Sanitation promotion: experiences from government-led initiative in southern Ethiopia

In Ethiopia’s Southern Nations Nationalities and People’s Region (SNNPR) an innovative programme has promoted latrine construction and use, hand washing and safe water storage and handling. The intervention is an example of how visionary government leadership can create the political momentum for low-cost sanitation and hygiene (S&H) and reach out to rural communities.

Papers from the Overseas Development Institute, in the UK, and the IRC International Water and Sanitation Centre, in the Netherlands investigate the SNNPR approach. The research was undertaken by Ethiopian researchers on behalf of the Research-inspired Policy and Practice Learning in Ethiopia and the Nile Region (RiPPLE) project.

[...] In 2003 the SNNPR Bureau of Health (BoH) began a new community health strategy, including S&H [which aimed] to reach households through paid health extension workers (HEWs) and volunteer community health promoters (CHWs) [and which] promoted latrine construction without any form of subsidy.

A combination of political promotion and institutional mobilisation was successful in launching and expanding the regional government’s strategy as a ‘movement’. [...] The key elements of the S&H strategy were designed to be politically attractive and administratively feasible, and were written in non-technical language.

The researchers found after the project:

• The proportion of households having latrines increased by a factor of eight.
• There was less acceptance of open defecation.
• Questionnaire results indicated better knowledge on hand washing, although actual practice remained poor.
• There were hand washing facilities in 82 percent of households, but only 6 percent were near the household latrine and few people used soap or detergents.
• Water storage and handling practices also remained poor.
• Men mostly decided latrine design, siting and construction, although women were involved in providing materials and plastering.

Despite these positive developments, doubts remain about sustainability and some latrines have collapsed [and] many are infested with flies. As CHWs are unpaid and receive little follow-up support or training, many have lost motivation. Higher levels of government have not provided enough technical support or monitored changes in household S&H behaviour.

[...] Aspects of the SNNPR experience which might help improve [sanitation elsewhere] include:

• promoting local, rather than donor-driven, S&H programmes and technology designs
• using community promotional change agents coordinated by local authorities in command and facilitation roles
• reviewing local S&H progress within wider health sector review processes
• ensuring that strategising, political positioning and communication are based on solid evidence
• realising that sanitation workers cannot make their case to high-level politicians without understanding the political dynamics around S&H.

Source: id21, 01 Apr 2009

Transparency: public accountability through “Citizens’ Voice” initiative, Cape Town, South Africa

The “Raising Citizens’ Voice in the Regulation of Water Services” is a public education initiative driven by the National Regulator (currently within the Department of Water Affairs and Forestry [DWAF]). It supports a bottom-up approach to water services regulation by actively involving citizens in the local monitoring of water and sanitation services.

It aims to empower citizens to hold local government accountable through:

• Training citizens about their rights and responsibilities, and then
• Setting up “User Platforms” which serve as monthly meetings between the municipality and the community for ongoing civil society water services monitoring and problem solving.

The initiative aims to build partnerships between the three spheres of government (national, provincial and municipal levels) and civil society.

Important lessons learned so far are:

• the need to secure political support, through getting endorsement and providing training to local government officials;
• after citizens are trained, User Platforms should be established as soon as possible to keep them engaged;
• ensure citizen ownbership of User Platforms and not let them become a public relations vehicle for local government.

Read the full story in the WIN-SA lesson series no. 20 “Public accountability through “Citizen’s Voive”: City of Cape Town shares good practice (March 2009).