TRAINING REPORT

COMMUNITY LED TOTAL SANITATTION (CLTS)

TRAINING OF TRAINEERS – TOTs

KARATU, TANZANIA.

18th – 22 March, 2013. JANUARY-FEBRUARY 2

008

Lead Master Trainer/Facilitator

Charles Ngira,

Plan International, Kenya.

IntroductionThis report covers details of proceedings of a training of trainers’ (ToTs) workshop on CLTS conducted by Plan International, Kenya. Plan Kenya has been providing CLTS capacity support to interested partners to accelerate rural sanitation in and outside Kenya. As a part of this initiative, a five day training of trainers was conducted from 18 th -22nd March, 2013 in Karatu, Tanzania.

BackgroundCommunity Led Total Sanitation (CLTS) is not a new approach in Tanzania. However, in Karatu, CLTS was being practiced along with other methodologies like PHAST and PHASE in what is popularly known as the “Mutumba approach”. This workshop was therefore useful in initiating a standard CLTS process as opposed to the “Mutumba approach” that has been in practice. This new methodology will be adopted by Catholic Relief Services (CRS) and its partner organizations.

ParticipantsA total of 20 participants were trained as TOTs on CLTS approach. Participants were drawn from CRS, Partner organizations and ministry of health staff. Majority of participants had knowledge of CLTS and others had practiced ‘Mutumba CLTS”. At the end of 5 days training, participants prepared action plans (for next 1-2 months with commitment) for achieving ODF based on start-up, Implementation and post- implementation activities.

AGENDA: DAY 1

Session 1: Welcome & Inaugural Address.The head of CRS team welcomed trainees on behalf of the organization. He said that this was a great opportunity for CRS and especially partner participants who have been practicing Mutumba CLTS approach, as they were going to acquire the real CLTS knowledge and skills for triggering communities. Later the area District Medical Officer (DMO), Dr. Lucas Juma Kazingo officially opened the workshop.

In his speech the DMO said that participants should be committed to the workshop if they were expected to become good CLTS ToTs. This he said would make them understand CLTS properly to become good facilitators. He cautioned participants to be aware of the norms and values of the community which sometimes hinder latrine use. He thanked the organizers for the workshop and wished participants all the best.

IntroductionIntroduction among the participants was done by pairing up. By use of Vipp cards for recording individual particulars, participants introduced themselves in the following manner;

Name/preferred Station of work

Likes and dislikes Favourite color Last time they did open defecation

The last time they saw someone doing open defecation

Session 2: Workshop norms and identifying leaders

Workshop norms were set by participants to help maintain a learning environment. The norms included;

Active participation by participants Mobile phones on silent mode during session Stop unnecessary movement in and out of training hall Punctuality Respect individual and other peoples’ opinion Allow flexibility No drop out

LeadershipParticipants identified the following to represent them during the workshop.

1. Chairperson :Pastor Gerald Rwebangira2. Spiritual Leader : Rither Mallewo- 3. Welfare officer :Sauda levery4. Timekeeper : Said Panga5. Rapporteur: A representative from each partner organizations was selected.

Day1-DMDD Day2: KDS Day3:AAIDRO Day4:LDC Day5: MAMADO

Session 3: Expectations and Workshop ObjectivesParticipants listed out their individual expectations from the workshop on Vipp cards. Those with more than one expectation were given two cards so that each card carries only one expectation. The expectations were as follows:

Expectation to be a good CLTS facilitator To have good knowledge and skills for CLTS facilitator Sharing experience on CLTS To know about the concept of CLTS e.g. tools To understand CLTS to the extent of being facilitator To Increase my knowledge on the hygiene and sanitation through CLTS Learn more about sanitation

Community hygiene and sanitation control Advantages of CLTS To acquire knowledge , skills on CLTS How can CLTS help to shape culture and traditions that hinder sanitation and

hygiene Increase awareness and knowledge of health in the general, sanitation and

hygiene services to society Increase knowledge and skills on good hygiene and sanitation practices The situation of CLTS in Tanzania To train other staff on CLTS To learn about water and sanitation To deliver the same knowledge acquired to the community.

After going through these expectations with participants, the facilitator categorized them into 5 groups i.e. facilitation skills, knowledge, facilitation skills and knowledge, experience as well as others.

Workshop objectivesBy end of this workshop, participants will be expected to have:

To understood meaning of CLTs, its background, genesis and the concept of CLTS.

To acquire the requisite knowledge, skills and attitudes for triggering villages/ communities to attain ODF status.

To acquire skills to train other facilitators (ToT) on CLTS. (however, first as practitioner before training others)

To understood the monitoring and reporting framework and responsibilities at all levels.

Develop institutional action plans for introduction & scaling up CLTS in the respective areas of work/ communities.

Session 4: Forming groupsThis was a short exercise in which two groups were formed. These were formed by counting 1, 2, 1, 2, 1, 2 etc. All 1’s formed group1 namely OD group and 2’s formed group 2 known as ODF zone. This formation created a sitting arrangement in which members of both groups sat together.

Session 5: Pre- assessment Participants were taken through pre-assessment exercise to test their understanding of sanitation related issues. This was 15 minutes assignment and performance recorded as follows:

Session 6: What is sanitation? Give sanitation components

This was a group exercise where participants were tasked to explain the meaning of sanitation, and give sanitation components. This was followed by group presentations.

GROUP 1: ODSanitation refers to safe removal and disposal of human excreta by the use of facility e.g. toilet /latrine can also refer to safe removal and disposal of solid waste

Component of sanitation:1. Source of waste2. Waste its self3. Means of disposal (facilities) e.g. toilets

GROUP2: ODF Zone

Sanitation is the process of clearing protecting and maintaining the environment in a safe model. Component of sanitation

Clean and safe Proper disposal of water materials(solid and liquid waste) Proper disposal of faces Hand washing Personal hygiene

In his contribution, the facilitator said that sanitation has been explained in many ways by different people in various disciplines. While some say it is a process whereby people demand, effect, and sustain a hygienic and healthy environment for themselves by erecting barriers to prevent the transmission of water and sanitation related diseases, others have explained it in terms of safe disposal of both night soils, liquid and dry waste. Others still have explained it in terms of hardware and software components. The facilitator discussed with participants the meaning and even gave examples of hardware and software components of sanitation.

Session7: Sanitation ladderParticipants explained the meaning of sanitation ladder as step by step progression towards attaining improved sanitation.

The facilitator led participants in identifying sanitation challenges that hinder sanitation improvement in many rural communities. The following challenges were identified:

o Affordability/cost

o Lack of knowledge

o Cultural issues

o Life style

o Technology

o Geographical issues(rock and swamp)

o Negligence/ignorance

o Shortage of artisans

o Shortage of materials

o Sharing latrine

o Old age

o Poverty

Participants in their groups then arranged these sanitation challenges onto a ladder, starting with easier to resolve challenges at the bottom of the ladder and placing the most difficult challenges higher up on the ladder. This was done and stimulated a strong discussion among members.

Session 8: How to prevent spread of diarrheal diseasesIn this exercise, participants brainstormed on how diarrheal diseases spread by drawing the Faecal-Oral Route. Participants made presented their work on the routes. At the end of this session, the facilitator summed up by giving brief information on how poor sanitation brings about diarrhoea and that the high impact intervention is “hand washing with soap at critical times”. Primary and secondary prevention/barriers were also discussed.

Session9: Experiences and assessment of sanitation programs in TanzaniaThis exercise was to enable participants reflect on the sanitation programs of the past that failed and were implemented in the region. This was done by identifying the project; the goal/objectives; what worked well; what did not work well and recommendations for improvement.

After free group discussions, the following was presented:

Group 1:The project Name: Global Water Initiative Project

Goal: “Poor rural communities in arid and semi-arid zones reduce their vulnerability to water related shocks and improve their quality of life through Integrated Water Resource Management.

Main objective: Rehabilitation of water supply system to community and schools Training the Watsan community on PHAST Training the school Health clubs on CHAST

What worked well? PHAST ToT training was successful Adaptation of Ecosan latrine Sanitation coverage increased from 45% to 70%

Why failed? Adoption of PHAST was very slow to reach the community members Community members selected VIP latrine which they could not afford to construct

them selves Target of 100% coverage of Latrine was not reached Too much emphasis on water supply and not sanitation and hygiene promotion

Recommendations While putting the emphasis on the water supply should also put emphasis on hygiene

and sanitation promotion Need to facilitate the community to latrine options that they can afford Use locally available materials to construct the latrine

Group 2:The ProjectHYDROSANITARY Project

Goal: improved community health through provision of safe and clean water and good hygiene and sanitation services

Main objectives Provision of hygiene and sanitation facilities in 254 HHs in Qangdend village Provision of clean and safe water Capacity building on O & M

What worked well? Availability of clean and safe water Increased knowledge on hygiene and sanitation practices Availability of skilled village health workers and local artisan

Why failed? Low coverage of sanitation facilities because village health workers & Artisans were

not given incentive It was not participatory

Recommendations Participatory approach Provision incentives to the local artisans

The facilitator made the following contributions: Inadequate sensitization and awareness to the community Lack of government good will Subsidies to the community as a solution to their problems Subsidy toilets better than community houses. Forcing people to construct latrines as stipulated by the law Lack of software component Political interference.

AGENDA: DAY 2

Session 1: Recap Recap of the first day’s activities was conducted by DMDD.

Session 2: Introduction to CLTS. The facilitator began by telling participants that the real training of CLTS was beginning with this session and they needed to be very attentive or miss the whole thing. He asked trainees what was meant by CLTS, and how many of them had ever practiced the approach? But there seemed to be nobody willing to commit him/herself.

The facilitator started the session by trying to help the participants understand what CLTS was. This was followed by a presentation on the background, concept, rationale and the underlying CLTS principles. Participants were briefed on the emergence of CLTS approach by saying that CLTS methodology started in Bangladesh and from Bangladesh spread to other regions of the world. Dr. Kamal Kar and PRA master Mr. Robert Chamber were the initiators of the approach in 1999 -2000.

The facilitator was able to give a good brief on the difference between the traditional sanitation approach and CLTS. He said that the traditional approach focuses on promoting subsidy culture, latrine construction and does not promote human behavior change. On the other hand CLTS promote self-respect & social solidarity, address behavior change and total elimination open defecation.

Session 3: CLTS film.

The film on open defecation in India was shared with participants for better understanding of this approach and how the community was mobilized to take local collective action to stop open defecation. The film also showed the role that different people including children and women took to achieve ODF status for their villages.

Session 4: CLTS Tools

Participants were introduced to the CLTS tools and how to use them accordingly. The tools were thoroughly discussed and demonstrations made for each with participants under following headings;

Introduction/ Rapport Building Social Mapping Walk of shame/transect walk Calculation of faeces Flow Diagram Calculation of medical expanses Community Action Plan (CAP)

The presentations were clear and participants learnt how these tools worked and how they applied into the CLTS triggering process.

Session 5: How to trigger behaviour change

The facilitator led participants in brainstorming on some general actions and incidents that promoted behaviour change. This was followed by explaining events in the community (like health, status and fear of darkness or wild animals or rape) that promoted behaviour change to stop open defecation. Lastly, the facilitator helped participants to classify triggers and differentiate between individual and community triggers and how applied.

Session 6: CLTS Practical Demonstration (Mock triggering)In preparation for real life triggering, participants were exposed to mock triggering exercise where two groups were formed. One group representing the community and the other acting as the visitors (triggering team). The later conducted a triggering process. The session that followed this was some corrections a discussion on how to improve on tool application.

Session 7: Challenging field scenariosThis was a group assignment where participants were assigned scenarios and asked to develop, after discussions, their responses to address the arising challenges in a given typical community. Group 1 discussed scenarios 1 and 2 while group 2 scenarios 3and 4. This was later presented in a plenary session with participants reacting differently.

Session 8: Preparation for field visit triggering in villagesThis session was to prepare participants for field level learning. The facilitator led participants through key roles to be played. Each group identified;

1. Lead facilitator: To lead the team and to initiate the process of triggering in the community.

2. Co- facilitator: To assist the lead facilitator in his roles3. Environment setter: To ensure there is smooth and conducive environment for the

process.4. Note taker: To record the proceedings of the field triggering.5. Logistician: To ensure materials for field work are intact.

The rest of team members will assist in the triggering process. This was followed by disclosure information on the villages to be triggered. Group 1 to visit Qaru village and group 2 : Kinihe village.

AGENDA: DAY 3

Session 1. Recap

Recap on reflections for day two was done by was done AAIDRO. This was followed by further discussion on CLTS tools and their applicability to ensure that participants get it right before taking off for the field.

Session 2. Field visit

The groups left for field triggering at 10.30 Am.

Group 1. Geer sub- village

Group 2: D. Magaribi sub- village

Session 3: Field report analysis.

Back from the field, participants prepared brief reports for presentations. The facilitator gave the report format as follows;

i. What did you enjoy most about the field work?ii. What did you find difficult?iii. Which trigger tools did you find most effective? Why?iv. Which trigger tools did you find least effective? Why?v. What would you do differently when you go to the field again?

Main findings: Consolidated report analysis from the two groups

i. What did you enjoy most about field work

Different reactions from the community members

Active participation of both men and women during social mapping (tool#2).

Negative reactions when the shit was brought before the meeting

Cooperation of the leaders on mobilizing people for the meeting

ii. What did you find difficult?

The transect walk was too long and difficult before they found the shit. The community members had to split into groups in order to find shit.

Re -assembling community members because of late arrival by the visitors.

iii. Which trigger tools did you find most effective? Why?

All the tools were effective starting from introduction, social mapping and Transect walk moved the community a lot.

Shit calculation created awareness and enabled community to understand magnitude of the sanitation problem.

iv. Which trigger tools did you find least effective? Why?

One group found shit calculation tool not effective because they could not remember what time to introduce it.

v. What would you do differently when you go to the field again?

Consider community calendar

Introduce shit calculation tool at the right time.

Need for translation as some of members were not understanding Kiswahili

Session 4: Preparation for field visit II

After sharing field experience reports, participants embarked on preparation of field visit II arrangements. The logisticians for each group took lead in this activity assisted by group members.

AGENDA: DAY 4

Session 1: Recap:

A brief reflection for day three was done by LDC. It was quite brief because the better part of the day was spent in the field.

CRS team gave a brief on the villages to be visited for the second triggering emphasizing on the need to observe time.

Session 2: Field visit

Group 1: OD group – Geer sub village

Group 2: ODF zone group: D. Magharibi Sub-village

During plenary, each group shared the experiences and lessons learnt. However, both groups felt that the second triggering session had polished them up and better than the first triggering. They felt more confident that they could do it on their own.

Session 3: Triggering outcome

The facilitator discussed the triggering outcomes. Basing on the four types, the facilitator said the triggering process could lead to either Matchbox in Petrol station, promising flames, scattered sparks or damp matchbox. Each outcome was explained in details. Participants were asked to rate the triggering exercise they conducted in the day based on the above outcomes. Some felt it was promising flames while other said it was scattered sparks.

AGENDA: DAY 5Session 1. Recap Was conducted by MAMADO.

Session 2: Shearing community action plans A total of twelve (12) community members attended the workshop on the last day of the training. They shared their experiences, commitment and action plans to make their sub-villages ODF. After presentations, there was an interactive session where the community made specific commitment like achieving ODF was a must within the shortest time possible. Other community members made 1-2 months commitment to achieve ODF.

Session 3: Identifying elements that support behaviour changeThe facilitator explained that after triggering communities, ignition alone was not sufficient to promote and support behaviour change to achieve ODF and sustain results. The facilitator brainstormed with participants on elements required to support behaviour change. The following was generated:-

Close and sustained follow up after ODF

Hygiene behavior promotion

Enforcement of local laws(by laws)

Sanitation technology options

Stakeholders support

Community monitoring

Rewards incentives

Exchange visit

Sanitation marketing

Session 4: Post –assessment

Self-assessment questionnaires were distributed to the workshop participants on

the last day of the training. After the exercise, the facilitator noted that there was an improved understanding of sanitation related issues than during pre-test assignment as seen on the line group.

Session 5: Participatory Community monitoringThe facilitator emphasized the importance of participatory Monitoring of CLTS to determine success. The process should be participatory and the community should take the lead. Outsiders monitoring should also be conducted but more emphasis is on Participatory community monitoring. When communities track their own progress, they easily decide on:

What is working well What is not working well How to proceed next

Monitoring tools should be developed locally by implementing agency in conjunction with the Ministry of Health. There should be different tools for different implementing cadres for instance, CHWs and Health officials.

Session 6: Preparing action plansParticipants were divided into their working partner organizations and asked to develop their action plans for stopping OD in their respective working areas. Participants were required to present the same but requested more time to consult further with their respective organizations. They promised to hand over their action plans to CRS.

Session 7: Workshop evaluation.

Participants were asked to rate the training by indicating Excellent, Good and Average as responses for statements below. The following responses were received from various participants;A – EXCELLENT B – GOOD C - AVERAGENo. Resource Rating1 Course material provided Excellent Good Average

xxxxxxxxxx xxxxxxxx2 Relevance of the course for your job xxxxxxxxxxxxx xxxxx x

3 Have your expectations been fulfilled xxxxxxx xxxxxxxxx

4 Accommodation and facilities xxx xxxxxxxxxxxxx xxx

5 Field trip xxxxxxxx xxxxxxxxx xx

6 Participation xxxxxxxxxxxx xxxxxxx

7 Facilitation skillsxxxxxxxxxxxx xxxxxxx

Please mention three important lessons you have learned during the workshop

1. CLTS tools (x 4)

2. Facilitation skills (x 5)

3. Community to initiate their own actions

4. Triggering skills (x 4)

5. Community participation as key to CLTS success

6. Follow ups top priority after triggering

7. Triggering if not facilitated well, no results (x 3)

8. How to end up triggering session (x2)

9. Steps of community declaration of ODF (x2)

10. Social marketing (x2)

Please mention three topics that interested you most

1. Sanitation ladder ( x2)2. CLTS tools ( x4)3. Field visit4. Introduction of CLTS (x 5)5. Community action plans

6. What is sanitation? (x 3)7. Mock triggering (x 3)8. Experience and assessment of sanitation programs (x 2)9. Challenging field scenarios (x 3)10. Elements that support behaviour change11. Participatory M&E12. Triggering outcome (x 2)13. How to trigger behaviour change14. How to make action plans (x 3)15. Shit calculation (x 4)

How can the quality of the workshop be improved?

1. At least 3 field visits2. More time to be allocated for mock triggering (x 3)3. Reading materials should be provided (x3)4. Increase days of training (x4)5. The training should not go to late hours (x3)6. Improve accommodation facilities for participants7. CLTS film should be based on our local environment, not India.

Any other comments:

1. Good training, excellent facilitation (x 10)2. Refresher course will be required to check how TOTs are performing (x 5)3. CRS should keep up with trainer for future mentoring (x 2)4. Participants should be left to decide where to eat in evening.

END OF EVALUATION

WAY FORWARD

I am making the following suggestions as way forward:

Follow-up of triggered villages: Participants to make intensive follow up of the 5 triggered sub-villages during field visit. In future, any suggested triggering should be done after proper planning for timely and intensive follow-up in triggered villages.

Providing required support to triggering and follow-up teams: The teams deployed on triggering villages to be given required support (transport and materials).This is to ensure that there is no detachment from the community.

Development of inventory of natural leaders (NLs): The triggering and follow-up

teams must keep an eye on potential NLs that emerge during the process. Those who contribute to make their village ODF should be included in the triggering/follow-up

teams after giving them some orientation for 1 day. This is an important step towards scaling up.

Follow-up trainings on CLTS: 2- 3 days follow-up programs (for instance, refreshers or review meetings) on CLTS should be organized after 1-4 months or so.

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