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Results from the Hygiene Cost Effectiveness study in Burkina Faso
 

Results from the Hygiene Cost Effectiveness study in Burkina Faso

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By Juste Hermann Nansi, IRC Burkina Faso. IRC International Water and Sanitation Centre. ...

By Juste Hermann Nansi, IRC Burkina Faso. IRC International Water and Sanitation Centre.
Prepared for the Monitoring Sustainable WASH Service Delivery Symposium, 9 - 11 April 2013, Addis Ababa, Ethiopia

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    Results from the Hygiene Cost Effectiveness study in Burkina Faso Results from the Hygiene Cost Effectiveness study in Burkina Faso Presentation Transcript

    • Results from theHygiene Cost Effectivenessstudy in Burkina FasoJuste Hermann Nansi IRC International Water and Sanitation Centre
    • Hygiene cost effectiveness study in Burkina Faso, Juste NANSI Outline • Context • Limitations • Results • Next steps Monitoring Sustainable WASH Service Delivery Symposium
    • Hygiene cost effectiveness study in Burkina Faso, Juste NANSI Context of the HCE methodology application in Burkina Faso Monitoring Sustainable WASH Service Delivery Symposium
    • Hygiene cost effectiveness study in Burkina Faso, Juste NANSI SaniFaso• Four-year rural household sanitation programme running from 2010-2014• Application of National H&S strategy toward MDG in 12 districts• 3 millions Euros budget co-funded by EU• Aiming to improve H&S for 16 000 households by supporting services management by local authorities, subsidising construction of improved latrines and hygiene promotion (combining CLTS and SARAR/PHAST)• Implemented in consortium: Eau Vive, GIZ, Helvetas, IRC and WaterAid. Monitoring Sustainable WASH Service Delivery Symposium
    • Hygiene cost effectiveness study in Burkina Faso, Juste NANSI Hygiene Cost / Effectiveness evaluation within SaniFaso Monitoring Sustainable WASH Service Delivery Symposium
    • Hygiene cost effectiveness study in Burkina Faso, Juste NANSI HCE within SaniFaso CLTS CLTS CLTS CLTS CLTS CLTS workshop inin workshop workshop 1 1 in workshop in workshop 2 2 in workshop in Ladiana Ladiana Ouahabou Ouahabou Ouahabou Ouahabou Home visits inin Ladiana and Ouahabou Home visits Ladiana and Ouahabou Home visits (continuing) Home visits (continuing) November 2011 February 2012 May 2012 November 2012 • Household costs • Project costs • Household costs • Household behavioural data • Household behavioural data Monitoring Sustainable WASH Service Delivery Symposium
    • Hygiene cost effectiveness study in Burkina Faso, Juste NANSI Limitations of the HCE study Monitoring Sustainable WASH Service Delivery Symposium
    • Hygiene cost effectiveness study in Burkina Faso, Juste NANSIAbout some assumptions• This study does not capture information about where hand washing water comes from (supposed to be clean while this is often not the case).• Behaviour is dependent on specific equipment e.g. a family latrine is a necessary condition for hygienic HH sanitation. This approach rules out other scenarios that could be considered as hygienic behaviour: for example, burying faeces or using public latrines which are better than open defecation. Monitoring Sustainable WASH Service Delivery Symposium
    • Hygiene cost effectiveness study in Burkina Faso, Juste NANSIAbout collected data• Data on household expenditures are very limited: do not take into account in kind expenditures or sums spent on accessing water from an improved source• Data on external expenditures do not take into account expenditure for direct support which are very important in hygiene promotion activities e.g SaniFaso staff costs or support given by public health authorities that are involved in the promotion of hygienic behaviour Monitoring Sustainable WASH Service Delivery Symposium
    • Hygiene cost effectiveness study in Burkina Faso, Juste NANSI Result of the HCE study Monitoring Sustainable WASH Service Delivery Symposium
    • Hygiene cost effectiveness study in Burkina Faso, Juste NANSI Effectiveness of SaniFaso on faecal containment and latrine use in Ouahabou• High effectiveness with 28 HH (from 1 in 2011 to 29 in 2012 owning and using an improved latrine)• Basic effectiveness with 6 HH (from 0 to 6)• Limited effectiveness with 11 HH (from 0 to 11)• Slight but Positive change (822 HH), taking into account that: – Not all households had already been covered by home visits of hygiene workers or given opportunity of subsidized latrine – Most of those able to finance themselves an improved latrine need more than one year from decision to action. Monitoring Sustainable WASH Service Delivery Symposium
    • Hygiene cost effectiveness study in Burkina Faso, Juste NANSIEffectiveness of SaniFaso on domestic watermanagement in Ouahabou• 35 additional HH always use improved water sources and collect water with appropriate containers (from 446 to 481)• High effectiveness with 10 HH (from 109 in 2011 to 119 in 2012 with adequate behavior of domestic water management i.e. previous criteria + appropriate drawn)• Little but Positive change (822 HH), taking into account that: – Not all households have already been covered by home visits of hygiene workers – All costs related to this behavior improvement are paid by HH, no subsidies. Monitoring Sustainable WASH Service Delivery Symposium
    • Hygiene cost effectiveness study in Burkina Faso, Juste NANSIEffectiveness of SaniFaso on hand washingwith soap at critical times in Ladiana• All the HH already had hand washing facility in 2011, no change in 2012• From 2% of HH with good behaviors in 2011 to 0% in 2012• Surprising observations that need to be shared and discussed with local stakeholders for better understanding and appropriate adjustments in hygiene promotion activities Monitoring Sustainable WASH Service Delivery Symposium
    • Hygiene cost effectiveness study in Burkina Faso, Juste NANSICosts of hygiene behaviour changes in Ladiana andOuahabou from 2011 to 2012 Ouahabou (822 HH) Ladiana (271 HH) HH with good Nov. 2011 Nov. 2012 Nov. 2011 Nov. 2012 behaviour Faecal containment 1 29 (+3.4%) 0 3 (+1.1%) and latrine use Hand washing 26 59 (+4%) 15 5 (-3.7%) Domestic water 109 119 (+1.2%) 4 8 (+1.5%) management SaniFaso hygiene 841 USD 1090 USD promotion costs 1 USD per HH 4 USD per HH 23 USD / 5.11 USD / HH latrine CapEx Not available Not available latrine latrine 0.75 USD / 0.75 USD / HH latrine OpEx 1 USD/ latrine Not available latrine latrine HH hand washing 4.18 USD / 4.5 USD / 3 USD / 2.55 USD / OpEx month month month month Monitoring Sustainable WASH Service Delivery Symposium
    • Hygiene cost effectiveness study in Burkina Faso, Juste NANSISome analysis around Costs and Hygienebehaviour changes• While the target groups of hygiene promotion activities are HH, the observed expenditures per village are not proportional to the number of HH targeted• But surprisingly comparing Ladiana to Ouahabou, higher external investment per HH doesn’t induce better effectiveness thus there is an urgent need to reflect on what happened in Ladiana• Lack of external investment in water induce very limited improvement in domestic water management behavior• Visibly, higher HH investments lead to better effectiveness of hygiene promotion activities• Confirm necessity to track costs/effectiveness to improve hygiene interventions Monitoring Sustainable WASH Service Delivery Symposium
    • Hygiene cost effectiveness study in Burkina Faso, Juste NANSI Next steps… Monitoring Sustainable WASH Service Delivery Symposium
    • Hygiene cost effectiveness study in Burkina Faso, Juste NANSIFrom project evaluation to service monitoring• Improving SaniFaso hygiene promotion activities based on the results of the HCE study• Improving and adapting HCE methodology for local authority-led regular hygiene services monitoring to improve decisions/actions• Enable the embedding of HCE methodology in national hygiene interventions monitoring framework Monitoring Sustainable WASH Service Delivery Symposium
    • Barka!Juste Hermann NANSI / IRC