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World Water Week
Stockholm, Sweden
29 August 2012
Sanitation, Hygiene Education and
Water Supply – Bangladesh
(SHEWA B)
The WASH Situation in Bangladesh
• 1 Source: Bangladesh 2011 Census (Bangladesh Bureau of Statistics) • 2 Source: JMP 2010 data • 3 Source: National Drinking Water Quality Survey 2009 (part of MICS 2009)
Estimated Population (2011) 1 149,772,364
Estimated population density 1015/km2
Urban/Rural %1 23.3% % / 76.7% %
Access to improved water sources2 81% (Urban 85%, Rural 80%)
Access to improved sanitation sources2 56%
(Urban 57%, Rural 55%)
Coverage of sanitation facilities in Primary schools 65%
Extent of Arsenic contamination – Household (sources > 0.05 mg/l) 3 13.4%
Estimated number of people drinking water in excess of 0.05 mg/l 22 million
Estimated number of people living in urban slums 7 million
ESHWSRA SHEWA-B
2001-2006 (Development Phase)
Environmental Sanitation,
Hygiene and Water Supply in
Rural Areas (ESHWSRA)
2007-2012 (Implementation Phase)
Sanitation, Hygiene Education
and Water Supply - Bangladesh
(SHEWA-B)
WORKING AT SCALE
ESHWSRA SHEWA-B % CHANGE
2001 – 2006 2007-2012 -
Development Phase Implementation Phase -
8 Million Beneficiaries 30 Million Beneficiaries 275%
10 Districts 31 Districts 210%
37 Sub-districts 114 Sub-districts 208%
37 Agencies 81 Agencies 119%
273 Local Government Institutions
708 (690 rural + 18 urban) Local Government
Institutions
159%
2,909 Community Hygiene Promoters
10,000 Community Hygiene Promoters
243%
4,844 Primary Schools
13, 000 Primary Schools
168%
750,000 New Latrines Promoted
1.14 Million New Latrines Promoted
52%
6,939 New Water Points 23,100 New Water Points 233%
SANITATION ACTIVITIES
Promotion and construction of low cost latrines at household level;
Construction of demonstration latrines in urban and rural areas;
Piloted latrines for the disabled;
Piloted (EcoSan) Ecological Sanitation latrines;
Targeted rural ultra-poor for government subsidies;
Development of low cost sanitation guidelines;
HYGIENE PROMOTION ACTIVITIES
Developed hygiene promotion training manuals and materials;
Community hygiene promoters (CHP) trained and supported to assist communities;
Facilitated development of Community Action Plans (CAP) and Community Maps;
Mass-media campaign with radio, TV and multi-media messaging;
Community level activities in tea stalls, mothers’ meetings, courtyard sessions, house-to-house visits and interactive popular theater;
Construction of new wells;
Rehabilitation of existing wells;
Use of evidence-based appropriate technology;
Water quality testing of all new wells;
Training for Operation & Maintenance;
Water Point Coding System established and implemented;
ARSENIC SITUATION
Policy changes:
Cease shallow well construction in arsenic areas;
Construct only deep boreholes in arsenic areas;
Advocate to change GoB admissible levels to WHO global standards;
Focus new construction of deep wells in heavily contaminated areas;
CHPs Trained on using Arsenic Field Testing Kits;
Provide other water supply options if wells contaminated;
Pilot testing of household arsenic filters;
Painting of spigots:
Red – contaminated
Green - safe
WASH IN SCHOOLS ACTIVITIES
School Brigades
Student involvement in school hygiene;
Monitoring of catchment areas;
Taking home hygiene messaging to family;
Ensuring running water with all latrines;
Construction of new water points, latrines & hand washing stations;
Rehabilitation of existing water points and latrines;
Separate stalls for boys and girls, and urinals for boys;
Lessons & Demonstrations;
SHEWA B ACHIEVEMENTS
Hygiene Promotion Sanitation (Latrines promoted)
Water Supply WASH in Schools
1.5 Million mothers of children under 5 participated in BCC activities
1.14 Million new latrines constructed by communities
14,500 water points constructed & tested and 8,600 under construction
2,617 primary school facilities constructed/repaired
133,000 Community Maps & Community Action Plans Created
2,789 New latrines constructed in urban slums by project
29,000 caretakers trained on O&M
70,000 teachers/ school management committee members trained
11,000 urban adolescent girls active as peer change agents
300 EcoSan latrines constructed
1,600 CHPs trained to monitor using arsenic field-testing kits
1.08 Million Students in Brigades trained and functioning
Trained 10,000 CHPs
6 Compost Plants Constructed
MIS & geo-coding system developed and implemented
National Standard facilitated and approved
SHEWA-B INTERIM RESULTS
1. The extent of the health impact is under evaluation –final evaluation June 2013;
2. Due to the scale of the project, any slight % reduction in diarrhoeal cases would be significant in terms of population affected;
3. Significant knowledge increases were noted throughout the process and impact monitoring;
4. Open defecation reduced from 25% to 5%;
5. Reduction in the number of people drinking arsenic contaminated water;
Urban Sanitation and Hygiene: Baseline-Midline Findings
Indicator Baseline 2009 Midline 2010
Intervention HHs have clean latrines (spot check) 12% 24%
Intervention HHs have soap/ash and water at convenient place for hand washing after defecation (spot check) 24% 49%
Mothers washing both hands with soap after cleaning baby’s bottom (observation)
12% 33%
Mothers washing both hands with soap before feeding baby (observation) 2% 7%
Interim School Findings 2011
Indicators Combined hardware
and software intervention schools
Software only intervention
schools Control Schools
Schools maintaining a functional water point and environmental sanitation around it.
56% 42% 35%
School latrines that are operational, accessible, clean and useable.
66% 65% 56%
Schools having soap/ash and water at a convenient hand washing place after defecation event.
81% 79% 68%
Schools having an appropriate solid waste disposal system
61% 65% 54%
0%
5%
10%
15%
20%
10 11 12 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4 5 6 7 8 9
Mean d
iarr
hea p
revale
nce
Intervention Control
Month
2007 2008 2009
Prevalence of diarrhoea among children < 5 years
First 8 quarters 2007-2009, Rural Bangladesh
10.1% 9.9%
Prevalence of diarrhoea among children < 5 years
2011-2012, Rural and Urban Bangladesh
Rural: 13% vs. 9% (p=0.02)
Urban: 7% vs. 7%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
1 2 3 4 5 6 7 8 9 10 11 12 1 2
2011 2012
Mea
n d
iarr
hea
pre
va
len
ce
Control(Rural) Intervention(Rural)
Control(Urban) Intervention(Urban)
Month
Enormous scale of the project affected quality and sustainability • Data should be consistently integrated/used for project
management and corrective actions;
• Aspects of sustainability with all stakeholders should be integrated from the start of the project:
– payment versus volunteer status of field workers (CHPs);
– exit strategy should be agreed and initiated from the start;
– real ownership at the community level must be a priority;
• Enabling environment is critical to ensure sustainability;
• Development partnerships and working at a Ministerial level, across sectors;
• Opportunities to ensure pockets of innovation should be expanded throughout the project;
SHEWA-B – LESSONS LEARNED
• Evaluate behavior change strategies to identify which activities are leading to changes in behaviour versus increased knowledge;
• Increase the focus on strengthening the enabling environment at all levels;
• Expand to a programme approach to encompass national and global trends;
• Projects of such a scale should be incorporated into long term (+ 25 years) sector planning;
• Support policy development and implementation at Ministerial levels, across sectors;
• Partnerships need to be nurtured in order to share risks, responsibilities, resources and benefits;
• Ensure expansion of innovations by documenting and disseminating all WASH innovations, both successes & failures;
SHEWA-B - RECOMMENDATIONS
Recommended