integrating handwashing into community approaches to total sanitation (cats)
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Integrating Handwashing into
Community Approaches to Total Sanitation
(CATS)
PPPHW Think Tank, February 2014
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Community Approaches to Total Sanitation
What are CATS?
CATS is an umbrella term developed by UNICEF to encompass a wide
range of community-based sanitation programming (including CLTS).
Community Approaches to Total Sanitation (CATS) aims to eliminate
open defecation in communities around the world.
The CATS Essential Elements are the common foundation for UNICEF
sanitation programmingglobally.
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CATS: The Essential Elements
At their core, CATS rely oncommunity mobilization and
behavior change to improve
sanitation and integrate hygiene
practices.
They are demand-driven and
community-led, and emphasize the
sustainable use of safe, affordable,
user-friendlysanitation facilities.
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CATS: A Global Perspective
CATS is currently being implemented in 53 countries
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How is handwashing being included?
Through new triggering
exercises, as part orfollow-up to the initial
village triggering
Interpersonal hygienepromotion, as part of
community level follow-
up and school-based
activities
Inclusion in national
ODF protocols
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Example: Creating new HW triggering tools
10 tools field tested inMalawi (UNICEF, SalimaDistrict Council, ECBCanada)
Handwashing practice
increased by 69% andsoap availability athandwashing facilitiesincreased by 15%(compared tocommunities where nospecific HW triggeringtools were used)
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Example: ODF protocols
But a lot of variation in the way HW is included.
Environmentiscompletely
100%ODF
Eachho
useholdhasaccess
tot
heirownlatrine
Alllatrinesmustbefully
functionalandclean
Each
householdhas
accesstoHWWS
facilities
Child
rensfaecesare
dispo
sedofeffectively
Eachho
useholdhasaccess
toasharedlatrine
Eac
hmemberofthe
communityunderstandsthe
need
tocontainexcreta
i
,
i
Action
Planand/orother
communityM&Estructure
present
nstitutionalWASHfacilities
schoolsandhealthcentres)
mus
talsobepresent
lllatrin
esmusthaveatight
fittingcover
Allla
trinesmusthave
sanitarybins
i
isibly
cle
an
no
garbage
or
flies
By-law
simposedatLocal
overnm
ent/communitylevel
t
oprohibitOD
Bangladesh X X X X X X X
Chad X X
Cote dIvoire X X X XEthiopia X X X X X
Ghana X X X X X X X
India X X X X X X X
Kenya X X X X
Madagascar X X X X X X
Mali X X X X
Mozambique X X X X X
Niger X X X
Nigeria X X X X
Sierra Leone X X X X X X X X X
Syria X X X X X X X
Togo X X X X
Zambia X X X X
Country
Essential Indicators Additional Indicators
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Example: ODF protocols
Zambia
ODF verification form requires visit to each HH in villagelooks at: Handwashing station (Y/N)
Handwashing station with water + soap/ash (Y/N)
ODF certification letter sent to community includes:
Following the ODF verification visit of your village conducted on the XXX month
year, I am happy to inform you that the verification team has recognize the
achievement of the ODF status of your village. This is no mean achievement and
the district team takes this opportunity to congratulate you for your efforts
I urge you to continue your effort to ensure that all household use and maintaintheir latrines appropriately and practice hand-washing with soap/ash. As you
know Hand-washing with soap/ash before eating and after using the latrine is
key to reduce diarrheal disease and keep you community healthy.
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Example: ODF protocols
Ethiopia:
Phase 2 certification (to get white flag) includes:
Handwashing facilities are in working order and have enough
water and soap or soap substitute (applies to HHs and
institutions, such as schools, health centres)
Communal latrines with
hand washing facility
available for passengers
on main routes andpublic gathering places
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Example: ODF protocols
Others are less precise:
GhanaModel Clean Community
(MCC) criteria includes:
An increase in handwashing practice
(evidenced by hand
washing facilities with soap
or other agent) close totoilet facilities, in
institutions such as schools
and health posts
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Immediate impact of including hygiene
promotion in CATS:
0%
20%
40%
60%
80%
100%
120%
Toiletsinuse
Toiletswith
superstructures
Roofedtoilets
Toiletswithlids
Coveredorifices
Smoothand
cleansquatting
surface
Toiletswith
handwashing
facilities
Zambia6 month follow-up survey:
76% of toilets had hand-washing facilities (a significantimprovement on the initial pilot) - of these, 84% had water,
51% of households were using soap and 34% using ash for hand-
washing
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Some findings from the Global CATS Evaluation
Survey shared with regional
and country level staff andpartners218 responses from
45 countries:
Broad agreement that
hygiene promotion shouldbe integrated into CATS
programmes
Majority of respondents
reported that
Handwashing station with
water and soap/ash is one
of the most difficult results
to achieve
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Some findings from the Global CATS Evaluation
And hand washing was reported as being the hardest ODF
certification criteria to maintain
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Some findings from Sustainability Checks:
Increasingly being used by UNICEF (with partners) to ensure that
project outputs are sustainable beyond the end of the projects bysystematically auditing key sustainability criteria and using the
results to make course corrections and as a core indicator for
assessing project success:
In Mozambique, virtually all ODF communities visited werefree of signs of OD, but only 40% met the more stringent ODF+
standards which includes new criteria on latrine quality,
handwashing facilities and the presence of soap or ash.
A key challenge for ODF sustainability monitoring through the SCs
is finding tools nuanced and flexible enough to assess defecation
and hygiene practices and behaviour change patterns within the
quick in-and-out visits typical of SCs.
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Thank you!
Any questions?
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