Developing and Monitoring Protocol for the Elimination of Open Defecation in Sub-Saharan Africa

Ann Thomas, UNICEF ESARO Jane Bevan UNICEF WCAROIRC WASH Symposium, April 2013

Objectives of this presentation:

• Review variation in ODF programming and monitoring frameworks across SSA.

• What is a protocol and why develop one?

• Key considerations

• Best practice from SSA

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Total Sanitation - CLTS

CLTS is the key model for scaling up sanitation in SSA

Results at Scale: the number of people who have achieved ODF status has increased almost exponentially since CLTS was introduced

CATS/CLTS is now recognised as a ‘Headline Corporate Priority’

in UNICEF

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ODF Population in WCAR– mid 2012

ODF programming and protocol across SSA

EthiopiaODF Popn 2,042,735

Kenya 2013ODF Popn 950,000

Malawi 2014ODF Popn 450,000

NigeriaODF Population

1,944,144

Newly ODF Population

1 – 100,000

100,001 –500,000

500,001 – 1000000

1,000,000 +

Countries with ODF Protocol

Madagascar 2018ODF Popn 227,507

SomaliaNewly established ODF programming

and protocol

ODF villagehere

Namibia ODF 2017

Zambia 2015ODF Popn 512,300

Zimbabwe 2017

22% practice OD

~40% use unimproved or shared latrines

Over 10 million ODF in SSA

Why ODF Protocol?• “an accepted or established code of procedure”…

usually a national level document

• Validation of the national CLTS strategy as part of the larger sector strategy.

• Harmonizing approaches nationally-streamline processes , agree on key programming principles and philosophy across the sector i.e. subsidies, rewards, recognition, definition, etc.

• Step toward improved sanitation and other outcomes - as part of a broader sector strategy.

• Opportunity to link monitoring to sustainability at various steps.

What is an ODF Protocol?

Definition of ODF

Baseline Triggering Reporting Verification CertificationPost ODF Monitoring

Which indicators will be monitored: Feces in the environment, HWWS, disposal of children’s feces

Which communities, what is the baseline behavior, usage?

What are the key behavior change activities/are they working?

Who reports initial ODF achievement, how and to who?

Who is responsible for verifying the claim and how (paper audit, visit,etc.) ?

Who certifies? Recognition?

Monitoring schedule, indicators of relapse, etc.

Reward orRecognition

Links to SanMark/

enhanced ODF statusFacilitator

quality

Key considerations

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Step Key Questions

1. Defining Open Defecation - Is open defecation simply safe disposal of feces or should it include HWWS and/or more? What about latrine quality and features?

2. Reporting & Verification What roles should community/local leaders/NGOs play (i.e. peer reviews, audits)?What type of delay can be programmed between the steps (i.e. between verification and recognition/celebration of ODF?)

2. Rewards and recognition Providing a monetary award to a community that achieves ODF vs. Recognizing district officials who’s districts are ODF.

4. Post ODF MonitoringSchedule or Links to upgrading/SanMark programming

What kind of ongoing support and monitoring is needed in the community?Who can provide this over the long term?Second tier ODF Status ++

5. Coordination & data At the national and state level, what kind of coordination and information management system is needed?

Ethiopia Somalia Malawi Zambia

Yellow flag:

50 % of HHs use covered latrines

50% Institutional latrines (gender)

Green flag (ODF 1)

100% usage of covered latrines

100% institutional latrine coverage

White flag (ODF 2)

100% latrines in use/hwws facilities

Safe water handling practices.

Communal latrines + hwws

facilities

Water source/s well protected.

Red flag: Relapsed community.

Yellow flag (ODF) No sign o f OD.

All use a latrine (shared ok)

Latrine is well located and covered.

Proper disposal of children’s faeces.

Green flag (Post ODF 1):100% use of latrines.Latrines with HWWS facilities. Schools/Health centres.Safe storage/handling of water.

White (Post ODF 2): San/hygiene committee.Environmental hygiene and sanitation.

ODF 1Every hh uses a latrine with privacy.

No evidence of shit in the bush.

ODF 2Every hh uses a latrine with a cover + hwws facilities.

All institutions have latrines with covers and hwws facilities.

No sign of open defecation.

Each household has/uses a latrine.

The latrines have:

o A superstructure providing privacy

o A smooth floor

o A cover

4. Each household latrine has a hand-washing device with water and soap/ash

Ethiopia CLTSH IndicatorsI. Open Defecation-Free Status

1 No open defecation practice No observed fresh faecesHousehold (HH), institutions and transectwalk

2 Availability of latrinesAvailability of latrines meeting minimum standards1

HH, communal areas institutions and transectwalk

3 Cover for latrine drop-hole Safe cover on latrine holeHH, communal areas and institutions

4 Latrines in useFaeces in pit, visible access, latrine maintained, presence of spider webs HH, communal and

institutions

5Separate blocks or rooms for males and females Separate rooms or clearly marked male/female

facilitiesHH, communal and

institutions

II. Safe Handwashing Practice

1Handwashing facilities (HWF)

attached/adjacent to latrines

Existence and functionality of the facility HH, institutions, communal

2 Availability of water in theHWF Availability of at least 3-5 litter water HH, institutions, communal

3 Handwashing facility in useSplashed water, no algae or spider webs, no duston the handle of the unit HH, institutions, communal

4Availability of soap or soap

substitute within 3 meters of

handwashing facility

Presence near HWF HH, institutions, communal

Kenya Malawi Somalia (Puntland)

Verification and Certification

Third party certification as part of the process of validating ODF claims (although expensive).

Two stages of ODF. Four month delay between verification and certification. Third party verification.

Recognition Celebration. Recognition via signboards, media, etc.

Media attention, certificate billboard.

Post ODF Monitoring

Linked with SanMark activities.

Conducted by HSAs. Linked with SanMark activities.

Requirement for communities to develop a POST ODF Sustainability plan that includes improved latrines, training, leadership etc. Overseen by district officials, linked to cleaning days.

Process Indicators - MadagascarCommunity

testimonials

Testimonies from the

Women

2: At least one female confirms the Open

Defecation eradication

0: The selected female(s) are unable to confirm the

eradication of open defecation

Testimonies from the

Children

2: Children confirm the eradication of Open

Defecation

0: No child is able to confirm the eradication of

open defecation

Testimonies from the

Community’s Leaders

2: Community leaders can confirm the eradication

of open defecation

0: Community Leader(s) cannot confirm the

eradication of open defecation

Quality of Natural

Leader facilitation

(question the Natural

Leaders and review

their evaluation data)

Natural Leader(s) make

regular latrine inspection

visits

3: At least once per week

2: Once every two weeks

1: Once per week

0: Natural Leaders have never visited latrines

Community By-

laws/Sanctions for

OD

By-laws exist deterring Open

Defecation

2: By-laws exist

0: Sanction do not exist

Lessons from country

experiences• Leverage ODF protocol development for outcomes beyond ODF

- hwws, disposal of children’s feces, environment.

• Develop second tier ODF

• Develop one coherent protocol for the national sanitation sector.

• Include both process and

output indicators

• Focus on recognition not

rewards.

Lessons from country experience

• Include deliberate timelags and outcomes beyond ODF.

• Consider the certification and sustaining of ODF as the chief outcome, not initial ODF reporting.

• Consider, include and budget for follow up visits/continued monitoring.

“Pas de defecation ouverte dans la brusse!”Des enfants à Kailahun devant leur latrine scolaire ATPC. © UNICEF/MUWODA 2010

Thanks! !