Nepal Country Paper - United Nationsesa.un.org/.../countries/nepal/pdfs/FinalNepalCountryPaper.pdfNepal Country Paper Sanitation 16 ... 4.6 Urban ... and tourism sectors, and strengthening

Nepal Country Paper Sanitation

16 - 21 November 2008, New Delhi, India

Ministry of Physical Planning and Works (MPPW) Department of Water Supply and Sewerage (DWSS)

Panipokhari, Kathmandu, Nepal

November 2008

for the third South Asian Conference on

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TABLE OF CONTENTS

1. EXECUTIVE SUMMARY ....................................................................................1

2. COUNTRY PROFILE ........................................................................................3

2.1 Key demographic indicators ......................................................................................3 2.2 Socio-economic highlights .........................................................................................3

3. POLICIES, PRINCIPLES AND REFORMS ............................................................4

3.1 Policy framework for sanitation and hygiene...............................................................4 3.2 Reforms in the sector and their impact.......................................................................4

4. STRATEGIES ...................................................................................................6

4.1 Coverage ...................................................................................................................6 4.2 Technology choices....................................................................................................6

4.3 Hardware management (community involvement and support) ...............................6

4.4 Software (information dissemination, coordination and behaviour change) ..............7

4.5 Rural............................................................................................................................7 4.6 Urban ..........................................................................................................................7

4.7 Convergence with related sectors ..............................................................................7

4.8 Service delivery mechanisms......................................................................................8

5. ACHIEVEMENTS .............................................................................................9

5.1 Progress towards MDG (report card)............................................................................9

5.2 Progress towards hygiene behaviour development ....................................................9

5.3 Addressing SACOSAN I & II recommendations............................................................9

5.4 Sanitation links to other MDGs (health and education) .............................................10 5.5 Government initiatives ..............................................................................................10

5.6 Private initiatives ........................................................................................................11

5.7 Urban initiatives .........................................................................................................11

5.8 School sanitation and hygiene .................................................................................12 5.9 Resource mobilization (financial, human and others)...............................................12

5.10 Dignity of women......................................................................................................13

5.11 Quality of life .............................................................................................................13

5.12 Bridging gaps: equity, gender and environment ......................................................13

6. ROLE OF CIVIL SOCIETY...............................................................................14

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6.1 Mobilization...............................................................................................................14

6.2 Capacity-building .....................................................................................................14

6.3 Monitoring.................................................................................................................14 6.4 Innovations................................................................................................................14

6.5 Social audits..............................................................................................................15

7. PARTNERSHIPS, ALLIANCES AND NETWORKING.............................................16

7.1 Public–private partnerships .......................................................................................16

7.2 Media as partner ......................................................................................................16

7.3 Knowledge management ........................................................................................16

7.4 Research and development ....................................................................................17 7.5 Reaching the difficult to reach—use of IT .................................................................17

7.6 Intersectoral collaboration ........................................................................................17

8. LESSONS LEARNED AND THEIR APPLICATION ................................................18

9. EMERGING ISSUES.......................................................................................19

9.1 Standards and benchmarks .....................................................................................19

9.2 Measuring outcomes (behaviours: use and maintenance of toilets)........................19 9.3 Public sanitation (highways, eateries, market places and others) .............................19

9.4 Sanitation and water (quality and quantity)...............................................................19

9.5 Waste as a resource .................................................................................................19

9.6 Addressing slippages (sustaining results) ...................................................................20

9.7 Communicating through communities ....................................................................20

10. CHALLENGES AND SOLUTIONS.....................................................................21

10.1 Challenges ...............................................................................................................21 10.2 Ways for solution .......................................................................................................21

11. AFTER SACOSAN III—KEEPING PROMISES: ACTION PLAN WITH TIMEFRAME ...23

12. MEMBER ORGANIZATIONS OF THE STEERING COMMITTEE FOR NATIONAL SANITATION ACTION AND STAKEHOLDERS....................................................24

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1. EXECUTIVE SUMMARY Nepal is a land-locked country with a population of over 27 million people. The country’s geography ranges from the southern plains at less than 100 m to the high mountains in the north that rise to 8,850 m. Over the last decade, there have been noticeable improvements in the country’s health and sanitation situation. Infant morality and under-five morality rates have decreased significantly, by 39 per cent and 48 per cent, respectively. Likewise, sanitation coverage has increased to 46 per cent. Girls’ enrolment in primary school has reached 87 per cent. The reduction in mortality of infants and under-fives and the increase in girls’ enrolment can be attributed in part to improvements in the sanitation situation.

Nepal’s commitment to reaching the sanitation target of the Millennium Development Goals (MDGs) and the national target of universal sanitation by 2017 are driving the nation’s legal, institutional, financial and programme implementation approaches. Within the legal framework, the Rural Water Supply and Sanitation National Policy 2004, the Vision Paper 2007–2020 and the Three-Year Interim Plan (2007–2010) have guided major sanitation and hygiene promotion interventions. Within the institutional strengthening setting, the Steering Committee for National Sanitation Action (SCNSA) through its over 25 member organizations is promoting multi-stakeholder coordination, private–public partnerships, programme integration with the health, education, environmental, and tourism sectors, and strengthening of the capacity of stakeholders at national, regional, district and local levels.

In addition to the mobilization of financial resources through revolving funds and financial rewards, the Ministry of Local Development has committed 20 per cent of its total water sector budget to sanitation promotion. From this fiscal year, the Government of Nepal has initiated to allocate a separate budget for stand alone sanitation program in addition to budgetary provisions for sanitation in regular water supply and sanitation projects. Moreover, the Ministry of Finance has given a mandate to Village Development Committees to use up to 25 per cent of their fund for achieving Open Defecation Free status and implementation of Child Friendly programmes. Among programme implementation approaches, school- and community-based sanitation programmes including School Sanitation and Hygiene Education (SSHE), School-Led Total Sanitation (SLTS), Community-Led Total Sanitation (CLTS) and National Sanitation Action Week (NSAW) are credited with producing hygiene and sanitation behaviour changes and promotion of sanitation facilities in schools and communities across rural Nepal. These programmes have resulted in improved health, increased educational standards, higher girls’ enrolment in school, enhanced pride and dignity, and greater community ownership and environmental benefits. Among these sanitation focused programmes, Nepal is the founder of SLTS. Recently, the International Year of Sanitation 2008 (IYS 2008) and Global Hand-Washing Day have raised advocacy and awareness, enlarged multi-stakeholder partnerships, and enhanced media coverage throughout Nepal as well as elsewhere.

Despite such progress, Nepal still faces several challenges including numerous child deaths from diarrhoea and acute respiration infection (ARI), lower than targeted coverage of sanitation facilities, poor hygiene practices, and substantial coverage gaps between sanitation and water supply, rural and urban, rich and poor, hills and lowlands, and

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knowledge and practice. Moreover, the large number of support mechanisms used to overcome these challenges has hindered sanitation promotion in many cases. As an immediate step to overcome these challenges and build on successful approaches, Nepal is developing a national sanitation master plan that will guide institutional and financial systems, coordination among development organizations, integration of sanitation programmes with other sectors, and uniformity in approaches to sanitation and hygiene programming. Nepal has also endeavoured to scale up sanitation stand-alone programmes throughout the country, build political commitment, and increase public–private partnerships to speed up efforts to achieve universal sanitation coverage.


2. COUNTRY PROFILE

2.1 Key demographic indicators Nepal’s annual estimate of life expectancy at birth in 2005 was 62.6 years, slightly increased from 61.0 years in 2001 (UNDP, 2005). Infant mortality has declined 39 per cent over the last 10 years from 79 deaths per 1,000 live births to 48 deaths per 1,000 live births. Under-five mortality has declined by 48 per cent from 118 deaths per 1,000 live births to 61 deaths per 1,000 live births. Acute respiratory infection (ARI) is the leading cause of under-five mortality, with 10,900 deaths per year, and diarrhoea is the second major cause of death. The maternal mortality ratio is 281 per 100,000 women aged 15–49 years (Nepal Demographic and Health Survey (NDHS), 2006). Figures from a 2004 survey show that only 17 per cent of the population washed their hands after defecation. A 2008 follow-up study, currently under evaluation, is expected to show an important improvement in hand-washing practices. A recent study found a 44-per-cent reduction in risk of death, if mothers washed their hands prior to handling their newborn infant.

2.2 Socio-economic highlights Some 85 per cent of the population lives in rural areas. Nepal’s per capita income stands at US$ 290, with 31 per cent of the population living below the poverty line (UNDP, 2007). In 2007, the economic growth rate was 2.5 per cent (World Bank, 2007). Figures on operational landholdings reveal that large proportions of the population are wage labourers with no land of their own for farming. Households consist of an average of 4.9 persons (NDHS, 2006). The combined primary, secondary and tertiary gross enrolment rate is 58.1 per cent (UNDP, 2007). Figures for 2007 put girls’ enrolment in primary school at 87.4 per cent, in lower secondary school at 49.6 per cent, and in secondary school at 32.8 per cent. At least 12 per cent of the population are estimated to suffer from disabilities of various types (UNDP, 2004).


3. POLICIES, PRINCIPLES AND REFORMS Nepal has set multi-year goals and targets, following commitments to address the nation’s sanitation challenges and improve the health and wellbeing of its citizens. It has endorsed the MDGs and expressed commitment to fulfil the sanitation target of reaching 53 per cent coverage by 2015. The Rural Water Supply and Sanitation National Strategy 2004 envisages the provision of safe and potable water and basic sanitation services to all rural people within the Twelfth Five-Year Plan period (2012–2017). As a gradual approach to contributing to the national sanitation goal, the Three-Year Interim Plan (2007–2010) aims to increase sanitation coverage to 60 per cent by 2010. Sanitation and hygiene promotion approaches currently being implemented use these targets and goals.

3.1 Policy framework for sanitation and hygiene The Government of Nepal has designed enabling strategies, policies, acts and regulations to address sanitation challenges and improve the nation’s hygiene and sanitation status. A National Sanitation Policy formulated in 1994 put emphasis on sanitation for improved health through knowledge and behaviour development. Reformulated in 2004, the Rural Water Supply and Sanitation National Policy provides broad direction on technical arrangements, institutional management, legal/financial mechanisms, operation, monitoring, and information management that is specific to water supply and sanitation promotion. To guide implementation of the national sanitation policy, the government has designed the Rural Water Supply and Sanitation National Strategy and Action Plan 2004 that provides a mandate to mobilize up to 20 per cent of the total budget for water supply and sanitation towards sanitation promotion.

The Local-Self Governance Act 1999 has delegated authority to local bodies including municipalities, District Development Committees and Village Development Committees to mobilize locally generated revenues to address local needs. The Solid Waste Management and Resource Mobilization Act has outlined the duties of the Solid Waste Management and Resource Mobilization Centre (SWMRMC) and has authorized it to take action to control haphazard waste disposal and collect service fees. The Environment Protection Act 1996 and Environment Protection Regulations 1997 (first amendment 1999, second amendment 2006) have made the generators of waste responsible for waste management.

3.2 Reforms in the sector and their impact Over the years, Nepal has made important reforms to institutional frameworks, programme strategies, policies, approaches, financial mechanisms, concepts and methods for promoting hygiene and sanitation. In the face of Nepal’s new socio-political situation, the Vision Paper 2007–2020 has set sector-wise strategies, long-term and medium-term programmes, and financial and infrastructure estimations to meet the sanitation and water supply needs of the country. The government’s Tenth Five-Year Plan (2002–2007) has contributed to the national goal of achieving total sanitation within the Twelfth Five-Year Plan (2012–2017).

The SCNSA, a national network of over 25 organizations, has enhanced coordination among stakeholders, lobbied to bring uniformity in sanitation approaches among organizations, strengthened the capacity of stakeholders, coordinated policy-related discourses, launched NSAW and World Water Day, and implemented a variety of


sanitation programme packages in coordination with UN agencies and other development organizations. Efforts aimed at ensuring the success of the IYS 2008 and Global Hand-Washing Day resulted in national-level political commitment, intensive advocacy and awareness generation, increased media coverage, and enhanced public–private partnerships for sanitation and hygiene promotion.

In rural sanitation promotion, the government, in coordination with UN agencies and other development organizations, has implemented programmes on SSHE, SLTS, CLTS, Water, Sanitation, and Hygiene (WASH) campaign, Hand-Washing with Soap Campaign, Point-of-Use Water Treatment campaign, and National Sanitation Action Week. Nepal is the founder of the SLTS programme. The Open Defecation Free achievement of the SLTS programme, in many cases, has now extends from school catchment areas to the Village Development Committee. A few districts have planned to achieve total sanitation in their entire areas in two or three years. These programmes have been credited with improved sanitation coverage and enhanced hygiene practices in schools and communities. To address urban water supply and sanitation issues, the following four initiatives have played a key role: Small Towns Water Supply and Sanitation Sector Project (STWSSP); Kathmandu Valley Water Supply Sector Development Programme (KVWSSDP); Urban and Environment Improvement Project (UEIP); and High Power Committee for Integrated Development of Bagmati Civilization (HPCIDBC). Moreover, the Nepal Human Rights Commission has initiated a project to explore access to safe sanitation as one of two social human rights.


4. STRATEGIES The Government of Nepal adopts the guiding principles of the Rural Water Supply and Sanitation National Strategy 2004 when it implements sanitation and hygiene promotion programmes. The following strategies are used to promote hygiene and sanitation within a broader framework of national development.

• Promotion of sanitation and hygiene programmes throughout the country in close coordination with relevant bodies of the government, UN agencies, donors, development organizations, networks, federations, schools, and community-based organizations.

• Integration of sanitation programmes with the health, education, economic, social, environmental, and tourism sectors, and promotion of public, private, community and school partnerships at national, regional, district and local levels.

• Emphasis on the needs of the poor, disadvantaged, female-headed households, and rural areas, and encouragement of participation by women, school children and local institutions in the development, planning, implementation and monitoring of sanitation programmes.

4.1 Coverage The government intends to scale up and extend successful sanitation approaches including stand-alone sanitation programmes by attracting interest from donor agencies, mobilization of resources from international and national non-governmental organizations (I/NGOs), and promotion of public, private, community and school partnerships. A key strategy for increasing sanitation coverage is to promote the total sanitation approach and its replication throughout the country, with its emphasis on the declaration of open-defecation-free areas followed by sustainable sanitation and hygiene promotion.

4.2 Technology choices Nepal promotes the selection of appropriate sanitation technologies on the basis of customer/user demand; construction, operation and maintenance cost; skill and capability of user groups for operation and maintenance; and standardized hardware designs. Other crucial strategies include (i) promotion of child-friendly, gender-friendly and disabled-friendly toilets, water supply, and hand-washing facilities in schools and communities; (ii) encouragement of the use of indigenous knowledge, innovation and invention in technology development at local and national levels for toilet construction, solid waste management, water management, and production of toiletries; and (iii) and encouragement of on-site sanitation options, re-use of waste as a resource and ecological sanitation according to geography, culture and economic status.

4.3 Hardware management (community involvement and support) Strategic actions to mobilize community resources to manage hardware facilities in schools, communities and households include (i) the establishment of revolving funds, funded and managed by communities with special support for construction of toilets for poor households (defined by food insufficiency, female-headed households, wage level,


and disability indicators), and (ii) provision of pan, pipe and cement facilities for the poor, disadvantaged and landless, who are unable to afford toilet construction materials.

4.4 Software (information dissemination, coordination and behaviour change) Nepal promotes software as an integral component of sanitation and hygiene promotion. In this regard, Nepal (i) seeks commitments and contributions from political parties, policy makers and donors for enabling policy development, budget allocation and programme development; (ii) mobilizes teachers, child clubs, women’s groups, and user committees; (iii) promotes health and hygiene through a variety of mass communication means and locally suitable methods; (iv) strengthens the SCNSA to coordinate national hygiene and sanitation activities and extend the existing network of sanitation stakeholders; (v) empowers and mobilizes stakeholders at local, district, regional and central levels; (vi) rewards individual and institutional sanitation champions; and (vii) uses participatory tools and techniques for ignition of sanitation- and hygiene-related activities.

4.5 Rural Nepal’s rural sanitation strategy concentrates on social mobilization and capacity-building of rural-based local stakeholders. As strategic actions for rural sanitation promotion, Nepal implements sanitation projects through both school- and community-based sanitation and hygiene promotion approaches; mobilizes local community-based organizations; mainstreams gender, and the needs of the disadvantaged and minority groups; and promotes local-level resource mobilization, including financial, human and technical resources.

4.6 Urban To promote urban sanitation and hygiene, Nepal (i) promotes socio-economic development in urban centres through productive use of urban water supplies and responsible management of all waste (solid and liquid); (ii) builds institutional, and operational capacity to ensure new and existing urban schemes are efficiently and transparently managed and maintained in order to provide adequate services; (iii) harnesses, develops and manages surface and groundwater sources serving urban centres in an efficient and equitable manner, and ensures their protection and that of surrounding ecosystems; (iv) encourages the private sector to initiate environmental and economic incentive-based urban sanitation management; and (v) introduces innovative pro poor financing mechanism for establishment of sustainable sanitation facilities and increased affordability.

4.7 Convergence with related sectors Nepal particularly promotes convergence of sanitation programmes with the water, health and education sectors. Nepal’s strategic interventions include (i) integration of sanitation programmes with economic, social, environmental, and tourism sectors; (ii) promotion of public, private, community and school partnerships including collaboration with the media, civil society and user committees; (iii) promotion of sanitation-based product development, marketing and retailing; and (iv) encouragement to social sector agencies in increasing awareness and providing knowledge of better practices, and to the private sector in providing products.


4.8 Service delivery mechanisms The government, donor agencies and development organizations act as facilitators and encourage schools and communities to develop and implement sanitation service delivery mechanisms. For effective and efficient service delivery mechanism, Nepal (i) promotes low-cost and user-friendly (child-friendly, gender-friendly, disabled-friendly) hygiene and sanitation facilities at household and institutional levels; (ii) ensures effective service delivery of appropriate services as per the ecological zone at affordable prices; (iii) promotes producers and their distribution systems for hardware service delivery to communities; (iv) encourages community organizations to market and retail sanitation and hygiene products; and (v) promotes institution-building at the grassroots level for service delivery.


5. ACHIEVEMENTS

5.1 Progress towards MDG (report card) In recent years, Nepal has made rapid progress in sanitation coverage. Sanitation coverage had reached 46 per cent by 2007, and water coverage had reached 78 per cent. The growth trend of sanitation coverage and increasing hygiene and sanitation achievements indicate that Nepal is on the track to achieve the MDG target. The graph presents progress trend figures from MDG data, official data, and required growth trend for total sanitation.

5.2 Progress towards hygiene behaviour development Many sanitation and hygiene promotion approaches have put increased priority on developing proper hygiene and sanitation behaviour, especially of school children and community people. In several cases, school children have acted as the major change agents for improved hygiene behaviour in schools and communities. Initiatives on hand-washing with soap and point-of-use water treatment have helped bring about positive changes in the hand-washing behaviour of children, women, and others in the community.

A participatory assessment carried out in 2006 of the School Sanitation and Hygiene Education programme implemented schools showed that most children had developed proper hygiene and sanitation behaviour. The majority of students and teachers with access to proper hygiene and sanitation facilities were regularly cleaning school toilets, compound, and classrooms, and managing solid waste at school. They were washing their hands with soap at critical times, and maintaining personal hygiene and clean clothing. Moreover, many schools had set up a personal hygiene table in school premises with sanitary products for students and teachers. In the community, increased numbers of people in areas where sanitation programme had been implemented were washing their hands with soap and water, using toilets properly, covering water and food, using safe water, and cleaning their kitchen, utensils, yards and nearby areas.

5.3 Addressing SACOSAN I & II recommendations The actions, strategies and approaches of Nepal, following commitments made in SACOSAN I and II, focus on attaining the national goal of achieving total sanitation. As per the commitment from SACOSAN I and II, the government has prepared a master plan for sanitation with short-term and long-term visions in consultation with a wide range of stakeholders. The master plan also addresses issues concerning major institutional and financial mechanisms required for achieving total national sanitation.


A comprehensive country plan was developed for IYS 2008 and has been implemented by over 25 member organizations of the SCNSA. Nepal’s participation in SACOSAN, IYS initiatives, Global Hand-Washing Day and its emerging collaboration with the Global Sanitation Fund has contributed to expediting the process of collaboration with both the national and global community. Newly developed sanitation promotional approaches, strategies and programmes have adequately incorporated provisions for stakeholder capacity development, empowerment of women and socially disadvantaged communities, and community-level resource mobilization.

5.4 Sanitation links to other MDGs (health and education) Research has concluded that there is clear evidence that increments in sanitation status directly improve health status and that growth in education helps increase coverage of sanitation. The table below shows a gradual reduction in infant mortality, under-five mortality, maternal mortality, and an increase in student enrolment and sanitation coverage over the years for Nepal.

Indicators 1990 1995 2000 2005 2007 2015 (Target)

Health

Infant mortality rate 108 79 64 61 48 34

Under-five mortality rate 162 118 91 82 61 54

Maternal mortality ratio (MMR) 850 or 515 539 415 n/a 281 213 or 134

Education

Net enrolment in primary education (%) 64 69 81 84 – 100

Pupils that start Grade 1 and reach Grade 5 (%)

38 n/a 63 76 – 100

Literacy rate of 15–24-year-olds (%) 49.6 56.2 70.1 73.0 – 100

Ratio of girls to boys at primary level 0.56 0.66 0.79 0.86 – 1.0

Ratio of girls to boys at secondary level 0.43 0.56 0.70 0.82 – 1.0

Ratio of women to men at tertiary level 0.32 n/a 0.28 n/a – 1.0

Ratio of illiterate women to men aged 15–24 years

0.48 0.56 n/a 0.73 – 1.0

Source: Millennium Development Goals Progress Report 2005; and Nepal Demographic and Health Survey 2006.

5.5 Government initiatives In addition to efforts on development and implementation of sanitation policies, guidelines, rules, regulations, acts, strategies and approaches, the government has made moves to strengthen institutional capacity and resource mobilization. Recently, the government allocated NRs 50 million for hygiene and sanitation promotion countrywide. In addition, the Ministry of Local Development has committed 20 per cent of its total budget for the water sector to sanitation. Besides, the Ministry of Finance has provisioned up to 25 per cent of the Village Development Committee (VDC) fund, if the village manages to declare Open Defecation Free and implement Child Friendly programmes. In 2007, the government initiated implementation of the SLTS programme in all of Nepal’s 75 districts and initiated sanitation model district concept for total sanitation achievement.


The government has empowered District Development Committees, Village Development Committees, municipalities, District and Local Sanitation Steering Committees through implementation of enabling policies, acts and capacity-development packages. At the centre, a National Council for Solid Waste Management mobilizes concerned ministries, municipalities, private sector agencies, and experts. Furthermore, a Solid Waste Management and Resource Mobilization Centre (SWMRMC) coordinates solid waste management activities in urban areas. At present the centre is in the process of formulating Solid Waste Management Guideline and Act. The government in coordination with UN agencies and stakeholders achieved Open Defecation Free situation in six village development committees, 150 school catchment areas and several settlements/communities through total sanitation approaches of SLTS including CLTS and others.

5.6 Private initiatives The government, in collaboration with UN agencies and development organizations, has initiated a Public–Private Partnership (PPP), launched a campaign to promote hand-washing with soap, mobilized mass media to a greater extent, and run various hand-washing demonstration activities in schools and communities. Initially, two major private soap manufacturers joined the partnership. This year, hotel, tourism, education, philatelic, media and telecom sectors have promoted key messages on the importance of hand-washing with soap, launching a weeklong campaign on the occasion of Global Hand-Washing Day. A national steel manufacturer has initiated the production of pans and pipes in Nepal to support thousands of rural communities in constructing toilets. Besides, several writing pad producers developed notebooks with latrine use and hand washing messages and disseminated to the schools. With gradually increasing private sector involvement, Nepal has several good prospects for private sector contributions to national sanitation promotion in the years to come.

5.7 Urban initiatives The government’s Three-Year Interim Plan (2007–2010) provides guidance on urban sector priorities, highlighting, in particular, the need to address the effects of rapid urbanization, water quality, and urban scheme maintenance. Recently, the government designed a vision paper that puts emphasis on a sewerage system with treatment facilities in emerging urban settlements; a sewer system for rivers and streams; and the construction of public toilets in major public places.

The UN’s country-level strategic perspective on national water and sanitation—the Common Country Assessment of Nepal 2007—addresses several urban issues including lack of access to safe drinking water, poor sanitary and hygiene habits, and lack of adequate facilities at schools and health posts. The United Nations Development Assistance Framework (UNDAF) 2008–2010 for Nepal places major focus on pro-poor water and sanitation provision, integrated urban environmental sanitation, economic development from urban sanitation management, pro-poor water and sanitation coverage, capacity-building, and advocacy. Nepal promotes decentralized wastewater management systems and waste-based alternative energy—for example, biogas—in urban and peri-urban centres. Under this programme, community-managed reed bed treatment systems have been established for the treatment of wastewater. The government in coordination with UN agencies and stakeholders has implemented sanitation initiatives in


urban and peri-urban areas under Water for Asian Cities (WAC) program. An Urban Environmental Guideline is also being developed to support urban sanitation initiatives.

5.8 School sanitation and hygiene Since 2000, Nepal has promoted the school as a model and students as change agents for improving hygiene and sanitation. A School Sanitation and Hygiene Education programme is currently being implemented in more than 1,500 schools in Nepal. The programme receives support from the government, UN agencies, and other development organizations. A participatory assessment of the programme carried out in 2006 showed that most programme schools had child- and gender-friendly facilities, that water supply, toilets and urinals were adequate in number for students and teachers, that students and teachers had good practices and behaviour on environmental and individual sanitation and hand-washing, and that sanitation programme management in schools and communities was good. The programme has empowered students to work as change agents and develop their leadership capacity, strengthened school and community partnerships for action, scaled up sanitation coverage in school catchments, and strongly advocated for gender-friendly, child-friendly and disabled-friendly water and sanitation facilities in schools and communities. The programme has also contributed to promoting household toilets, and enhancing children’s health and quality education.

Since 2004, the government, through the Ministry of Education and Sports, has implemented a programme of constructing separate toilets for girls in community schools. This has contributed to a notable increase in girls’ enrolment and their retention in school.

5.9 Resource mobilization (financial, human and others) Government and support agencies have mobilized their resources for sanitation promotion through a number of ways including reward and recognition, revolving fund mechanisms, direct material support, and encouragement of community ownership and contribution to financial and human resource mobilization. Several schools, child clubs, Village Development Committees, and local-level sanitation committees have generated funds at the local level from their internal sources and through fund-raising activities. In addition, micro-credit agencies, women’s development cooperatives, and community-based organizations are supporting rural financial mechanisms. Together with the government, the UN agencies have initiated to create a basket fund for sanitation promotion in rural areas.

Stakeholders at various levels have all contributed to increasing national sanitation coverage over the years. Stakeholders that are effectively mobilized and active at the local level include headmasters/teachers/members of school-based child clubs, and members of Local Sanitation Steering Committees, women’s groups, and community-based organizations. Similarly, at the district level, Water Supply and Sanitation Coordination Committees/District Sanitation Steering Committees, District Development Committees and the district offices of development organizations have supported the design, implementation and monitoring of sanitation programmes. At the centre, personnel from the government, UN agencies, donors and I/NGOs as well as sanitation experts, politicians and policy makers have contributed to designing strategies and approaches, motivating sanitation champions, and monitoring sanitation programmes. In addition, journalists have played a critical role in advocacy and awareness generation.


5.10 Dignity of women Women have enhanced feelings of dignity and pride resulting from successful initiatives concentrating on benefits for the poor, disadvantaged and those from minority groups. As a result of sanitation initiatives, there has been an increase in female decision-makers that has their boosted leadership capacity. Sanitation provisions that are dedicated to women and girls include 50 per cent membership for girl students in child clubs, gender-friendly toilets and urinals in school-based sanitation programmes, gender and poverty approaches to water supply and sanitation projects, mother-and-child tap-stand groups, women’s technical support services, and human-value-based water supply and sanitation education. As a result, women’s groups have emerged in recent years as a major force in spearheading hygiene and sanitation programmes within the total sanitation movement.

5.11 Quality of life The gradual rise in life expectancy, the reduction in infant mortality, and the increase in girls’ enrolment in school are prominent examples that show the relationship between improved sanitation and enhanced quality of life. Improvements in hygiene and sanitation have been equated with quality education, health improvement, generation of productive human resources, gender empowerment, and reduction in child and maternal morbidity and mortality. Toilet promotion and hand-washing with soap interventions followed by advocacy and community/child club mobilization activities have generated tremendous pressure to adopt good hygiene behaviour. This has ultimately resulted in a reduction in diseases associated with poor hygiene and sanitation, and an improvement in health and wellbeing.

5.12 Bridging gaps: equity, gender and environment Sanitation strategies, policies, approaches and programmes have emphasized pro-poor sanitation interventions, equal recognition of males and females, especially in SSHE and SLTS programme, child clubs, sanitation committees, and in several other institutions. Introduction of the concept of universal toilet coverage followed by ‘no open defecation’, re-use of waste as a resource through eco-san approaches, and urban waste management are some of the major attempts made towards addressing the issues of environmental sustainability.

Nepal’s newly elected members of the Constitution Assembly have expressed a mutual commitment to recognizing sanitation as a basic human right of all citizens and a prime environmental concern in the new Constitution of Nepal. Nepal’s sports persons, artists, school children, professors, entrepreneurs, politicians and policy makers have also expressed commitment to promoting environmental sanitation. The Local-Self Governance Act 1999 has placed high priority on uplifting the socially marginalized, the adoption of rights-based and participatory approaches to project work, maximizing the use of local resources, and protection of the environment.


6. ROLE OF CIVIL SOCIETY

6.1 Mobilization The role of civil society is particularly significant in addressing the needs of high-risk communities, the physically impaired, the socially disadvantaged, and bridging the government and citizen's interface for pro-poor benefits. The media, interest groups, professional groups, women, students and user groups are increasingly involving themselves in sanitation promotion. The role of community-based organizations, intellectual groups, women’s groups, community healers, priests, opinion leaders and school children has been crucial in instigating community support and support for individual, household and environmental sanitation promotional activities. Community ownership and its capacity to design and implement local sanitation and hygiene programmes have a strong influence on changes in the sanitation situation and its sustainability. School children and women also show strong leadership capacities in sanitation programme promotion.

6.2 Capacity-building Training, orientation, fellowship programmes, rallies, processions, interactions and study visits are key activities being promoted to strengthen the capacity of civil society. Journalist orientation and fellowship under the Water, Sanitation and Hygiene (WASH) campaign and media training by the End Water Poverty campaign are major initiatives used to sensitize civil society. The Centre for Human Resources Development Unit (CHRDU) develops training packages and conducts training at different levels for civil society organizations. At the local level, major stakeholders receiving capacity-building programmes on behalf of civil society include child clubs, sanitation sub-committees, School Management Committees, Parent–Teacher Associations, and community-based frontline workers, volunteers, facilitators, and natural leaders.

6.3 Monitoring Local communities, school children, opinion leaders and social workers carry out self-monitoring of sanitation programmes in intervention areas. Through NSAW, SSHE, SLTS and WASH campaigns, civil society is continuously highlighting issues of hygiene and sanitation that are often overshadowed and forgotten. For example, the issue of toilets in public offices for disabled people was raised for the first time in the country through civil society before SACOSAN II. Similarly, child-friendly/gender-friendly facilities in schools have become major monitoring indicators of school-based sanitation programmes. Independent assessment by freelancers, community information boards, media interaction programmes on thematic issues, public audit, and collection of the voices of community people are a few of the monitoring activities carried out by civil society.

6.4 Innovations Partnerships with mass media, collection and dissemination of public voices through audio-visual materials, joint publication, reward and recognition to individuals and organizations, and public pressure generation through advocacy campaigns are major innovations made to mainstream hygiene and sanitation in civil society. Mega-events for IYS 2008 and Global Hand-Washing Day and submission of 0.15 million signatures to


the Prime Minister under the End Water Poverty campaign have created an enabling environment for the State to mobilize resources for sanitation promotion. A social accountability promotion based program namely 'Jagaran' has initiated a mechanism in which stakeholders, community institutions, support organizations, and project facilitators follow a downward accountability approach.

6.5 Social audits The Rural Water Supply and Sanitation National Strategy 2004 has given priority to setting up a Water Users’ and Sanitation Federation specifically for independent monitoring and social auditing of rural water supply and sanitation programmes. Civil society, independent researchers, university students and journalists conduct surveys, make field visits, and collect stories and case studies, providing clear and succinct information on the performance of hygiene and sanitation programmes against social objectives. Politicians, social workers and local groups have paid increased interest in observing local-level sanitation and hygiene promotion activities and raising issues in the media and local-level forums.


7. PARTNERSHIPS, ALLIANCES AND NETWORKING

7.1 Public–private partnerships The concept of public–private partnership has been broadened for sanitation promotion in Nepal into a public, private and community partnership. Through the concept, partnership for hygiene and sanitation promotion has been sought from the government, the private sector, user committees, local entrepreneurs, community people, schools, media, local bodies and civil society. SCNSA and WASH collaboration are prominent institutional examples of public–private partnership and a multi-stakeholder platform for action. The IYS 2008 mega-event and Global Hand-Washing Day were major successful events in public–private partnership in 2008.

Through this approach, production and sale of sanitation materials, social marketing, advocacy, communication, and financing are being facilitated. Nepal’s Three-Year Interim Plan expects local authorities to be responsible for overseeing project implementation, with private sector organizations having an increased role in urban waste management. Urban sanitation management strategies, policies, approaches and programmes have encouraged the private sector to create economic incentives and socio-environmental benefits.

7.2 Media as partner The Nepal IYS 2008 Desk with support from SCNSA has designed and implemented a media campaign strategy for IYS 2008, making the media a crucial partner in increasing coverage of sanitation messages throughout the country. With effective implementation of this strategy and priority towards the media campaign, Nepal has been able to increase media coverage on sanitation this year. In addition, UN agencies and other stakeholders in coordination with the government have built on common understanding, and expressed mutual commitment to make additional efforts to mobilize the media at different levels so as to contribute to hygiene and sanitation in Nepal. Nepal also has a plan to include major national media organizations in the SCNSA. Their inclusion is expected to help build an institutional relationship with the media and execute effective media strategies and activities. Interaction with the media on IYS 2008, the media campaign on sanitation, journalist orientation, press-meet programmes, media monitoring, and the WASH media awards are some of the important steps that have strengthened relations with media organizations.

7.3 Knowledge management Over 25 members of the SCNSA assemble regularly to discuss, share and innovate ideas, knowledge and good practices to promote the sanitation and hygiene sector. Participatory approaches and consultation processes adopted by the members of the SCNSA have enhanced interaction among policy makers, UN agencies, donors and local-level stakeholders. Lessons learned, and research and its findings have been shared in forums run by the IYS 2008 Desk on a regular basis. At the centre, use of information technology, development and sharing of e-newsletters, and publication of good practices have facilitated the process of productive knowledge management. Recently, a resource centre network has been established with support from concerned stakeholders at the national level. The centre collects crucial pieces of information, manages them, promotes


their efficient use, and provides information services to stakeholders through its information management system. The government has established a resource centre network and introduced the National Management Information Project in its progress towards knowledge management and documentation of information on sanitation. Besides, a Management Information System (MIS) of 29 small towns has been developed to promote sanitation and water in small town areas.

7.4 Research and development Major surveys on the nation’s health and sanitation development include the Nepal Living Standard Survey (NLSS), Population Census (PC), and Nepal Demographic and Health Survey (NDHS). Health and sanitation findings in these surveys reveal the status of child and infant health, maternal health, nutrition, and other prevalent diseases. UN agencies, donors and development organizations also carry out research that helps in the design and implementation of effective health and sanitation programmes. For example, learning from an assessment of the SSHE programme in 2006 led to scale-up of the SSHE programme in Nepal. The National Multiple Information Project (NMIP) has collected data on hygiene, sanitation and water status from all 75 districts of Nepal. An assessment of hand-washing with soap and point-of-use water treatment programmes is underway, and is expected to be crucial for the sector. In addition, small-scale research on issues such as eco-san, financial resource mobilization, vermi-composting, water treatment through constructed wetlands, recycle/reuse of wastewater, and recharging of groundwater have taken place at individual and institutional levels in the field of waste management. Recently, the Ministry of Physical Planning and Works (MPPW) set up a monitoring and evaluation unit in its institutional framework to coordinate research and development for the hygiene and sanitation sector.

7.5 Reaching the difficult to reach—use of IT Large numbers of communities lack access to information technologies such as email, internet and fax. In several inaccessible districts of Nepal, FM radio stations are the major means of disseminating sanitation messages and information. Meetings, orientations and social campaigns are alternative means used in several geographically inaccessible areas. Currently, the government has a plan to introduce a GIS for the water supply and sanitation sector.

7.6 Intersectoral collaboration Realizing the importance of making sanitation and hygiene a cross-cutting issue, intersectoral partnership and interdepartmental collaboration have been advocated at local, district, regional and national levels. Nepal promotes intersectoral collaboration between water, health, education, nutrition, women’s development, tourism, and environmental sectors. At the centre, Ministry of Physical Planning and Works, Ministry of Health and Population, Ministry of Local Development, Ministry of Education and Sports, Ministry of Children, Women and Social Welfare, UN agencies, donors, and I/NGOs have been collaborating to contribute to the MDGs. The SCNSA, Regional and District Sanitation Steering Committees/Water Supply and Sanitation Coordination Committees at regional and district levels coordinate respective national, regional and district organizations from the health, education, environment and tourism sectors. This collaboration has brought together strengths, capacities and resources from multiple organizations to contribute to sanitation and hygiene promotion across the country.


8. LESSONS LEARNED AND THEIR APPLICATION The government, UN agencies and other development organizations in Nepal have learnt the following lessons from sanitation programmes over the years.

• Participatory tools, techniques and approaches (PHAST, SARAR, PRA/RRA) in sanitation programme are effective for bringing about expected results in a limited time and sustaining them in schools and communities. Application of these components into the SLTS, SSHE, CLTS and WATSAN approaches has led to enhanced community participation and ownership in planning, designing and implementation of programmes.

• A combination of software, hardware, mind-ware and org-ware is important for the promotion of hygiene and sanitation, especially in rural areas. Most sanitation programmes currently under implementation have adopted this learning as an inevitable element to succeed in bringing improvements in sanitation facilities and hygiene behaviour.

• School children are key change agents for hygiene and sanitation behaviour and facilities promotion not only in school but also in communities. With this basic learning, SSHE has been implemented in 15 UNICEF-supported districts of Nepal. SSHE is being scaled up across the country, focusing on child-, gender- and disabled-friendly facilities.

• Total sanitation, as in SLTS/CLTS, is an efficient, effective and rapid approach to bringing about sanitation promotion of knowledge, behaviour and facilities in settlements/school catchment areas and Village Development Committees. This approach is inclusive of poor and disadvantaged people because of its distinctiveness in achieving universal toilet coverage.

• Reward, recognition and revolving fund, as used in the SLTS approach, and innovative and creative activities motivate people and facilitate effective implementation, monitoring and follow-up of sanitation programmes. In the SLTS approach, such reward and revolving fund mechanisms have been a motivating factor in declaring areas to be open-defecation free.

• Sanitation and hygiene are a matter of dignity, identity and pride. Nepal’s stakeholders including members of the SCNSA have promoted this as a key message throughout the country through implementation of the Nepal Country Plan for the IYS 2008.

• Promotion of innovative and creative activities such as multiple personal hygiene table, permanent soap case, fund raising activities, and flexibility in programme implementation as per the local situation are effective and important.


9. EMERGING ISSUES

9.1 Standards and benchmarks Experience has shown that the sanitation sector lacks uniformity in programme approaches and financing and monitoring mechanisms used by various organizations. Toilet and sanitation coverage is often defined and understood differently in different agencies. Responding to this issue, stakeholders have tried to maintain uniformity in support modalities. Stakeholders have also built on common consensus to incorporate key components into their programmes, including universal toilet coverage, promotion of hand-washing with soap, provision of child-friendly and gender-friendly facilities in schools, promotion of self-monitoring mechanisms, and institution-building at the grassroots level. A sanitation master plan will be used as a guiding document to set standards and benchmarks for the overall sanitation programme in the country.

9.2 Measuring outcomes (behaviours: use and maintenance of toilets) Generally, assessment of behaviour change after sanitation and hygiene interventions has been rigorously implemented. Tangible indicators such as construction of a toilet in homes, condition of its use and operation, reduction of open-defecation practices, provision of hand-washing facilities, provision of waste disposal pits, and reduction in the frequency of diarrhoeal disease are used as measuring rods for behavioural change.

9.3 Public sanitation (highways, eateries, market places and others) A survey of roadside hotels/restaurants revealed the deplorable condition of food hygiene, water hygiene, personal hygiene, and environmental sanitation. Generally, the sanitary condition of toilets in public areas is poor. Open defecation is also common in such places. In such conditions, the transmission of communicable diseases is highly likely. Furthermore, many restaurants and mobile food outlets use inedible colours and serve stale food that can adversely affect the health of customers.

9.4 Sanitation and water (quality and quantity) In Nepal, 46 per cent of the population has access to toilets and 78 per cent has access to water supply. In public and community schools, 41 per cent have toilet facilities. However, only two-thirds of schools have sufficient facilities and only one-fourth has separate facilities for girls and boys. Solid waste and wastewater problems are growing rapidly, as there has been a vast population influx into urban areas in recent years. The rate of growth of per capita waste coupled with poor drainage is affecting safe water. Most households in urban areas either have drinking water piped into the house (40 per cent) or collect it from tubewell/borehole (31 per cent). Major sources of drinking water in rural areas are public tap/standpipe (29 per cent) and tubewell/borehole (39 per cent). The government has endorsed a water quality standard to maintain the standard of water supply facilities (DHS, 2006).

9.5 Waste as a resource Solid waste is mostly an urban phenomenon in Nepal. Two-thirds of municipal waste is organic. Municipalities are taking responsibility for managing solid waste. However,


because of the lack of resources and institutional and infrastructure facilities, solid waste is the most visible environmental problem in urban areas. Very little of the organic waste is composted and most municipal waste is dumped on riverbanks and open spaces. A few municipalities have landfill sites and a small proportion of waste is composted. Ecological sanitation is promoted in rural and peri urban areas to convert human faeces and urine in to fertilizer. Likewise, bio-gas has been promoted to produce energy and use of a toilet. These need to be scaled up to make visible progress in increasing economic benefits and environmental sanitation.

9.6 Addressing slippages (sustaining results) Maintaining community motivation, transforming knowledge into behaviour, and developing the institutional capacity to regularly monitor sanitation programmes are all required to sustain progress in hygiene and sanitation. Parallel priorities on hygiene knowledge, behaviour development, and hardware facilities installation are important. Despite good understanding of these issues, the government and development organizations have yet to build a strong mechanism to sustain the improved community and school hygiene and sanitation situation. Massive capacity development for programme facilitation, especially in programme areas, is the most needed intervention for ensuring sustainability of sanitation programmes.

9.7 Communicating through communities Several hygiene and sanitation initiatives in the country are primarily concentrated on advocacy, communication and social mobilization activities. Use of participatory tools such as social mapping, door-to-door visits, street drama, rallies, and mobilization of teachers, students, parents, local leaders, women’s groups, and community-level skilled labourers have been effective in sharing and disseminating messages in communities. The participation of community members in total sanitation campaigns, sanitation fairs/festivals, and open-defecation-free declaration ceremonies has inspired nearby communities to achieve similar results. Video documentary shows, exchanging learning, success stories, study visits to model schools and communities, and dissemination of public voices have also been effective in promoting communication and mass sensitization. The communication and advocacy made by child clubs members greatly motivate their parents to build and use toilets at home and practice good hygiene behaviour.


10. CHALLENGES AND SOLUTIONS

10.1 Challenges Lack of knowledge, behaviour and practice among most people and their ignorance of common transmission routes for diseases through flies, dirty hands, animal, unsafe food and water have complicated sanitation promotion efforts. A large segment of the population still does not know that diseases can be controlled by construction and proper use of toilets and hand-washing with soap. Preference for defecating in open spaces rather than toilets, especially among lowland communities, and landlessness are bottlenecks to expansion of toilet coverage. Poverty, illiteracy, remote and inaccessible villages, and cultural mindsets are barriers to accelerating sanitation and hygiene improvements. Many girls who attend primary school do not go on to secondary school, primarily because of the lack of proper sanitation facilities in schools.

Inadequate sanitation facilities in schools and communities has hindered development of proper sanitation behaviour and use in some places in Nepal, and has directly affected the health and wellbeing of school children and community people. There are few gender- and disabled-friendly sanitation facilities in schools and communities. Only 41 per cent of public/community schools have toilets. Even in schools that have toilet facilities, only 26 per cent have a separate toilet for girls. A big gap exists in coverage between sanitation and water supply, between rural and urban areas, between poor and rich, and in knowledge and practice. In Nepal, the overall sewerage system situation is poor, and the infrastructure is insufficient.

Institutional support is inadequate to speed up sanitation coverage and variation in financial support for sanitation and hygiene promotion among support agencies and communities has slowed sanitation promotion initiatives. Private sector operators are unwilling to take on the operation and management of urban schemes until tariff collection and associated income can guarantee a working profit.

10.2 Ways for solution The growing joint effort among stakeholders including public, private, school and community partnerships, political commitment, and sanitation programme integration with health, education, nutrition and environment sectors can be harnessed to ensure the expansion needed to meet the national goal of total sanitation. Additionally, increasing investment for stand-alone sanitation programmes by the government, UN agencies and other donor communities is necessary. Enhancement of institutional capacity and the role of the SCNSA, Regional Sanitation Steering Committees, Water Supply and Sanitation Coordination Committees/District Sanitation Steering Committees, Village Development Committees, water and sanitation user committees, schools, municipalities, and community-based organizations will help significantly in achieving total sanitation in Nepal.

Expansion of sanitation facilities including installation of child-, gender- and differently-abled-friendly sanitation facilities in schools and communities is essential for addressing the needs of the deprived, poor and disadvantaged sections of society, and girls' menstrual hygiene management. Besides, scaling up of sanitation best practices through out the country is necessary. Provision for differently-abled-friendly sanitation


facilities in public places such as colleges, airports, government offices, department stores, bust stops, and cinema halls are also essential. Timely delivery of services, promotion of technological innovation, involvement of sanitation-based entrepreneurs, use of indigenous knowledge, and mobilization of local resources for production of sanitation facilities are all necessary for easing the facility installation aspect of sanitation promotion.

Advocacy, awareness generation and total sanitation: Existing advocacy, awareness generation, media mobilization and social mobilization requires further intensity at national, regional, district and local levels. The concept of total sanitation can lead to universal coverage through community initiatives with minimum support from the centre. Approaches similar to SLTS and CLTS need extensive replication throughout the country. The practice of open defecation needs to be discouraged socially. The government and local bodies also need to promote ‘no open defecation’ through policy provisions, rules and regulations. Development of a master plan with short-term and long-term goals will help mainstream issues related to gender and disadvantaged communities, and promote hygiene and sanitation in Nepal. Besides, the government need to allocate adequate budget for stand alone sanitation programmes to achieve total sanitation in Nepal by 2017.


11. AFTER SACOSAN III—KEEPING PROMISES: ACTION PLAN WITH TIMEFRAME Nepal is in the process of finalizing a sanitation master plan and urban water supply and sanitation policy. The master plan will be a basic conceptual guiding document for achieving the national sanitation target of sanitation for all by 2017. Medium-term plans and programmes with indication of resources will be developed for national and district levels. Knowledge gained and decisions made by SACOSAN III will be taken into consideration in annual and multi-year planning. The following plan of action presents the planned post-SACOSAN III activities.

Activities Timeframe Key responsibility

Revision and finalization of master plan on sanitation Dec 2008 SCNSA

Development and finalization of master plan implementation guidelines Mar 2009 SCNSA

Revision and finalization of urban water supply and sanitation policy Jul 2009 MPPW

Finalization and dissemination of documentation for database on sanitation

Jan 2009 NMIP/DWSS

Development and dissemination of strategy for media advocacy 2009/2010 SCNSA

Assessment and documentation of IYS 2008 initiatives Apr 2009 SCNSA and IYS Desk

Preparation of annual work plan (general and specific) based on approaches appropriate for each geographical region

Yearly Government and stakeholders

Participatory assessment of CLTS, SLTS and NSAW 2009/2010 SCNSA

Follow up SACOSAN declaration 2009/2010 SCNSA and stakeholders


12. MEMBER ORGANIZATIONS OF THE STEERING COMMITTEE FOR NATIONAL SANITATION ACTION AND STAKEHOLDERS ! Ministry of Physical Planning and Works (MoPPW)

! Ministry of Finance (MoF)

! Ministry of Education and Sports (MoES)

! Ministry of Local Development (MoLD)

! Ministry of Women, Children and Social Welfare (MWCSW)

! Ministry of Health and Population (MoHP)

! Department of Water Supply and Sewerage (DWSS)

! Department of Health Service (DoH

! Department of Education (DoE)

! Department of Local Infrastructure Development and Agricultural Roads (DoLIDAR)

! Nepal Water Supply Corporation (NWSC)

! United Nations Children's Fund (UNICEF)

! World Health Organization (WHO)

! UN-Habitat Water for Asian Cities Program Nepal

! The World Bank (WB)

! Asian Development Bank (ADB)

! Rural Water Supply and Sanitation Fund Development Board (RWSSFDB)

! Nepal Red Cross Society (NRCS)

! Nepal Water for Health (NEWAH)

! National Trachoma Program (NTP)

! National Association of Village Development Committee in Nepal (NAVIN)

! Association of District Development Committee in Nepal (ADDCN)

! Municipality Association in Nepal (MuAN)

! GTZ/Udle

! JMA/JICA

! Helvetas Nepal

! Plan Nepal

! CECI

! Gurkha Welfare Scheme (GWS)

! Biogas Support Program (BSP)


! Nepal National Teachers’ Association (NNTA)

! Nepal National Teachers’ Organization (NNTO)

! CARE Nepal

! RVWRMP/FINNIDA

! SEAM-N

! Water Aid Nepal

! Nepal Scouts

! Federation of Drinking Water and Sanitation Users Nepal (FEDWASUN)

! World Vision

! Eco Himal

! Environment and Public Health Organization (ENPHO)

! LUMANTI

! Media Help Line

! Community Development Forum (CODEF)

! NGO FUWS

! Solid Waste Management and Resource Mobilization Center (SWMRMC)

! Society of Public Health Engineers Nepal (SOPHEN)

! High Power Committee for Integrated Development of Bagmati Civilization (HPCIDBC)

Documents

Nepal Country Paper - United Nationsesa.un.org/.../countries/nepal/pdfs/FinalNepalCountryPaper.pdfNepal Country Paper Sanitation 16 ... 4.6 Urban ... and tourism sectors, and strengthening