Lessons and Results from

India, Indonesia, Ethiopia and Tanzania

Eduardo A. Perez

Senior Sanitation Specialist

Water and Sanitation Program

Sustainable Rural Sanitation

at Scale

2.6 Billion People Lack Access to Hygienic Sanitation

Developing World Population

70 million Indonesians defecate in the open

221 million Africans in SSA defecate in the open

550 million Indians defecate in the open

1.3Open Defecation

1.3Shared/ Unimproved Sanitation

3.8

The Challenge

Rural sanitation programs that are:

• Effective

• Large scale

• Sustainable

• Includes the

poor

•Start at Scale – but building on evidence of promising

approaches

•Government owned and led

•Technical support from WSP

•Strong explicit learning component

Global Learning Project in partnership with

governments in India, Indonesia , Tanzania

and Ethiopia

•More than 9 million people with increased access and

use of improved sanitation

•Over 9,000 communities are Open Defecation Free (ODF)

Results Through December - 2010

Other Key Results:

•Measurably Stronger national government Enabling

Environments

Stronger local government capacity to operationalize and

sustain large scale rural sanitation programs

•Global and national learnings adding to sanitation sector

evidence and knowledge

ENABLING

ENVIRONMENT

Create

DEMAND For Sustainable Sanitation

Create

SUPPLY Of improved

Sanitation Services

Theory of Change for Sustainable

At Scale Program

Conceptual Approach

India

Changing Behaviors First to Stop Open Defecation

and Create Demand for Moving Up the Sanitation Ladder

Programmatic Approach

India

Community-Led

Total Sanitation

Behavior Change

CommunicationsSanitation

Marketing

Creating Demand and Supply

+ +

•Facilitator triggering

•Community Ignition

•Formative Research

•Mass Media

•Community Events

•Household visits

•Promotion

•Product

•Price

•Place

An integrated programmatic approach to change behaviors and increase access and use of

sanitation facilities

CLTS + Behaviour Change Comm. Sanitation marketing + BCC

Role and Functions of Local Government

Local Governments have responsibility to

ensure (not provide) sustainable sanitation services

Role of the Domestic Service Provider

Creating a supply of affordable consumer responsive

sanitation products and services

MONITORING &

EVALUATION

POLICY, STRATEGY& DIRECTION

INSTITUTIONALARRANGEMENT

S

PROGRAMMETHODOLOGY

IMPLEMENTATION

CAPACITY

AVAILABILITY OF PRODUCTS AND TOOLS

FINANCING

COST-EFFECTIVEIMPLEMENTATION

ENABLING

ENVIRONMENT

Enabling Environment for Sustainable At Scale Sanitation

Reform Policies and Institutions to

Sustain National Programs

Financial Strategy

Householdsfinance

Construction of Household Facility

Governmentsfinance

•Sanitation & Hygiene promotion

•M & E

•Incentives for community outcomes

•Subsidies for poor households•Institutional sanitation facilities

Donors finance

•Advocacy

•Technical Assistance•Capacity Building•Knowledge management

Financial Strategy

WSP p

rovid

es techn

ical sup

po

rt National and State Governments Creates an Enabling Environment for a large Scale Sustainable Rural

Sanitation Program

Local Governments Implement

Rural Sanitation Program

Facilitates CLTS behavior change triggering

Promote Demand creation for improved sanitation

Stimulate growth of

Supply

•Train

•Monitor

•Regulate

Rural Communities Ignite and Commit to becoming

100% Open Defecation Free

Households build and use improved sanitation

facilitates

Local private sector produces sanitation products and services

Increase supply

Increase demand

Buy sanitation products

and services

At Scale Service Delivery Model

What did we learn - key success factors

• Formative research to understand market segments and

key behavioral determinants

• Starting with behavior change rather than construction

• Identifying and developing at scale service delivery

models

• Clear and explicit rural sanitation policy and institutional

reform at National , State and local government levels

• Distinct budget allocations for sanitation and hygiene

Emerging Lessons

CLTS triggering to ignition “hit rate” varied widely

Revised approach

• Revise BCC strategy for those near water bodies

•Develop improved systematic capacity building plan

•Strengthen post CLTS triggering follow up

•Real time performance monitoring

Quality at Scale

Real Time Performance Monitoring used to Improve performance

Jan, 2011Jan, 2007

Score >76 51-75 26-50 ≤ 25

Band Superior Good Improving Weak

Lessons LearnedEmerging Lessons

Sustaining Behavior Change is

challenging

•Assessments show some backtracking

on BC achievements such as OD

•Latrines not being properly maintained and

cleaned

Revised approach•Competition for sustaining ODF

•Going from individual behavior change to

changing social norms

•Revised BCC strategy for shared latrines

•Sustaining national and local government

leadership

Maintaining 100% ODF

Lessons Learned

Subsidies

Well-targeted household

subsidies can be effective

at helping poor

households gain access to

higher quality and more

sustainable sanitation

facilities

Requires resources to

sustain subsidy at scale

Emerging Lessons

Lessons LearnedEmerging Lessons

Incentives/Rewards

Output/outcome-based

financial and non-financial

incentives are effective at

improving local government

performance and motivating

communities.

Requires an effective and

credible verification system

Emerging Lessons:

Enabling Environment

Necessary but not sufficient at

creating sustainable national

rural sanitation programs

BUT strong Enabling

Environment is needed for

strong performance and results

Requires a long-term

commitment, flexibility, and

recognition that it is not a linear

progression

Develop evidenced based

advocacy/knowledge products

Need better understanding of

Political Economy

Benin

Burkina Faso

Ethiopia

Kenya

Mozambique

Senegal

Tanzania

Uganda

Bangladesh

India

Pakistan

Nicaragua

Peru

Cambodia

Indonesia

Lao PDR

Philippines

Vietnam

Take Home Message

Replicable Model for Working at Scale

Financing to Governments for Rural Sanitation

from WB, ADB, GSF, USAID, AUSAID

Looking Ahead

Continue to gather and

document evidence

Develop tools and resources

Work with partners to support

government efforts and

replicate approach

Partner with WEDC!