This paper estimates two sources of benefits related to sanitation infrastructure access on early childhood health: a direct benefit a household receives when moving from open to fixed-point defecation or from unimproved sanitation to improved sanitation, and an external benefit (externality) produced by the neighborhood's access to sanitation infrastructure.
In the context of the recent evolution of the sanitation sector, CATS can be seen in a twofold way: as a move from technically based, supply-driven approaches toward behavior change, demand-driven approaches; and also as a recognition of the centrality of the adoption of a new social norm around ending open defecation as a key issue to be addressed, with impact on and linkages with other sectors.
This paper shows that “small-scale” and “low cost” are not necessarily roadblocks for setting up effective farm-based treatment systems. A larger challenge is to understand how best to facilitate any behavior change that requires farmers to adjust their farming practices.
Thirty-seven publications covering 33 studies conducted in 16 countries were selected for this review. Few studies have been done describing the excretal disposal practices of young children at the household level and very few have investigated the relationship of those practices with diarrhea.
Community-managed anaerobic decentralized wastewater treatment systems (DEWATS) offer the possibility of relatively swift sanitation improvements in high priority neighborhoods that communities can manage themselves, where local government does not yet provide a full sanitation service. This review explores Indonesia’s experience in implementing community-managed DEWATS on a growing scale.
Microfinance could be used in two main ways to promote access to sustainable sanitation services: by enabling households to spread out the costs of investing in household sanitation solutions (such as latrines and septic tanks), thereby improving the affordability of such investments and by supporting the development of a broad range of sanitation service providers, including masons, communal toilet block operators, or pit latrine emptiers.
Participatory design offers a methodology for ensuring that users participate in creating and selecting sanitation technologies that are appropriate and affordable for them. It provides an opportunity for users to express their traditional and often hidden knowledge and skills in partnership with designers and researchers.
This study presents findings from a systematic literature review on the effectiveness and impact of CLTS programs. This document was prepared by The Water Institute at UNC for Plan International USA as part of the project Testing CLTS Approaches for Scalability, funded by the Bill & Melinda Gates Foundation.
SanPack distinguishes ten stages in a life-cycle services approach to sanitation:Preparations for programmesCreating sustained demandEnabling informed choicesFacilitating financingProviding supply servicesServices for hygienic useServices for maintenance,...
SanPack contains an overview of available methods, techniques, and tools in a low-cost, non-sewered sanitation service model. The materials have been developed and used by IRC and its long-standing and more recent partners in the South and the North in some 20 countries in Africa, Asia, and Latin America.
The authors identified distinct pathways sufficient to support well-managed school sanitation services. Two of these are applicable to both government and nongovernment schools: (1) quality construction, financial community support, and a champion; and (2) quality construction, financial government support, a maintenance plan, and school management committee involvement. Ongoing financial support for operations and maintenance was also identified as necessary, however, financial support was determined to be insufficient on its own.
CLTS provides an excellent opportunity to facilitate hand washing behavior change. The purpose of this document is to outline several practical tools that can be used as a part of CLTS in order to trigger realization among communities of the importance of hand washing with soap, as well as eliminating open defecation.
This book aims to compile existing and recently generated knowledge on issues of anaerobic digestion of organic solid waste at small and medium-scale with special consideration of low- and middle-income country conditions. The book is divided into two parts: Part 1 focuses on practical information related to anaerobic digestion and biogas production, and Part 2 presents selected case studies from around the world.
In the context of the recent evolution of the sanitation sector, CATS can be seen in two ways: as a move from technically based supply-driven approaches toward behavior change, demand-driven approaches, and also as a recognition that a new social norm around ending open defecation is a key issue to be addressed because of its impacts on and linkages with other sectors (health, education, etc.). CATS successfully contributed to shifting the sanitation sector toward demand-driven rather than directly subsidized approaches. The evaluation shows that CATS has given a new momentum to rural sanitation in the more than 50 countries supported by UNICEF. This new momentum has translated into a change in how rural communities regard sanitation, invest in it, commit to new behaviors around ending open defecation—and eventually improve their living conditions.
The purpose of this study was to explore child defecation and feces management practices in rural Bangladesh with the aim to redesign and pilot a tool to facilitate removal and disposal of feces. Until 3 years of age, a child commonly defecates in the courtyard and occasionally inside the house. A heavy digging hoe was commonly used to remove child feces. Mothers preferred a redesigned “mini-hoe” and found it easier to use for removal and disposal of liquid feces. Promoting modified local tools may contribute to improving environmental sanitation and health.
This study summarizes the main challenges to scaling up access to sustainable sanitation services in the urban areas of three countries in the East Asia and Pacific region—Indonesia, Philippines, and Vietnam—and proposes the main steps these countries need to take to redress the status quo
Given the low willingness to pay for latrines with cash, efforts to sell latrines at market price without any financing mechanism will lead to continued low penetration. The major implication of this study is that offering microfinance loans for latrines will dramatically increase uptake of latrines, while also making distribution significantly cheaper per latrine sold. Large-scale efforts to offer financing packages for latrines should be aggressively pursued in rural Cambodia and have the potential to increase latrine coverage from the current national rural level of 20 percent to 60 percent.
The health benefits and transferability of CLTS remain uncertain, and there are differences of opinion on both the costs and benefits of CLTS, among advocates as well as between advocates and detractors. One can debate whether the no-subsidy policy that many proponents of CLTS adhere to is appropriate, whether the resulting improvements are really sustainable, whether CLTS addresses gender equity, whether eliminating open defecation necessarily results in sufficient health improvements, and whether the “shaming” really conforms to the principles of participatory research or undermines people’s human rights.
Decreases in diarrhea, cholera, and skin infections were the main health outcomes reported in this study. However, methodological weaknesses, including the lack of clarity around the proportions of the population exposed before and after implementation of CLTS to these conditions, made it challenging to determine the quality of the evidence presented. Evidence on impact of CLTS on non-health outcomes was also reported. Improvements in open defecation free/open defecation status, latrines constructed, and access to sanitation were commonly reported. However, none of the studies that reported on these tested the increment/decrease for statistical significance.
The purpose of this study was to investigate public toilet sites in Accra, Ghana, as a delivery model for sanitation in urban Africa. The goal was to articulate the maintenance and management practices of public toilet operators as a way of identifying sanitation delivery challenges and potential strategies for future interventions aimed at expanding sanitation access in Accra. The data suggest that public toilet sites in Accra are largely operating above the break-even point and that the logic of cost recovery is well intact.
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