The primary objective of the Better Waste Management and Disposal for Bolivia (BWMDB) intervention is to reduce the incidence of diarrheal illness among Tomina residents by 20% within four years of program implementation through improved access to basic sanitation.

1. Holly Marie Bevagna
PubH 6132: Global Wash, Sanitation and Hygiene Programs
Introduction
The following proposal formally requests $3,300,084.44 for the implementation of a
public health intervention in Tomina, a rural province in the Chuquisaca Department of Bolivia.
The primary objective of the Better Waste Management and Disposal for Bolivia (BWMDB)
intervention is to reduce the incidence of diarrheal illness among Tomina residents by 20%
within four years of program implementation through improved access to basic sanitation. This
will be accomplished through enhanced community participation in the design of innovative
solutions, construction and installation of sanitation technology, education of the populace about
disease risks and mechanism, and high levels of community and stakeholder engagement. The
requested amount of $3,300,084.44 is based on a thorough appraisal of the geographical,
logistical, social, economic, cultural and political factors specific to Tomina Province that could
potentially affect program implementation.
Background
Officially known as the Plurinational State of Bolivia, Bolivia is one of the poorest
countries in South America, ranking 107th globally with an average per capita income of $911
(Eder et. al, 2012). In rural provinces and towns, this figure is substantially smaller ($150) (Eder
et. al, 2012), highlighting an inequitable distribution of resources throughout the country. In
terms of percentages, this translates to 60% of Bolivians living below the poverty line (Eder et.
al, 2012), much higher than other Latin American countries (World Bank). Due (in part) to the

2. high costs of proper excreta disposal and management, indigent Bolivians sometimes resort to
open defecation, facilitating the transmission and proliferation of enteric and waterborne diseases
via the fecal oral route (Macchioni et. al, 2017). Consequently, the risk of diarrheal illness,
stunting, under-nutrition, intestinal worms, bacterial infection and viral encephalopathy is
significantly higher than that of neighboring countries (Esrey, 1991), such as Argentina, Brazil
and Chile.
Over time, Bolivia has seen significant improvement in sanitation and WASH indicators,
particularly in urban areas. The prevalence of open defecation in Bolivia has decreased
considerably, from 33% in 2000 to 14% in 2015, and the use of limited and at least basic
sanitation services has increased, from 15% in 2000 to 20% in 2015 and from 38% to 53%,
respectively. In terms of improved sanitation facilities, the proportion of the population using
sewage or safely managed wastewater has also risen, with 36% having a sewer connection in
2015, compared to 22% in 2000, and 19% having properly managed wastewater in 2015, as
opposed to 15% in 2000 (Joint Monitoring Program, 2017). These paradigms are mirrored in
both rural and urban settings. Yet, while these improvements are laudable, the proportion of the
Bolivian population with improved sanitation remains considerably lower than that of other
countries. Furthermore, sanitation percentages differ remarkably between rural and urban
settings. In rural settings, only 18% of people had a basic service, whereas 51% of urban
residents enjoyed this form of improved sanitation in 2000. More remarkably still, 63%
practiced open defecation in rural settings compared with only 15% in urban settings (Joint
Monitoring Program, 2017).
The Bolivian government has affirmed its commitment to improving WASH in the
country. In 2009, the legislature enacted the new Constitution of the Bolivian State, which

3. provides that access to clean and safe water is a fundamental right (United Nations Water, 2015).
Subsequently, in 2011, the President of the Plurinational State of Bolivia officially launched the
More-Investment for Drinking-Water Program to meet the Millennium Development Goals
(United Nations Water, 2015). Thanks to this project, the country achieved 81% coverage of
improved drinking sources (United Nations Water, 2015); however, the program had limited
success in improving sanitation, whether by expansion of pre-existing sewage disposal systems,
treatment of wastewater or proper management and storage of excreta. According to an article in
the American Journal of Epidemiology, improving sanitation led to better health outcomes than
improvements in water sources (Esrey, 1996), suggesting that more emphasis needs to be placed
on increasing improved sanitation, rather than improved water.
Education is vital to ensuring the sustainability and effectiveness of WASH
interventions. Poor sanitation is strongly associated with waterborne disease and malnutrition,
particularly in developing countries with inadequate access to appropriate sanitation
infrastructure, such as Bolivia. Still, many people in developing countries are unaware of this
association or do not realize the full health implications of improper excreta disposal. George et.
al found that only a small percentage of study participants identified inadequate sanitation and
contaminated water as etiological factors of malnutrition and diarrheal illness, highlighting a
need for education in future WASH initiatives (George et. al, 2014). Hence, this program will
encompass three essential components: technological development, micro-financing and
educational seminars aimed at promoting behavior change through enlightenment and
motivational enhancement, all of which are recommended by the United Nations Agency for
International Development.
DesiredBehavior

4. A significant percentage of Bolivians (up to 63% in rural settings) still practice open
defecation. This behavior substantially increases the risk of waterborne and enteric diseases,
including helminth infections, cholera, polio, trachoma and typhoid, to name a few. Recurrent
and/or prolonged exposure to these pathogens can result in severe malnutrition (believed to be
due to pathogen-induced inhibition of key digestive enzymes and damage to the intestinal
mucosa), anemia, and intestinal obstruction. Hence, the practice of open defecation inevitably
leads to grave health consequences that can easily be prevented through improved sanitation.
Other behaviors that this intervention seeks to reform are the incorrect use of pit latrines and
inadequate maintenance. Behaviors that this public health intervention will promote and
encourage among community participants include taking precautions to minimize vector
transmission of enteric pathogens (i.e. covering the opening to the pit latrine, closing the
outhouse door and turning off the lights after using the latrine); scheduling needed maintenance
in a timely fashion, emptying the pit latrine when it becomes full and using protective gear
should the need arise to handle excreta.
Behavioral Theory
A review of existing literature indicates that interventions focused solely on the
installation of sanitation technologies typically do not result in sustained change (Water and
Sanitation Program Andean Region). Better Waste Management and Disposal for Bolivia
(BWMDB) is an evidence-based intervention that seeks to improve access to basic sanitation and
reduce open defecation by addressing misperceptions about sanitation; facilitating latrine use
through technological innovation and financial support mechanisms; and informing the masses
about disease prevention. The goal of the program is not to offer a one-size fits all solution to a
pressing public health issue through economic investment and sanitation engineering, but rather

5. to equip community participants with the tools and knowledge they need to collectively tackle a
challenging public health problem. Program planners and implementers will engage stakeholders
throughout the program to engender feelings of program ownership and accountability among
Bolivians. Cultural sensitivity and respect for local traditions, beliefs and values throughout this
process will facilitate trust among study participants and, hopefully, a greater propensity for
behavioral change.
The Information-Motivation-Behavioral (IBM) Skills Model lays the theoretical
foundation for the BWMDB initiative. As its name suggests, the IBM model states that behavior
change is collectively determined by three principle factors: information, motivation and
behavioral skills. Within the context of public health, information is defined as an individual’s
basic knowledge of the etiology, pathogenesis, treatment and/or prevention of disease.
Motivation refers to attitudes and perceptions toward engaging in a certain behavior. Strong
motivators might include subjective norms and perceived social support for a specific behavior.
Lastly, in order for someone to perform a behavior correctly, they must possess the necessary
skills (WHO, 2003). For example, during medical school, aspiring doctors learn to conduct a
proper physical examination. Without adequate training, a layman will not be able to perform
this behavior successfully. The following section describes how the BWMDB intervention will
build on the three tenets of the IBM Skills Model.
The Three Building Blocks of the Intervention
BWMDB will promote information, motivation and behavioral skills as follows:
Information-Some Bolivians are not aware of the role sanitation plays in the prevention of
disease (Water and Sanitation Program). Program facilitators (influential figures and esteemed

6. leaders within the province of Tamara) will inform program participants of the risks associated
with exposure to fecally contaminated water during lightning talks. Community leaders will also
describe the role of sanitation in the prevention of waterborne illness and diarrhea during
knowledge cafés, a familiar and relaxed environment where community members can voice their
opinions, thoughts and concerns about using latrines. Different sanitation technologies and waste
management procedures will be compared and judged for appropriateness, feasibility of
implementation and cost effectiveness.
Motivation-Excreta disposal in Bolivia is a sensitive topic, requiring tact and skillful diplomacy.
Among certain ethnic groups (e.g. the Aymara and Quechua), the earth or Pachamama, is
honored and revered as the source of all life, including humans, plants and animals. Many
Bolivians also consider their home to be sacred place, causing reluctance to use household
toilets. Some even oppose latrine use-since outhouses are “small homes”. Other identified
barriers to basic sanitation in Bolivia include fear of holes, fear of the dark and embarrassment
over using a latrine (Water and Sanitation Program, 2015). One way to offset opposing
ideologies on latrine use is to increase perceived threat (perceived susceptibility and perceived
severity), as well as perceived benefits. An emotional appeal to protect one’s child from harm
may be effective since diarrheal illness affects a significant number of children under the age of
five.
Behavioral skills-The program will increase behavioral skills through preliminary identification
of perceived barriers and benefits and expert advice on how to properly dispose of and manage
human waste. Specifically, program facilitators will demonstrate how to properly use a latrine,
including replacing the cover after use, minimizing exposure to light, reporting defects and

7. scheduling needed maintenance. Furthermore, they will reiterate the dangers posed by open
defecation and act out the consequences of not following public health recommendations.
Pre-existing behavioral interventions and governmental efforts will be determined through
formative research and interviews with key policymakers (data on behavioral interventions is
limited in the literature).
Technology
Consumer markets offer a broad selection of sanitation technologies, including pour-flush
toilets, composting toilets, pit-latrines, septic tanks and sewage pipes. Due to its low capital cost,
the pit latrine is one of the most economically feasible selections. It is particularly ideal for rural
settings like the province of Tomina, Bolivia, where large swaths of land provide ample room for
latrine construction. However, the pit latrine has several disadvantages, among which are the
release of fetid odors and the potential for groundwater contamination (Tilley et. al, 2014). To
reduce said unpleasant odors-as well as prevent the transmission of enteric pathogens by flies-
each pit latrine will be outfitted with a ventilation pipe during installation. In addition, the
latrines will be built far from groundwater sources to prevent environmental contamination.
Bolivia experiences both periods of prolonged drought, which lowers the water table, and
torrential rainfall, which raises the water table (U.S. Army Corps of Engineers). Therefore,
program engineers and public health practitioners will advise community members on the pit
latrines measurements (include depth and distance from surface and ground water sources). The
composition of the soil (i.e. the soil is largely comprised of clay) should limit the percolation of
excrement-contaminated fluid into the groundwater supply (U.S. Army Corps of Engineers).

8. In terms of waste management, a vaccuum truck will collect the human excrement and
transport it to a designated disposal and/or treatment facility. Currently, Bolivia has fourteen
water and sanitation providers, referred to colloquially as “Empresas Prestadores de Servicios de
Agua Potable y Alcantarillado” (EPSA). Collectively, these EPSAS are known as the National
Association of Water and Sewage Companies (ANESAPA), an institution that manages and
governs water and sanitation service providers in department capitals. The closest EPSAS are in
Sucre (approx. 4 hours) and Potosi (approx. 5 hours). While these sanitation facilities are not as
well-regulated as those in the U.S., they provide for some treatment and management of human
excreta through stabilization lagoons (cities of Santa Cruz, Cochabamba, Tarija, Oruro, Trinidad
and El Alto) (SEMAPAR).
Vacuum truck personnel will observe safety precautions to ensure effective management
of waste and prevent illness. All untrained personnel will receive instruction and tested on their
knowledge. Compliance with regulations will be strictly monitored and all personnel found in
noncompliance will be subjected to disciplinary action. Since the cost of waste disposal and
treatment is substantially higher than the capital cost of latrines, program facilitators will
establish micro-financing arrangements on behalf of community residents to pay for pit emptying
and its associated transportation costs.
Private Sector Engagement
This sanitation intervention will use a multifaceted approach to promote, facilitate and enable
private-sector involvement in Bolivia. Program coordinators will liaison with corporations such
as Stafsjö Valves AB and Acrison, Inc (environmental-expert website), and the Bolivian
government to reform policies that constrain and/or undermine the sale, distribution and
marketing of sanitation technology, and reach a compromise on permitted business practices.

9. Additionally, public health specialists will conduct formative and evaluation research on
consumer preferences regarding user interfaces and methods for collection, storage and disposal
of human excrement. This research will be disseminated to private sector stakeholders and
governmental agents at a conference meeting in the 5th month of program implementation,
enabling the private sector to tailor their products to the needs of their consumers and thereby
increase demand for sanitation technologies. This will generate more revenue for private firms
as more people demand their services, creating incentive to partake in the intervention.
Consumer preferences may be based on one or a combination of the following factors:
accessibility, affordability, convenience and acceptability. Since Tomina is one of the poorest
provinces of Bolivia, it is plausible that the cost of implementing and maintaining a sanitation
intervention will be identified by most as a significant deterrent. Therefore, program
management will also partner will microfinance institutions to set up installment plans with
community members and with the private sector to engineer affordable technologies.
Improving the Enabling Environment
The Bolivian Government has made significant strides toward improving sanitation in the
Plurinational State of Bolivia through partnerships with the non-profit international development
organizations, such as Water for People, the United Nations Children’s Fund and international
financial institutions like the World Bank. UNICEF and the World Bank provide technical
assistance and capacity-building expertise to program implementers; support WASH policy
formulation; help to improve service delivery; and in the case of the World Bank, finance WASH
programs through loans (World Bank, UNICEF). On the other hand, Water For People-Bolivia
seeks to improve sanitation through increased consumer demand for sanitation technologies,
such as user interfaces and waste storage systems (Water For People).

10. Despite some progress, however, municipal governments and public utilities (i.e. EPSAS)
have limited technical and administrative capacity, insufficient monetary support and low
awareness of consumer needs and desires (WASH WATCH). Moreover, no comprehensive
water policy exists to regulate the largely privatized water industry in Bolivia and there is hardly
any coordination between governmental agencies (U.S. Army Corps Engineers). Lastly, efforts
have mostly concentrated on urban areas, widening the sanitation gap between urban and rural
regions.
This intervention will collaborate with the Bolivian government to improve logistics by
increasing the number of publicly-owned treatment facilities to allow for safe and effective
management of human excreta. This initial investment will produce more public worker jobs and
facilitate transport of excreta from the latrines to treatment sites, which will lead to decreased
morbidity due to diarrheal and parasitic illness and large economic returns. These economic
returns could serve as a source of general revenue to sustain public health interventions and pay
public health workers. Second, the program will advocate for improved sanitation laws and
policies, particularly policies that define the roles and legal obligations of certain governmental
employees. Clearly defined organizational roles will enhance program implementation and
supply of sanitation technologies. By improving the bureaucratic, legal, political and fiscal
structures in Bolivia, the program will increase the number of Bolivians using improved
sanitation and decrease adverse health outcomes, primarily diarrheal illness.
Learning
A review of the literature on evidence-based WASH interventions indicates that community
engagement is vital to program effectiveness and sustainability. Consequently, this program will employ
severallearning activities to encourage active participation and cultivate teamwork and collaboration.

11. These include workshops, community of practice sessions, lightning talks, knowledge cafes and
brainstorming sessions. Unlike seminars lectures and conferences,community-of-practice sessions have a
more relaxed structure and will allow for the exchange of ideas and sharing of experiences between
community members (World Bank Group). This is important since community members must rely on
each other to keep their community open defecation free long after the intervention. Conversely,
knowledge cafes,facilitator led discussions designed for similar purposes (World Bank Group), will
provide direction and ensure that program participants focus on the task at hand. To promote knowledge
and awareness of sanitation, program facilitators will host a series of lightning talks lasting no more than
7 minutes on risk factors for diarrheal illness, the impact of sanitation on health, the definition of
improved sanitation, the distinction between basic and limited sanitation, and current sanitation
technologies. These talks are intended to convey the most important information on sanitation as briefly
as possible to increase knowledge retention (World Bank Group). In addition to lightning talks,
workshops will be held during the first year to develop analytical thinking skills and build capacity
among community participants and design VIP latrines suitable to the culture, physical environment and
personal preferences of Tomina residents (World Bank Group). Public health experts will moderate
brainstorming sessions during these workshops to generate ideas and guide the design and development
of pit latrines conceived by community members. This will afford community members the opportunity to
claim ownership of the intervention, increasing its sustainability.
Monitoring and evaluation
Program facilitators will use a variety of evaluation techniques to monitor and critically assess the
efficacy of the intervention. Surveys will be conducted prior to and after lightning talks to evaluate
knowledge concerning the impact of sanitation on health. Knowledge of correct latrine use will be further
assessed through demonstrations by select community participants without invading personal privacy
(participants will not be asked to defecate but simply to demonstrate what their normal routine would look
like). Laws and policies will be tracked through government websites and via communication with

12. political stakeholders and the condition of pit latrines at follow-up will be used as a proxy to monitor the
number of micro-financing arrangements. Lastly, participation at community events will be monitored
through attendance sheets and eye-witness accounts. Please refer to the table below for a more exhaustive
list of program indicators.
Development
Goal
Smart Objective Outputs Expected
Outcomes
Verification
To ameliorate
sanitation in
Tomina province
by increasing the
use of ventilated
improved pit
latrines among
residents
Decrease the
incidence of
diarrheal illnessby
20% among
residents of Tomina
province within 4
years of program
implementation
--% of households
with access to
ventilatedpit
latrines
80% of residents
use improved
sanitation facilities
At least 80% of
residents do not
practice open
defecation
-Surveys & Visits to Area
Average numberof
learning activities
attended
Per participant
--All community
members know how
to effectively use a
latrine.
-Post-intervention survey
-Successful demonstrations
Direct observation
Average numberof
workshops
attended per
participant
--At least 75% of
Community
residents are
knowledgeable in
latrine construction
and maintenance
-Select interviews and
questionnaires
-% of latrine pits
emptiedon a
regularbasis
90% of Latrine pits
are well maintained
Inspections of pit latrines
Transportation logs
Balance sheets/financial
statements

13. --# of micro-
financing
arrangements to
community
members
Micro-financing
arrangements are
establishedon
behalf of all
community
members
Audits
Interviews
-# of people who
know theirrole in
the WASH
industry
--There is increased
coordination
between
governmental
actors, NGOs and
the private sector
and clearly defined
roles
-Interviews
# of meetings with
political
stakeholders
Implementation of
WASH related
policies
Records of laws and statutes
enacted

14. References
1. Eder, C., Schooley, J., Fullerton, J., & Murguia, J. (2012). Assessing impact and
sustainability of health, water, and sanitation interventions in Bolivia six years post-
project. Revista Panamericana De Salud Publica, 32(1), 43-48.
2. Draft country programme document for Bolivia (Plurinational State of). (2012). United
Nations Children’s Fund. Retrieved from
https://www.unicef.org/about/execboard/files/Bolivia-2013-2017-final_approved-
English-14Sept2012.pdf
3. Global Analysis and Assessment of Sanitation and Drinking Water in Bolivia. (2015).
UN Water. World Health Organization. Retrieved from
http://www.who.int/water_sanitation_health/monitoring/investments/bolivia-6-jan-
16.pdf?ua=1
4. Institute of Medicine (US) Roundtable on Environmental Health Sciences, Research, and
Medicine. Global Environmental Health: Research Gaps and Barriers for Providing
Sustainable Water, Sanitation, and Hygiene Services: Workshop Summary. Washington
(DC): National Academies Press (US); 2009. 5, Achieving Water and Sanitation Services
for Health in Developing Countries. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK50770/
5. Improved sanitation facilities (% of population with access). (n.d.). Retrieved October 5,
2017, from https://data.worldbank.org/indicator/SH.STA.ACSN
6. Progress on drinking water, sanitation and hygiene: 2017 update and SDG baselines.
(2017). World Health Organization (WHO) and the United Nations Children’s Fund

15. (UNICEF). Retrieved from
http://apps.who.int/iris/bitstream/10665/258617/1/9789241512893-eng.pdf?ua=1
7. Sanitation. (n.d.) Retrieved October 04, 2017, from
https://washdata.org/monitoring/sanitation
8. Improved water and Sanitation Data by country. (n.d.). Retrieved October 07, 2017, from
http://apps.who.int/gho/data/node.main.WSHIMPROVED?lang=en
9. Improving the Rural Water and Sanitation Information Systems in Latin America and the
Caribbean Region. (n.d.). Retrieved October 05, 2017, from
http://www.worldbank.org/en/results/2017/04/04/improving-rural-water-sanitation-
information-systems-latinamerica
10. Macchioni, F., Segundo, H., Totino, V., Gabrielli, S., Rojas, P., Roselli, M., & ...
Cancrini, G. (2016). Intestinal parasitic infections and associated epidemiological drivers
in two rural communities of the Bolivian Chaco. Journal Of Infection In Developing
Countries, 10(9), 1012-1019. doi:10.3855/jidc.7657
11. Esrey, S. A. (03/1996). American journal of epidemiology: Water, waste, and well-being:
A multicountry study. Oxford University Press.
12. Esrey, S. A. (1991). Bulletin of the world health organization: Effects of improved water
supply and sanitation on ascariasis, diarrhoea, dracunculiasis, hookworm infection,
schistosomiasis, and trachoma. World Health Organization.
13. George, C. M., Perin, J., Neiswender de Calani, K. J., Norman, W. R., Perry, H., Davis,
T. J., & Lindquist, E. D. (2014). Risk factors for diarrhea in children under five years of
age residing in peri-urban communities in Cochabamba, Bolivia. The American Journal
Of Tropical Medicine And Hygiene, 91(6), 1190-1196. doi:10.4269/ajtmh.14-0057

16. 14. USAID water development strategy 2013-2018. (2013). Washington, D.C.: U.S. Agency
for International Development.
15. Strategy for Water, Sanitation and Hygiene 2016-2030. (2016). Program Division. United
Nations Children’s Fund. New York. Retrieved from
https://www.unicef.org/wash/files/UNICEF_Strategy_for_WASH_2016-2030.pdf
16. Traffic and Road Conditions in Bolivia. (n.d.). Retrieved November 10, 2017, from
http://www.countryreports.org/travel/Bolivia/traffic.htm
17. SEMAPAR. (n.d.). Retrieved December 1, 2017, from http://www.anesapa.org/empresas-
socias/semapar/
18. 18. Water Resources Assessment of Bolivia. (2004). US Army Corps of Engineers.
Mobile District & Topographic Engineering Center. Retrieved from
http://www.sam.usace.army.mil/Portals/46/docs/military/engineering/docs/WRA/Bolivia/
FINAL%20BOLIVIA%20WRA%20COMBINED%2013%20DEC%202004.pdf
19. (n.d.). Retrieved December 1, 2017, from
http://apps.who.int/medicinedocs/en/d/Js4883e/9.1.4.html
20. (n.d.). An Anthropological view of Sanitation Issues in rural Bolivia. A Summary.
(2015). Water and Sanitation Program Retrieved November 10, 2017, from
https://www.wsp.org/sites/wsp.org/files/publications/2272007102015_ruralboliviaanthro
view.pdf
21. Water and Wastewater Companies near Bolivia. (n.d.). Retrieved November 20, 2017,
from https://www.environmental-expert.com/water-wastewater/companies/near-bolivia
22. (n.d.) Plan de Desarrollo Económico y Social En El Marco de Desarrollo Integral Para
Vivir Bien. 2016-2020. Estado Plurinacional de Bolivia.

17. Lecture materials
23. The Art of Knowledge Exchange- A Result Focused Planning Guide for Development
Practitioners in the Water Sector. World Bank Group.
24. Access to Behavioral and Outcome Indicators for Water, Sanitation and Hygiene. (2010).
USAID. Hygiene Improvement Project
25. Tilley, E., Ulrich, L., Lüthi, C., Reymond, Ph. and Zurbrügg, C., 2014. Compendium
of Sanitation Systems and Technologies. 2nd Revised Edition.
Swiss Federal Institute of Aquatic Science and Technology
(Eawag). Dübendorf, Switzerland.

18. Appendix 1: Budget
Direct Project Expenditures
Personnel Costs
Title
Quantit
y
Annual
Salary FTE
Project
Salary
Fringe
Benefits Unit Cost Total Cost
Program Manager 1 $80,000.00 100% $80,000 $20,000.00 $100,000.00 $100,000.00
Engineers 2 $60,000.00 50% $30,000 $7,500.00 $37,500.00 $75,000.00
Linguist/Cultural Expert 1
$42,000.00
100% $42,000 $10,500.00 $52,500.00 $52,500.00
Program Educator 3 $25,000.00 50% $12,500 $3,125.00 $15,625.00 $46,875.00
SanitationConsultant 1 $45,000.00 50% $22,500 $5,625.00 $28,125.00 $28,125.00
Program Evaluator 1 $40,000.00 100% $40,000 $10,000.00 $50,000.00 $50,000.00
Health Researchers 2 $35,000.00 100% $35,000 $8,750.00 $43,750.00 $87,500.00
Annual total expenditures $262,000 $65,500.00 $327,500.00 $440000
Project total expenditures
(4 years) $1,760,000.00
Capital Expenditures (Hardware)
Item Unit
Quantity
Est. # of
Households Unit Cost Total Cost
Wooden Slabs andTubingfor Pit
Latrines hardware 10000 $36.84 $368,400.00
Ventilation hardware 10000 $20.00 $200,000.00
Outhouses hardware 10000 $26.32 $263,200.00
Capital Investment $831,600.00
Program Activity Expenditures
Constructionof Outhouses self-installation 38,000 $0.00 $0.00
Installationof wet latrines self-installation 38,000 $0.00 $0.00
Printedsanitationdiagrams/posters reminder prompts 38,000 $0.50 $19,000.00
Workshopmaterials brochures 38,000 $0.20 $7,600.00
Total Expenditures $26,600.00
Indirect Project Expenditures
Administrative Costs $678,034.44
Air Travel $3,850.00
Subtotal 681,884.44
Total Project Expenditure $3,300,084.44

19. Appendix 2: Work Plan
Task Responsibili
ty
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Conduct
Formative
Research
Health
Researchers
Disseminate
findings
Program
Manager
Hire
Personnel
Program
Manager
Develop
educational
materials
Program
Educators
Conduct pilot
study
Program
Evaluators
19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36
Analyze
Results
Program
Evaluator
Engage the
community of
Tomina
Program
Manager &
Linguist
Implement
learning
activities
Health
Educators &
Linguist
Host
sanitation
workshops
Engineers &
Program
Educators
Procurement
of raw
materials
Program
Manager
Assist in the
construction
of pit latrines
Engineers
Contract with
Wastewater
Treatment
Facility
Program
Manager
Makemicro-
financing
arrangements
Program
Manager
Develop a
maintenance
plan
Sanitation
Consultant
& Program
Manager
Conduct
process eval
Program
Evaluator
37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54
Assist in the
construction
of pit latrines
Engineers
Collect end
line data
Program
Evaluator
Analyzedata Evaluator
Publish
Report
Program
Manager
Disseminate
findings
Program
Manager