Developing and monitoring protocol for the elamination of open defecation…
Developing and Monitoring Protocol for the Elimination of Open Defecation in Sub-Saharan Africa Ann Thomas, UNICEF ESARO Jane Bevan UNICEF WCARO IRC 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 SSA3/16
Total Sanitation - CLTS 6 ODF Population in WCAR – mid 2012 5.3CLTS is the key model for scaling up sanitation 5in SSA 4Results at Scale: the number of people who 3.8 Population - Millionshave achieved ODF status has increasedalmost exponentially since CLTS was 3introduced 2 2 CATS/CLTS is now recognised as a ‘Headline Corporate Priority’ 1 in UNICEF 0.7 0.9 0.3 0 Jul-09 Jan-10 Aug-10 Feb-11 Sep-11 Apr-12 Oct-1
ODF programming and protocol across SSA22% practice OD~40% use Ethiopiaunimproved or ODF Popnshared latrines 2,042,735 Somalia Newly establishedOver 10 million ODF programming and protocolODF in SSA Nigeria ODF Population Kenya 2013 1,944,144 ODF Popn 950,000 Newly ODF Population Zambia 2015 1 – 100,000 ODF Popn 512,300 100,001 –500,000 Malawi 2014 500,001 – 1000000 ODF Popn 450,000 1,000,000 + Madagascar 2018 Namibia ODF 2017 ODF Popn 227,507 Countries with ODF Protocol ODF village here Zimbabwe 2017
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?Which indicators will Who is responsible Monitoringbe monitored: Feces in What are the key for verifying the schedule, indicatthe behavior change claim and how ors ofenvironment, HWWS, d activities/are (paper relapse, etc.isposal of children’s they working? audit, visit,etc.) ? Links tofeces SanMark/ enhanced ODF Facilitator status quality Definition Post ODF Baseline Triggering Reporting Verification Certification Monitoring of ODFWhich Who reports initial Reward or Who certifies? Recognitioncommunities, what is ODF Recognition?the baseline achievement, how andbehavior, usage? to who?
Key considerations 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 Monitoring What kind of ongoing support and monitoring is Schedule or Links to needed in the community? upgrading/SanMark Who can provide this over the long term? programming Second tier ODF Status ++ 5. Coordination & data At the national and state level, what kind of coordination and information management system15/16 is needed?
Ethiopia Somalia Malawi ZambiaYellow flag: Yellow flag (ODF) ODF 1 No sign of open50 % of HHs use covered latrines No sign o f OD. Every hh uses a defecation.50% Institutional latrines (gender) latrine with All use a latrine (shared privacy. Each household ok) has/uses a latrine.Green flag (ODF 1) No evidence of100% usage of covered latrines Latrine is well located shit in the bush. The latrines have:100% institutional latrine coverage and covered. ODF 2 o A superstructureWhite flag (ODF 2) Proper disposal of Every hh uses a providing privacy children’s faeces. latrine with a100% latrines in use/hwws facilities cover + hwws o A smooth floorSafe water handling practices. Green flag (Post ODF 1): facilities.Communal latrines + hwws 100% use of latrines. o A coverfacilities Latrines with HWWS All institutionsWater source/s well protected. facilities. have latrines 4. Each household Schools/Health centres. with covers and latrine has a hand-Red flag: Relapsed community. Safe storage/handling of hwws facilities. washing device with water. water and soap/ash White (Post ODF 2): San/hygiene committee. Environmental hygiene and sanitation.
Ethiopia CLTSH IndicatorsI. Open Defecation-Free Status Household (HH), 1 No open defecation practice No observed fresh faeces institutions and transect walk Availability of latrines meeting minimum HH, communal areas 2 Availability of latrines standards1 institutions and transect walk HH, communal areas and 3 Cover for latrine drop-hole Safe cover on latrine hole institutions Faeces in pit, visible access, latrine 4 Latrines in use maintained, presence of spider webs HH, communal and institutions Separate blocks or rooms for Separate rooms or clearly marked male/female 5 males and females HH, communal and facilities institutionsII. Safe Handwashing Practice Handwashing facilities (HWF) Existence and functionality of the facility HH, institutions, communal 1 attached/adjacent to latrines 2 Availability of water in the Availability of at least 3-5 litter water HH, institutions, communal HWF Splashed water, no algae or spider webs, no dust 3 Handwashing facility in use on the handle of the unit HH, institutions, communal Availability of soap or soap Presence near HWF HH, institutions, communal 4 substitute within 3 meters of handwashing facility
Kenya Malawi Somalia (Puntland)Verification Third party Two stages of ODF. Four month delay betweenand certification as part verification andCertification of the process of certification. Third party validating ODF verification. claims (although expensive).Recognition Celebration. Recognition via Media attention, certificate signboards, media, etc. billboard.Post ODF Linked with Conducted by HSAs. Requirement forMonitoring SanMark activities. Linked with SanMark communities to develop a activities. POST ODF Sustainability plan that includes improved latrines, training, leadership etc. Overseen by district officials, linked to cleaning days.
Process Indicators - Madagascar Testimonies from the 2: At least one female confirms the OpenCommunity Women Defecation eradicationtestimonials 0: The selected female(s) are unable to confirm the eradication of open defecation Testimonies from the 2: Children confirm the eradication of Open Children Defecation 0: No child is able to confirm the eradication of open defecation Testimonies from the 2: Community leaders can confirm the eradication Community’s Leaders of open defecation 0: Community Leader(s) cannot confirm the eradication of open defecationQuality of Natural Natural Leader(s) make 3: At least once per weekLeader facilitation regular latrine inspection 2: Once every two weeks(question the Natural visits 1: Once per weekLeaders and review 0: Natural Leaders have never visited latrinestheir evaluation data)Community By- By-laws exist deterring Open 2: By-laws existlaws/Sanctions for Defecation 0: Sanction do not existOD
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 andoutput indicators• Focus on recognition notrewards.
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.