Author Archives: dietvorst

Innovative approaches to sustain handwashing with soap and open defecation free status in rural communities in Tanzania

By SSH4A Tanzania

In Tanzania, SNV has developed, under the Sustainable Sanitation and Hygiene For All programme, two innovative approaches to sustain handwashing with soap and open defecation free status in rural communities. These are triggering with soap at vaccination centres and Jirani (neighbours) sanitation groups.

The first intervention consists of triggering at vaccination centres as they were found to be ideal places to raise awareness of the importance of washing hands with soap among pregnant women, mothers and other caregivers.

The second intervention is based on having neighbours who monitor the sanitation and hygiene progress of the households closest to their homes and sensitise other neighbours on the importance of building, taking care of, and improving sanitation and handwashing facilities.

The following case studies provide practical information for implementing the interventions, and brief discussions on the remaining challenges and lessons learned by the SNV team and their partners on the ground:

SSH4A Tanzania, 2019. Emotional demonstrations (emo-demos) of handwashing with soap at vaccination centres. Dar es Salaam, Tanzania: SNV Tanzania. 8 p. Download case study

SSH4A Tanzania, 2019. Jirani sanitation groups : sustaining open defecation free status in Tanzania. Dar es Salaam, Tanzania: SNV Tanzania Download case study

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Training Program on Implementing and Operationalizing Faecal Sludge Management

In the next five years, it is expected that more than 500 faecal sludge treatment plants (FSTPs) have to be designed, built and operated in India. However, there is a significant gap in understanding of the faecal sludge management opportunities and operations amongst practitioners such as contractors and operators.

To address this gap, the Centre for Advanced Sanitation Solutions (CASS) in partnership with The Bill and Melinda Gates Foundation, BORDA and the CDD Society is organising a training course + exposure visit on faecal sludge management from 5-8 February 2019 in Bengaluru, India.

For more information go to: www.trainings.cddindia.org

 

New guide on female-friendly toilets by WaterAid, WSUP and Unicef

1 in 3 people across the world don’t have a decent toilet of their own. But it’s not just a question of lacking a household toilet – low availability of public and community toilets is also an issue. Where they do exist, these facilities often don’t meet the needs of women and girls, undermining women’s human rights.

The ‘Female-friendly guide‘, out in October 2018 and written by WaterAid, UNICEF and WSUP, is designed primarily for use by local authorities in towns and cities who are in charge of public and community toilets. It’s also useful for national governments, public and private service providers, NGOs, donors and civil society organisations who play a role in delivering these services.

The guide explains why toilets must be female-friendly, before detailing the essential and desirable features needed to make them so. It also suggests ways to increase gender sensitivity in town planning on sanitation.

Recommendations and practical steps have been drawn from existing literature, expert opinion and analysis of pioneering experiences from around the world.

The guide is available to download now, and will also be presented at the UNC Water and Health Conference on 1 November 2018.

Download “Female-friendly public and community toilets: a guide for planners and decision makers”.

This news item was originally published on WaterAid’s WASH Matters website.

Sanitation and health: what do we want to know?

Experts meet to discuss reaching a consensus on what the evidence tells us.

Radu Ban

Radu Ban

Jan Willem Rosenboom

Jan Willem Rosenbom

This is the first of two blogs written about the “Sanitation and health evidence consensus meeting”, convened by the World Health Organization (WHO) in Seattle on May 24 and 25 of 2018. It was written by Jan Willem Rosenboom and Radu Ban, who are both Sr. Program Officers on the Water, Sanitation and Hygiene (WSH) team at the Bill & Melinda Gates Foundation. This first blog will describe the process used to arrive at the consensus, while the second blog will describe the outcome of the consensus and will come out once the results of the consensus meeting have been published. Also, mark your calendars for a session during the 2018 UNC Water and Health conference dedicated to this consensus!

Cambodia - India Two sides of sanitation rubbish and cleanliness. Credit Bill & Melinda Gates Foundation

Two sides of sanitation: rubbish and cleanliness. Credit Bill & Melinda Gates Foundation, Cambodia/India

Introduction: What is this about?

It is hard to imagine that making improvements in sanitation wouldn’t play a role in improving health. After all, we know that shit spreads disease and the F diagram shows us that sanitation is an important tool in blocking the transmission of pathogens from one person to the next, thus lowering exposure. And sure enough: we have strong evidence about the effectiveness of sanitation interventions and improving health and human capital outcomes from rigorous historical studies, from high- as well as low- and middle-income countries.

At the same time, looking at the specific impact of programmatic sanitation interventions, it can be hard to figure out what the evidence is really telling us. On the one hand, a systematic review of the whole body of evidence on sanitation and health (carried out by Freeman et al. in 2017) suggests that sanitation protects against diarrhoea, active trachoma, some soil-transmitted helminth (STH) infections and schistosomiasis. It also improves height-for-age scores of children (i.e. it decreases stunting, which is an important measure of human capacity). On the other hand, several recent sanitation intervention studies have found limited or no impact on different health outcomes. The table below (copied with permission from a presentation by Tom Clasen), provides a summary of key findings from the most recent sanitation studies:

Sanitation blog - Summary of effects from recent sanitation studies

  1. Fewer observed flies and feces; no change in fecal contamination of water
  2. Fewer observed soiled hands and less fecal contamination of water
  3. Except in the study arm considering just water quality improvements

This seeming lack of agreement is confusing, and partly in response to questions from practitioners, on May 24 and 25 of this year WHO convened a meeting of experts to review the existing evidence and reach a consensus about what it is telling us. The group of experts consisted of researchers across multiple disciplines who had written extensively on the topic of sanitation and health. We thought it was necessary to reach consensus among researchers before engaging, in a unified voice, the practitioner community.

At the same time, to make sure that the concerns of practitioners would be considered in the meeting, we published a “request for input” online (through the SuSanA network as well as the Sanitation Updates blog) and we will summarise the responses here. But first…

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Toilets need water, Indian women suffer under ODF drive

Toilets in households have only increased the drudgery of village women as they have to fetch water from faraway sources for toilet use, writes Amita Bhaduri, Programme Director of the Society for Promotion of Wastelands Development (SPWD), in an article posted on the Indian Water Portal.

Rajasthan is all geared up for the open defecation free (ODF) status well before the national deadline of October 2, 2019. According to the assistant engineer of the nagar parishad, Resha Singh, 4.75 lakh [475 thousand] toilets have been constructed since October 2, 2014 in Alwar district which is about to be declared ODF.

Paari, a 45-year-old woman of Ghevron ki dhaani village in the district got a toilet at her household under this toilet construction drive. She does not have to go far away to find a place for her sanitary needs anymore. She is, however, unhappy and exhausted from the numerous trips to the water source she has to make to get water in the toilet. Her feet are aching from treading the path filled with rocks and thorns without any footwear for protection.

Water access and women's donkey work

Read the full article

SACH Impact Incubator seeks applications from Indian WASH & waste management social ventures

sach-impact-logo

Subhash Chandra Foundation, the philanthropic initiative of Rajya Sabha MP and Essel Group Chairman, Subhash Chandra has launched ‘SACH Impact’ Incubator, in partnership with LetsEndorse, to support early-stage social ventures aspiring to solve the problems of millions of Indians.

Two annual cohorts of resolute social entrepreneurs shall be constituted every year, with each one working on one of the 8 focal areas (Education, Healthcare, Clean Energy, Agriculture, Inclusion, Waste Management, Livelihood, WASH), aligning with the UN Sustainable Development Goals. The programme aims to equip them with market access for pilots, financial support to do so, necessary mentorship, knowledge networks & more, to take their solutions to the next level and prepare them to scale and serve the large Indian population.

Ventures with already developed testable versions of their innovative product/technology/software or those which have just begun conducting pilot tests on-the-ground and have the potential to make transformational impact on the society can apply online through this link: http://bit.ly/SachImpact before 25th June, 2018

Seeking inputs for “consensus” meeting on sanitation interventions

Following the publication of results from a number of recent studies investigating links between improvements in sanitation and health (such as the WaSHBenefits study, studies in Tamil Nadu, Madya Pradesh and Orissa in India and others) some of you have contacted the Gates Foundation WSH team with questions and concerns about the seeming lack of consensus about the relationship between sanitation and health demonstrated in those studies.

Looking at a number of historical studies, it is hard to imagine that improvements in sanitation did not play a significant role in improving population health. And indeed, older as well as more recent historical evidence from US, Europe and developing countries establish causal relationships between sanitation and health. However, when considering more granular evidence considering the effects of individual and categories of interventions, there is less alignment.

Understandably, this has led to concerns about the meaning of this evidence, and questions about how it should be interpreted and used by practitioners, working to design and implement sanitation programs.

Partly in response to those concerns, WHO is convening an expert meeting in May this year, to develop a “consensus statement” around two specific questions:
• Are particular sanitation interventions more likely to have protective effects?
• What pre-conditions are likely to impact the effectiveness of these sanitation interventions?

The meeting will bring together researchers, from both life and social science backgrounds from around the world for two days of deliberations, informed by evidence and identifying points of agreement and contention. The Water, Sanitation and Hygiene team at the foundation strongly supports the organization of this meeting, and to make sure that issues relevant to practitioners are considered (and hopefully answered) during the discussions, we would like to invite you to share with us the most important questions you (and your teams) face when considering the use of evidence in program design.

The consensus meeting is scheduled to take place on May 24 and 25. To allow for review and incorporation into the agenda, the deadline for the submission of questions for consideration is end of day Thursday May 17.

There is no particular format for submission, although when we say we are looking for questions, we mean just that; a short sentence with a question mark at the end (no need to over-think it). If you are concerned that there is the possibility of mis-interpretation, you should feel free to provide some context and explanation.

Following the meeting, the results will be published and broadly disseminated.

We look forward to hearing from you what concerns you. If you have any questions about the process (or the scope) of this effort, please feel free to get in touch.

Jan Willem Rosenboom and Radu Ban

Contact:  janwillem.rosenboom [at] gatesfoundation.org