine and Hygiene, June 2019. The results from this evaluation indicate that bulk chlorination targeting medium- to large-volume water suppliers such as water vendors could be a feasible mechanism to address chlorination gaps at the community level during emergencies and disease outbreaks.

Drinking water quality and human dimensions of cholera patients to inform evidence-based prevention investment in Karonga District, Malawi. Water Supply, June 2019. The cost of a reactive response to cholera outbreaks puts a burden on Malawi, providing an opportunity for investment in innovative and localized preventive strategies to control and eliminate the risk of cholera while acknowledging social and cultural norms.


WASH in Urban Emergencies (Online Course), summer 2019 by RedR UK – The WASH in Urban Emergencies course will equip experienced WASH humanitarians with the necessary skills and knowledge to effectively work in the early stages of an urban emergency, and to identify the unique challenges of working in urban environments.

Climate Fragility Risks (CFR) In Development Sectors: Six Principles for Managing Synergies and Trade-Offs. United Nations University, May 2019. This document proposes six principles to manage CFRs in key development sectors, namely (1) implement interdisciplinary approach, (2) focus on vulnerable groups, (3) promote preventive and adaptive measures, (4) enhance inclusive and participatory governance, (5) allocate and manage finances for CFR effectively and efficiently, and (6) build resilient and green infrastructure.

Reducing Protracted Internal Displacement: A Snapshot of Successful Humanitarian-Development Initiatives. OCHA, June 2019.  While each situation is unique and requires tailored solutions, this paper offers valuable insights on how to best combine short- and long-term initiatives of international organizations, local partners and governments, while taking into account the needs of IDPs and host communities as well as market forces.

Webinar (June 27th) Support Mechanisms for Rural Sanitation Programmes

Join the CLTS Knowledge Hub for a free webinar from Dr. Jeremy Kohlitz and Professor Juliet Willett, authors of the forthcoming edition of Frontiers of CLTS: Support Mechanisms for Rural Sanitation Programmes.

Date: Thursday 27th June 2019
Time: 11:00 – 12:30 (BST)
Register here

The webinar will focus on:

  • Different individual support mechanisms including financial, in-kind and non-material that go beyond conventional CLTS support processes.
  • How these mechanisms can be designed to address the challenges faced by disadvantaged individuals and groups.
  • The necessary monitoring systems and knowledge sharing needs
  • Recommendations for practice moving forward

It will begin with a presentation by authors Dr. Jeremy Kohlitz and Professor Juliet Willetts followed by a Q&A.

A renewed focus on equity is being driven by the Human Rights to Water and Sanitation framework and Sustainable Development Goal 6, which emphasise the importance of adequate and equitable sanitation for all. Community-Led Total Sanitation (CLTS) is based on the idea that sustained, collective improvements in sanitation work best when communities identify and drive their own sanitation solutions. However, there is evidence that CLTS processes to achieve community-wide outcomes are not always systematic, adequate, sustained, or sufficient to meet the needs of disadvantaged groups. To ensure equitable outcomes, there is increasing attention on additional support mechanisms that complement conventional processes of demand creation, behaviour change, community empowerment and community action.

The webinar is based on the forthcoming edition of Frontiers of CLTS: Support Mechanisms for Rural Sanitation Programmes, which will be available in print and online at the end of June/early July 2019. This is the second part of a two part series on the overarching theme of Equality and non-discrimination (EQND) in sanitation programmes at scale. Part one is available to download here.

USAID WASH in the News

Links to the news articles below can by found in the USAID in the News section of the website. Be sure to check out the website for updates on USAID WASH-related activities and publications: usaidnews

  • Zimbabwe – Solar Garden Changes Lives in Rural Gwanda
  • Vietnam – USAID Launches Water Supply Systems in Thanh Hoa Province
  • As Global Population Grows, This Global Collaboration Works To Ensure Adequate Food And Water
  • Leveraging Satellites and the Internet of Things, SweetSense Facilitates Water Service Access in Kenya and Water Resource Management in California
  • Water Security in an Uncertain Future: Enhancing Water Resources Management and Planning by Reducing Climate and Weather Related Risks
  • USAID Office of U.S. Foreign Disaster Assistance (OFDA) – Meet Our Experts: Trevor White

Read more news articles.




Nigeria needs a more effective sanitation strategy. Here are some ideas

Nigeria needs a more effective sanitation strategy. Here are some ideas., June 5, 2019. nigerianeeds

Our research shows that while community-led total sanitation is effective in Nigeria’s poorer areas, there are two main challenges.

First, community-led total sanitation had no perceivable impact in the wealthier half of our sample. There, open defecation remains widespread. And second, even in poor areas, a large number of households still engaged in open defecation after the .

This suggests that while community-led total  can be better targeted, it needs to be complemented with other policies—subsidies, micro-finance or programmes that promote private sector activity in this under-served market.

Read the complete article.

WASH weekly research update – June 3, 2019

The USAID Water CKM project sends out an informal bibliography each week via email of some of the latest WASH-related studies, webinars, etc. Please contact us if you would like to be added to the subscription list.


Water as a Tool for Resilience in Times of Crisis – In this webinar, the Environmental Change and Security Program, USAID’s Sustainable Water Partnership, and Winrock International discuss where the challenges lie and what practitioners and policymakers can do to bolster effective water management for the world’s most vulnerable communities.


Lasting results: A qualitative assessment of efforts to make community-led total sanitation more inclusive of the needs of people with disabilities in Rumphi District, Malawi. Disability and Health Journal, 28 May 2019. Implications for future replication show the need to invest in training a wider group of people to assist with implementation and to keep the program simple and focused on more active learning methods to make sustainable behavioral changes.

Water, sanitation and hygiene: measuring gender equality and empowerment. WHO Bulletin, June 2019. Based on a process of expert input and literature review, here we offer a compilation of current water, sanitation and hygiene indicators that measure gender equality and empowerment in four interrelated priority areas.

When the pits fill up: (in)visible flows of waste in urban India. Journal of Water, Sanitation and Hygiene for Development, June 2019. Based on a rich ethnography of cleaning trucks in Bangalore, India, we show that trucking operations dispose of sludge in ways that harm both public health and the environment, and that the caste composition of sanitation work helps to keep it invisible from officials and the public.


WASH reflections series: Water safety planning: What have we learned so far? WHO, May 2019. Water safety plans have been implemented in at least 93 countries, with 46 countries reporting to have policies or regulations in place that promote or require WSPs.

Optimizing Access to Safe Water through Chlorinated Dispensers in Rural Kenya, Uganda and Malawi. Evidence Action, March 2019. Furthermore, community knowledge about the chlorine dispensers and other water treatments methods contributed significantly (p<0.001) to a household using chlorine across the three countries. In Kenya, households that attended Village Community Sensitization forums were 3.2% more likely to treat their water, while in Uganda and Malawi, households who attended Community Education Meetings were 2.5% and 7.0% respectively more likely to chlorinate their water.


 There’s a Better Way to Manage Human Waste by Pallavi Bharadwaj. Engineering for Change, March 2019. Sadly, from India all the way to Kenya, the practice of manual scavenging, as the dirty clean-up work is called, is still fairly common. Despite the practice being banned since 1993 in India, the news of sewer deaths are not rare.

Economist-engineers and public health economists: is WASH economics a “field”? WASHeconomics, May 29, 2019. This post explores ways of breaking down the “field” of WASH economics.

Reflections from a mother on Menstrual Hygiene Day. Water Blog, May 28, 2019. I recently returned to work after six months of maternity leave with my second child. Transitioning back to my ‘original’ role as a Water Supply and Sanitation Specialist at the World Bank, alongside my new role as a Mum, has been a challenging but fun experience!