Sanitation
Can WASH deliver more than just sanitation ?
By Suvojit Chattopadhyay
The abysmal state of access to safe water and sanitation facilities in the developing world is currently a
Brigdet Achweng Photograph : WSSCC major cause for alarm ; 580,000 children die every year from preventable diarrheal diseases . This is due largely to the 2.5 billion people around the globe who do not have access to safe sanitation . Not only can an effective WASH intervention save lives , it can also engineer changes in the social fabric of communities that adopt these behavioural changes . This points to a key attribute of a successful WASH intervention – that through these programmes , communities not only access a new service that improves their quality of life , but they also learn from being part of a concrete intervention that emphasizes equity and inclusion . Let me explain how . Safe sanitation is essentially ‘ total ’. In a community , even one family practising open defecation puts the health of other families at risk . Also , unsafe sanitation practices pollute local potable and drinking water sources in the habitations . Together , this can undo any gains from partial coverage of WASH interventions . This much is now widely accepted by sanitation practitioners around the world . However , there remains a serious challenge when it comes to the implementation of this concept . When a community is introduced to a WASH-focused behaviour change campaign , there are often variations in the levels of take-up in different families . This could be because of several barriers – financial ability , cultural beliefs , education levels , etc . In response , external agencies have many options . They can focus more on families in their behaviour change campaigns , offer them material and financial support or incentives , or exert peer pressure ( which may in some cases become coercive , etc ). However , the best approach – whether facilitated by an external agent or not – is for a community to devise a collective response . The issue should be framed as a collective action problem that requires solving for the creation of a public good . In many instances , communities have come together to support the poorest families – social engineering at its finest . At its best , recognizing the needs of every member of a community will lead to recognition of the challenges that the typically marginalized groups face . It is this recognition that could prompt a rethink of social norms and relationships .
On the other hand , the power of peer pressure can be effective . Where families that are able , but unwilling , to construct a toilet and switch behaviour , the initial take-up from other families has a strong demonstration potential . In societies with caste and class differences , this can be deployed effectively to highlight choices that threaten the public good . Encouraging the development of shared norms and collective action is also a key aspect of determining the role of subsidies in WASH programmes . As research evidence from Bangladesh shows , subsidies could be effective when targeted at communities , instead of at individuals . Where it is possible to measure progress at the community-level , subsidies can be designed and delivered accordingly . This will encourage communities to take up WASH as they would approach say , the building of a road or a school . This is no longer just a theory . Increasingly now , various organizations have documented such successes . For example , in multiple NGO-led programmes in eastern India and Bangladesh , local community-based organizations formed initially to tackle sanitation went on to engage in collective livelihoods activities . However , as with any other , this theory too should be put to test – evaluated at different sites and for different approaches . Currently , we are not sufficiently focused on the positive social externalities a WASH intervention could generate , and as a result , are running the risk of restricting ourselves to narrow technocratic approaches . This needs to change . This brings me to a key message I have for WASH interventions : do not hurry into scaling up . Given the urgency of the problem – about 2.5 billion people do not practice safe sanitation – this might seem completely counter-intuitive . However , there is the real risk that aiming for scale will lead to the perpetration of target-driven hardware interventions which will neither change behaviour , not create social cohesion . It is not unusual for organizations that rush to scale end up compromising on exactly those key design elements that made their pilots a success . In conclusion , it is important to acknowledge that WASH interventions have the potential to go far beyond basic service delivery . In order to realize these gains , one must follow a very careful sequence of steps designed to promote community ownership and systematically change behaviour . The goal should be to nudge communities towards a public spirit and collective problem solving , so that WASH works as an entry point into communities , creating fertile ground for future interventions . Suvojit Chattopadhyay is a development sector professional with a deep interest in examining the design and implementation of programmes . He is a passionate advocate for a dignified approach to sanitation for the poor .
28 Africa Water , Sanitation & Hygiene • August 2018