Enabling Environment Assessment for Scaling Up …...Report Enabling Environment Assessment for Scaling Up Sanitation Programs: Himachal Pradesh, India Andy Robinson and Rajiv Raman

Report

Enabling Environment Assessment for Scaling Up Sanitation Programs:

Himachal Pradesh, India

Andy Robinson and Rajiv Raman

Global Scaling Up Sanitation Project

January 2008 This report is part of the WSP Scaling Up Sanitation Project funded by the Bill and Melinda Gates Foundation. A major focus of the project is on learning how to scale up. The project is testing proven and promising approaches to create demand for sanitation and the use of marketing techniques to generate demand and improve the supply of sanitation-related products and services among the rural poor. This series of reports document the findings of work in progress and are disseminated to encourage the exchange of ideas and information and to promote learning. We invite comments and feedback. Please send your feedback to: [email protected]. The Water and Sanitation Program (WSP) is a multi-donor partnership of the World Bank. For more than 30 years, WSP has helped the poor gain sustained access to improved water supply and sanitation services (WSS).WSP works with governments at the local and national level in 25 countries. For more information visit our website: www.wsp.org Credits Photo Credits: The World Bank Photo Library Editorial Support: Hope Steele Production Coordination: Paula Carazo

ABOUT THE AUTHORS Andy Robinson

Andy Robinson is an independent water and sanitation specialist based in the French Alps. Since 1987, he has worked on the design, implementation, and analysis of water and sanitation programs in Asia and Africa for a diverse range of clients (including The World Bank, the WSP, UNICEF, and WaterAid). Over the last five years, he has been heavily involved in the promotion of improved sanitation and hygiene (and the spread of community-led total sanitation) in Asia, working with governments, development partners, and communities in Pakistan, India, Bangladesh, Cambodia, Indonesia, Laos, the Philippines, Timor-Leste, and Vietnam. Rajiv K. Raman

Rajiv K. Raman is an independent consultant based in Bangalore. He has managed large survey tasks in national resource management, community development, decentralization, water supply and sanitation and energy sectors. In addition, he has advised on strategy development, program design, institutional design, financial options, management and evaluation of interventions in these and allied sectors. His work in the energy, rural water supply and community development sectors reflects his extensive knowledge and experience working with diverse organizations, government institutions at state, district and sub-district levels, civilian society coalitions and project management agencies. The findings, interpretations and conclusions expressed in this report are entirely those of the author. They do not necessarily represent the views of the International Bank for Reconstruction and Development/World Bank and its affiliated organizations or those of the Executive Directors of the World Bank or the governments they represent. The World Bank does not guarantee the accuracy of the data included in this publication and accepts no responsibility whatsoever for any consequence of their use. The boundaries, colors, denominations and other information shown on any map in the document do not imply any judgement on the part of the World Bank concerning the legal status of any territory or the endorsement or acceptance of such boundaries.

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mailto:[email protected]

Table of Contents ACKNOWLEDGMENTS…………………………………………………………………….V ACRONYMS AND ABBREVIATIONS……………………………………………………….VI SUMMARY…………………………………………………………………………………1 1. INTRODUCTION…………………………………………………………………………7 Assessment framework and methodology…………………………………………………………7 Assessment Dimensions……………………………………………………………………………8 Methodology of Assessment……………………………………………………………………...10 Sampling Protocol………………………………………………………………………………...10 2. CONTEXT……………………………………………………………………………...12 Sanitation: The Scale of Challenge……………………………………………………………....12 Legal Framework………………………………………………………………………………...14 3. TOTAL SANITATION CAMPAIGN………………………………………………………15 Evolution of the Total Sanitation Campaign……………………………………………………..15 TSC Methodology………………………………………………………………………………..16 TSC Latrine Subsidies……………………………………………………………………………19 TSC Incentive Framework………………………………………………………………………..20 TSC Progress……………………………………………………………………………………..21 4. FINDINGS………………………………………………………………………………23 Policy, Strategy, and Direction…………………………………………………………………...23 Institutional Arrangements………………………………………………………………………..31 Implementation Capacity…………………………………………………………………………33 Financing………………………………………………………………………………………….34 Program Methodology……………………………………………………………………………35 Availability of Products and Tools……………………………………………………………….37 Cost-Effective Implementation…………………………………………………………………...39 Monitoring and Evaluation……………………………………………………………………….40 5. CONCLUSIONS…………………………………………………………………………42 Policy, Strategy, and Direction…………………………………………………………………...42 Institutional Arrangements………………………………………………………………………..44 Program Methodology……………………………………………………………………………45 Implementation Capacity…………………………………………………………………………45 Availability of Products and Tools……………………………………………………………….45 Financing…………………………………………………………………………………………46 Cost-Effective Implementation…………………………………………………………………...46 Monitoring and Evaluation……………………………………………………………………….46 6. RECOMMENDATIONS………………………………………………………………….47 Policy, Strategy, and Direction…………………………………………………………………...47 Institutional Arrangements………………………………………………………………………..47 Program Methodology……………………………………………………………………………48 Implementation Capacity…………………………………………………………………………48

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Availability of Products and Tools……………………………………………………………….49 Financing…………………………………………………………………………………………49 Cost-Effective Implementation…………………………………………………………………...49 Monitoring and Evaluation……………………………………………………………………….50 7. ENABLING ENVIRONMENT INDICATORS……………………………………………...51 8. ACTION PLANS………………………………………………………………………...53 REFERENCES……………………………………………………………………………..60 APPENDIX A: GLOSSARY………………………………………………………………...61 LIST OF FIGURES Figure 1: Infant Mortality Rate…………………………………………………………………...12 Figure 2: Trend in Rural Sanitation Coverage: India……………………………………………..13 Figure 3: Institutional Arrangements for the Total Sanitation Campaign………………………..18 LIST OF TABLES Table 1: Comparative TSC and NGP Performance……………………………………………….2 Table 2: Project Areas and Numbers of Beneficiaries…………………………………………….8 Table 3: Himachal Pradesh: 2001 Rural Sanitation Coverage……………………………………14 Table 4: TSC Components: Revised Earmarking and Funding Pattern………………………….17 Table 5: Growth in Nirmal Gram Puraskar Awards……………………………………………...21 Table 6: Physical Progress: Individual Household Latrines……………………………………...22 Table 7: Physical Progress: Institutional Toilets…………………………………………………22 Table 8: Financial Progress: Excluding Beneficiary Contributions (Rs crore)…………………..22 Table 9: Financial Progress: Excluding Beneficiary Contributions (US$ millions)……………...22 Table 10: Growth in Nirmal Gram Puraskar Awards: Madhya Pradesh…………………………22 Table 11: TSC District-Level Monitoring (Individual Household Latrines)…………………..…41 Table 12: Enabling Environment Indicators……………………………………………………...51 Table 13: India: National Action Plan……………………………………………………………53 Table 14: Himachal Pradesh: State Action Plan………………………………………………….56 ENDNOTES………………………………………………………………………………..63

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Acknowledgments The fieldwork and research could not have taken place without the support and assistance of the Government of Himachal Pradesh (Rural Development Department, Irrigation and Public Health Department), the Government of India, and the Water and Sanitation Program – South Asia. Special thanks are due to Soma Ghosh Moulik, Ajith Kumar, Upneet Singh, Milind Saxena, and Nitika Surie for their kind assistance and support in India.

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List of Acronyms and Abbreviations

Anganwadi Nursery school or (courtyard) childcare center ADC Assistant district collector (also known as assistant district magistrate) APL Above poverty line BPL Below poverty line CBO Community-based organization CCDU Communication and capacity development unit CLTS Community-led total sanitation crore 10,000,000 (ten million) CRSP Central Rural Sanitation Programme DC District collector (or district commissioner, or district magistrate) DLM District-level monitoring (program of the TSC) DRDA District Rural Development Agency DWSM District water and sanitation mission GoI Government of India GoHP Government of Himachal Pradesh HPVHA Himachal Pradesh Village Health Association IEC Information, education, and communication JMP WHO-UNICEF Joint Monitoring Programme for Water Supply and Sanitation lakh 100,000 (one hundred thousand) M&E Monitoring and evaluation MSJVS NGO operating in Mandi District, Himachal Pradesh NGO Nongovernmental organization NGP Nirmal Gram Puraskar (clean village award) ODF Open defecation–free Panchayat Indian administrative system: the literal meaning is “an assembly of five respected elders”; gram panchayat is an elected body at the village level. PHED Public Health Engineering Department PRI Panchayati Raj Institutions (local government system) RDD Rural Development Department RGNDWM Rajiv Ghandi National Drinking Water Mission RSM Rural sanitary mart SRSP State Rural Sanitation Programme TSC Total Sanitation Campaign TSSM Total Sanitation and Sanitation Marketing UNICEF United Nations Children’s Fund WHO World Health Organization WSP Water and Sanitation Program (South Asia) ZP Zila Parishad (district council)

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Summary The Water and Sanitation Program (WSP) is in the start-up phase of a new Global Scaling Up Sanitation project. The project is applying Total Sanitation and Sanitation Marketing (TSSM) to stimulate and scale up sanitation demand and supply. One of the central objectives of the project is to improve sanitation at a scale sufficient to meet the 2015 Millennium Development Goal (MDG) targets for improved sanitation in Indonesia, Tanzania, and the Indian states of Himachal Pradesh and Madhya Pradesh.

The baseline enabling environment assessment was carried out during the start-up phase of the overall project in May and June 2007. A follow-up assessment will be carried out at the end of project implementation, in approximately May or June 2009. The main objective of this assessment was to establish a baseline of the programmatic conditions needed to scale up, sustain and replicate the total sanitation and sanitation marketing in the Indian states of Himachal Pradesh and Madhya Pradesh.

In order to ensure consistency in the assessment findings, the WSP developed a conceptual framework for assessing the enabling environment for sanitation. This framework was based on a literature review and a series of discussions with key actors. The framework consists of eight dimensions considered essential to scaling up the total sanitation and sanitation-marketing approaches in rural areas:

• Policy, Strategy, and Direction • Institutional Arrangements • Program Methodology • Implementation Capacity • Availability of Products and Tools • Financing • Cost-Effective Implementation • Monitoring and Evaluation

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TOTAL SANITATION CAMPAIGN

One of the key differences between the methodology for the TSSM project in India and that in either Tanzania or Indonesia is the preexistence of a successful, large-scale rural sanitation program. The Total Sanitation Campaign (TSC) is a huge and ambitious program—in its current phase, the national TSC budget exceeds US$800 million—with a goal in the next five-year phase (2008–12) of providing toilets to 115 million households in order to achieve open defecation–free status across the whole country.

The TSSM project will work through the TSC in the State of Himachal Pradesh. The Water and Sanitation Program (WSP) had already established a good relationship with the Government of Himachal Pradesh prior to the launch of the TSSM project, resulting in the formulation of an outcome-based strategy for rural sanitation in Himachal Pradesh. The TSSM project enables the WSP team to enhance and broaden the level of support provided, to leverage TSC resources and sector opportunities at the national level, to extend its preexisting engagements at the state level, and to facilitate achievement of the TSSM objectives and outcomes.

The TSC is already operating at scale in Himachal Pradesh: it was initiated in seven of the twelve districts by 2005, and had expanded into every district by 2007. The universal implementation of the TSC by the State Government of Himachal Pradesh signals a shift from latrine construction to the more demand-driven and people-centered strategy inherent in the TSC. Following a mid-term review of the TSC, a set of revised TSC guidelines was issued in 2004. These revised guidelines highlighted two outcome-based objectives:

• elimination of open defecation to minimize risk of contamination of drinking water sources and food

• conversion of dry latrines to pour flush latrines BASELINE ASSESSMENT OF ENABLING ENVIRONMENT

In general, the enabling environment for rural sanitation in India is already extremely good. The TSC provides a solid financial and policy framework for the national goal of universal sanitation by 2012, which is well in excess of the MDG goal pursued by the TSSM project; and the TSC is well supported by the Nirmal Gram Puraskar (NGP) incentive program, which rewards local governments that achieve centrally defined sanitation outcomes.

Although the TSC has been operating since 1999, it is only since 2004 that it has promoted the elimination of open defecation and the achievement of collective sanitation outcomes. In the last few years, the TSC and NGP guidelines have provided a well-understood framework for sanitation and hygiene improvement with most state and district governments now actively engaged in sanitation promotion and sanitation-related activities.

The TSC provides a broad financial and policy framework for sanitation improvement in India, but allows individual states and districts the freedom to develop local policies and interventions according to their specific needs and priorities. This freedom limits central control of program methodology, but allows more progressive local governments to develop and implement new approaches and policies. As a result, there is a wide variation in the effectiveness and outcomes of the TSC in different states.

Table 1: Comparative TSC and NGP Performance Area TSC

expenditure (Rs million)

Household toilets

(number)

TSC progress

(%)

BPL toilet usage (%)

2007 NGP awards

(number) Himachal Pradesh 86 102,428 16 100 28 Madhya Pradesh 1,639 1,748,874 23 65 191 Maharashtra 2,132 3,127,223 34 87 1,974 All India 30,353 33,261,001 29 81 4, 959

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The performance data suggest that the TSC is doing relatively well in Himachal Pradesh, despite the fairly late start of the program in several districts. The district-level monitoring surveys suggest that toilet usage is universal among below poverty line (BPL) households, compared with 81 percent usage in the rest of India. In addition, the number of NGP awards to local governments is relatively high given the limited expenditure: Rs 3 million per NGP award, compared to an average of Rs 6 million per NGP award nationally.

POLICY, STRATEGY, AND DIRECTION

National-level political support for TSSM approaches is growing. The budget for the TSC program has almost doubled since 2005 in recognition of the rapid sanitation improvements encouraged by the TSC and NGP programs.

The Strategy for Total Rural Sanitation in Himachal Pradesh (2005) contained several progressive policy elements, notably that the TSC budget that had been allocated for cash incentives to BPL households would instead be used to finance lump sum payments to gram panchayats that achieve open defecation–free (ODF) status. However, this performance grant policy has not been adopted by any of the districts, which have defaulted to paying cash incentives to BPL households once ODF status has been achieved.

The national TSC guidelines remain problematic in Himachal Pradesh because of the instruction “to convert dry latrines to pour-flush latrines.” Pour-flush latrines do not operate in cold climates, such as those found in northern Himachal Pradesh, because the water in the flush latrine freezes. The current national guidelines prohibit variants on traditional dry latrines and improved pit latrines that are effective and hygienic under local conditions and are considered improved sanitation facilities by the WHO-UNICEF Joint Monitoring Program.

INSTITUTIONAL ARRANGEMENTS

The Joint Secretary of the Rural Development Department (of the Government of Himachal Pradesh), the nodal officer for the TSC, is responsible for 12 large rural development programs. As a result, despite the best efforts of the joint secretary, the management of the intensive TSC program does not receive the attention it needs.

The absence of sanitation units at either state or district level is a major constraint. The lack of state-level capacity or resources for both sanitation strategy and policy development, and for the regular monitoring and evaluation of district projects, has hindered state guidance of the TSC program. A similar problem exists at the district level, where few of the districts have established TSC units despite the state directive contained in the sanitation strategy. The administration component of the TSC, which is intended to finance staff and administrative costs, remains underutilized, thus there is no obvious constraint to the establishment and financing of district TSC units.

The TSSM project in Himachal Pradesh is relatively small (US$0.2 million per year) when compared with the US$4 million per year invested by the Government of India (GoI) in implementing the TSC and NGP programs. However, the WSP India team believes that the TSSM project can leverage additional central and state level resources and help develop new opportunities and approaches toward achieving TSSM objectives and outcomes.

A key constraint in Himachal Pradesh is the shortage of suitable implementing partners. Few NGOs with sector experience are available, and few alternative social intermediation models have been developed. Furthermore, there is evidence of resistance to NGO involvement by some government officials. The few NGOs active in the sanitation subsector are concerned that levels of partnership and remuneration are low, with little involvement in planning or decision making, and an ongoing struggle against the perception that NGOs provide largely voluntary (rather than nonprofit) services.

Cross-sectoral collaboration is likely to improve following the (May 2007) inception of the State Sanitation Review Committee, but there remain many gray areas in the distribution of subsector

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roles and responsibilities. For example, operating and maintaining school sanitation and hygiene facilities is difficult because of the multiagency nature of service development and provision, which reduces the ownership of involved agencies (for example, the District Rural Development Agency builds facilities under the TSC, but is not responsible for operating or maintaining them; whereas the Education Department, which becomes responsible for the school facilities on completion, feels little ownership or responsibility for facilities built by another department).

PROGRAM METHODOLOGY

Both the central sanitation programs (TSC and NGP) and the state sanitation strategy already promote a total sanitation methodology (based on eliminating open defecation). There has been some local resistance to the introduction of the more demand-driven community-led total sanitation (CLTS) approach in Himachal Pradesh, but the recent development of hybrid forms of the total sanitation approach (combining local community development techniques with CLTS tools for demand generation) appears acceptable and appropriate to local culture and norms.

Sanitation marketing remains a weaker. The TSC promotes “production centers and rural sanitary marts” but has encouraged a supply-driven and subsidy-based approach to sanitation marketing that limits the sustainability and effectiveness of these suppliers. One of the central problems has been that most production centers and sanitary marts have focused on the supply of components to a single latrine option priced to match the BPL cash incentive offered by the TSC (currently Rs 1,200).1 Standard latrine pans, concrete rings, and latrine slabs are produced with almost no allowance for variations in household taste, willingness to pay, or local constraints. In particular, few options are provided to assist in the development of larger and more desirable facilities by above poverty line (APL) households.

IMPLEMENTATION CAPACITY

The main capacity constraint is the lack of professional expertise in three fields: social intermediation, sanitation improvement, and hygiene promotion. Despite the huge sums involved in the TSC program, most promotional efforts are led by government officials with little training or expertise in social marketing or techniques for sustainable behavior change. Government efforts have been remarkably successful in the relatively small groups of communities targeted during the initial phases of the TSC program, but it is already apparent that the same staff-intensive approach, which is usually dependent on multiple visits by local administrators, will not work at the larger scale required to achieve district and state sanitation targets.

AVAILABILITY OF PRODUCTS AND TOOLS

Despite the availability of a substantial budget (approximately US$100,000 per district) for “alternate delivery mechanisms,” and a similar amount allocated for revolving funds that increase the availability and affordability of sanitation products and services, few districts projects have undertaken activities to improve local sanitation supply chains.

The WSP has made efforts to develop technical manuals, undertake research on consumer preferences, and support the construction of district technology parks, but these interventions have not yet translated into the larger-scale or more sustainable supply of sanitation goods and services.

FINANCING

The TSC district projects provide ample and predictable finance over a five-year time horizon, thus allowing strategic planning and encouraging large-scale implementation. Additional sanitation finance is available to successful communities through the NGP awards and state clean village competition.

The current sanitation financing framework is significantly better than in many countries, but it does not provide any incentive for the continuing development of sanitation services once the gram panchayat gains an NGP award. Furthermore, the inclusion of wider environmental

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sanitation criteria means that the current NGP requirements may prove too difficult for less able local governments to achieve.

COST-EFFECTIVE IMPLEMENTATION

The effectiveness of the TSC program is, increasingly, measured by the number of local governments that achieve ODF and NGP status. Reaching the MDG target requires increasing the state sanitation coverage by about 35 percent. Thus the current success rate may be sufficient to reach the MDG if every gram panchayat in Himachal Pradesh is targeted over the next five years. Sanitation coverage also increases in communities that do not eliminate open defecation, although the TSC online monitoring suggests only a 9 percent increase in sanitation coverage over the last couple of years, so faster progress will be needed in order for non-ODF communities to contribute significantly toward the sanitation MDG.

The TSSM project is developing a system to monitor its performance and cost-effectiveness, but few data were available at the time of the assessment. A simple calculation based on current data in the TSC online monitoring system (see Tables 6 to 9) suggests the following averages for the Himachal Pradesh TSC projects:

• cost per improved household sanitation facility = Rs 820 ($20.50) • cost per NGP gram panchayat = Rs 30 lakh ($75,000) • cost per NGP household = Rs 8,000 ($200)

The relatively high cost per NGP award reflects the early stage of the process (the first NGP awards to Himachal Pradesh were made in 2007) and is likely to reduce significantly if, as predicted by the Government of Himachal Pradesh (GoHP), the number of NGP awards increases significantly in 2008.

MONITORING AND EVALUATION

Current monitoring and evaluation systems are fragmented and inadequate. The TSC online monitoring system, which is the main monitoring and reporting portal for the TSC, monitors only physical (number of toilets) and financial (expenditure) progress.

The TSC district-level monitoring (DLM) process surveys a sample of 500 households in each district,2 examining community sanitation coverage and latrine usage among BPL households. The 2006–07 DLM data for Himachal Pradesh suggest that only 34 percent of households (of 10,500 households surveyed) owned sanitation facilities, but that 99 percent of the 875 BPL households surveyed were using their facilities. While suggesting high latrine usage among BPL households, the DLM results highlight the limited success of the TSC among APL households in Himachal Pradesh, as well as the importance of using collective outcomes to monitor sanitation progress: in this case, the 99 percent BPL latrine usage obscures the fact that 66 percent of the population surveyed are either using inadequate facilities or practicing open defecation.

RECOMMENDATIONS

It is recommended that the state government match its sanitation goals to those of the national government, which wants universal sanitation for India by 2012. The TSSM project should assist the already-successful Mandi District in developing a strategic action plan for the remainder of its gram panchayats, and then use the learning from this process to assist each district in Himachal Pradesh to develop strategic sanitation action plans that provide a realistic roadmap toward universal sanitation in the state by 2012.

There is a shortage of professional community development and sanitation expertise in Himachal Pradesh. The TSSM project needs to train a cadre of sanitation and hygiene specialists, and to encourage the use of TSC funds to finance private (or community) efforts to achieve sustainable sanitation outcomes.

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The absence of sanitation units at either state or district level is a major constraint. The lack of state-level capacity or resources for sanitation strategy and policy development, and for the regular monitoring and evaluation of district projects, has hindered state guidance of the TSC program. The TSSM project will provide some important short-term support and capacity building, but there is a need for a state-financed sanitation unit to manage TSC and NGP activities, and provide direction for wider state objectives.

The sanitation marketing methodology should focus primarily on the supply of sanitation goods and services to APL households. Based on the June 2007 TSC monitoring data, APL households comprise 83 percent of the target TSC households; only 13 percent of these APL households have been served to date, compared with 30 percent of the target BPL households. The sanitation marketing component of the TSSM needs to formulate and market a range of latrine options that are attractive to APL households.

More information is required on the number and nature of the different products, retailers, and service providers (such as masons) available in Himachal Pradesh; and on the latrine options that are considered affordable and desirable by the different market segments (for example, food poor, poor, non-poor with water supply but no latrine, non-poor with traditional latrine, and remote communities).

The increasing importance of the NGP program—whose proposed 2008–2012 budget is likely to be larger than the TSC program—requires that further investigation be undertaken into the sustainability of the sanitation outcomes generated by the NGP, and into the effective use of the financial rewards garnered by NGP winners (that is, do these funds result in additional sanitation improvements, or does this money repay previous sanitation investments by local governments, or is it used for other non-sanitation-related activities).

In light of the sustainability and impact questions raised against the TSC and NGP programs, it is recommended that the TSSM project consider the development of a more phased incentive framework:

• providing the 10 percent TSC finance allocated to environmental sanitation after achieving ODF

• providing performance grants to village governments that achieve post-NGP outcomes • financing recurrent costs in communities that sustain sanitation outcomes

Data on cost-effectiveness are important for developing consensus on the best approaches for large-scale implementation. The WSP needs to strengthen the case for using the CLTS approach by documenting the relative cost-effectiveness of the various approaches tried in Himachal Pradesh, in particular when programs scale up and begin to target less-active and committed communities and local governments. The cost-effectiveness data can also be used to benchmark district performance.

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1. Introduction The Water and Sanitation Program (WSP) is in the start-up phase of a new Scaling Up Sanitation Project. The project is applying Total Sanitation and Sanitation Marketing (TSSM) to stimulate and scale up sanitation demand and supply. One of the central objectives of the project is to improve sanitation at a scale sufficient to meet the 2015 sanitation Millennium Development Goal (MDG) targets in Indonesia, Tanzania, and the Indian states of Himachal Pradesh and Madhya Pradesh.

The baseline enabling environment assessment was carried out during the start-up phase of the overall project in May and June 2007. A follow-up assessment will be carried out at the end of project implementation in approximately May or June 2009. The main objective of this assessment was to establish a baseline of the programmatic conditions needed to scale up, sustain, and replicate the Total Sanitation and Sanitation Marketing (TSSM) approaches in the Indian states of Himachal Pradesh and Madhya Pradesh.

The purposes of the baseline assessment are to: (1) assess the extent to which the programmatic conditions for scale up and sustainability are in place at the beginning of the project, and (2), on the basis of the baseline assessment findings, recommend what should be done to address the gaps during project implementation, and determine whether conditions are conducive for scaling up and sustaining results at the end of the implementation period. The purpose of the final assessment (at the end of the implementation period) will be to determine whether suitable programmatic conditions are in place to meet the 2015 MDG targets and sustain these broader achievements over time. The fundamental question that the assessment is intended to answer is whether the country can continue to scale up after 2009 without assistance from the TSSM project.

This report presents the main findings and recommendations from the baseline assessment of the enabling environment to scale up, sustain, and replicate sanitation improvements in Himachal Pradesh, India.

Assessment Framework and Methodology In order to ensure consistency in the assessment findings, the WSP has developed a conceptual framework for assessing the enabling environment. This framework was based on a literature review and discussions with key actors. The framework consists of eight dimensions that are considered essential to scaling up the TSSM approaches in rural areas:

• Policy, Strategy, and Direction • Institutional Arrangements • Program Methodology • Implementation Capacity • Availability of Products and Tools • Financing • Cost-Effective Implementation • Monitoring and evaluation Definition of scale-up: Increase the scale, rate of provision, and sustainability of sanitation services to reach the two-year 2009 targets in the TSSM project and the MDG targets for 2015 (see Table 2).

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Table 2: Project Areas and Numbers of Beneficiaries population in millions

Project areas (population)

People without access to

sanitation in 2006 (estimate)*

People who will gain access to sanitation

during two-year project (estimate)

Additional access to sanitation

needed to meet 2015 MDG targets**

Tanzania (26.7 rural) 14.25 0.75 6.5 East Java, Indonesia (36.5) 18.60 1.40 10.0 Himachal Pradesh, India (5.5 rural) 4.30 0.70 1.2

Madhya Pradesh, India (45 rural) 43.60 1.10 20.0

Totals 80.75 3.95 37.7

Source: UN population data; JMP 2006 report. * Best estimates given poor status of data. ** Accounts for population growth estimates

Assessment Dimensions The eight assessment dimensions represent a conceptual framework for assessing scalability and sustainability. Scale up has been defined as an increase in the present scale, rate of behavior change, and sustainability of the program promoting TSSM. 1. Policy, Strategy, and Direction

Establishing a shared vision and strategy and ensuring the political will to implement a program is the starting point for scale up. Developing this shared vision and strategy in a collaborative manner is also the foundation for coordination and for creating motivation all levels. Policy is defined as the “set of procedures, rules, and allocation mechanisms that provide the basis for programs and services. Policies set the priorities and often allocate resources for implementation. Policies are reflected in laws and regulations, economic incentives, and the assignment of rights and responsibilities for program implementation.”

2. Institutional Arrangements

Institutions at all levels must clearly understand their roles, responsibilities, and authorities. They must also have the resources to carry out their roles. In addition to clear roles and responsibilities, institutional arrangements must include the mechanisms for actors at all levels to coordinate their activities.

Programs are based on, or promote, the establishment of a public-private partnership. A partnership is a relationship where two or more parties, having compatible goals, form an agreement to share the work, share the risk, share the power, and share the results or proceeds. Partnerships need to be built at all levels among public, private, and NGO sectors, between communities and local governments, and so on.

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3. Program Methodology The program methodology consists of the program rules as well as specific activities and their timing and sequence. Each country will adapt and apply the program methodology making it specific and appropriate to the country context. A workable program methodology that is clear and agreed upon by all key stakeholders is a key programmatic condition.

4. Implementation Capacity

Institutions at all levels must have the institutional capacity to carry out their roles and responsibilities. Institutional capacity includes adequate human resources with the full range of skills required to carry out their functions, an “organizational home” within the institution that has the assigned responsibility, mastery of the agreed-upon program methodology, systems and procedures required for implementation, and the ability to monitor program effectiveness and make continual adjustments.

5. Availability of Products and Tools The ability of target consumers to adopt the promoted behavior(s) is highly dependent on the existence and availability of products and services that respond to consumer preferences and their willingness and ability to pay for them. Any and all relevant products and services need to be considered, specific to each country situation. As each project area will be conducting market surveys and market analysis in conjunction with the private sector partners, this assessment dimension will be dealt with in broad, general terms with a focus on the government role and its policy implications.

6. Financing This dimension assesses the adequacy of arrangements for financing the programmatic costs. These costs include training, staff salaries, transportation, office equipment and supplies, and the development of communication and education materials as well as programmatic line items in budgets for program and promotion activities.

7. Cost-Effective Implementation Although it will not be possible to assess the cost-effectiveness of the approach, or how best to achieve economies of scale and scope, until the end of the project, data must still be collected during implementation to make this determination at the end of the project. Therefore, the focus in this assessment is to ensure that information will be collected from the outset and that the capacity to collect the information is in place—that systems and procedures for collecting cost information and the capacity to use and collect it exist.

8. Monitoring and Evaluation Large-scale sanitation programs require regular monitoring and periodic evaluation, and perhaps more importantly, the willingness and ability to use the monitoring process to make adjustments in the program. Effective monitoring will identify strengths and weaknesses in the program methodology, implementation arrangements and cost efficiencies. Overall monitoring responsibility must be at the highest level of the program, but must be based on information collected at the local government or community level.

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Methodology of Assessment The baseline assessments in India were carried out by a two-person team consisting of an international and national consultant, supported by the WSP state coordinators in Himachal Pradesh and Madhya Pradesh,3 with overall direction and support from the WSP country task manager for the TSSM project (Soma Ghosh Moulik) and the WSP India country team.

The baseline assessments were conducted through a series of one-to-one interviews with key stakeholders at national, state, division, district, block, gram panchayat, and village level. In addition, some self-report forms were distributed in order to capture the views of any stakeholders that the assessment team was unable to meet in person.

A generic interview guide and self-report form were prepared based on this assessment framework, and were further revised and developed by the consultants and the WSP India team in order to match the questions and language more closely to local contexts and norms. The India-specific interview guide was used in each interview, although some dimensions and questions were not considered relevant (or appropriate) to some stakeholders (for example, asking local retailers about national strategy issues). All the dimensions of the assessment framework were covered, but not by every stakeholder.

Primary data sources comprised main stakeholders and present partners for the in-country program work, including but not limited to government agencies, international agencies, international nongovernmental organizations (NGOs), local NGOs, private sector businesses and community-based organizations (CBOs). These primary data sources were contacted at all appropriate levels: national, state, district, and local.

Secondary data sources comprised key documents and potential influencers or secondary implementers such as media, ministries with no direct involvement, advocacy groups, and so on. Because program activities are in the very early stages, several “potential” stakeholders/partnering organizations were interviewed.

Few self-report forms were completed. Despite considerable efforts during the assessment, the response to the self-report forms was very poor—only a handful of forms were completed (out of the dozens distributed), mostly by stakeholders that had already been interviewed. On review, it was clear that these few forms did not contain any information that had not already been obtained through interviews. As a result of this experience in Himachal Pradesh, the self-report forms were not utilized during the Madhya Pradesh assessment.

Sampling Protocol Sampling was purposive for all primary data sources.

Criteria for selection for both interviews and self-reports included stakeholders that:

1. have participated in a sanitation program (or related program) for at least 6 months;

2. represent a main workforce type—a decision maker, an implementer, or a mid-line supervisor or manager of the program; and

3. represent one of the different levels of the organization that are involved in the program—national, regional, district, and local.

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Because of the limited time available for the assessment, only two (of the twelve) districts in Himachal Pradesh were visited. Based on information from the ongoing Total Sanitation Campaign (TSC) activities, one above-average district and one below-average district were selected.

Mandi was selected as an “above-average district” based on its exceptional TSC performance (home to 22 out of the 28 Nirmal Gram Puraskar, or NGP, award winners in Himachal Pradesh), and the desire of the assessment team to examine the unique institutional model and approaches developed by the district administration. Bilaspur was selected as the “below-average district” following reports of disappointing progress despite the involvement of large NGO.

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2. Context Himachal Pradesh is a small state in the mountainous northwest of India, bordered by Tibet to the east and Jammu and Kashmir to the north. The lowest point in the state is at an altitude of 450 meters above sea level, and the highest reaches 6,500 meters. As a result, some parts of Himachal Pradesh experience extremely cold winter temperatures.

Himachal Pradesh is divided into 12 districts, which contain 75 blocks and 3,243 gram panchayats. It is a predominately rural state, with 90 percent of the population (5.5 million people) living in rural areas. About 25 percent of the population belongs to scheduled castes.

Figure 1: Infant Mortality Rate

Infant Mortality Rates

56

34 36

78

68

57

85 86

70

0

10

20

30

40

50

60

70

80

90

1993 1998 2005

Source: NFHS I, II & III

100Himachal PradeshAll IndiaMadhya Pradesh

Source: GoI (2006); data taken from National Family Health Surveys (NFHS) I, II, and III.

Despite its rural nature, Himachal Pradesh has above-average human development indicators, and is bettered only by Kerala in both infant mortality rate (36 deaths per 1,000 live births) and literacy rate (77 percent). Himachal Pradesh also has one of the highest per capita state incomes in India, deriving from a strong economy built around agriculture, hydroelectric power, and tourism.

Sanitation: The Scale of Challenge The practice of open defecation has long been traditional in rural India. According to the 2001 census data, only 21.9 percent of the rural population in India own latrines (see Figure 2). In addition, the supply-driven nature of previous sanitation interventions—whereby highly subsidized sanitation facilities were provided to rural households unconvinced of their benefits—means that some of these latrines are not used.

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Simple linear projections of rural population growth show that, in order to achieve the target of universal sanitation by 2012, accelerated progress is required. Recent progress has been good, with some surveys estimating that 2.8 million individual household latrines (IHLs) have been constructed annually over the 2001–05 period. However, at this rate, universal sanitation will not be achieved until 2024. In addition, latrine usage remains a problem: sample surveys carried out by GoI assessment teams in 478 districts (under the district-level monitoring, or DLM, program) indicate that actual latrine usage is around 80 percent nationally, with significant variation across and within states.

Access to improved sanitation in Himachal Pradesh is marginally above average, with official figures suggesting 28 percent sanitation coverage. About 380,000 toilets were built through subsidy-based programs in the 1990s: the Central Rural Sanitation Programme (CRSP) and SRSP provided subsidies of Rs 1,700–2,000 per household toilet,4 but a 2003 rapid assessment in six districts found that these supply-driven programs resulted in toilet usage of only 20 to 30 percent.5 Other household surveys suggest usage as low as 15 percent.6 The rapid assessment also found that, despite perceptions that latrines were expensive to construct, more than 60 percent of the household latrines surveyed were constructed by private individuals without any external assistance. Usage levels were found to be close to 100 percent among private latrine owners.

Stakeholder interviews suggested that the people of Himachal Pradesh perceive themselves to have a relatively unpolluted environment and a healthy lifestyle. However, despite a cultural affinity with the mountains and forests, this perception is not supported by conditions in the wider communal environment: unsafe excreta disposal and indiscriminate waste disposal are widespread outside the immediate domestic sphere (see Table 3). A recent assessment found that more than 90 percent of the population still practice open defecation, with nearby forests, nalas,7 and river banks suggested as common defecation sites.8

1 14

11

3

10 1114

6

17 1718

2224

0

5

10

15

20

25

30

1975

1980

1985

1990

1995

2000

2005

Year

Pro

port

ion

of R

ural

Hou

seho

lds

with

Lat

rine

s (%

)

Figure 2: Trend in Rural Sanitation Coverage: India Source: India Assessment 2002 (PC) and Census of India 2001.

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Table 3: Himachal Pradesh: 2001 Rural Sanitation Coverage

Rural households

Rural households with

latrine Number District

Blocks (numbe

r)

gram panchayats

(number) Villages (number)

Total households

(number) Number Percent Number Percent

1 Lahaul & Spiti 2 41 521 9,155 9,155 100

5,425 59

2 Kinnaur 3 65 660 20,781 20,781 100

7,582 36

3 Hamirpur 6 229 1,842 87,596 81,097 93

28,398 35

4 Solan 5 211 2,794 98,519 77,414 79

26,150 34

5 Bilaspur 3 151 1,082 67,195 61,648 92

21,169 34

6 Una 5 235 552 88,869 80,790 91

23,077 29

7 Mandi 10 473 2,877 186,571 171,299 92

46,112 27

8 Kangra 14 760 NA 272,697 257,467 94

70,611 27

9 Shimla 9 363 2,441 160,646 114,066 71

27,624 24

10 Sirmaur 6 228 971 82,543 72,664 88

16,831 23

11 Kullu 5 204 2,862 78,362 70,565 90

16,182 23

12 Chamba 7 283 1,598 87,699 80,574 92

15,041 19

Total 75 3,243 18,200 1,240,633 1,097,520 90

304,202 28 Source: Census of India 2001. Available at http://www.censusofindia.net (accessed 9 May, 2007).

Legal Framework The Constitution of India determines that water supply, sanitation, and other public health services are state responsibilities. However, the 73rd and 74th constitutional amendments allow states to pass the responsibility and powers for water supply and sanitation down to local governments.

In Himachal Pradesh, the Panchayati Raj Act 1996 (updated in 2001) states that sanitation is a local body (gram panchayat) function. Prior to the TSC, however, few gram panchayats were aware of their responsibility or showed any interest in undertaking sanitation activities. Specifically, the gram panchayat is responsible for the following functions:

• sanitation • clearing of roads and drains • organizing school health check-up programs • reporting the outbreak of gastroenteritis and any other epidemic • constructing and maintaining village drains and disposing of wastes • preventing and controlling water pollution

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3. Total Sanitation Campaign One of the key differences between the methodology for the Global Scaling Up Sanitation Project in India and that in either Tanzania or Indonesia is the preexistence of a successful, large-scale rural sanitation program. As described in more detail in the following section, the TSC is a huge and ambitious program. In its current phase, the national TSC budget exceeds US$800 million and has a goal in the next five-year phase (2008–12) of providing 115 million household toilets and achieving open defecation–free status across India by 2012.

The TSSM project will work through the TSC in Himachal Pradesh. Prior to the start of the project, the Water and Sanitation Program (WSP) India team had already established a good relationship with the Government of Himachal Pradesh (GoHP), resulting in the formulation of an outcome-based strategy for rural sanitation in the district. The TSSM project now enables the WSP team to enhance and broaden the level of support provided, to leverage TSC resources and sector opportunities at the national level, to extend its preexisting engagements at the state level, and to facilitate achievement of the TSSM objectives and outcomes.

Evolution of the Total Sanitation Campaign India’s first nationwide program for sanitation was the Central Rural Sanitation Programme (CRSP), which was initiated in 1986. This program focused on providing household sanitation facilities and relied on a hardware subsidy to “generate demand” for pour-flush toilets. In light of the relatively poor national sanitation coverage, a revised CRSP (RCRSP) was launched in April 1999. The revised program advocated a shift from a high-subsidy to a low-subsidy regime; greater household involvement and demand responsiveness; the promotion of a range of toilet options to advance increased affordability; and strong emphasis on information, education, and communication (IEC) and social marketing. The program envisaged complementary systems such as trained masons and supply of building materials through rural sanitary marts and production centers, and called for a thrust forward on school sanitation as an entry point for encouraging wider acceptance of sanitation by the rural population.

After pilots in selected states, the program was announced as the Total Sanitation Campaign (TSC) for roll-out on a national level in 2003. The program included assistance for construction of individual household toilets, sanitary complexes for women, school sanitation, and the setting up of alternative delivery systems such as rural sanitary marts. The recognition that water and sanitation in schools are critical to the formation of proper attitudes and habits for hygiene, sanitation, and safe water use, and that schools are powerful channels for communicating hygiene messages to households and communities, was evident in its emphasis on school sanitation programs. Likewise, measures were advocated to raise awareness levels and improve hygiene behavior, while simultaneously advocating the “capacity building” of program delivery staff and other stakeholders through training initiatives.

The TSC, launched by the Government of India (GoI) in 1999, is a comprehensive national program to improve rural sanitation coverage, promote latrine use, and eliminate the practice of open defecation. The TSC is already operating at scale in Himachal Pradesh: starting in 1999, it was initiated in seven of the twelve districts by 2005 and has now expanded into every district.

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The universal implementation of the TSC by the GoHP signals a shift from latrine construction to the more demand-driven and people-centered strategy inherent in the TSC. The key objectives of the TSC are to:

• improve the quality of life in the rural areas; • accelerate sanitation coverage in rural areas; • generate felt demand for sanitation facilities through awareness creation and health

education; • provide rural schools and nursery schools with sanitation facilities,9 and promote

hygiene education and sanitary habits among students; and • encourage cost-effective and appropriate technologies in sanitation. The approach adopted in this campaign aims at motivating rural households to build latrine facilities and encouraging them to use them. Thus, the emphasis is on designing strategies to motivate individual households so that they realize the need for good sanitation practices, and as a result, in time, not only construct toilets but also have the members of the family use them. In addition, the program also aims at modifying and improving personal hygiene behavior. Following a mid-term review of the TSC, a new set of revised guidelines was issued in 2004. These guidelines accorded emphasis on sanitary arrangements, not merely on the construction of household latrines. Three outcome-based objectives were highlighted:

• eliminate open defecation to minimize risk of contamination of drinking water sources and food

• convert dry latrines to pour-flush latrines • eliminate manual scavenging practice The School Sanitation and Hygiene Education (SSHE) component was strengthened; and the provision of toilets was extended to anganwadi centers, all levels of schools (primary, middle, secondary, and so on), and all establishments of the gram panchayat. The GoI sought to reorient the focus of the sanitation program to achieving the outcome of an open defecation–free (ODF) environment. Thus, not only individual households, but also communities, village, and panchayat governments started to be targeted.

TSC Methodology The Department of Drinking Water Supply (DDWS) is responsible for the TSC, through the mission director of the Rajiv Gandhi National Drinking Water Mission and its CRSP. In most states, either the Rural Development Department (RDD) or the Public Health Engineering Department (PHED) are given responsibility for state-level management of the TSC program, with a State Water and Sanitation Mission, which is a multi-stakeholder body—that is, including all relevant government departments and nongovernment stakeholders, mandated as the main body responsible for planning, supervising, and monitoring the implementation of drinking water and sanitation programs in the districts. The program management arrangements also provide for suitable institutional arrangements at the district and subdistrict levels. The fund flow for the centrally sponsored programs such as TSC is directly to the district, with the matching state share being released when the utilization and request is put in by the district agency.

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The TSC operates through district projects of three to five years in duration, each jointly financed by the GoI, the state government, and the beneficiary households. The funding split varies according to the program component, but averages about 65 percent from the GoI, 23 percent from the state government, and 14 percent from the beneficiaries. The TSC financial framework specifies exactly how the project funds are to be earmarked and divided between components and funding sources (see Table 4).

Table 4: TSC Components: Revised Earmarking and Funding Pattern

Relative contribution (percent) Component Amount earmarked

(percent) GoI State Household IEC campaigns and start-up activities

Up to 15 80 20 n.a.

Alternate delivery mechanisms (production centers, sanitary marts)

Up to 5 80 20 n.a.

(i) Individual latrines for BPL households (ii) Community sanitary complexes

Amount required for full coverage

60 20 20

Individual latrines for APL households

Nil n.a. n.a. 100

Institutional sanitation (anganwadi, school, and public facilities)

Amount required for full coverage

70 30 n.a.

Administration (training, overheads, M&E)

Less than 5 80 20 n.a.

Solid and liquid waste management (capital costs only)

Up to 10 60 20 20

Source: GoI DDWS 2006.

Note: The table used the revised pattern as per March 2006 modifications in TSC guidelines (which updated the January 2004 guidelines).

The district has to submit a project proposal (in line with the guidelines issued by the GoI) and a project implementation plan to the state government to avail itself of the GoI funding. Each state is required to establish appropriate institutional arrangements to facilitate project implementation by districts and monitor implementation. Specialist consultants from the fields of communication, human resource development, monitoring, and school sanitation and hygiene education can be appointed as consultants at the state level, and where required at the district level.

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Figure 3: Institutional arrangements for the Total Sanitation Campaign Source: GoI website http://ddws.nic.in/tsc-nic/html/tsc_delivery.htm (accessed 07 May 2007).

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http://ddws.nic.in/tsc-nic/html/tsc_delivery.htm

The states remain free to devise their own specific approaches within the broad framework provided by the program. Several states, notably Maharashtra and West Bengal, have modified the TSC guidelines to accord better with their existing sanitation initiatives. These modifications include such elements as the use of part of the funds provided for latrine subsidies to promote improved sanitation and hygiene practices. In addition, the TSC guidelines provide a flexible framework for the district projects, allowing different methodologies to be adopted depending on the different contexts, demands, and capacities within the district.

Although the program delivery strategy in most states follows the overall TSC framework, the structure and institutional linkages varied with the situation of local self-government systems and the mode of development program administration in the state. In states where the Panchayati Raj Institution system is mature and financial and functional devolution has taken place, the fund flow continues down to the subdistrict (block) level for awareness creation and overall program management. In other states, the program (and fund) management is centralized with the district administration, and subdistrict tier functionaries are directed and managed from the district level.

TSC Latrine Subsidies Under the TSC, financial incentives were to be paid to below poverty line (BPL) households up to 80 percent of the cost of a Rs 625 basic latrine unit (usually a single pit latrine without a superstructure), and 60 percent for latrine models costing up to Rs 1,000. However, the TSC guidelines state that:

The construction of household toilets should be undertaken by the BPL household itself, and on completion and use of the toilet by the BPL household, the cash incentive can be given to the BPL household in recognition of its achievement. GoI TSC Guidelines (2004) p.9 para. 9(d).

In addition, the TSC guidelines clearly state that individual rural households should have a choice as to the type of latrine that is built:

The physical implementation gets oriented towards satisfying the felt needs, wherein individual households choose from a menu of options for their household latrines. The built-in flexibility in the menu of options gives the poor and disadvantaged families opportunity for subsequent upgradation depending on their requirements and financial position. GoI TSC Guidelines (2004) p.7 para. 7.

TSC Guidelines Revised in 2006: Raised Subsidy Further revisions to the TSC guidelines were issued in March 2006, stipulating that the incentive for BPL household latrines was to increase from Rs 500 to Rs 1,200. This apparently inflation-driven revision doubled the maximum latrine cost to Rs 2,000, in large part because the basic low-cost unit was now deemed to require a superstructure. This revision represented a substantial change for the TSC, both in terms of the higher financial requirements of the campaign because the amount of the BPL latrine incentive had increased by 240 percent, and the increased construction and monitoring requirements now that an adequate superstructure must be provided before completion and usage can be verified.

TSC Guidelines Revised in 2006: Full Coverage of BPL Households and Schools

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In addition, the 2006 revisions state that financing for household latrine incentives should now cover the “actual amount required for full coverage [of the BPL households].” Similarly, financing for institutional toilets (including school and anganwadi toilets) now includes the “actual amount required for full coverage.” Community contributions for school and anganwadi toilets, which were previously set at 10 percent, are no longer required.

Importantly, the revisions also introduced solid and liquid waste management as a component of the TSC (up to 10 percent of project outlay), as well as provisions for establishing a revolving fund (up to Rs 50 lakh) for the provision of sanitation loans (with a maximum of Rs 2,000 per household) to self-help groups and cooperative milk societies.

As a result of the March 2006 TSC revisions, each district has been asked to resubmit a revised project proposal (based on the higher latrine incentives and new cost-sharing arrangements). The GoI estimates that the budget for the revised TSC (to be included in the 11th Five-Year Plan) will be Rs 5,700 crore,10 (US$1.4 billion; a billion is 1,000 million), with the overall program objective of achieving universal rural sanitation coverage by 2012.

TSC Incentive Framework Taking note of the need to empower local government institutions and promote community-based action for sanitation and hygiene, states such as Maharashtra and Tamil Nadu announced innovative incentive frameworks for Panchayati Raj Institutions, including the Sant Gadge Baba Gram Swachayata Abhiyan (2000) and the Clean Village Campaign (2003), both of which promoted competition among local governments to achieve preset standards for environmental cleanliness and collective sanitation outcomes. In 2002, the Government of Maharashtra also initiated the Hagandhari Mukt Abhiyan, which was the first program that attempted to motivate panchayats to move toward ODF status within their entire jurisdiction.

Following the success of state incentive schemes such as the Sant Gadge Baba scheme, the GoI introduced the Nirmal Gram Puraskar (Clean Village Award) in October 2003. Villages (gram panchayats) are eligible to apply for the NGP award on achieving the following collective outcomes:

1. 100 percent sanitation coverage of individual households 2. 100 percent school sanitation coverage (with separate facilities for boys and girls) 3. free from open defecation 4. maintenance of a “clean environment”

Gram panchayats, blocks, and districts are eligible for the award, as are individuals and organizations that contributed significantly to achieving the goals within a particular area. The cash award ranges (depending on population size) from Rs 0.5 to 5 lakh (for gram panchayats) 11 and Rs 10 to 20 lakh (for blocks, that is, with all their gram panchayats being covered) to Rs 30 to 50 lakh (for districts, with 100 percent blocks and gram panchayats covered). 12 Individuals and organizations can win cash awards of between Rs10,000 and 50,000. The cash incentive provided to Panchayati Raj Institutions is to be utilized for improving and maintaining sanitation facilities in their respective areas, with a focus on the safe disposal of solid and liquid wastes and the maintenance of sanitation standards.

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In addition to the financial incentive attached to the award, the NGP benefited from an early decision to add some prestige and profile to the NGP awards by asking the President of India to make the awards in person. As a result, the initial winners of the NGP awards, who were mostly elected village leaders (Sarpanch or Pradhan), were honored by the President at a prestigious ceremony attended by ministers and high-ranking officials from all over India. The prestige and positive publicity generated by this high-profile award ceremony was far greater than anticipated, giving considerable impetus to local government involvement in the TSC, and resulting in strong interest and competition for the NGP awards at all levels of government.

Unfortunately, the unprecedented success of the NGP award has had unexpected side effects. In the last two years the number of NGP awards has increased dramatically, from 40 NGPs at the first ceremony in 2005 to 4,959 NGPs in May 2007, with a commensurate increase in the number and spread of NGP applications (see Table 5).

Table 5: Growth in Nirmal Gram Puraskar Awards Number 2004–05 2005–06 2006–07 NGP applications 481 1,421 9,745 NGP awards 40 769 4,959 States involved 6 16 22 Source: WSP India (personal communication).

This rapid expansion has stretched the resources available to provide independent assessments of the applications, necessitated a reduction in the amounts awarded to smaller gram panchayats (from Rs 200,000 down to Rs 50,000), and made it impossible for the President to congratulate each recipient personally. As a result, the NGP awards were delayed in 2007 (from January to May), and several stakeholders complained that the positive impact of the awards has been diminished by the reductions in financial rewards and prestige.

Nevertheless, the number of states proffering applications has increased from only six (West Bengal, Maharashtra, Tamil Nadu, Tripura, Kerala, and Gujarat) at the outset to twenty-two states in 2006-07. The ever-widening catchment of NGP applicants reflects the growing political and popular interest in the awards, which has important knock-on effects that improve and increase support and involvement in the TSC.

Because the NGP is an open and one-time only award, the GoI hopes that every gram panchayat in India will qualify and apply for it before 2012. Therefore, the GoI estimates that the 11th Five-Year Plan (2008–12) budget for the separately financed NGP needs to be Rs 6,000 crore (US$1.48 billion), which is Rs 300 crore (US$74 million) higher than the TSC budget over the same period.

TSC Progress The GoI operates an online monitoring system for the TSC, which requires that each district provides monthly updates on its physical and financial progress. Tables 6 through 10 summarize the current situation (as at end June 2007).

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Table 6: Physical Progress: Individual Household Latrines number of latrines

Target Achieved BPL

households APL

households Total BPL

households (%)

APL households

(%)

Total (%)

Himachal Pradesh

108,017 543,032 651,049 32,549 (30) 69,879 (13) 102,428(16)

Madhya Pradesh

3,368,972 4,273,749 7,642,721 963,563 (29)

785,311(18) 1,748,874(23)

All India (millions)

56.3 58.7 114.9 19.7 (35) 13.6 (23) 33.3 (29)

Source: http://ddws.nic.in/tsc-nic/.

Table 7: Physical Progress: Institutional Toilets number of institutional toilets Target Achieved School Anganwadi School (%) Anganwadi (%) Himachal Pradesh 6,926 1,090 1,162 (17) 210 (19) Madhya Pradesh 76,128 10,592 36,760 (48) 2,626 (25) All India 1,009,814 362,926 383,787 (38) 117,096 (32) Source: http://ddws.nic.in/tsc-nic/

Table 8: Financial Progress: Excluding Beneficiary Contributions Rs crore Project outlay* Project approved

(%) Project released (% of

approved) Expenditure reported (%)

Himachal Pradesh 42.3 36.3 (86) 11.2 (31) 8.3 (23)Madhya Pradesh 761.8 660.8 (87) 193.0 (29) 141.1 (21)All India 12,495.1 7,802.1 (62) 3,599.9 (46) 2,462.6 (32)Source: http://ddws.nic.in/tsc-nic/ * Includes beneficiary contributions

Table 9: Financial Progress: Excluding Beneficiary Contributions US$ millions Project outlay* Project

approved (%) Project

released (% of approved)

Expenditure reported

Himachal Pradesh 10.6 9.1 (86) 2.8 (31) 2.1 (23) Madhya Pradesh 190.4 165.2 (87) 48.3 (29) 35.3 (21) All India 3,123.8 1,950.5 (62) 899.8 (46) 615.5 (32) Source: http://ddws.nic.in/tsc-nic/ * Includes beneficiary contributions

Table 10: Growth in Nirmal Gram Puraskar Awards: Himachal Pradesh 2004–05 2005–06 2006–07 NGP applications (nr) 0 0 80 NGP awards (nr) 0 0 28* Districts involved (nr) 0 0 5 Source: http://ddws.nic.in/tsc-nic/ * Initially this was only 22 awards, but it increased to 28 awards following the reverification process.

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4. Findings Based on a literature review and a series of discussions with key actors, a narrative of key findings was prepared for each of the eight dimensions considered essential to scaling up the total sanitation and sanitation-marketing approaches in rural areas.

Policy, Strategy, and Direction Despite the existence of a Model Public Health Act 1987 (revised) prepared by the GoI and the clear responsibility of the state for public health services, Himachal Pradesh has not adopted a Public Health Act. As a result, there is no legislative framework for the regulation of public health services in the state.

The consensus among senior government officials was that a public health act will not be needed until basic sanitation coverage increases substantially and the provision of environmental sanitation services becomes the priority. However, the inclusion of wastewater and solid waste disposal requirements in the NGP criteria means that there is a need for legislation and technical guidelines on effluent and disposal standards to assist in the planning of sustainable environmental sanitation improvements.

Direction (Vision, Goal, Objectives) Senior government officials responsible for rural sanitation (for example, the Secretary and Joint Secretary of Rural Development, and the Secretary of Irrigation and Public Health) share a clear vision and direction for rural sanitation in Himachal Pradesh: to achieve ODF status across the state by 2009, and from there to start building toward statewide “Total Sanitation” (by which they mean universal environmental sanitation services).

However, many lower-level officials and stakeholders remain focused on building facilities rather than on the achievement of collective outcomes. Variable understanding of the main goals and objectives of the TSC is mirrored at all levels—state, district, block, and village (gram panchayat)—with officials in the more-active and engaged local governments fully aware of wider objectives and collective outcome goals. Officials in the less-active areas tend to argue for larger hardware subsidies and incremental coverage increases rather than collective outcomes.

Strategy for Total Rural Sanitation in Himachal Pradesh In 2005, the state cabinet of Himachal Pradesh approved the Strategy for Total Rural Sanitation in Himachal Pradesh. The state strategy included several progressive policy declarations—notably that no individual household latrine subsidies would be paid to BPL households, and that sanitation marketing by the private sector should be used to improve the supply of sanitation goods and services.

The state strategy proposed that the funds allocated to the BPL latrine subsidies should be used to finance collective incentive payments to communities and local governments that achieve ODF status—that is, no payment should be made until the community is declared ODF and everyone is using a latrine, and the payment should be a lump sum paid to the gram panchayat (rather than individual household payments).

The state strategy presented survey data showing low latrine usage and high rates of open defecation, and used this evidence to argue the need for more awareness raising, demand creation, and informed choice. However, several stakeholders disputed the survey

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findings, stating that latrine usage and hygiene behavior were good (and open defecation rare) in Himachal Pradesh.

It appears that support for the state strategy, and specifically the collective subsidy policy, waned following changes to the administrative leadership in Himachal Pradesh. Without the leadership that developed and framed the state strategy, efforts to promote, implement, and institutionalize the strategy have met with limited success.

Impact of High-Level Transfers on Policy, Strategy, and Direction

A similar decline in the state-level priority and attention attached to the TSC program was reported by several stakeholders, again attributed to high-level personnel changes in 2005. However, a more recent reappointment is already starting to reenergize the subsector and improve coordination, thus reinforcing the critical influence that high-level transfers have on state policy, strategy, and direction.

Perhaps because of this hiatus at the state level, there was little knowledge of the state sanitation strategy at the district or lower levels. In practice, district-level objectives are determined largely by the central program guidelines, not least because the direct payment of project funds to district governments bypasses state government control and provides the districts with considerable freedom in their strategic decisions, providing that they work within the central government guidelines.

Strategic Planning The revised TSC district proposals, which are currently pending approval by the GoHP, are based on the provision of household sanitation facilities to every BPL household. Although providing a reasonable investment plan, these district proposals do not include any strategic planning—there is no attempt to identify the areas most affected by inadequate sanitation or the areas and groups with the highest disease burden, and there is no prioritization of interventions.

At the state level, there has been no aggregation of the district plans (other than that already provided by the online monitoring system, which provides state totals for physical and financial targets and progress). In addition, the informal approach to state-level monitoring means that there are few strategic goals or formal reports of progress.

Mandi District is an exception. The well-organized TSC implementation in this district has been built around a strategic and phased “roadmap”:

• Year 1: 85 gram panchayats targeted (these were selected based on high sanitation coverage)

• Year 2: 251 gram panchayats targeted (these were deemed demand-responsive) • Year 3: 137 gram panchayats (the remaining gram panchayats)

Now in its second year of implementation, the TSC program in Mandi District is active in 336 out of a total of 473 gram panchayats, with 59 of the 85 (69 percent) gram panchayats targeted in the first phase claiming ODF status only 17 months after the project start-up. In Phase I, 7 gram panchayats were selected from each block (subdistrict), based largely on their sanitation coverage. Following early successes among the Phase I gram panchayats, there was significant demand for inclusion in the second phase. In the end, 251 gram panchayats were selected (approximately 50 percent of the total), leaving only 137 gram panchayats for the third phase. Sanitation Guidelines

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The NGP awards are a significant factor in the raised awareness of officials in the more-active local governments. The high profile of the awards has also proved to be a strong motivational factor. The award criteria have been very effective in disseminating and implementing central government policies, while the independent verification system has provided an effective enforcement mechanism.

However, the TSC guidelines and the NGP criteria are quite general in nature. This generality allows considerable freedom for active districts to innovate, adapting policies and approaches to their local circumstances, but it does not provide much guidance to less-motivated or less-organized districts. As a result, a wide range of local policies and approaches are found across the districts in Himachal Pradesh, with matching variations in effectiveness and outcome.

Within districts, policy alignment is good—in part because few organizations other than the local government are active in sanitation development. A minor exception was reported in Bilaspur District, where a local NGO had offered up-front latrine subsidies to selected households in a small number of villages in contravention of the district policy to delay payment of sanitation subsidies until the community achieves ODF status.

Policy: Conversion of Dry Latrines into Pour-Flush Latrines The TSC guidelines (2004) state that one of the main objectives of the TSC is “to convert dry latrines to pour-flush latrines, and eliminate manual scavenging practice, wherever in existence in rural areas.”13 This policy statement is significant as it sets the minimum level of service in India higher than that recommended by the UNICEF-WHO Joint Monitoring Programme for Water Supply and Sanitation (JMP), which categorizes both dry latrines with slab and pour-flush latrines as improved sanitation facilities (provided that the pour-flush latrine is connected to a latrine pit, septic tank, or sewer).

In Himachal Pradesh, there is a more practical problem with this technical guideline: large areas of Himachal Pradesh are high and mountainous, and thus they become extremely cold in winter. In many areas of Himachal Pradesh, the water seal in a pour-flush latrine freezes solid during winter, rendering the latrine unusable (unless hot water is poured into the pan before each use). The GoHP has informed the GoI that this guideline is inappropriate (and unworkable) in cold climates, but is awaiting the results of a forthcoming GoI evaluation before finalizing state policy.

Policy: Latrine Impacts on Groundwater Quality

The GoI preference for pour-flush latrines also impacts on another important area of technical policy: water quality. Several stakeholders expressed concern that rapid increases in pit latrine coverage, particularly in more densely populated settlements, risks groundwater contamination and related health problems. The WSP is conducting a study on groundwater contamination in Kerala, but the findings are not yet available.

In general, communities with low sanitation coverage already face water quality problems because of contamination caused by widespread open defecation, surface water run-off, and badly protected water supplies. Therefore, the provision of improved sanitation facilities is likely to lower the risk of contamination except in areas with unusually high groundwater flow rates (due to porous soils, high water tables, and hydraulic gradients) and densely clustered facilities (latrines and water points).

There are two key factors to consider: the amount of water that enters the latrine pit or septic tank, and the time taken for pathogens to flow from the latrine to the water point.14

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The majority of pathogens (disease-causing organisms) lack the capacity to propel themselves any distance, thus are carried from one point to another either by their hosts or by some other medium. In this case, the liquid that accumulates in the latrine pit is the pathogen transport medium, which means that pathogens cannot travel further or faster than this liquid. Large pathogens are usually removed by filtration through the soil, and many other pathogens have short die-off times and thus do not survive long enough to reach the water point through the relatively long groundwater route.

Local understanding of groundwater contamination by latrines remains limited. It is therefore important that the GoI develop some sensible and easily understood guidelines on this topic, balancing the relatively low risk of groundwater contamination from pit latrines against the relatively high risk of contamination from open defecation, and considering the additional sanitation costs that overly stringent regulations might impose. In addition, the GoI needs to recognize that dry latrines pose much less risk of groundwater contamination than pour-flush latrines or septic tank systems (due to the smaller amount of water available for pathogen transport) and, therefore, present a useful alternative to flush facilities in high-risk environments.

Policy: Impact of Latrine Ownership on Poverty Rating

The GoI and state governments use an asset and service–based scoring system to assess whether individual rural households qualify as BPL households. BPL status carries significant benefits, including rations, subsidies, and other handouts; thus, this assessment is extremely important to rural households.

Each state is allowed to set their own BPL cut-off score, below which households are deemed to be poor (and thus qualify for BPL benefits). In Himachal Pradesh, the cut-off score is 20 points. Latrine ownership is one of thirteen criteria assessed by the BPL survey,15 with a maximum of 4 points allocated to households that own a “private bathroom.” The 4 points allocated to private latrine ownership comprise 20 percent of the BPL cut-off score, hence are sufficient to push many households above the BPL threshold, creating a major disincentive to sanitation improvement among BPL households.

Incentive Framework: Nirmal Gram Puraskar Twenty-eight gram panchayats from Himachal Pradesh received NGP awards in May 2007: 22 of these (79 percent) were in Mandi District, with the remaining 6 awards in Chamba, Kullu, Solan, and Kinnaur Districts.16 The NGP awards have generated significant interest and attention among local politicians, administrators, panchayati raj institution officials, and communities. The NGP develops a sense of competition between administrative units, both internally and externally—for instance, some senior officials were dismayed that Himachal Pradesh had fared worse than several less-developed states, while the high-profile success of Mandi District, which captured the majority of the awards made to Himachal Pradesh, has galvanized rival districts and administrators.

However, there were also several criticisms of the NGP system. The verification process was problematic: several of the best-performing gram panchayats in the state were rejected by the NGP verification process, and received their NGP awards only after vociferous complaints from the district and state governments. This led to a reverification process that eventually confirmed that the initial verification process was overly stringent. Despite the important role played by NGO support organizations and nonelected community members, all of the awards made in Himachal Pradesh were to

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gram panchayat leaders. The NGP has provision for individual nominations, but the criteria for these individual awards are not well known; thus few officials are willing to recommend NGO or community activists for NGP recognition (however worthy their case).

Problems were also noted with the independent verification system used to assess NGP applications. Negative feedback from the verification teams, combined with the use of assessment criteria different from those understood by the implementation teams, proved un-motivational for both local governments and communities. In part, this reflects the moving target presented by the NGP—the criteria given to the NGP verification teams appear to evolve every year, but this information is not widely publicized. As a result, some officials felt that the GoI was constantly raising the bar to prevent them from winning awards. However, the last two rounds of the NGP have clarified understanding of the criteria and process, thus the GoHP expects a better NGP showing in 2008.

Incentive Framework: National Policy Discontinuity This issue also highlights a fundamental discontinuity in the current GoI policy and financing framework. The TSC guidelines state that individual BPL households should be paid a cash incentive (now Rs 1,200) on completion and use of their toilet, whatever the hygiene behavior of their neighbors, whereas the NGP encourages collective sanitation outcomes, in recognition of the larger benefits of universal sanitation.

Although there is some merit in encouraging greater sanitation coverage among poor households, because poor households are usually the worst affected by inadequate sanitation in terms of disease burden and economic losses, this national policy neglects the significant benefits associated with collective sanitation outcomes—that is, when everyone uses improved sanitation facilities all the time. If only a few households—those poor households that are not motivated by the cash incentive, or nonpoor households reluctant to change their ways—continue with open defecation, then everyone in the community faces health risks, economic losses, and environmental hazards. Considerable sums can be expended on cash incentives to BPL households that build toilets, but many of the benefits will be lost if other people in the community continue with open defecation and unsafe excreta disposal.

The GoHP attempted to resolve this issue through the state sanitation strategy, which notes that no cash incentives should be paid to BPL households until after the collective sanitation outcome has been achieved. This approach ensures that poor households, who may have had to borrow money for their facility, receive some recompense for their investment, and that everyone in the community—those who already owned toilets, those who stand to gain cash incentives, and those who recognize the importance of universal sanitation—work together to ensure the collective sanitation outcome. But at national level this policy issue remains unresolved.

Incentive Framework: Household Incentives The state sanitation strategy also proposes that the funds for cash incentives to BPL households, as detailed in the TSC guidelines, should be used instead as collective incentive payments to gram panchayats after verification of ODF status and universal latrine usage. However, recent workshops on sanitation promotion alerted stakeholders to the original GoI guidelines and, because no cash incentives had been distributed, led to ungrounded accusations that the incentive funds were being taken by corrupt officials rather than distributed to BPL households. As a result, several districts have now

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distributed the cash incentives (Rs 1,200 per BPL household) in communities that had already been verified as ODF. 17

These household payments contravene the collective payment policy advocated in the state sanitation strategy, but the state government has taken no action to address the issue. This inaction reflects both limited support for (or understanding of) the state sanitation strategy among high-ranking officials, and a general perception (with little supporting evidence) that the individual cash incentives may be a more useful promotional tool than the lump sum payments. Nevertheless, the household incentives are being paid only after ODF status is verified, thus ensuring that collective sanitation outcomes remain the main objective.

Incentive Framework: Local Rewards and Sanctions The GoHP initiated an annual sanitation competition in 2006, using broad cleanliness criteria to assess and select winning communities at state and district levels. Only one district-level award has been made to date, as most districts either did not have any suitable candidates or were unable to prepare applications in time, but the state authorities hope that all 12 districts will take part in the next competition.

Mandi District has introduced a district-financed incentive scheme: Rs 50,000 performance grants are awarded to individual villages that achieve ODF status (Rs 250,000 for gram panchayats), with these funds to be spent on solid waste collection, drainage, or water storage facilities. In mid-2007, only one grant had been awarded and the district collector (DC) was financing the grants from the district development budget. However, the DC was planning to enlarge the funds available by reducing the amount of the BPL household incentive to Rs 1,100 and pooling the surplus Rs 100 per BPL household to provide additional funds for the performance grants.

Several of the communities visited during the fieldwork reported that the gram panchayat had agreed to issue Rs 50 (US$1.25) fines to anyone caught defecating in the open once their household had access to a latrine. No fines had yet been issued, so it remained unclear whether the gram panchayats would actually be able to enforce these fines, but they were adamant that the threat of a fine was sufficient deterrent for most people.

Political Support: Budget Allocations and Media Coverage Large TSC budget commitments indicate support for rural sanitation in central government. However, the CRSP has been running for more than 20 years, with substantial budget allocations, thus the more recent increases in budget allocations are probably more indicative of genuine political support than the mere existence of a large rural program. TSC commitments have almost doubled in the last few years—from Rs 6.5 billion (US$162.5 million) per year in 2005 to Rs 11.0 billion (US$275 million) per year in 2007, with an additional Rs 12.0 billion (US$300 million) per year allocated to the NGP. These recent budget increases appear to recognize the rapid success of both the TSC and NGP programs after more than 20 years of slow progress by the CRSP and SRSP programs.

Despite these huge investments, rural sanitation remains a relatively low priority for the state and district rural development departments. In general, the three largest and most important rural development schemes are as follows:

• the rural roads program • the employment guarantee scheme

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• the watershed and water supply program These three national schemes are the flagship programs—in terms of both budget and political priority—for the current government, involving the disbursement of huge amounts of project investment and household subsidies, which capture the bulk of political interest and administration resources. Political support for rural sanitation is undoubtedly growing, especially in areas that have received NGP awards, but sanitation remains largely a local rather than a national issue. Sanitation is ineffective in winning blocks of votes and, therefore, is not a fundamental concern of most national or state politicians.

Nevertheless, the NGP awards have shown that high-profile ceremonies and positive publicity attract political support: a large number of federal and state ministers attended the May 2007 NGP ceremony in New Delhi, proving that sanitation improvement can attract political support if it focuses on positive and measurable outcomes (rather than counting toilets), and if media coverage is well informed and well managed.

The same conclusion can be drawn from a recent public health incident in Himachal Pradesh: in late 2006, untreated sewage leaked from a sewerage network into a river in Shimla District, causing more than 1,000 cases of viral hepatitis. The mass publicity and adverse public reaction surrounding this incident led to widespread demands for sanitation improvements, placing sudden and unexpected pressure on state ministers and their departmental secretaries. This pressure soon led to several government departments contacting the rural development department (currently managing the TSC program) with urgent requests for assistance in sorting out sanitation problems.

Political Support: District Level The political and administrative systems in Himachal Pradesh allow DCs to remain relatively autonomous. As long as the current political priorities (for example, the Employment Guarantee Scheme) are well managed, then the DCs are given fairly free rein to use development resources to pursue their own agendas within the district. There is no evidence that any significant state pressure has been exerted regarding the TSC program. It is just one of many rural development concerns, which means that district performance is often based on the particular interests and application of the DC, rather than on any institutional direction or incentive.

Where TSC progress has been good, it is because the DCs have taken an interest, allocated time and resources, monitored progress regularly, and set clear and realistic targets for their subordinates. The WSP India team recently organized an exposure visit to Nagpur in Maharashtra, which was attended by 7 of the 12 DCs in Himachal Pradesh. The visit was used to highlight the different initiatives and management models used in Maharashtra, and had a very positive impact on the DCs who attended. Given the busy schedule of these administrators, who are responsible for districts with populations of 500,000 to 1,000,000, the fact that all but 5 decided to attend a sanitation-related visit would suggest that the district priority attached to sanitation is growing.

Support for Total Sanitation Approach The TSC guidelines state that “the construction of household toilets should be undertaken by the [BPL] household itself” and that only “on completion and use of the toilet by the [BPL] household” may the cash incentive be given.18 When combined with the NGP guidelines, which require 100 percent sanitation coverage (in both schools and

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households), open defecation–free areas, and maintenance of a clean environment, the TSC program clearly promotes a total sanitation approach.

Most stakeholders in Himachal Pradesh are supportive of the total sanitation approach embodied by the TSC and NGP guidelines. The higher standard of living found in Himachal Pradesh means that many people are willing to invest in a well-built pour-flush latrine rather than a pit latrine, but most local governments now recognize that adequate latrines can be built for as little as Rs 300–400 (US$7–10), and that up-front subsidies are rarely required. And there are few that question the wisdom of encouraging (and rewarding) local governments that achieve beneficial collective sanitation outcomes.

The WSP India team has been promoting the community-led total sanitation (CLTS) approach as the most cost-effective methodology for eliminating open defecation and achieving total sanitation in rural areas. The CLTS approach uses the universal feelings of shame and disgust associated with human excreta to trigger behavior change. Unlike conventional participatory methods—which tend to be more sympathetic to local cultures and beliefs, using positive messages, encouragement, and support to stimulate development—the CLTS approach makes people aware of the unpleasant costs and realities of open defecation, and then asks how they are going to solve these problems.

The CLTS approach requires that the community lead the process, designing and building simple latrines with a minimum of external assistance and no financial support.

Many of the development practitioners interviewed in Himachal Pradesh, particularly those experienced in participatory development, were uncomfortable with this radical approach, not least because it challenges some of their guiding development principles.

Although GoHP officials in Shimla are generally supportive of the CLTS methodology, some central government officials—including high-level officials in the Rajiv Ghandi National Drinking Water Mission (RGNDWM) CRSP—remain opposed to the CLTS approach. However, the resistance to CLTS appears to reflect wider subsidy issues—some states still provide large up-front latrine subsidies, which are prohibited under the CLTS approach—rather than any evidence-based assessment of the merits of the methodology.

At the time of the assessment fieldwork, the WSP had conducted CLTS training sessions in 10 of the 12 districts in Himachal Pradesh, with mixed results. Several district teams, including the successful TSC team in Mandi, rejected the CLTS approach outright, claiming that it was incompatible with the culture and people of Himachal Pradesh, and that neither their staff nor the villagers liked the approach. Instead, these district teams preferred to continue with a more conventional mix of promotional activities: posters, pamphlets, traditional street theater (kala jata), and participatory “awareness raising” camps.

The more conventional triggering approach has been successful in active, progressive, and government-friendly communities, particularly when supported by regular visits and messages from powerful local administrators. However, even in Mandi District—which has by far the most-organized and professional district program—the TSC team now recognize the value of the CLTS approach in difficult situations and among more resistant communities.

The outcome-based NGP incentives encourage implementation teams to develop and utilize the most cost-effective approach possible—hence, when the Mandi team found

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that the conventional approaches were not working, which meant that they would be unable to achieve ambitious district targets, the team decided to try the CLTS methodology. Much to their surprise, the CLTS approach proved more effective than expected, and the Mandi District team has now developed a hybrid approach that combines elements from the two methodologies.

Institutional Arrangements Considering the scale and scope of the TSC program, the state-level institutional arrangements appear inadequate. The Joint Secretary for Rural Development is the nodal officer for the TSC, but has to manage another 11 large rural development programs in addition to the TSC. There is no state-level sanitation unit, and no routine budget for state-level sanitation activities.

Eighteen months ago, a lone MIS specialist was assigned to assist with state-level TSC monitoring and reporting duties. In early May 2007, the WSP appointed a full-time state coordinator in Himachal Pradesh. The state coordinator will be supporting TSSM project activities and working to build state-level sanitation capacity.

The state-level Communication & Capacity Development Unit (CCDU) recently allocated four consultants to work full-time with the RDD on water and sanitation reforms, although these consultants had not taken up their positions at the time of the assessment. The CCDU consultants will be placed at divisional level (each division covers several districts), but will spend about four days a month in the state headquarters. While this is a significant and positive development, 75 percent of the CCDU consultant fees will be paid by central government (for the first three years) and the remainder by the Irrigation and Public Health Department, which suggests that this team is unlikely to form the nucleus of a sustainable state sanitation unit.

Few of the districts have formed TSC cells to manage their district projects. Mandi District pays three full-time NGO staff to undertake TSC day-to-day management, monitoring, and reporting duties. In Bilaspur District, the head of the NGO support organization is expected to complete all of the TSC monitoring and reporting requirements, in addition to managing contracted NGO activities, but with no payment. In the other districts, DRDA staff undertake TSC management duties in addition to their many other duties, with the result that there are often long delays in the preparation of project proposals and progress reports.

The TSC program earmarks up to 5 percent of the project budget for administrative charges, including staff salaries, support services, and monitoring and evaluation activities. Yet few of the districts have utilized any of this administration budget or employed any full-time staff to administer the TSC and NGP activities. The 2005 state sanitation strategy required that each district establish a district TSC cell, but state-level officials are reluctant to press on this issue because of recent problems with short-term government appointees that have taken successful legal action to make their government jobs permanent.

Implementation Arrangements The shortage of suitable support organizations for TSC implementation in Himachal Pradesh limits the effectiveness of performance-based contracts, and suggests that the way forward is through the training of a cadre of sanitation specialists in each district. The WSP has already commenced this process, through its CLTS training courses, but

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considerable effort will be needed over the next two years to establish sufficient capacity to scale up the TSC across the entire state.

At community level, the elected head of the gram panchayat (Pradhan) remains the most effective institution for service delivery. Efforts to empower village water and sanitation committees and village health and sanitation committees within small, rural communities have been largely unsuccessful: the same members tend to appear on every committee, and the elected Pradhan often ends up controlling decision making and the use of resources. The community-led process is important, but committed local leaders drive many of the successful activities. Therefore, it is important that district and block-level administrators and politicians align and coordinate their policies, messages, and activities.

In Mandi District, a District Sanitation Mission has been established to manage the TSC activities. Chaired by the DC (rather than the chairman of the district council), the mission includes nongovernment members and meets regularly to monitor progress, share lessons learned, and discuss how to overcome constraints. The full mission meets quarterly; those directly involved with implementation meet monthly; and the core team (DC, ADC, DRDA project officer, and NGO district coordinator) meet on an almost daily basis.

At the subdistrict level, the DC has taken the unusual step of appointing the subdivisional magistrate to oversee and coordinate TSC activities. The block development officer would normally lead any sanitation-related meetings, but the block development officer holds the same rank as the health and education officers at block level, thus has little authority over them. The subdivisional magistrate is the senior official at this level and, although normally busy with judicial duties, is sometimes asked to manage development activities. In Mandi District, several stakeholders credited this institutional arrangement with encouraging the full cooperation and active involvement of lower-tier government officials.

Coordination: State Sanitation Review Committee The state water and sanitation mission is the main coordination body for the sanitation subsector, but the busy members of this high-level mission meet rarely, and then with an agenda that is dominated by water supply issues. In May 2007, the GoHP formed a state sanitation review committee intended to bring together the key sanitation stakeholders—panchayati raj and rural development department, irrigation and public health department, education department, health department, and the national rural health mission—on a more regular basis to agree on common policies and strategies, develop state-wide guidelines and recommendations, and coordinate monitoring activities.

The establishment of the sanitation review committee is an important step, both to focus attention on sanitation issues and to improve links with the health sector. The National Rural Health Mission is a newly mandated health institution with a remit for developing preventive health strategies, coordinating health interventions with sanitation and hygiene efforts, and the specific objective of reducing infant and child mortality rates in rural areas. The early involvement of the National Rural Health Mission in the sanitation review committee is significant, and is likely to encourage a more health outcome–based and coordinated approach.

The TSSM project builds on the WSP’s preexisting relationship with the GoHP and on its wider experience in helping to develop and improve the national TSC and NGP

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programs. However, the government sanitation programs in Himachal Pradesh are so much larger than the investments planned by the TSSM project that the partnership is necessarily an unequal one.

The combined expenditures of the TSC and NGP programs in Himachal Pradesh should reach about US$4 million per year as the programs scale up, whereas the WSP TSSM project will invest only an estimated US$0.2 million per year in Himachal Pradesh over the next three years.19 Although the GoHP is pleased that the WSP is using its expertise to assist them in developing and improving their sanitation programs, several officials made it clear that the TSC was a government program, and that the WSP must obtain official approval before undertaking any interventions or activities in Himachal Pradesh. The strong ownership of the TSC felt by GoHP officials is an undoubted positive, but it illustrates how difficult it will be to separate out the beneficial outcomes and impacts that result from the TSSM project from those that would have occurred anyway under the preexisting TSC and NGP programs.

Implementation Capacity District governments are free to choose their preferred mode of project implementation. Two main institutional models exist in Himachal Pradesh: NGO support organizations contracted by the district to undertake IEC activities and social intermediation, and direct implementation by the District Rural Development Agency (DRDA) through the lower tiers of local government.

One of the problems faced by the district governments is the shortage of suitable NGOs. Only two large NGOs were reported to be active in the health and sanitation sectors in Himachal Pradesh: MSJVS (Mandi) and HPVHA (an association of 50 small NGOs). There were also reports that some NGOs had been blacklisted because of previous fraud and corruption problems, which has resulted in a general resistance among officials to the use of NGOs in government development programs. However, NGO representatives suggested that fake (temporary) NGOs were responsible for many of the previous problems; that district officials were often complicit in any fraudulent behavior; and that these same officials often resisted NGO involvement because they wanted to protect their access to, and control over, inadequately audited IEC budgets.

Another problem is the lack of performance criteria. Several districts have already expended their entire IEC budget, either through external support organizations or through their own efforts, but most have little to show for their expenditures other than a list of outputs (brochures distributed, posters printed, camps completed). The only current measure of effectiveness, in the absence of any state- or district-level evaluations, is the number of NGP awards garnered by each district.

Where NGOs have been contracted as TSC support organizations, there is little sense of partnership. The NGO support organizations have been given responsibility only for the IEC component, and have little involvement in planning or decision-making forums. The one exception is the MSJVS in Mandi District: the MSJVS team helped to design the district project, are responsible for all TSC activities, and are fully involved in planning and management decisions. However, even the MSJVS commented on the low remuneration received for their extensive activities—their committed outreach workers are considered volunteers by the local governments, and thus often receive no pay or recompense for the time and resources that they expend on TSC activities.

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Financing The huge GoI and state budget allocations to the TSC and NGP limit the possibility of any other financial partnerships. At the central government level, UNICEF, the WSP, and WaterAid are active in the rural sanitation subsector, but most external agency and nongovernment support focuses on advocacy, policy research, monitoring, and evaluation, rather than on direct implementation.

Private Sector Partnerships The government-dominated TSC program has established few formal partnerships with the private sector in Himachal Pradesh. A handful of private contracts have been let for the supply of specialist sanitation wares such as plastic latrine pans, but the few attempts to establish production centers and sanitary marts have been unsuccessful. Thus most of the supply of goods and services is market-based through local retailers and service providers.

There has been no formal training or capacity building of service providers (for example, masons), and no technical training for implementation teams. This reflects the relatively demand-driven nature of the program in Himachal Pradesh—rural households are expected to finance and build their own latrines—but also reflects the limited capacity of the state TSC team. A rural sanitation technology manual has been developed,20 but few efforts have yet been made to train stakeholders in the use of appropriate technologies or to improve the capacity of the private sector to reach the unserved.

Public Sector Partnerships

In the past, there has been little incentive for cross-sectoral collaboration in the public sector. Most major government programs were centrally designed and administered, thus the implementing teams answered more to their line departments than to the local governments with the responsibility for services. Decentralized programs such as the TSC, which transfer the full implementation budget and management responsibility directly to the district government, are starting to generate better district-level partnerships, but there remain few incentives for cross-sectoral partnerships at the state level.

One of the problems is that the other key sector stakeholders—for example, the state health and education departments—are not clear on their sanitation roles and responsibilities. For instance, the TSC program provides finance for the construction of school sanitation facilities, but considers these facilities to be the responsibility of the school and its education department once they are completed. In contrast, whilst the education department is happy that other projects and programs are building school toilets, it does not appear to recognize any responsibility for managing and financing the sustainable operation and maintenance of these school facilities. These gray areas need to be carefully examined in order to develop clear guidelines on the overlapping roles and responsibilities of public sector stakeholders in the provision of sustainable sanitation services.

Program Methodology The TSC guidelines do not lay out any detailed methodology, but instead provide a general policy and financing framework for the district projects. As a result, the methodologies used for critical components of the program (for example, how to stimulate household demand, promote sanitation improvement, and ensure sustainable

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behavior change) must be determined by individual states and their district projects. The intention behind the broad TSC guidelines is to focus attention on achieving sanitation outcomes rather than just counting outputs (which may or may not lead to positive outcomes, depending on how appropriate, useful, and sustainable the outputs turn out to be).

The TSSM project has three components that require detailed methodologies:

• total sanitation • sanitation marketing • enabling environment improvements

Methodology: Total Sanitation The revised (2004) TSC guidelines make clear that the elimination of open defecation is one of the program’s primary objectives. In addition, the NGP criteria direct sanitation improvement efforts toward achieving ODF communities with universal sanitation. Therefore, both of these centrally designed programs promote a total sanitation methodology. In this regard, the one weakness of the TSC guidelines issued by the GoI is that they allow payment of cash incentives to BPL households prior to the achievement of collective sanitation outcomes. However, the GoHP has corrected this weakness by instructing that cash incentives should not be paid until after the achievement (and verification) of ODF status. The WSP India team has been promoting the CLTS approach for the total sanitation component. Although the CLTS methodology appears more effective at a large scale than the conventional IEC approaches used in Himachal Pradesh, resistance to the use of shame and disgust as triggers for behavior change may prevent this methodology from being adopted as widely as hoped. Therefore, it may be prudent to repackage the CLTS approach into a more culturally acceptable methodology that combines the strengths of CLTS with more traditional elements, along the lines of the hybrid approach now being used in Mandi District. The recent CLTS training courses may have increased support for a total sanitation approach, but it seems likely that some form of rapid appraisal to gather concrete evidence of the relative cost and effectiveness of the different IEC approaches will be needed to develop consensus on the best methodology for eliminating open defecation and triggering widespread demand for sanitation.

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Methodology: Sanitation Marketing Sanitation marketing remains one of the main weaknesses of the TSC program. Most of those involved in the TSC program are either government or NGO staff, and have little experience or understanding of private sector supply issues, social marketing techniques, or how best to facilitate sustainable improvements in local supply chains. At the time of the enabling environment assessment, a sanitation marketing assessment was underway. This assessment, and its related action plan, will provide the basis for the design of the sanitation marketing component and of the detailed methodology needed to implement this project component. Methodology: Enabling Environment To date, there have been only limited efforts to raise awareness of the importance of sanitation—and its links to health, education, social development, economic growth, and the environment—among key decision makers, officials, and stakeholders. Formative research has been conducted on key hygiene behaviors in Himachal Pradesh,21 but this information has not been fed into IEC campaigns or used in any wider awareness-raising activities.

Implementation Capacity Few countries can claim to have a rural sanitation program that matches the scale and scope of the TSC. As a result of the massive investments associated with the TSC and NGP programs, there are very few capacity constraints. State-Level Capacity

As mentioned earlier, state-level implementation capacity is inadequate. There is no full-time program coordinator to assist the joint secretary of the RDD, and no state budget for professional support to the TSC. As a result, the RDD is too overstretched to produce strategic plans or update guidelines, to develop state-wide promotional campaigns, or to organize much-needed evaluations. WSP Capacity The WSP India team has expanded substantially over the last few years. The Delhi-based team has extensive experience of rural sanitation development in India, and is exceptionally responsive to state and local government demands. The recent appointment of full-time WSP state coordinators in the two TSSM project states has further enhanced the level of support provided. Hygiene Promotion Capacity There remains a shortage of professionals with skills and experience in hygiene improvement. The main focus of the TSC has been on the development of improved sanitation facilities, but the gradually widening criteria of the NGP awards are starting to reinforce the importance of matching sanitation gains with hygiene improvements.

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Availability of Products and Tools A more detailed analysis of the availability of sanitation goods and services will be conducted under the sanitation marketing assessment. For this reason, only limited fieldwork and assessment were conducted in this area. Despite the availability of a substantial budget (approximately US$100,000) for “alternate delivery mechanisms” and a similar amount allocated for revolving funds that increase the availability and affordability of sanitation goods and services, few districts projects have undertaken activities to research or improve local sanitation supply chains. The state sanitation strategy is based on allowing freedom of technology options and avoiding any interference with market supply. Most stakeholders agree that market supply is working well: products are reasonably priced (Rs 150–250 for a ceramic latrine pan)22 and are widely available (despite the large distance from the major ceramic goods manufacturers in Gujarat), and retailers report few government restrictions on their business activities. Cold conditions, and generally higher standards of living, mean that the typical latrine in Himachal Pradesh is some way up the “sanitation ladder.” Most self-provided household latrines in Himachal Pradesh have ceramic pans, large lined latrine pits, and solid superstructures (often a combined bathroom and latrine). Anecdotal evidence suggests that many latrines are overdesigned. For example, there are often technical misconceptions regarding the need to line latrine pits (for example, in rocky conditions where the risk of collapse is low). Other misconceptions result in the provision of impermeable linings in latrine pits, which need to be permeable; the provision of vent pipes in water-sealed latrines; and inappropriate sizing of the latrine pit. A technical manual detailing the advantages and disadvantages of the different sanitation technologies was produced and circulated by the RDD,23 but it does not appear to have been widely used at the district level. The RDD now proposes to build sanitary technology parks in every district, in the hope that this more practical display of the different technology options will prove more effective in raising technical awareness. The WSP is currently financing a study on consumer sanitation preferences, which should complement the more supply-driven technology manual.

Financing Approximately 25 percent of the total TSC budget is earmarked for investment in the three main areas of the TSSM project:

• total sanitation (up to 15 percent on IEC and start-up activities) • sanitation marketing (up to 5 percent on alternate delivery mechanisms) • enabling environment (up to 5 percent on raising awareness, capacity building, and

administration)

In Himachal Pradesh, this means that about US$500,000 per year (more than US$40,000 per district per year) is available for creating sanitation demand, increasing the supply of appropriate sanitation goods and services, and improving the enabling environment. At present, most districts have been underutilizing the software elements of their TSC budgets (with the exception of those districts that have already spent their entire IEC

37


budget). Therefore, taking into account the additional TSSM funds (approximately US$200,000) and the five-year duration of the TSC, there is clearly no shortage of funds for implementation. The remaining 75 percent of the TSC budget is earmarked for cash incentives for BPL households and for facility construction (community sanitary complexes, institutional toilets, and solid and liquid waste management facilities). This substantial hardware investment should stimulate private sector supply and strengthen supply chains. Nirmal Gram Puraskar The proposed budget for the NGP clean village awards in the 11th Five-Year Plan (2008–12) is Rs 6,000 crore (US$1.48 billion), some Rs 3 billion (US$74 million) higher than the Rs 5,700 crore budget proposed for the TSC program. Although the NGP awards have been a significant factor in generating support for rural sanitation and scaling up sanitation improvements, it remains unclear whether this huge investment is generating the expected long-term benefits. The NGP process is relatively new in Himachal Pradesh—the first 28 NGPs were awarded in May 2007. Thus little is known about the sustainability of the community sanitation outcomes generated by the NGP, or about how the financial awards are utilized by the recipient local governments. State Reward Scheme In addition to financing its contributions to the TSC program, the GoHP has started funding its own clean village competition. The state competition has been given a budget of Rs 75 lakh (US$187,500) per year, but only one award was made in 2007 because of the limited preparedness of the districts. Financing: Institutional Sanitation The revised TSC financing framework states that district proposals should include the “actual amount required for full coverage” of institutional toilets (including school and anganwadi facilities). Several stakeholders complained that the 10 percent TSC financing previously earmarked for school sanitation was inadequate, but it appears that the GoI has responded to these concerns, and signaled the importance of institutional sanitation, with a substantial increase in the funds allocated to institutional sanitation. Financing: Environmental Sanitation

As the NGP criteria have developed, there has been a growing emphasis on environmental sanitation, particularly solid and liquid waste management. For the first time, the 2006 revisions to the TSC guidelines included a 10 percent component for financing solid and liquid waste management facilities. Although some stakeholders believe that the 10 percent TSC funds earmarked for environmental sanitation is insufficient for the development of effective drain networks and communal solid waste collection systems, there is already some evidence that the outcome-based NGP criteria are encouraging local governments to search for cost-effective solutions to their environmental sanitation challenges. In Mandi District, some gram panchayats are returning to traditional clay-lined open drains in order to achieve collective environmental sanitation outcomes using their limited development budgets.

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Cost-Effective Implementation In India, the outcome-based goals promoted by the national TSC and NGP programs are increasingly being used to assess effectiveness. In the past, state governments wanted to know how many latrines had been built and how this affected state sanitation coverage. But now, increasingly, state ministers and secretaries are asking about the number of ODF communities and the number of NGP awards. These indicators represent an important step forward from simple output indicators, but provide only a snapshot of sanitation outcomes, rather than the regular measures needed for reliable monitoring and evaluation of effectiveness and sustainability. ODF Success Rate The TSSM program design in Himachal Pradesh assumes that 300 village governments or gram panchayats will have been verified as ODF by the end of the project. At this stage, it is unclear how many gram panchayats in Himachal Pradesh the TSC program will have covered over the two-to-three-year duration of the TSSM project. In the two districts visited during the fieldwork, the district TSC projects were attempting to trigger total sanitation in almost every gram panchayat in the district over a three-year period: 350 gram panchayats targeted in Bilaspur and all 473 gram panchayats in Mandi. But the results are very different. The Mandi District project claims that 52 out of 85 (60 percent) Phase I gram panchayats are ODF after 17 months, and that 7 out of 251 (3 percent) Phase II gram panchayats are already ODF after only 5 months of promotional activity. Based on regular monitoring, the Mandi TSC team predicts that more than 120 of the 336 Phase I & II gram panchayats (a minimum of 35 percent) will achieve ODF status. The higher ODF success rate among the Phase I Mandi gram panchayats probably reflects the more supportive context in these specially selected communities, whereas the predicted overall success rate of 35 percent compares well with an ODF success rate of 37 percent in Indonesia (where 149 were ODF from the 400 communities that started the CLTS process). The Bilaspur District TSC project has a much lower ODF success rate, perhaps because the team did not shift to an ODF-based approach until the second year of the project. Despite holding more than 350 awareness-raising camps since late 2005, the TSC team predict that only 8 to 10 gram panchayats (3 percent) will achieve ODF status this year. Instead, the Bilaspur TSC team prefer to focus on their success in raising district sanitation coverage from 32 percent in late 2005 to 47 percent in December 2006 (according to a rapid appraisal by the NGO support organization), which represents an additional 9,000 household latrines. Cost per Sanitation Outcome The TSSM project intends to develop a detailed system to monitor its performance and cost-effectiveness, but few data were available at the time of the assessment. Therefore, the following cost-effectiveness indicators were assessed in order to produce some baseline estimates of cost-effectiveness that can be compared against the more rigorous data emerging from subsequent TSSM studies of impact evaluation and cost-effectiveness. A simple calculation based on current data in the TSC online monitoring

39


system (see Table 11) suggests the following averages for the Himachal Pradesh TSC projects:

• cost per improved household sanitation facility = Rs 820 (US$20.50) • cost per NGP gram panchayat = Rs 30 lakh (US$75,000) • cost per NGP household = Rs 8,000 (US$200)

The relatively high cost per NGP award reflects the early stage of the process (first awards to Himachal Pradesh made in 2007) and are likely to reduce significantly if the number of NGP awards increases from 28 to 200 over the next year (as predicted by the GoHP): the cost per NGP award will reduce to approximately US$20,000; and the cost per NGP household will reduce to about US$50 (assuming that TSC expenditures double during this period). However, it should also be noted that these costs exclude TSSM costs, local government funding (outside of the TSC budget) and household contributions. The disaggregated district data will provide a more useful assessment of relative cost-effectiveness, as the combined state totals include expenditures in districts that have achieved very little. There is also a suspicion that some of the districts have over-reported their achievements – for instance, that some of the APL household latrines, which comprise 70 percent of the claimed increases in sanitation coverage, were constructed prior to the commencement of the TSC program. The TSSM project impact evaluation component should provide some valuable baseline and impact data for use in cost-effectiveness assessments. In the interim, the project team should encourage state and district coordination teams to compare sanitation outcomes against health data available through existing health systems. Examples include the twenty point health progress report, clinical data aggregated from health sub-centers, referral data from the ICDS department, morbidity data from dispensaries and ayuvedic centers, and data collated by the recently formed National Rural Health Mission and Integrated Disease Surveillance Programme (IDSP). There are no mechanisms for assessing the cost of government involvement in sanitation interventions. Significant RDD and PRI time and resources are required to implement the TSC effectively, but their routine costs (salaries, training, overheads) are rarely included in cost assessments. Several stakeholders commented that the resource-intensive campaign mode required by the TSC could not be sustained for longer than a year or two in each area without having a detrimental impact on other activities. These comments reflect the currently unmeasured direct and opportunity costs of diverting valuable government staff and resources from other duties.

Monitoring and Evaluation The GoI carries out independent DLM of the TSC program, which provides a randomized check on the achievements claimed by the districts through the TSC online monitoring database. Fifty independent agencies are tasked to cover five to seven districts each, with a remit to survey 25 randomly selected households in each of 20 purposively selected villages (8 control villages and 12 noncontrol).

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Table 11: TSC District-Level Monitoring (Individual Household Latrines) 2004–05 2005–06 2006–07 State Sanitation

coverage (%) BPL latrine usage (%)

Sanitation coverage (%)

BPL latrine usage (%)

Sanitation coverage (%)

BPL latrine usage (%)

Himachal Pradesh

75 (1,000

households)

97 (381

households)

59 (7,264

households)

100 (2,075

households)

34 (10,516

households)

99 (875

households) Madhya Pradesh

55 (4,588

households)

43 (1,783

households)

56 (65,105

households)

53 (24,413

households)

66 (28,864

households)

65 (11,982

households) All India 64 77 51 78 52 81

Source: hppt://ddws.nic.in/DLM/ Originally intended to be a quarterly exercise, the DLM survey was completed in three quarters of 2005 (Q2, Q3, Q4); in the third quarter of 2006; and in the second quarter of 2007. The CRSP reports that 478 districts across the country (out of the total 602 districts) were surveyed in the last DLM exercise. The DLM monitoring data report very high latrine usage (97–100 percent) in Himachal Pradesh. However, the rigorousness of the sampling protocol and methodology for the DLM are unknown. In addition, the online reports appear to contain some errors: for instance, the 2006–07 DLM report for Himachal Pradesh notes that 2,075 of the BPL households surveyed owned latrines, but then states that 2,083 BPL households were assessed to be using latrines. The NGP and state award systems provide limited annual monitoring systems, but both systems have weaknesses. The NGP is a one-off process: once the award has been made to a gram panchayat, it is no longer eligible, and thus no longer features in the process—every community can apply for the NGP, but there is no guarantee that the sanitation outcomes will be sustained once the award has been gained. The state clean village competitions have a different problem. These awards are made only to an elite group, the cleanest villages in each area, and thus are unlikely to reach the much larger and more critical group of average and below-average communities. There is a need for regular monitoring of sanitation outcomes such as latrine usage, prevalence of open defecation, handwashing, and the disposal of infant excreta. Some of these outcomes are currently recorded by the TSC monitoring system, but these monitoring systems are not harmonized or combined with other monitoring systems, and they are not sustainable because of their project-based funding. As a result, with the exception of the sampled DLM data and the periodic census data, there are almost no national or provincial data on sanitation coverage or outcomes. The GoI recently stepped up its TSC monitoring requirements. Data must now be entered for each gram panchayat, which has greatly increased the monitoring and data entry requirements at district and state levels. Several other national stakeholders undertake routine assessments of sanitation coverage and outcomes. Both UNICEF and WaterAid are planning separate, large-scale sanitation surveys across a number of states and districts. More effort is required to coordinate these efforts with those of government, to align the methodologies and indicators used, to

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increase the transparency of the processes, and to develop consensus on the survey findings. Impact evaluation remains a major area of weakness. Few national or local institutions have the specialist knowledge and expertise required to design and conduct rigorous impact evaluations. As a result, few reliable impact evaluations are conducted; the findings are rarely shared or disseminated (especially if they demonstrate lower impacts than anticipated); and, hence, program design rarely includes the lessons learned from previous programs and impact evaluations. It is hoped that the TSSM impact evaluation component will make significant inroads in this area. There is a need for simple and generic evaluation tools, and for consensus on a set of common evaluation methodologies and indicators that can be fed into a national database.

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5. Conclusions One of the key difficulties in framing the baseline assessment of the enabling environment for rural sanitation in Himachal Pradesh was to try and disaggregate the activities, outcomes. and impacts that are likely to be the direct (or indirect) result of TSSM interventions from the counterfactual—the results that would have occurred if the TSC and NGP programs, and any other related programs, in Himachal Pradesh had continued without any assistance or support from the WSP-managed TSSM project.

Policy, Strategy, and Direction National-level political support for TSSM approaches is growing. The budget for the TSC program has almost doubled since 2005 in recognition of the rapid sanitation improvements encouraged by the TSC and NGP programs. The GoHP vision of achieving statewide ODF status by 2009 is not matched by appropriate planning, technical support, or local capacity. The national TSC program provides finance for five-year district projects that have the potential to deliver universal sanitation, if program resources are used efficiently and effectively. At present, the district TSC projects focus on this five-year goal rather than on the less realistic state objective. The Strategy for Total Rural Sanitation in Himachal Pradesh (2005) contains several progressive policy elements, notably that the TSC budget allocated for cash incentives to BPL households would instead be used to finance lump sum payments to gram panchayats that achieve ODF status. However, this performance grant policy has not been adopted by any of the districts, which have defaulted to paying cash incentives to BPL households once ODF status has been achieved. The national TSC guidelines remain problematic in Himachal Pradesh because of the instruction “to convert dry latrines to pour-flush latrines.” Pour-flush latrines do not operate in cold climates, such as those found in northern Himachal Pradesh, because of frozen water-seals. The current national guidelines prohibit variants on traditional dry latrines and improved pit latrines that are effective and hygienic under local conditions, and are considered improved sanitation facilities by the WHO-UNICEF Joint Monitoring Programme. The best of the current district TSC projects in Himachal Pradesh looks likely to facilitate ODF status (and, possibly, NGP status) in about one-third of its gram panchayats by mid-2008. This achievement will be the result of at least two years of concerted efforts by the district administrators and coordination team, which will still leave two-thirds of the district to cover in subsequent years. Other district projects have been less successful, because of the wide variety of approaches and institutional models utilized. Mandi District provides a model for policy, strategy, and direction through its three-year roadmap for universal sanitation and its introduction of a multilayered incentive system (including district-financed incentives and preferential scheme allocations for collective sanitation outcomes).

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Institutional Arrangements The joint secretary of the RDD (of the GoHP), the nodal officer for the TSC, is responsible for 12 large rural development programs. As a result, despite the best efforts of the joint secretary, the management of the intensive TSC program does not receive the attention it needs. The absence of sanitation units at either state or district level is a major constraint. The lack of state-level capacity or resources for sanitation strategy and policy development, and for the regular monitoring and evaluation of district projects, has hindered state guidance of the TSC program. A similar problem exists at district level, where few of the districts have established TSC units despite the state directive contained in the sanitation strategy. The administration component of the TSC, which is intended to finance staff and administrative costs, remains underutilized; thus there is no obvious constraint to the establishment and financing of district TSC units. The GoHP has allocated several consultants from the CCDU to the TSC, but this support is a short-term solution (financed by central government for the first three years) and thus is unlikely to provide the nucleus of a sustainable sanitation unit. The WSP appointed a state coordinator in mid-2007 to assist the GoHP in managing the TSC, and at a similar time the government established the State Sanitation Review Committee to increase attention to the subsector. The TSSM project in Himachal Pradesh is relatively small (with a budget of US$0.2 million per year) when compared with the US$4 million per year invested by the GoI in implementing the TSC and NGP programs. However, the WSP India team believes that the TSSM project can leverage additional central and state-level resources and help develop new opportunities and approaches toward achievement of the TSSM objectives and outcomes. A key constraint in Himachal Pradesh is the shortage of potential implementing partners. Few NGOs with sector experience are available, and few alternative social intermediation models have been developed. Furthermore, there is evidence of resistance to NGO involvement by some government officials. The few NGOs active in the sanitation subsector are concerned that levels of partnership and remuneration are low, with little involvement in planning or decision making and a continual struggle against the mistaken perception that NGOs provide largely voluntary (rather than nonprofit) services. Cross-sectoral collaboration is likely to improve following the (May 2007) inception of the State Sanitation Review Committee, but there remain many gray areas in the distribution of subsector roles and responsibilities. For example, operation and maintenance of school sanitation and hygiene facilities remains ineffective because of the multiagency nature of service development and provision, which reduces the ownership of involved agencies (for example, the DRDA builds facilities under the TSC, but is not responsible for operating or maintaining them; whereas the education department, which becomes responsible for the school facilities on completion, feels little ownership or responsibility for facilities built by another department).

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Program Methodology Both the central sanitation programs (TSC and NGP) and the state sanitation strategy already promote a total sanitation methodology (based on eliminating open defecation). There has been some local resistance to the introduction of the more demand-driven CLTS approach in Himachal Pradesh, but the recent development of hybrid forms of the total sanitation approach (combining local community-development techniques with CLTS tools for demand generation) appears more acceptable and appropriate to local culture and norms. Sanitation marketing remains a weakness. The TSC promotes “production centers and rural sanitary marts” but has encouraged a supply-driven and subsidy-based approach to sanitation marketing that limits the sustainability and effectiveness of these suppliers. One of the central problems has been that most production centers and sanitary marts have focused on the supply of components to a single latrine option priced to match the BPL cash incentive offered by the TSC (currently Rs 1,200).24 Standard latrine pans, concrete rings, and latrine slabs are produced with almost no allowance for variations in household taste, willingness to pay, or local constraints. In particular, few options are provided to assist in the development of larger and more desirable facilities by APL households. The WSP is working on the development of new approaches to sanitation marketing, but no details of the new methodology were available at the time of the enabling environment assessment. WSP efforts to improve the enabling environment for sanitation have had a positive impact (for example, approval of the state sanitation strategy in 2005, initiation of the State Sanitation Review Committee in mid-2007) but are not yet generating the high-level state support needed for significant strides in rural sanitation improvement.

Implementation Capacity The main capacity constraint is the lack of professional expertise in three fields: social intermediation, sanitation improvement, and hygiene promotion. Despite the huge sums involved in the TSC program, most promotional efforts are led by government officials with little training or expertise in social marketing or techniques for sustainable behavior change. Government efforts have been remarkably successful in the relatively small groups of communities targeted during the initial phases of the TSC program, but it is already apparent that the same manpower-intensive approach, which is usually dependent on multiple visits by local administrators, will not work at the larger scale required to achieve district and state sanitation targets.

Availability of Products and Tools Despite the availability of a substantial budget (approximately US$100,000) for “alternate delivery mechanisms” and a similar amount allocated for revolving funds that increase the availability and affordability of sanitation goods and services, few districts projects have undertaken activities to research or improve local sanitation supply chains. The WSP has made efforts to develop technical manuals, undertake research on consumer preferences, and support the construction of district technology parks, but few

45


of these interventions appear to have translated into more large-scale or sustainable supply of sanitation goods and services.

Financing The TSC district projects provide ample and predictable finance over a five-year time horizon, thus allowing strategic planning and encouraging large-scale implementation. Additional sanitation finance is available to successful communities through the NGP awards and state clean village competition. The current sanitation financing framework is significantly better than that found in most countries, but fails to provide any incentive for the continuing development of sanitation services once the gram panchayat gains an NGP award. Also, since the inclusion of the wider environmental sanitation criteria, even the current NGP may prove too difficult for less able local governments to achieve.

Cost-Effective Implementation The effectiveness of the TSC program is, increasingly, measured by the number of local governments that achieve ODF and NGP status. Existing program methodologies manage an ODF success rate of about 35 percent25—that is, about a third of the project communities in which a form of total sanitation methodology is implemented manage to achieve ODF status. While this rate is comparable with figures from other national programs, alternative and complementary approaches need to be developed to increase the success rate and tackle the remaining 65 percent of communities. Reaching the MDG target requires increasing the state sanitation coverage by about 35 percent, so the current success rate may be sufficient to reach the MDG if every gram panchayat in Himachal Pradesh is targeted over the next five years. Sanitation coverage also increases in communities that do not eliminate open defecation, although the TSC online monitoring suggests only a 9 percent increase in sanitation coverage over the last couple of years, so faster progress will be needed in order for non-ODF communities to contribute significantly toward the sanitation MDG.

Monitoring and Evaluation Current monitoring and evaluation systems are fragmented and inadequate. The TSC online monitoring system, which is the main monitoring and reporting portal for the TSC, monitors only physical progress (number of toilets) and financial progress (expenditure). The TSC DLM process surveys a sample of 500 households in each district,26 examining community sanitation coverage and latrine usage among BPL households. The 2006–07 DLM data for Himachal Pradesh suggest that only 34 percent of households (of 10,500 households surveyed) owned sanitation facilities, but that 99 percent of the 875 BPL households surveyed were using their facilities. Although suggesting high latrine usage among BPL households, the DLM results highlight the limited success of the TSC among APL households in Himachal Pradesh, and the importance of using collective outcomes to monitor sanitation progress. In this case, the 99 percent BPL latrine usage obscures the fact that 66 percent of the population surveyed are either using inadequate facilities or practicing open defecation.

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6. Recommendations In framing the baseline assessment of the enabling environment for rural sanitation in Himachal Pradesh, one of the key difficulties was to distinguish the outcomes that were the direct or indirect result of TSSM project interventions from those that would have occurred without assistance or support from the WSP-managed TSSM project. What follows are recommendations that attempt to make this distinction for each of the eight dimensions.

Policy, Strategy, and Direction It is recommended that the state government match its sanitation goals to those of the national government, which wants universal sanitation for India by 2012. The TSSM project needs to assist Mandi District in developing a strategic action plan for the remainder of its gram panchayats, and needs to use the learning from this process to assist each district in Himachal Pradesh to develop strategic sanitation action plans that provide a realistic roadmap toward universal sanitation in the state by 2012. High-level political support for, and routine monitoring of, these district strategic sanitation action plans will be important for the statewide scaling up of sanitation improvement. Without political support and direction, the less-committed district administrations are unlikely to allocate the required time, resources, or enthusiasm. The TSSM project needs to use NGP publicity to generate political support, and needs to disseminate hard-hitting advocacy materials detailing the health, social development, economic growth, and environmental losses that result from inadequate sanitation. The TSSM project should also press the state government to adopt locally appropriate sanitation policies:

• Allow dry latrines (encourage them in water-scarce areas and cold areas, or where people want to use urine-diverting composting latrines)

• Formalize the criteria for cash incentives to BPL households (for example, after achieving ODF status)

Institutional Arrangements The absence of sanitation units at either state or district level is a major constraint. The lack of state-level capacity or resources for sanitation strategy and policy development, and for the regular monitoring and evaluation of district projects, has hindered state guidance of the TSC program. The TSSM project will provide some important short-term support and capacity building, but there is a need for a state-financed sanitation unit to manage TSC and NGP activities and provide direction toward wider state objectives. A similar problem exists at district level, where few of the districts have established TSC units despite the state directive contained in the sanitation strategy. The administration component of the TSC, which is intended to finance staff and administrative costs, remains underutilized; thus there is no obvious constraint to the establishment of district TSC units. The Mandi District management model, which employs a district sanitation mission (headed by the DC), a full-time three-person district coordination unit, and block

47


sanitation committees (headed by subdivisional magistrates) to expedite TSC progress, is an effective institutional arrangement that should be explored by other districts. However, there is a shortage of professional community development and sanitation expertise in Himachal Pradesh. The TSSM project needs to train a cadre of sanitation and hygiene specialists, and to encourage the use of TSC funds to finance private or community efforts to achieve sustainable sanitation outcomes. The community consultant approach (first tried in Bangladesh and currently being piloted in Pakistan) provides a useful model for scaling up progress. Individuals from communities that have achieved ODF status (or the minimum sanitation outcome prescribed) are encouraged to trigger sanitation improvements in nearby communities, with the incentive of a local government award (including a cash reward) to community consultants for each community that achieves pre-agreed sanitation outcomes. A simple contract is signed by the community consultant and the local government, detailing the required sanitation outcome (and verification process) and the cash reward. Given current cost estimates of US$20,000–75,000 per NGP award in Himachal Pradesh, this could be a substantially more cost-effective approach and would greatly enlarge the number of possible partnerships.

Program Methodology Strong district-level resistance to the CLTS methodology, notably to its use of shame and disgust as triggers for behavior change, suggests that the TSSM project needs to reassess the relevance and acceptability of this approach in Himachal Pradesh. If this assessment finds evidence that the CLTS methodology is more cost-effective (at large scale) than the alternative approaches, then the TSSM project should consider repackaging the CLTS methodology in a way that makes it more culturally acceptable in Himachal Pradesh. The sanitation marketing methodology should focus primarily on the supply of sanitation goods and services to APL households. Based on the June 2007 TSC monitoring data, APL households comprise 83 percent of the target TSC households; only 13 percent of these APL households have been served to date, compared with 30 percent of the target BPL households. The sanitation marketing component of the TSSM needs to formulate and market a range of latrine options that are attractive to APL households.

Implementation Capacity District governments should be encouraged to use the 5 percent administration budget included in the TSC to finance full-time sanitation units to help develop the improved management, skills, and capacity needed for more effective implementation of the TSC. The WSP has already used the TSSM project to fund a full-time WSP state coordinator in Himachal Pradesh. It is recommended that this state coordinator should provide strategic support at state level, and should also manage capacity-building efforts to develop improved social intermediation, sanitation improvement, and hygiene promotion skills in Himachal Pradesh.

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Availability of Products and Tools The sanitation marketing component needs to focus on practical steps to increase the availability and affordability of sanitation goods and services in Himachal Pradesh. At present, the limited information available on the rural sanitation market is constraining the development of practical sanitation marketing options. More information is required on the number and nature of the different products, retailers, and service providers (for example, masons) available in Himachal Pradesh; and on the latrine options that are considered affordable and desirable by the different market segments (for example, food poor, poor, nonpoor with water supply but no latrine, nonpoor with traditional latrine, and remote communities). It is also recommended that innovative ways to market (and leverage funds for marketing) goods and services through existing, related retail and wholesale channels (such as cement companies) be explored.

Financing The increasing importance of the NGP program, whose proposed 2008–12 budget is likely to be larger than the TSC program, requires that further investigation be undertaken into the sustainability of the sanitation outcomes generated by the NGP, and into the effective use of the financial rewards garnered by NGP winners—that is, do these funds result in additional sanitation improvements, or does this money repay previous sanitation investments by local governments, or is it used for other nonsanitation-related activities? In light of the sustainability and impact questions raised against the TSC and NGP programs, it is recommended that the TSSM project consider the development of a more phased incentive framework:

• providing 10 percent of environmental sanitation funds only after achieving ODF status

• providing performance grants to village governments that achieve post-NGP outcomes

• financing recurrent costs in communities that sustain sanitation outcomes

Additional incentives for sanitation improvement can be generated by linking the allocation of other development schemes to the achievement and sustainability of sanitation outcomes. For instance, approval of other community infrastructure schemes could be made dependent on reverification of ODF or NGP status.

Cost-Effective Implementation At present, there is only limited demand for cost-effectiveness data from national or state institutions and program managers. Therefore, the TSSM project needs to make significant efforts to build simple, reliable systems to record and report this information at subdistrict, district, and state levels. Data on cost-effectiveness are important for developing consensus on the best approaches for large-scale implementation. The WSP needs to strengthen the case for using the CLTS approach by documenting the relative cost-effectiveness of the various approaches tried in Himachal Pradesh, in particular when programs scale up and begin to target less

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active and committed communities and local governments. The cost-effectiveness data can also be used to benchmark district performance.

Monitoring and Evaluation There remains a need for more regular independent monitoring of sanitation outcomes, and for matching assessments of the extent to which these outcomes translate into positive impacts and benefits. Although the TSSM project impact evaluation component is likely to address many of these issues, it is also recommended that the TSSM project develop a simple, generic impact evaluation tool that can be used by state sanitation bodies, and that evaluation data be compiled into state and national databases.

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7. Enabling Environment Indicators The following indicators are proposed in order to establish a clear picture of the current enabling environment for sanitation in India, and to recommend possible targets to achieve by the end of the TSSM project (Table 12). Although some of the data included in the indicator framework are currently unavailable, it is hoped that further investigation by the WSP India team will provide sufficient data to complete the baseline indicators. The completed indicator table will provide a valuable baseline against which to measure progress when the endline assessment of enabling environment is undertaken.

Table 12: Enabling Environment Indicators

Indicator Baseline (2007)

Target (2009)

Comments/Action required

1. Policy, Strategy, and Direction Collective action policy Household subsidy after latrine use Household subsidy after ODF Collective incentive after ODF

No Yes No

No Yes Yes

Note: differentiate from NGP

State strategic action plan Consultation workshops (no. districts) Action plan approved Plan implemented (nr. districts)

0

No 0

6

Approved 12

Stakeholder consultation; develop plan; advocacy for approval; awareness campaign; implementation in every district

2. Institutional Arrangements Improved management & coordination State Water and Sanitation Mission meeting (gap) State sanitation meeting (gap) Dist Water and Sanitation Mission meeting (avg. gap)

12 months 1 month

14 months

3 months 1 month

6 months

(gap = months since last meeting) Last state water and sanitation mission meet in 2006? San. Review committee just started Average across 12 districts.

3. Program Methodology Scale of program: Total Sanitation implementation (nr districts) Sanitation Marketing implementation (nr districts)

5

0

12

6

Applications for awards NGP applications from Himachal Pradesh State award applications State screening of NGP applications

80 4

No

600 72

Yes

Shows commitment to process

4. Implementation Capacity Full-time TSC staff State level (total) District level (total)

0 3

3

24

Knowledge management Exposure visits (no. people per year) Best practice seminars (no. per year) Technology catalogs Fieldnote publication

44 0 0 0

50 12 6 1

2007 Nagpur visit Wider dissemination of learning

5. Availability of Products and Tools Technology options Promoted by govt (nr) Found in BPL households (nr)

5 2

10 4

Based on informed choice manual Based on rapid appraisal

User satisfaction % satisfaction with household latrine

75%

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52


Indicator Baseline (2007)

Target (2009)

Comments/Action required

School sanitation: Primary school coverage O&M budget (Rs per year per school)

Rs 0

+20%

Rs 5,000

Rural services (outside towns): Production centers (nonproject) Private retailers (nonproject) Experienced masons (nonproject)

+20% +20% +20%

Indicators intended to capture any scaling up of supply (outside direct project interventions).

6. Financing Financial commitments to sanitation: GoI approval of revised TSC budget GoI approval of revised NGP budget State finance of awards (per year) GP sanitation investments (per year)

No No Yes

Rs 5700 crore Rs 6000 crore

Rs 75 lakh Rs 300 lakh

11th 5-year plan: 2008–12 11th 5-year plan: 2008–12 From state funds (not TSC/CCDU) From 12th Finance Committee funds

Multi-layered incentives: National NGP awards (number of gram panchayats) State awards (amount awarded) District awards (amount awarded)

28

Rs 2.5 lakh Rs 0.5 lakh

300

Rs 75 lakh Rs 75 lakh

Approx. 100 expected in 2008 Non-TSC funds (4 in 2006–07) From district funds

7. Cost-Effective Implementation Effectiveness: Triggering complete (nr) ODF communities (nr) ODF-success rate (%) Cost per NGP application Cost per NGP community Cost per new household latrine

400 60

15% Rs 15 lakh Rs 30 lakh

Rs 820

1500 600 40%

Rs 5 lakh Rs 8 lakh Rs 400

CLTS active in 3–4 districts 35% success rate in Mandi US$10 per new latrine

8. Monitoring and Evaluation Health impact evaluations (rapid) WSP finance Govt finance Other stakeholder finance

1 0 0

2 2 2

TSSM baseline impact evaluation

Public health approach State review of health data (clinical+) District review of health data (no. of districts) Community-level monitoring

No

0/12

No

Yes 6/12

Yes

Health data collection needs improving; introduce community-level monitoring.

8. A

ctio

n Pl

ans

The

reco

mm

enda

tions

aris

ing

from

the

enab

ling

envi

ronm

ent a

sses

smen

t are

pre

sent

ed h

ere

in th

e fo

rm o

f tw

o ac

tion

plan

s: o

ne fo

r ac

tions

to b

e im

plem

ente

d at

nat

iona

l lev

el, a

nd a

noth

er fo

r act

ions

to b

e im

plem

ente

d w

ithin

Him

acha

l Pra

desh

.

Tab

le 1

3: In

dia:

Nat

iona

l Act

ion

Plan

A

ctio

n D

etai

led

Out

puts

R

esul

ts

Act

or

Shor

t-Ter

m A

ctio

n Pl

an (1

–6 m

onth

s)

1. P

olic

y •

Fram

e pr

opos

als

for t

wo-

stag

e co

llect

ive

awar

d pr

oces

s (O

DF

then

N

GP

) •

Ass

ist s

tate

gov

ernm

ent t

o pr

esen

t ca

se fo

r dry

latri

nes

(in c

old

clim

ates

an

d w

ater

-sca

rce

area

s; u

rine-

dive

rsio

n co

mpo

stin

g la

trine

s)

• A

ssis

t RG

ND

WM

to p

rese

nt c

ase

for

rem

ovin

g la

trine

s fro

m B

PL

surv

ey

(dis

ince

ntiv

e to

san

itatio

n)

• R

aise

d aw

aren

ess

rega

rdin

g.

bene

fits

of p

hase

d de

velo

pmen

t •

Pre

sent

atio

n to

the

GoI

on

inci

denc

e an

d su

stai

nabi

lity

of

alte

rnat

ive

optio

ns

• P

rese

ntat

ion

to th

e G

oI o

n th

e ne

gativ

e im

pact

of B

PL

poin

ts

syst

em o

n sa

nita

tion

WS

P w

ith R

GN

DW

M

WS

P w

ith G

oHP

W

SP

with

RG

ND

WM

2. R

egul

atio

n •

Dev

elop

pro

posa

ls fo

r reg

ulat

ion

of

envi

ronm

enta

l san

itatio

n in

rura

l ar

eas

• D

iscu

ssio

n of

regu

lato

ry

stan

dard

s by

the

GoI

W

SP

3. S

anita

tion

Mon

itorin

g &

Eva

luat

ion

• Fo

rmul

ate

prop

osal

s fo

r ann

ual

sani

tatio

n su

rvey

(alig

ned

with

na

tiona

l and

inte

rnat

iona

l def

initi

ons)

•

Ass

ess

optio

ns fo

r im

prov

ing

natio

nal s

anita

tion

mon

itorin

g (in

clud

ing

colle

ctiv

e ou

tcom

es,

impa

cts

etc)

•

Dev

elop

TO

Rs

for a

con

sulta

ncy

to

prep

are

a si

mpl

e, g

ener

ic im

pact

ev

alua

tion

tool

for u

se b

y al

l sa

nita

tion

stak

ehol

ders

• Fr

amew

ork

docu

men

t lis

ting

sani

tatio

n in

dica

tors

and

su

rvey

que

stio

ns

• TO

R fo

r dev

elop

men

t of

impa

ct e

valu

atio

n to

ol

WS

P

WS

P (u

nder

way

)

4. K

now

ledg

e M

anag

emen

t •

Arra

nge

inte

rnat

iona

l exp

osur

e vi

sits

(to

Indo

nesi

a, C

ambo

dia,

etc

.) •

Con

duct

a jo

int r

evie

w o

f rur

al

• R

aise

d aw

aren

ess

of n

ew

sani

tatio

n ap

proa

ches

•

Sha

re le

sson

s le

arne

d an

d

WS

P (c

ompl

eted

in

Aug

ust 2

007)

W

SP

, RG

ND

WM

,

53

Glo

bal S

calin

g U

p Sa

nita

tion

Proj

ect

Act

ion

Det

aile

d O

utpu

ts

Res

ults

A

ctor

sa

nita

tion

and

hygi

ene

in In

dia

•

Hol

d ad

voca

cy e

vent

s to

pro

mot

e th

e be

nefit

s of

san

itatio

n im

prov

emen

t

gene

rate

con

sens

us o

n th

e w

ay fo

rwar

d •

Rai

sed

awar

enes

s an

d po

litic

al p

riorit

y fo

r san

itatio

n

UN

ICE

F, W

ater

Aid

W

SP

(ong

oing

)

5. S

anita

tion

Fina

ncin

g •

Eva

luat

e th

e ef

fect

iven

ess

of th

e ap

proa

ches

in re

achi

ng th

e po

ores

t •

Con

duct

a ra

pid

asse

ssm

ent o

f the

su

stai

nabi

lity

of s

choo

l san

itatio

n (d

iffer

ent o

ptio

ns fo

r pro

visi

on a

nd

man

agem

ent)

• D

ata

on s

anita

tion

outc

omes

an

d im

pact

s am

ong

very

low

in

com

e ho

useh

olds

•

Evi

denc

e of

the

low

su

stai

nabi

lity

of s

choo

l sa

nita

tion

faci

litie

s

WS

P (T

SS

M im

pact

ev

alua

tion)

W

SP

(con

tract

out

)

Med

ium

-Ter

m A

ctio

n Pl

an (7

–12

mon

ths)

1.

San

itatio

n M

onito

ring

& E

valu

atio

n •

Con

duct

con

sulta

tion

wor

ksho

ps o

n th

e al

ignm

ent o

f san

itatio

n qu

estio

ns

and

cate

gorie

s in

hou

seho

ld a

nd

proj

ect s

urve

ys

• M

anag

e th

e de

velo

pmen

t of a

ge

neric

impa

ct e

valu

atio

n to

ol (l

ink

with

find

ings

of T

SS

M im

pact

ev

alua

tion)

• C

onse

nsus

on

the

min

imum

re

quire

men

ts a

nd d

efin

ition

s fo

r san

itatio

n su

rvey

s •

Mor

e ha

rmon

ized

, rel

iabl

e,

and

com

para

ble

data

from

sa

nita

tion

impa

ct e

valu

atio

ns

WS

P w

ith R

GN

DW

M

(and

oth

er s

take

hold

ers)

W

SP

(und

erw

ay)

2. K

now

ledg

e M

anag

emen

t •

Arra

nge

inte

rnal

exp

osur

e vi

sits

(o

ther

sta

tes

to v

isit

Him

acha

l P

rade

sh)

• H

old

advo

cacy

eve

nts

to p

rom

ote

the

bene

fits

of s

anita

tion

impr

ovem

ent (

use

evid

ence

-bas

ed

TSS

M fi

ndin

gs)

• P

rom

otio

n of

the

new

ap

proa

ches

use

d in

Him

acha

l P

rade

sh

• R

aise

d aw

aren

ess

and

prio

rity

for r

ural

san

itatio

n

WS

P (c

ompl

eted

) W

SP

(ong

oing

)

3. S

anita

tion

Fina

ncin

g •

Ass

ess

whe

ther

add

ition

al c

redi

t op

tions

are

requ

ired

for t

he p

oore

st

hous

ehol

ds (o

r for

AP

L ho

useh

olds

) •

Form

ulat

e pr

opos

als

for f

inan

cing

of

oper

atio

n an

d m

aint

enan

ce o

f sc

hool

san

itatio

n

• R

ecom

men

datio

ns fo

r re

achi

ng th

e po

ores

t •

Det

ail t

he o

pera

tion

and

mai

nten

ance

cos

ts o

f sch

ool

sani

tatio

n fa

cilit

ies

WS

P

WS

P w

ith R

GN

DW

M

Long

-Ter

m A

ctio

n Pl

an (1

3–24

mon

ths)

1.

San

itatio

n M

onito

ring

& E

valu

atio

n •

Lobb

y fo

r the

revi

sion

of t

he D

LM

met

hodo

logy

(in

line

with

the

• R

evis

ed D

LM s

urve

y •

App

rova

l for

mon

itorin

g W

SP

with

RG

ND

WM

54

Glo

bal S

calin

g U

p Sa

nita

tion

Proj

ect

Act

ion

Det

aile

d O

utpu

ts

Res

ults

A

ctor

pr

opos

als

emer

ging

from

the

cons

ulta

tion

proc

ess)

•

Ass

ist i

n fie

ld te

stin

g of

the

gene

ric

impa

ct e

valu

atio

n to

ol (a

nd e

nsur

e th

at th

e st

anda

rd im

pact

indi

cato

rs

are

incl

uded

in n

atio

nal m

onito

ring

syst

ems)

budg

et

• Tw

o W

SP

-fina

nced

rapi

d sa

nita

tion

impa

ct e

valu

atio

ns

• Tw

o ex

tern

ally

fina

nced

rapi

d sa

nita

tion

impa

ct e

valu

atio

ns

WS

P (u

nder

way

; TO

R

alre

ady

deve

lope

d)

2. K

now

ledg

e M

anag

emen

t •

Doc

umen

t les

sons

lear

ned

• P

rom

ote

less

ons

lear

ned

in In

dia

in

Inte

rnat

iona

l Yea

r of S

anita

tion

(200

8) e

vent

s

• W

SP

fiel

d no

te

• In

tern

atio

nal u

nder

stan

ding

an

d re

cogn

ition

of T

SS

M

lear

ning

WS

P (u

nder

way

)

3. S

anita

tion

Fina

ncin

g •

Rev

ise

TSS

M p

rogr

am p

olic

ies

to

allo

w fo

r rec

omm

enda

tions

for

reac

hing

the

poor

est

• Lo

bby

for m

ore

sust

aina

ble

finan

cing

of

sch

ool s

anita

tion

• C

lear

gui

delin

es fo

r rea

chin

g th

e po

ores

t (an

d m

onito

ring

disa

ggre

gate

d ou

tcom

es)

• A

ppro

val o

f sus

tain

able

fin

ance

fram

ewor

k

WS

P w

ith R

GN

DW

M

55

Glo

bal S

calin

g U

p Sa

nita

tion

Proj

ect

Tab

le 1

4: H

imac

hal P

rade

sh: S

tate

Act

ion

Plan

A

ctio

n D

etai

led

Out

puts

R

esul

ts

Act

or

Shor

t Ter

m A

ctio

n Pl

an (1

–6 m

onth

s)

1. O

utco

me-

Bas

ed in

cent

ive

fram

ewor

k •

Dev

elop

pla

ns fo

r pilo

t inc

entiv

e fu

nds

(at d

istri

ct le

vels

) •

Dev

elop

pos

t-OD

F op

tions

for

Him

acha

l Pra

desh

(env

ironm

enta

l sa

nita

tion

optio

ns in

a la

dder

of

ince

ntiv

es)

• Fo

rmul

ate

prop

osal

s fo

r reg

ulat

ion

of

envi

ronm

enta

l san

itatio

n

• D

etai

ls o

f inc

entiv

e fu

nd

shar

ed w

ith p

oten

tial i

nves

tors

•

Rai

sed

awar

enes

s on

the

need

for p

ost-O

DF

stra

tegi

es

WS

P s

tate

coo

rdin

ator

2. S

anita

tion

Sub

sect

or R

efor

ms

• Fo

rmul

ate

prop

osal

s fo

r a s

tate

sa

nita

tion

unit

• Fo

rmul

ate

deta

iled

stat

e sa

nita

tion

guid

elin

es

• W

ork

to b

ring

mor

e pa

rtner

s in

to th

e pr

oces

s (u

nive

rsiti

es, w

omen

’s

grou

ps, N

GO

s, h

ealth

pro

vide

rs a

nd

prog

ram

s, m

ason

s)

• D

evel

op tr

aini

ng p

acka

ge fo

r sa

nita

tion

and

hygi

ene

spec

ialis

ts

• N

eeds

ass

essm

ent f

or d

istri

ct

capa

city

bui

ldin

g

• E

stab

lish

cost

s an

d re

quire

men

ts o

f a s

tate

sa

nita

tion

unit

• Ta

ilorin

g TS

C g

uide

lines

to

Him

acha

l Pra

desh

con

text

and

ne

eds

• La

rger

poo

l of s

ervi

ce

prov

ider

s an

d fa

cilit

ator

s •

Trai

ning

cou

rse

on s

anita

tion

and

hygi

ene

prom

otio

n •

Iden

tify

capa

city

gap

s an

d tra

inin

g ne

eds

WS

P s

tate

coo

rdin

ator

W

SP

with

RD

D

WS

P s

tate

coo

rdin

ator

(o

ngoi

ng)

WS

P (c

ontra

ct o

ut;

ongo

ing)

W

SP

(ong

oing

)

3. S

anita

tion

Mon

itorin

g &

Eva

luat

ion

• B

asel

ine

surv

eys

(san

itatio

n co

vera

ge a

nd c

olle

ctiv

e ou

tcom

es)

• D

evel

op p

ost-i

nter

vent

ion

outc

ome

mon

itorin

g an

d fo

llow

-up

stra

tegi

es

• C

olle

ct h

ealth

dat

a (c

linic

al d

ata)

and

id

entif

y m

onito

ring

wea

knes

ses

• D

etai

led

info

rmat

ion

on lo

cal

sani

tatio

n si

tuat

ion

• R

aise

d aw

aren

ess

of n

eed

for

mon

itorin

g an

d fo

llow

-up

• R

aise

d aw

aren

ess

of

varia

tions

in d

istri

ct d

isea

se

burd

en a

nd h

ealth

cos

ts

WS

P (l

ink

with

DLM

pr

oces

s)

WS

P

WS

P s

tate

coo

rdin

ator

(w

ith R

DD

)

4. K

now

ledg

e M

anag

emen

t •

Dis

trict

adv

ocac

y (p

oliti

cal

com

mitm

ent b

uild

ing

pack

age)

•

Dev

elop

info

rmed

cho

ice

cata

logs

(b

ased

on

com

mun

ity d

esig

ns)

• In

trodu

ce a

latri

ne c

ompe

titio

n (a

war

d fo

r the

bes

t loc

al la

trine

• In

crea

sed

polit

ical

sup

port

and

prio

rity

for s

anita

tion

• R

aise

d aw

aren

ess

of

affo

rdab

le s

anita

tion

optio

ns

• Lo

cal i

nnov

atio

ns s

hare

d w

ith

a la

rger

pop

ulat

ion

WS

P (o

ngoi

ng)

WS

P (c

ontra

ct o

ut)

WS

P

56

Glo

bal S

calin

g U

p Sa

nita

tion

Proj

ect

Act

ion

Det

aile

d O

utpu

ts

Res

ults

A

ctor

de

sign

) 5.

San

itatio

n Fi

nanc

ing

• D

evel

op c

ost-e

ffect

iven

ess

indi

cato

rs

and

colle

ctio

n sy

stem

s •

Pro

pose

fina

ncin

g m

echa

nism

s fo

r sc

hool

san

itatio

n •

Ass

essm

ent o

f ran

ge o

f cos

ts fo

r N

GO

out

puts

• C

lear

und

erst

andi

ng o

f nee

d fo

r reg

ular

col

lect

ion

of re

liabl

e co

st a

nd im

pact

dat

a •

Rec

ogni

tion

of re

al c

osts

of

scho

ol s

anita

tion

• C

ost d

ata

on N

GO

act

iviti

es

WS

P (T

SS

M im

pact

ev

alua

tion)

W

SP

with

R

DD

/edu

catio

n W

SP

with

RD

D

6. S

trate

gic

Sani

tatio

n P

lann

ing

• U

nder

take

dem

and

asse

ssm

ents

(p

art o

f the

san

itatio

n m

arke

ting

com

pone

nt)

• P

rovi

de s

uppo

rt an

d tra

inin

g in

st

rate

gic

plan

ning

to d

istri

cts

• R

aise

d aw

aren

ess

of d

eman

d co

nstra

ints

(and

driv

ers)

•

Incr

ease

d ca

paci

ty fo

r st

rate

gic

plan

ning

WS

P (c

ontra

ct o

ut)

WS

P s

tate

coo

rdin

ator

(o

rgan

ize

wor

ksho

ps)

Med

ium

-Ter

m A

ctio

n Pl

an (7

-12

mon

ths)

1.

Out

com

e-B

ased

Ince

ntiv

e Fr

amew

ork

• In

trodu

ce s

anita

tion

ince

ntiv

e fu

nd

and

outc

ome

crite

ria fo

r sch

eme

allo

catio

n •

Cam

paig

n to

pro

mot

e sa

nita

tion

ince

ntiv

es a

nd a

war

ds

• P

ilot p

ost-O

DF

stra

tegy

in a

war

d-w

inni

ng c

omm

uniti

es

• R

aise

d aw

aren

ess

of c

lean

vi

llage

crit

eria

and

aw

ards

•

Incr

ease

d ra

nge

of in

cent

ives

•

Rai

sed

awar

enes

s an

d in

tere

st in

san

itatio

n •

Use

suc

cess

of a

war

d w

inni

ng

com

mun

ities

to le

vera

ge fu

nds

for e

nviro

nmen

tal s

anita

tion

WS

P w

ith G

oHP

/RD

D

WS

P w

ith R

DD

W

SP

with

RD

D

2. S

anita

tion

Sub

sect

or R

efor

ms

• S

ubm

it st

ate

sani

tatio

n gu

idel

ines

for

appr

oval

(pilo

t tes

t in

one

dist

rict)

• R

ecru

it an

d tra

in s

taff

for t

he s

tate

sa

nita

tion

unit

• R

un tr

aini

ng c

ours

es fo

r san

itatio

n sp

ecia

lists

•

Ens

ure

nong

over

nmen

t re

pres

enta

tion

in a

ll sa

nita

tion

wor

king

gro

ups

and

com

mitt

ees

• Fe

edba

ck o

n st

ate

sani

tatio

n gu

idel

ines

•

Est

ablis

hmen

t of s

tate

sa

nita

tion

unit

• In

crea

sed

prof

essi

onal

sa

nita

tion

capa

city

in

Him

acha

l Pra

desh

•

Rec

ogni

tion

of p

oten

tial

cont

ribut

ion

of n

ongo

vern

men

t st

akeh

olde

rs to

san

itatio

n im

prov

emen

t

WS

P w

ith R

DD

3. S

anita

tion

Mon

itorin

g &

Eva

luat

ion

• S

anita

tion

Wee

k: A

nnua

l com

mun

ity

revi

ews

(follo

w u

p fo

r pit

fillin

g an

d up

grad

ing

– lin

k to

san

itatio

n

• R

enew

ed c

omm

unity

inte

rest

an

d co

mm

itmen

t for

san

itatio

n im

prov

emen

t

WS

P s

tate

coo

rdin

ator

(w

ith d

istri

cts)

57

Glo

bal S

calin

g U

p Sa

nita

tion

Proj

ect

58

Glo

bal S

calin

g U

p Sa

nita

tion

Proj

ect

Act

ion

Det

aile

d O

utpu

ts

Res

ults

A

ctor

m

arke

ting;

dia

rrhe

a as

sess

men

ts)

• D

istri

ct im

pact

revi

ews

(com

pare

he

alth

dat

a w

ith s

anita

tion

outc

omes

)•

Pilo

t the

gen

eric

impa

ct e

valu

atio

n to

ol (u

se to

exa

min

e sh

ort-t

erm

be

nefit

s of

col

lect

ive

outc

omes

)

• R

aise

d di

stric

t and

com

mun

ity

awar

enes

s of

dis

ease

bur

den

• In

itial

dat

a on

ben

efits

of

colle

ctiv

e sa

nita

tion

outc

omes

WS

P (c

ontra

ct o

ut)

4. K

now

ledg

e M

anag

emen

t •

Dis

trict

per

form

ance

revi

ews

(eve

ry

six

mon

ths;

join

t rev

iew

s an

d be

nchm

arki

ng b

y a

grou

p of

dis

trict

s)

• U

pdat

es to

info

rmed

cho

ice

cata

logs

(a

dd c

ompe

titio

n w

inne

rs a

nd n

ew

desi

gns)

• P

erfo

rman

ce re

ports

(sha

ring

less

ons

lear

ned

and

iden

tifyi

ng g

aps

and

wea

knes

ses)

•

Cre

ate

cultu

re o

f inn

ovat

ion

and

flexi

ble

lear

ning

WS

P s

tate

coo

rdin

ator

w

ith S

tate

San

itatio

n R

evie

w C

omm

ittee

W

SP

sta

te c

oord

inat

or

5. S

anita

tion

Fina

ncin

g •

Col

lect

san

itatio

n co

st d

ata

• R

evie

w c

redi

t sys

tem

s an

d sa

nita

tion

outc

omes

for p

oore

st h

ouse

hold

s •

Lobb

y di

stric

t gov

ernm

ents

to re

war

d “s

usta

ined

NG

P” c

omm

uniti

es w

ith

recu

rren

t bud

gets

for s

choo

l sa

nita

tion

• D

evel

op p

erfo

rman

ce a

nd c

ost

crite

ria fo

r NG

O/S

O s

uppo

rt or

gani

zatio

n ac

tiviti

es

• S

uffic

ient

dat

a fo

r cos

t-ef

fect

iven

ess

anal

ysis

•

Rai

sed

awar

enes

s of

su

stai

nabi

lity

and

bene

fits

amon

g th

e po

ores

t •

Incr

ease

opt

ions

for

sust

aina

ble

finan

cing

of s

choo

l sa

nita

tion

• N

orm

s fo

r NG

O/S

O s

uppo

rt or

gani

zatio

n ac

tiviti

es

WS

P s

tate

coo

rdin

ator

w

ith R

DD

6. S

trate

gic

Sani

tatio

n P

lann

ing

• A

ssis

t in

the

prep

arat

ion

of d

istri

ct

sani

tatio

n ac

tion

plan

s (fo

r rea

chin

g M

DG

and

pro

vidi

ng u

nive

rsal

sa

nita

tion)

• D

etai

led

unde

rsta

ndin

g of

sa

nita

tion

chal

leng

es a

nd

oppo

rtuni

ties

WS

P s

tate

coo

rdin

ator

(th

roug

h w

orks

hops

)

Long

-Ter

m A

ctio

n Pl

an (1

3–24

mon

ths)

1.

Out

com

e-B

ased

Ince

ntiv

e Fr

amew

ork

• C

ondu

ct h

igh-

prof

ile c

ampa

ign

to

publ

iciz

e cl

ean

villa

ge a

war

ds a

nd

bene

fits

• E

nlar

ge fi

nanc

ial s

uppo

rt fo

r dis

trict

sa

nita

tion

ince

ntiv

e fu

nds

• Lo

bby

for l

adde

r of i

ncen

tives

(OD

F aw

ard

used

to fi

nanc

e en

viro

nmen

tal

sani

tatio

n se

rvic

es a

nd s

o on

) •

Rev

iew

sus

tain

abilit

y of

out

com

es in

• R

aise

d aw

aren

ess

of a

war

ds

and

high

er p

riorit

y fo

r sa

nita

tion

• A

bilit

y to

rew

ard

grow

ing

num

bers

of O

DF

com

mun

ities

•

Incr

ease

d fin

ance

for

outc

ome-

base

d in

frast

ruct

ure

gran

ts

• Id

entif

icat

ion

of a

ny

WS

P (u

nder

way

) W

SP

sta

te c

oord

inat

or

with

RD

D (l

obby

DC

s)

WS

P (u

nder

way

) W

SP

(TS

SM

impa

ct

59

Glo

bal S

calin

g U

p Sa

nita

tion

Proj

ect

Act

ion

Det

aile

d O

utpu

ts

Res

ults

A

ctor

aw

ard-

win

ning

com

mun

ities

w

eakn

esse

s in

the

ince

ntiv

e fra

mew

ork

eval

uatio

n)

2. S

anita

tion

Sub

sect

or R

efor

ms

• D

isse

min

ate

stat

e sa

nita

tion

guid

elin

es

• A

ssis

t the

sta

te s

anita

tion

unit

to

iden

tify

nonp

erfo

rmin

g di

stric

ts

• U

se tr

aine

d sa

nita

tion

spec

ialis

ts to

im

prov

e pe

rform

ance

in

nonp

erfo

rmin

g di

stric

ts

• R

aise

d aw

aren

ess

of s

tate

gu

idel

ines

(diff

eren

ce fr

om

TSC

gui

delin

es)

• A

pply

pre

ssur

e to

no

nper

form

ing

dist

ricts

•

Iden

tify

reas

ons

for

nonp

erfo

rman

ce

• In

crea

sed

capa

city

in

nonp

erfo

rmin

g ar

eas

WS

P s

tate

coo

rdin

ator

w

ith R

DD

3. S

anita

tion

Mon

itorin

g &

Eva

luat

ion

• U

se d

etai

led

impa

ct e

valu

atio

ns (a

nd

clin

ical

dat

a) to

iden

tify

any

sani

tatio

n an

d hy

gien

e co

sts

not r

educ

ed b

y ex

istin

g ap

proa

ches

(e.g

. wor

m

infe

stat

ions

, per

sona

l hyg

iene

)

W

SP

4. K

now

ledg

e M

anag

emen

t •

Dis

trict

per

form

ance

revi

ews

(eve

ry

six

mon

ths;

join

t rev

iew

s an

d be

nchm

arki

ng b

y a

grou

p of

dis

trict

s)

• U

pdat

es to

info

rmed

cho

ice

cata

logs

(a

dd c

ompe

titio

n w

inne

rs a

nd n

ew

desi

gns)

W

SP

sta

te c

oord

inat

or

with

Sta

te S

anita

tion

Rev

iew

Com

mitt

ee

WS

P s

tate

coo

rdin

ator

5. S

anita

tion

Fina

ncin

g •

Rev

iew

cos

t-effe

ctiv

enes

s da

ta (f

or

both

hou

seho

ld a

nd s

choo

l sa

nita

tion)

•

Dis

sem

inat

e in

form

atio

n on

typi

cal

cost

s fo

r NG

O/s

uppo

rt or

gani

zatio

n ac

tiviti

es

• U

se c

ost-e

ffect

iven

ess

data

as

basi

s fo

r pro

mot

ion

of p

olic

ies

and

appr

oach

es

• B

ette

r aw

aren

ess

of re

alis

tic

NG

O/s

uppo

rt or

gani

zatio

n co

sts

WS

P

WS

P w

ith R

DD

6. S

trate

gic

Sani

tatio

n P

lann

ing

• H

arm

oniz

e se

ctor

pro

gram

s w

ith

dist

rict s

anita

tion

actio

n pl

ans

• D

evel

op m

atch

ing

inve

stm

ent a

nd

impl

emen

tatio

n pl

ans

• R

oadm

ap fo

r rea

chin

g sa

nita

tion

MD

G a

nd w

orki

ng

tow

ard

univ

ersa

l san

itatio

n.

WS

P w

ith R

DD

60


References Elledge, M,, F. Rosensweig, and D. Warner. 2002. Guidelines for the Assessment of

National Sanitation Policies. Washington DC: Environmental Health Project Strategic Report 2, July.

Government of Himachal Pradesh. 2004. Strategy for Total Rural Sanitation in Himachal Pradesh. Processed report.

GoI (Government of India). 2004. Guidelines on Central Rural Sanitation Programme: Total Sanitation Campaign. New Delhi: Ministry of Rural Development, Department of Drinking Water Supply.

GoI, DDWS (Government of India, Department of Drinking Water Supply). 2006. Modification in TSC Guidelines: Increase in Unit Cost of Household Toilets. New Delhi: Ministry of Rural Development, Department of Drinking Water Supply, Memo No. W-11013/4/2000-CRSP (Pt. III), Processed report.

JMP (WHO-UNICEF Joint Monitoring Programme). 2006. Meeting the MDG Drinking Water and Sanitation Target: The Urban and Rural Challenge of the Decade. Geneva: WHO Press.

Kar, K. and K. Pasteur. 2005. “Subsidy or Self-Respect? Community Led Total Sanitation. An Update on Recent Developments.” IDS Working Paper 257, Institute of Development Studies, Brighton, England. http://www.ids.ac.uk/ids/bookshop/wp/wp257.pdf.

Knowledge Links. 2005a. Formative Research: Development of Sanitation IEC Manual for Himachal Pradesh. Processed report.

Knowledge Links 2005b. Discussion of Technologies for Sanitation in Rural Himachal Pradesh. Processed report.

RGNDWM (Rajiv Ghandi National Drinking Water Mission).. 2005. Nirmal Gram Puraskar: A National Award under Total Sanitation Campaign. New Delhi: Rajiv Gandhi National Drinking Water Mission. Available at the Government of India website: www.ddws.nic.in.

Robinson, A. 2005. Scaling Up Rural Sanitation in South Asia: Lessons Learned from Bangladesh, India and Pakistan. New Delhi: The World Bank, Water and Sanitation Program South Asia.

Sugden, S. 2006. The Microbiological Contamination of Water Supplies. WELL factsheet, University of Loughborough website: http://www.lboro.ac.uk/

WaterAid. 2006. “Total Sanitation in South Asia: The Challenges Ahead.” Discussion Paper, WaterAid, London.

WSP (Water and Sanitation Program). 2007.An Approach that Works: Community-Led Total Sanitation in Rural Areas. New Delhi: The World Bank, Water and Sanitation Program South Asia.

61


Appendix A: Glossary In order to ensure a common understanding of the concepts and terms used in the report, the following definitions are provided: CLTS: Community-led total sanitation is the original variant of the “total sanitation approach,” a process to inspire and empower rural communities to stop open defecation and start using sanitary toilets, without offering external subsidies for the purchase of hardware such as toilets, pans, and pipes.27 CLTS uses a participatory analysis of community sanitation to identify key triggers to motivate a community to take collective action to change its sanitation status. The CLTS facilitator should never lecture or advise on sanitation habits, and should not provide external solutions, such as toilet designs, in the first instance. The goal of the facilitator is to help community members to see for themselves that open defecation causes ill health and an unpleasant environment, and thus inspire and empower them to find locally appropriate sanitation solutions.

Gram panchayat: Gram panchayats are local elected government bodies at the village level in India and are the foundation of the Panchayat political system.

Handwashing: Hands become contaminated with fecal material after anal cleansing, or after cleaning children’s bottoms or handling their feces. Rinsing with water alone is not enough to remove sticky microbe-containing particles from hands. Some form of soap is required: hands need to be rubbed with soap and water until fully covered with soapsuds, then rinsed off with water.

Hygiene promotion: Hygiene promotion is a planned approach to prevent diarrheal disease (and other health problems) through the widespread adoption of safe hygiene practices—for example, campaigns to encourage regular handwashing at appropriate times. Note: Hygiene promotion is usually a much broader intervention than sanitation promotion, which focuses solely on the safe management and disposal of excreta.

Informed choice: Demand-based programming places the community in the role of decision maker in the selection, financing, and management of their water supply and sanitation system. In order to effectively implement a demand-responsive approach, the government should play a role as facilitator to provide informed choices to the community regarding the development and construction of sound infrastructure and services, taking into account local financial, technical, environmental, social, and institutional factors. Informed choices are provided in participatory sessions, covering technology and service options based on willingness to pay, to provide insight on the service provision schedule and know-how, management of funds and responsibilities, and management of services.

Program software: These are activities that support and promote the provision of program services and facilities—for example, media campaigns, capacity-building activities, community hygiene promotion sessions, and so on. Note: program software must be differentiated from program hardware (infrastructure), which includes tangible program products and facilities such as toilets, soakaways, handwashing facilities, and so on.

62


Rural: Rural describes that which is not urban, with urban spaces in India defined as towns (places with municipal corporations, municipal area committees, town committees, notified area committees, or cantonment boards); also, all places with 5,000 or more inhabitants, a population density not less than 390 persons per square kilometer, or at last three-quarters of the adult male population employed in pursuits other than agriculture.

Sanitation: Sanitation describes interventions for the safe management and disposal of excreta, with the principal safety mechanism being the separation of excreta from all future human contact. The term improved sanitation is used in this report to denote private facilities that provide safe management and disposal of excreta. The WHO-UNICEF Joint Monitoring Programme (JMP) offers the following simple definitions of improved sanitation facilities that provide “sustainable access to basic sanitation”:28

• pit latrine with slab; • ventilated improved pit latrine; • composting toilet; and • flush or pour-flush to latrine pit, septic tank, or piped sewerage.

Unimproved sanitation facilities, which do not provide adequate access to basic sanitation, include: • pit latrine without slab (open pit); • shared or public sanitation facilities; • hanging latrine; • bucket latrine; and • flush or pour-flush to elsewhere (street, yard, ditch, open drain, or other location).

Sanitation marketing: This is an approach that utilizes the power of the small- and medium-scale private sector in the provision of sanitation services and uses techniques of commercial marketing and behavior change communication to create demand.

Sanitation promotion: This encourages the safe management and disposal of excreta through the widespread adoption of safe sanitation facilities and practices—for example, programs promoting the construction and universal use of improved sanitation facilities (see sanitation definition above).

Total sanitation approach: This is a community-wide approach whose main aim is universal toilet use (total sanitation) in each community covered. The total sanitation approach focuses on stopping open defecation on a community-by-community basis through recognizing the problems caused to all by open defecation within and around the community, and ensuring that every household uses either their own affordable toilet or a shared toilet situated close to their home. The total sanitation approach is a broader variant of community-led total sanitation (see definition above) that may involve financial incentives (for example, post-construction subsidies provided by the Total Sanitation Campaign in India); the promotion of broader environmental sanitation objectives such as drainage and solid waste management; and the promotion of hygiene improvement activities such as handwashing.

63


Endnotes 1 This is approximately US$30 at the time of writing.

2 This breaks down to 25 households per village in 20 villages (12 TSC project villages and 8

non-TSC control villages).

3 The WSP state coordinator was appointed in May 2007.

4 Central Rural Sanitation Program (CRSP) and State Rural Sanitation Program (SRSP).

5 Knowledge Links survey, as quoted in Strategy for Total Rural Sanitation in Himachal Pradesh

2005, p. 2.

6 Ibid, p.1.

7 Nalas are drainage channels.

8 Knowledge Links 2005a.

9 Nursery schools (crèches) are known as anganwadis in India.

10 Note: One crore rupees = ten million rupees (US$250,000).

11 Note: One lakh rupees = one hundred thousand rupees (US$2,500).

12 The amounts mentioned are according to the revised incentive provision as of 2007. In the

earlier two years, the incentives for panchayat ranged from Rs 2 to 4 lakh.

13 GoI 2004, p. 7.

14 Sugden 2006.

15 Other criteria include amount of land, type of housing, number of clothes, number of meals per

day, consumer goods, education level, labor status, type of livelihood, children in school, loans,

migration status, and household priority.

16 Initially, only 22 NGP awards were made, but the total was raised to 28 awards following

complaints (from the state and districts) and a subsequent reverification process.

17 Rs 1,200 = US$30 per household (increased from Rs 600 in 2006).

18 GoI 2004, p. 9.

19 This is assuming that the TSSM invests US$1.0 million (of the US$1.6 million project total) in

the Madhya Pradesh project, and $ 0.6 million in the Himachal Pradesh project.

64


20 Knowledge Links 2005b A discussion of technologies for sanitation in rural Himachal Pradesh

21 Knowledge Links 2005a.

22 This is the equivalent of US$4–6 for a ceramic latrine pan.

23 Knowledge Links 2005b

24 This is approximately US$30.

25 This approximate success rate is based on anecdotal reports regarding the number of

communities triggered and number achieving ODF status.

26 This breaks down to 25 households per village in 20 villages (12 TSC project villages and 8

non-TSC control villages).

27 Kar and Pasteur 2005.

28 JMP 2006.

Documents

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