sustaining and scaling-up the social norm of not defecating in the open in ghana lorretta roberts...
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Sustaining and Scaling-up the Social Norm of not defecating in the open
in Ghana
Lorretta Roberts WASH Specialist UNICEF Ghana
Ghana is on Track for MDG Target for Water But NOT for Sanitation
0
20
40
60
80
10093
15
77
54
Co
vera
ge
(%)
201520081990
Sanitation
Water
MDG target
MDG target
201520101990
Sanitation
Water
MDG target
MDG target
14
86
20 Year Trend in Sanitation Progress - 1990 to 2010
Source: WHO/UNICEF Joint Monitoring Programme Data for the 2012 JMP Report
1990 2010
0
20
40
60
80
100
1219
44
73
33
211
6
Urban sanitation trends
Open defecationOther unimproved facilitiesShared facilitiesImproved facilities
Co
ve
rag
e (
%)
1990 2010
0
20
40
60
80
100
48
20
43
47
16
2933
Rural sanitation trends
Open defecationOther unimproved facilitiesShared facilitiesImproved facilities
Co
ve
rag
e (
%)
1990 2010
0
20
40
60
80
100
714
29
58
42
9
22 19
Total sanitation trends
Open defecationOther unimproved facilitiesShared facilitiesImproved facilities
Co
ve
rag
e (
%)
Open Defecation rates per region in Ghana
Why Open Defecation is a problem
- The Northern Region with 73% of OD accounts for 33% of under -5 diarrhoeal cases
- Cholera is an annual occurrence in Ghana. In 2012 alone, 4443 cases and 24 deaths
Government Response
• Adoption of CLTS approach in 2010 Revised Environmental Sanitation Policy
• CLTS seeks to stop the practice of open defecation and promote the use of latrines using a Social Norms approach
• CLTS is a non prescriptive approach in which householders adopt their own preferred solutions of improved sanitation options
• 152 communities currently ODF in Ghana
Focus of Analysis
• Focus is on new collective behaviour of not defecating in the open using the CLTS approach and the analysis of the approach using the SN framework
• Focus is not on the old custom of open defecation
• Focus is on how this new behaviour can be sustained and scaled up
Process for creating a new norm
Application to CLTS Process of ending OD
• Creating common knowledge on extent of open defecation in the community through defecation map and transect Walk
• Evoking collective emotions of disgust and shame at OD practice• Demonstration of faeco-oral routes using the glass of water ,
food and flies and shit and shake tools
Changing beliefs and attitudes
• Fines•Community pride as they celebrate ODF status•Community Sign board / Flag system
Collective Discussion and Decision to enact a new
practice
• Analysis of the quantity of faeces deposited in the environment through Shit Calculation
• Analysis of the health care and other costs of open defecation• Collective commitment to end OD and preparation of community
action plan
Introducing Sanctions
• Collective Pledge to become ODF signals norm change• Individual Commitment to construct latrines and sharing with
others • Sanctions have a signaling effect
Creation of Normative Expectations
• Construction and use of Latrines • Visibility of Community Based Monitoring and Evaluation using
Community Action Plan• Community Certification as ODF provides public knowledge
Creation of Empirical Expectations
Changing of Factual Beliefs
“….it is bad enough that one eats one’s faeces but it is unthinkable to know that one eats the faeces of one’s enemy”
Key Challenges Identified
• Sustainability : New norm in a community surrounded by other non conforming communities
• Continued Effectiveness of Approach : Social Networks ensure information diffuses to surrounding communities through markets , churches etc.
• Scaling up: MDG target to be met in 2015 and MAF developed. Scaling up one community at a time may not work
Make empirical expectations visible
throughout the country through the publication of
the ODF league and other
communication channels
Introduce legal norm supporting the social norm
Support Scaling up through a district
wide visioning process
Institutionalise a national campaign
using religious leaders and traditional authorities
Scaling and Sustaining
CLTS
Recommendations
Making use of Religion
Designate a place outside the camp where you can go and relieve yourself.
As part of your equipment, have something to dig with and when you relieve yourself, dig a hole to cover up your excrement.
For the Lord your God moves about in your camp to protect you and to deliver your enemies to you. Your camp must be holy so he will not see anything indecent and turn away. Deuteronomy 23: 11-14
Thank you!