Rural Sanitation Research Articles

Critical evaluation of planning frameworks for rural water and sanitation development projects

Poor initial planning processes have been implicated in the high failure rate of rural water and sanitation development projects. This article critically examines 17 existing planning frameworks for rural water supply and sanitation projects with respect to key attributes of good planning practice, in order to discover the extent to which these address the elements of planning that relate to sustainability. It identifies sustainability-related factors from the sector that have been recognised as such and incorporated into current frameworks, as well as factors that are not yet well covered, and makes recommendations to practitioners wishing to employ such frameworks.

Zero subsidy strategies for accelerating access to rural water and sanitation services

Community-Led Total Sanitation (CLTS) and Household-Led Water Supply (HLWS) are zero subsidy approaches to water and sanitation service provision that have been recently piloted in Zambia. The increases in access to sanitation and toilet usage levels achieved in one year under CLTS were far greater than any achieved in subsidised programmes of the past. Similarly, HLWS has shown that rural households are willing to invest in their own infrastructure and that they can increase coverage of safe water without external hardware subsidy. The promotion of self-sufficiency rather than dependency is a key component of both approaches, as is the focus on the development of sustainable services rather than the external provision of infrastructure. Zero subsidy strategies have the potential to deliver far more rapid increases in service coverage and higher levels of sustainability than the conventional subsidised approaches that predominate in low-income countries.

Source to point of use drinking water changes and knowledge, attitude and practices in Katsina State, Northern Nigeria

In many Sub-Saharan countries such as Nigeria, inadequate access to safe drinking water is a serious problem with 37% in the region and 58% of rural Nigeria using unimproved sources. The global challenge to measuring household water quality as a determinant of safety is further compounded in Nigeria by the possibility of deterioration from source to point of use. This is associated with the use of decentralised water supply systems in rural areas which are not fully reticulated to the household taps, creating a need for an integrated water quality monitoring system. As an initial step towards establishing the system in the north west and north central zones of Nigeria, The Katsina State Rural Water and Sanitation Agency, responsible for ensuring access to safe water and adequate sanitation to about 6 million people carried out a three pronged study with the support of UNICEF Nigeria. Part 1 was an assessment of the legislative and policy framework, institutional arrangements and capacity for drinking water quality monitoring through desk top reviews and Key Informant Interviews (KII) to ascertain the institutional capacity requirements for developing the water quality monitoring system. Part II was a water quality study in 700 households of 23 communities in four local government areas. The objectives were to assess the safety of drinking water, compare the safety at source and household level and assess the possible contributory role of end users’ Knowledge Attitudes and Practices. These were achieved through water analysis, household water quality tracking, KII and questionnaires. Part III was the production of a visual documentary as an advocacy tool to increase awareness of the policy makers of the linkages between source management, treatment and end user water quality. The results indicate that except for pH, conductivity and manganese, the improved water sources were safe at source. However there was a deterioration in water quality between source and point of use in 18%, 12.5%, 27% and 50% of hand pump fitted boreholes, motorised boreholes, hand dug wells and streams respectively. Although no statistical correlation could be drawn between water management practices and water quality deterioration, the survey of the study households gave an indication of the possible contributory role of their knowledge, attitudes and practices to water contamination after provision. Some of the potential water related sources of contamination were poor source protection and location, use of unimproved water source and poor knowledge and practice of household water treatment methods, poor hand washing practices in terms of percentage that wash hands and use soap. Consequently 34 WASH departments have been created at the local government level towards establishment of a community based monitoring system and piloting has begun in Kaita local government area.

Sustainability of rural sanitation marketing in Vietnam: Findings from a new case study

From 2003 to 2006, International Development Enterprises piloted a rural sanitation marketing approach in two provinces of Vietnam. During this period, coverage of sanitary toilets grew from 16 per cent to 46 per cent. Some three years after the project ended, the Water and Sanitation Program initiated a research study to investigate the sustainability of outcomes achieved. The study was conducted in collaboration with IRC and ADCOM and used a variety of methods including focus group discussion and structured interviews with community members, suppliers and promoters. The study found that coverage had continued to grow in pilot communes and had reached 59 per cent two years later. Promoters had continued their activities, albeit at a lesser intensity level. Many suppliers had expanded their product range and customer base and reported that their revenues from sanitation increased. Lack of tailored information on more affordable toilet construction and financing were the main barriers for those who had not yet built a sanitary toilet, despite having been reached by the pilot project.

Sanitation marketing in Cambodia

Concerns about enduring low rural sanitation coverage figures in Cambodia prompted a series of studies providing insight into overall sector performance, sanitation demand and existing supply chains. Findings from the research led to the formulation of a sanitation marketing pilot aiming to make affordable, desirable latrines available through market channels. Option design, contractor training, awareness raising and marketing are the main components of the programme, implemented in two provinces. To date (22 months since inception) the project has resulted in a branded, low-cost pour-flush latrine sold by trained suppliers, who have sold more than 7,400 units. Planned next steps include expanding technology choices (still lower costs, and/or suitable for challenging physical circumstances), developing stronger linkages with micro-credit schemes and developing approaches for scaling up the approach.

Implementing pro-poor policies in a decentralized context: the case of the Rural Water Supply and Sanitation Program in Tanzania

This paper examines the challenge of achieving a balance between the implementation of centrally designed pro-poor policies and the decentralization of responsibilities to local governments in many African countries. It analyzes the implementation of the Rural Water Supply and Sanitation Program in Tanzania. Key mechanisms for planning and allocating resources are analyzed at ministry, district, and village levels. Results show that a mixture of policy incoherencies, technical shortcomings and political influence determine that only a small proportion of funds reaches the underserved areas. We argue that a greater connection between the bottom-up and top-down planning mechanisms, and a sharp increase of downwards accountability are needed before decentralized decision-making result in better resources allocation. Meanwhile a bigger intervention from central government is needed.

Water Point Mapping for the Analysis of Rural Water Supply Plans: Case Study from Tanzania

In Tanzania, like in many other countries in the Sub-Saharan region, the government is implementing an ambitious rural water supply and sanitation plan (RWSSP) to increase access to water from 53% in 2005 to 90% by 2025. This paper exploits water point mapping (WPM) data to evaluate the principles underlying the design of this program and reveals some challenges for the rapid increase of access to water. The data set of water points analyzed accounts for 15% of the country’s total rural population. The results show that the inaccuracy of the baseline used for the program design, difficulties faced by underserved districts in keeping the water points functional, and the differences between the expected and real long-term functionality of the water points, especially for hand pumps, are the primary threats to the achievement of the targets. It is suggested that more effort be put into capacity building, particularly the supervision of construction, and the support of community-owned management during the first years of operation.

Doctors, Social Scientists, and Backlands Peoples: Continuity and Change in Representations of Brazil's Rural World

This article analyzes the importance of ideas mobilized by medical doctors active in Brazilian public health to interpret society and in discussions of the national question over the first half of the 20th century. Texts from three different moments are assessed: in the context of the movement for rural sanitation in the 1910s; those composing the fieldwork promoted by the Yellow Fever Service of the Rockefeller Foundation in the 1930s; and those from one of the most persistent debates among social scientists during the 1940s and 1950s revolving around the question of development, cultural resistance to change, and the “folk culture of the Brazilian backlander.” The article argues that, in the Brazilian case, the authors who constructed the domain of public health fulfilled, among other roles, that of social interpreters, influencing the process of the development of sociological thought in the country.

A practical method to evaluate the sustainability of rural water and sanitation infrastructure systems in developing countries

Over one billion people are without access to safe water, while twice as many lack access to improved sanitation services, making these two of the world’s most pressing issues. The sustainability of critical infrastructure systems, such as water and sanitation, is a necessary (though not sufficient) criterion for achieving sustainable human settlements since the lack of adequate services affects literally all aspects of a community’s daily existence including health, education, family, surroundings, and employment. Despite several decades of development aid, infrastructure solutions have not significantly improved these water and sanitation problems (with few exceptions). In this paper, we consider the holistic nature of water infrastructure development in terms of rural areas in developing countries. We propose an outcome-based evaluation method using Life-Cycle Analysis to examine three categories of infrastructure sustainability metrics: technical, environmental, and economic; both froma community perspective, and a social-equity perspective. We demonstrate the method with a simple, generic example of arsenic treatment approaches in Bangladesh.

What does it take to scale up and sustain rural sanitation beyond projects?

Combining learning gained from Community-led Total Sanitation experiences in South Asia and sanitation marketing initiatives in parts of Asia and Africa, the global Scaling up Sanitation project is exploring in India, Indonesia and Tanzania what it takes to scale up and sustain rural sanitation project outcomes. New learning from the project being implemented by the Water and Sanitation Program (WSP), in partnership with the three country governments and the Bill and Melinda Gates Foundation, is currently demonstrating that projects need to identify and nurture key components of an enabling policy, institutional and financial environment, for rural sanitation interventions to yield sustainable results at scale. This article explains what constitutes such an enabling environment, how it is being fostered and its progress monitored in the three countries, and the lessons learned thus far in the process.

WATSAN in Partnership with NGOs and Communities of Nepal

The Rural Water Supply and Sanitation Fund Development Board (The Board) has been implementing WATSAN schemes in Nepal since March 14, 1996 under assistance from World Bank/IDA and DFID. The Board brought fundamental changes in the conventional supply driven approach to promote Demand Driven Community based water supply and sanitation project with cost effective and sustainable services to the rural people of Nepal. Communities are supported to form inclusive local water supply and sanitation user groups that can plan, implement, and operate drinking water and sanitation infrastructure that delivers sustainable health, hygiene and productivity benefits to rural households. Under the Board fund presently 165 NGOs partner together with local communities in 71 districts of Nepal to deliver safe water and sanitation services. The Board has contributed to improve sector institutional performance by grooming service delivery capacity of NGOs, Communities and mainstreaming its successful approaches in to Government mechanism and other sector agencies delivering developmental services in Nepal. Latest contribution of the Board is to support Ministry of Physical Planning and Works in establishing computerized Monitoring and Evaluation Unit and provide information regarding progress in rural water supply and sanitation sector. This will help the government in performance based budget allocation to service delivering agencies. As to Board's own performance various studies shows after project 90 percent hand wash practice in community, 33 percent No Open Defecation schemes and 84–92 percent sustainability of 3-8years old schemes

An NGO in Search of a Business Model (Innovations Case Discussion: Sulabh International)

dollars invested in the world’s water supply failed to produce the anticipated reduction in the burden of disease that the international water sector began to pay serious attention to the “lack-of-toilet” crisis. The projected failure to attain the Millennium Development Goals’ sanitation target in much of sub-Saharan Africa and South Asia by 2015 finally brought the challenges of promoting hand-washing and the use of safe toilets much-needed attention—it even led the United Nations to declare 2008 the International Year of Sanitation. Of the nearly 1.2 billion people who practice open defecation worldwide, about 668 million live in India. Almost 74 percent of India’s rural population and 18 percent of its urban population still practice open defecation. This number is particularly shocking when one considers that the government of India has been actively trying to combat the practice for at least three decades. In development lingo, the scale-up has not been successful. According to one estimate, between 1986 and 1999, India’s Central Rural Sanitation Program installed 9.45 million latrines and gave about 85 million people new access to latrines. Over the same period, the population grew by 144 million, making the gains in improved sanitation imperceptible. Moreover, as the government and others in the sector found, increased access to latrines did not translate into their consistent and increased use, let alone tremendous health gains. While sanitation is a challenge in many parts of the world, in India it is a behemoth in a way that is particularly Indian. It is complicated by religion, tradition, caste, and social hierarchies that underpin generational poverty, gender inequality, rural-urban divides, political structures, and even economic incentives. Dr. Bindeshwar Pathak’s genius lies not in his solution to the problem of open defecation—which clearly remains an overwhelming issue for India—but in his direct assault on the social hierarchies that perpetuate the problem.

Carlos Chagas e os debates e controvérsias sobre a doença do Brasil (1909-1923)

The article explores the relation between the debate on Chagas' disease, discovered in 1909, and Brazil's 1916-1920 rural sanitation campaign. It argues that the political planks of the sanitary movement were intimately bound up with the definition and legitimization of this illness as a scientific fact and social issue. Presented as emblematic of rural endemic disease, this 'new tropical ailment' was characterized as 'the disease of Brazil', symbol of a 'sickly country'. The sanitary campaign was in turn a decisive element of the 1919-1923 polemic surrounding the disease. This is an exemplary case of how Brazilian scientists used theories from European tropical medicine to produce original knowledge in the field, basing themselves on meanings specific to the national context of their day.

Determinants of National Diarrheal Disease Burden

Diarrheal illness is a leading cause of child mortality in developing nations. Previous longitudinal studies have attempted to identify the factors that contribute to child mortality, but few have examined the determinants of diarrheal illness at a country level. Here we demonstrate the use of Classification and Regression Trees (CART) to predict diarrheal illness from a 192-country data set of country-level attributes and compare the performance of CART with a linear regression model. The CART model identifies improvements in rural sanitation as the most important spending priority for reducing diarrheal illness. We estimate that reducing unmet rural sanitation need worldwide by 65% would save the equivalent of 1.2 million lives annually.

Sustainability of rural water supply and disaster resilience in Zimbabwe

Rural water supply, especially through the provision of village hand pumps, is implicated in the Hyogo Framework for Action 2005–2015 to enhance the resilience of disaster-affected communities. Lessons from past programmes could help the design and implementation of future rural water supply and sanitation interventions as both a means and an end for sustainable and resilient communities, especially in disaster-prone areas. A study was carried out in the disaster-prone Binga District of Zimbabwe to ascertain whether rural water supply has helped in enhancing community resilience. The findings support the argument that, in addition to ‘hard’ technical inputs and ‘soft’ local human resource inputs, rural water supply is only effective if introduced with the ‘right’ reasons identified and made to operate sustainably, rather than for cost-cutting reasons. The latter is likely to reduce rather than enhance and sustain disaster resilience built by communities over centuries.

EFFICIENCY OF THE HEALTH CARE SYSTEM: A SUB‐STATE LEVEL ANALYSIS FOR WEST BENGAL (INDIA)

This paper attempts a sub‐state level analysis of health system efficiency, focusing on West Bengal, a low income Indian state. Using a stochastic frontier model, it provides an idealized yardstick for evaluation. Our results suggest that overall efficiency of the public health delivery system remains low due to considerable disparities across districts. This is owing to differentials in availability and utilization of inputs such as the per capita availability of hospitals, beds, and manpower, and adversely affects life expectancy. Overcoming these factoral disparities may help the deficient districts to improve life expectancy. It may require a considerable increase in medical and public health expenditure in rural areas in the state and especially calls for resource mobilization to improve infrastructure facilities and maintain essential supplies at primary health centers. This could be attempted partly through funds from the National Rural Health Mission (NRHM) and by improving rural sanitation in poorer districts.

Water management in a hyperinflationary environment: Case study of Nkayi district in Zimbabwe

This paper discusses the management of local drinking water supplies in Nkayi, a poor rural district in Zimbabwe. The government policy of rural development has evolved a national sector strategy for water and sanitation, implemented through an Integrated Rural Water Supply and Sanitation (IRWSS) programme 1987–2000, with largely donor funding. One aspect of the programme has seen the construction and upgrading of communally-owned boreholes and deep-wells in villages to allow continuous access to sufficient and safe drinking water within a reasonable walking distance. However, due to dwindling state resources and budgetary constraints, since the 1990s, government has been decentralising service provision to local communities’ including water supply. This paper reveals how eight villages in Nkayi have qualitatively managed to innovatively sustain reliable water supply to continue to meet domestic demand despite the challenges of acute water shortages and the burden of rising maintenance costs due to hyperinflation. Despite an unfavourable economic environment, a unique cost-sharing and resource mobilization process by the community, Nkayi has ensured that 87 per cent of water points remain functional.

Technical work of women in Nepal's rural water supply and sanitation

The Rural Water Supply and Sanitation Support Programme (RWSSSP) in Western Nepal trained more than 940 persons as village maintenance workers, local latrine builders, rainwater harvesting jar masons and water technicians. Of these, 116 were women. This study investigated the status of these women years after the training, paying attention to the technical quality of work, personal attitudes, views of the family and community, and socio-economic impacts. The interviewed women were positive about the training and related work, 77% were working, and all clearly had the support of their family members. Yet, there are many areas for improvement.

India needs a great sanitary awakening

Dear sir, I read the article titled “Environmental sanitation: An ignored issue in India” published in the April 2008 issue of your esteemed journal with keen interest. The author has chosen a vital subject that needs to be addressed urgently. Environmental sanitation is indeed still an ignored issue in India. This is evident from the facts available from the report of the National Family Health Survey-3 (NFHS-3), which throws light on some of the household characteristics like the type of house, safe drinking water and sanitation, cooking fuel and overcrowding.[1] It is reported that more than half of the households in India live in kachha/semipucca (14% kachha, 40% semipucca) houses. The proportion of households living in pucca houses is lowest in Manipur (10.7%). In 34% of the households, three to four persons and in 29% of the households, five or more persons share a single room for sleeping. Ninety percent of the rural households and 31% of the urban households use solid fuels for cooking, which generate smoke and unhealthy conditions when inhaled. About 90% of the households that use solid fuels cook on an open fire without diverting the smoke through a chimney. Although 88% of the households have access to an improved source of drinking water, only half the households reported having drinking water on their premises (51% urban, 28% rural). For 37% of the households, it takes up to 30 min and for the remaining 12% more than half an hour to fetch drinking water. Transportation and storage is known to cause contamination of water, but only 33%of the households treat their drinking water to improve its potability. More than half (55%) of the households (74% rural, 17% urban) have no toilet facility, the figure varying from 2% for Mizoram to 81.3% for Chhatisgarh. Only 29% of the households have toilet facilities that are improved and not shared with any other household. The survey about disposal of household (solid and liquid) and animal waste, which form a significant source of illness, is silent. Control of these factors has been responsible for a considerable improvement in the health of people during the past century in the developed countries. On the other hand much of the illness in India is due to poor environmental sanitation, i.e., unsafe drinking water, polluted soil, unhygienic disposal of human excreta and refuse, poor housing, insects and rodents.[2] The National Water Supply and Sanitation Programme was launched as early as 1954 and was supported by the Accelerated Rural Water Supply Programme (1971-72), the International Drinking Water Supply and Sanitation Decade (1981-90), the Rajiv Gandhi National Drinking Water Mission (1986), the Central Rural Sanitation Programme, the Total Sanitation Campaign and the Millennium Development Goals(2000) and similar programs. But, it is evident from facts reported by the NFHS-3 that the sanitary conditions have not changed much. The unsanitary conditions are appalling in India and[3] perhaps India also needs a great sanitary awakening like that which took place in London in the mid-nineteenth century.

The concept and practice of community management of rural water and sanitation programmes

The concept and practice of community management of rural water and sanitation programmes