Sustainability of Sanitation in Rural Bangladesh

The Manoff Group, Planning Alternatives for Change, Pathways Consulting Services Ltd., and

World Bank Water and Sanitation Program

Dr. Suzanne Hanchett, Mohidul Hoque Khan, Dr. Laurie Krieger, Craig Kullmann

“The Future of Water, Sanitation and Hygiene: Innovation, Adaptation and Engagement in a Changing World ”35th WEDC International Conference, Loughborough, UK, 2011

Study Goal: To assess the situation in unions* declared “100% sanitized” on or before June 2005• In 2003 Bangladesh Gvt

launched National Sanitation Campaign.

• Some unions were declared “100%” during 2003-2006: meaning all hh had hygienic/improved types of latrines.

2005 Sanitation Campaign Photos

*The Union is the lowest tier of government in Bangladesh

JMP 2010 trend-line: 52% improved latrine use in 2008

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Study Methods (1)

• Study Locations: 53 unions - Most were randomly sampled from a group of 481 declared “100%” on or before June 2005

• “Sanitation” issues studied: only human excreta management, behavior, supplies, services

Study Methods (2)

• Quantitative: Survey of 3000 randomly selected households in 50 unions

• Qualitative: Focus groups, key informants, children, transect walks, & other methods in 18 unions

Four Approaches to Sanitation Promotion in Study Unions

1) Local Government (union) only – no NGOs: 24 unions

2) GOB (Bangladesh national gvt, DPHE) + donor (UNICEF or Danida) – through NGO contractors: 9 unions

3) NGOs using CLTS methods: 10 unions4) Non-CLTS NGOs: 10 unions

With Follow-up Sanitation Programs: 27 (51%)No Follow-up Sanitation Programs: 26 (49%)

Sanitation Campaign Strategies

Different Strategies- Persuasion- Coercion(All did both in varying

degrees)

THE UNION CHAIRMAN WAS IN CHARGE

“Actually people changed the situation by their own practice. Law enforcement worked in their mind at first, but not for long. When people understood the disadvantages of bad defecation practice, then they changed themselves.”Female FGDparticipant

Three Ways of Analyzing HH Latrine Coverage: comparison• (1) This study counted “improved” latrines, as per JMP

criteria, whether shared or not: IMP/S

• (2) JMP counts “improved” latrines:– Feces confined in a pit or tank– Slab or other cover on the pit– Not used by more than one household

∙ (3) Bangladesh Government counts “hygienic” latrines:– Feces confined in a pit or tank– Must have tight pit closure (unbroken water-seal,

polyethylene flap, other)– Not used by more than two households

Present Status: Latrine Coverage

Study Unions

• 89.5% IMP/S

• 37% “hygienic” (GOB dfn)

• 53% “improved” (JMP dfn)

National Data

• GOB: rural coverage = 88.2% (June 2008) [includes shared?]

• JMP: rural coverage of “improved” = 52% (2009)

• Baseline: 29% rural latrine coverage in 2003

HH Facilities, by Approach

NUMEROUS LATRINE OPTIONS FOUND

Clay rings

Bamboo-made duli

Water tank on top

Concrete rings & slab with water-seal

Vented pit

Stone slabs & separated urine

Ceramic pan

Plastic potties

Motka latrine

Other Campaign Achievements

• Latrine producers & related services developed in response to increased demand.

• Successful businesses diversified their products.

• People mostly self-financed their latrine purchases.

IMPORTANT: CHANGES IN SOCIAL NORMS

• Prospective in-laws check on HH latrines during marriage negotiations.

• Yusuf: “Silently we all have agreed that open defecation is a bad habit.”

“Our latrine is not good enough. We will replace it with a better one before our relatives visit.”

Women are especially motivated to use latrines Woman-1: “In Muslim religion it is a strict rule that if a woman goes for open defecation and people see her, it is shameful.”Woman-2: “It is not only a shame. It is a sin.”(Focus Group Discussion)

Kusimon: “[In former times] we went outside to defecate either at night or early in the morning. During the day we did not defecate. If we felt the urge in daytime, we tried to halt it.”

Two women digging their own latrine pit in Gopalganj District

Union Parishad: Current Efforts

• Approx. 2/3 of 53 UP Chairmen still actively promoting sanitation improvements

• 10 of 18 known to fund sanitation

• No formal monitoring

Some Challenges

• Social & political conflicts• New house construction

without latrines (no rural bldg codes)

• Internal migration (new settlements & laborers)

• Technology for disabled & for young children

• Poor quality construction materials

• Pit-emptying : cost, effort• Cleanliness of latrines: a

major problem

The Latrine Cleanliness Problem: 56% not clean

An “unclean” latrine-Feces observed on floor, pan, or water-seal

and/or

-Profuse leakage from latrine pit

Statistically Associated with CLEAN LATRINE

Highly significant (p < 0.02)- Water source within 10 meters- Vent pipe- Roof- Water-seal- Ownership of latrine used- Higher education level of any HH

member

Significant (p </= .05)- Follow-up san. Program- Smaller no. HH use the latrine

Effects of pollution concerns on sanitation practice• 1- Placement of latrines far from living spaces (aver. 16 m.

away)

• 2 - Worry about buried feces polluting the settlement

• 3 – Women worry about the polluting effects of routine bathroom cleaning. They take a purifying bath after cleaning. Or, cleaning is frequently insufficient.

• 4 - Periodic pit emptying is a very polluting activity, so pit cleaners (Hindus/Muslims) are socially ostracized. They are paid rather well.

Open Defecation: big problem in 4 of 18 in-depth study unions

• Weak institutional support by local gvt

• Influx of large numbers of homeless/laborers

• Failure of latrine sharing arrangements

• New house construction without latrines

• Environmental factors (cyclones etc.)

Conclusions

• Scaling-up was largely successful• Technical, socio-economic, environmental, and programmatic factors were all important.• The task is not yet finished:

- The campaign focused on household latrines only. - Broader goals needed (total sanitation).- Open defecation not fully eliminated.

• Learning points: -Importance of governance & political will

-Adaptation of cultural principles to promote change

Principal Recommendations

•Establish and enforce manufacturing quality standards.•Monitor sanitation coverage in the future.•Offer installment-pay options or other help to enable the poor to purchase latrines. •Keep local government involved and responsible for sanitation in the future.

Thank you

for your participation