Improving our programmes for better results

The 3rd regional sanitation and hygiene practitioners workshop held last week (31 Jan-2 Feb 2011) generated many inspiring and animated interactions. And more people have joined the discussions via the Facebook page: http://www.facebook.com/SanHyP

Discussions at the 'Dhaka adda'/ gossip corner 

The overarching workshop themes were equity, monitoring and sustainability. Discussions have touched on a range of  issues and challenges around these themes.

Equity is the principle of fairness. While many poilicies and WASH programmes aim to reach everyone (women and men, rich and poor, social minorities and majority groups) in practice, many people are left behind. Practicing equity and involves recognising that people are different and need different support and resources to ensure that their rights are realized (Shordt, Da Silva Wells, Krukkert 2012).

Questions related to equity included: Are we reaching the poorest and how can we do better? What could be done to improve menstrual hygiene of girls who are not-in-school? How gender sensitive are ecosan toilets? And how do women use them when they menstruate? How to reach out to men?

Building on the conclusions of the 2010 workshop, we examined a number of monitoring methods which monitor performance and use of facilities, not just counting how many 'improved' toilets have been built. 

For sustainability it is crucial that we look beyond construction. Effective hygiene promotion is a key factor for achieving sustained behaviour change. But investments are also needed in ongoing monitoring of toilets and their use, solid and liquid waste disposal at village level, capacity building of local government and local small businesses. The Life Cycle Cost Approach and service levels developed by the WASHCost programme provide a useful framework to analyse spending by government and households on sanitation and the resulting levels of service.

WASHCost research in India, covering more than five thousand households, concludes that capital investments made on sanitation are often going to waste, as the toilets constructed are not being used.  Once pits fill up, people often revert to open defecation. In seven out of the 21 villages studied that were declared 'Open Defecation Free', more than half the population did not use a toilet. Read the full paper 'Looking beyond capital costs - Life-cycle costing for sustainable service delivery' here 

A study in Ghana -Of interest to hygiene practitioners

http://www1.voanews.com/english/news/africa/decapua-ghana-sanitary-protection-1feb10-83245322.html

Menstrual hygiene project (Hindi)

Mariya John Fernandes, Wateraid , was asked to speak again to the whole group on the specific project taken up in Chattisgarh . The project looked at menstrual hygiene beyond simply the production of sanitary napkins. Here is her talk in Hindi this time for a more local audience

http://www.youtube.com/watch?v=5xavHSFuQ8M

Freedom of mobility: experiences from villages in the states of Madhya Pradesh & Chhattisgarh India

Author: Mariya John Fernandes, Wateraid India

Maria discusses the issue of menstrual hygiene and how an experiment in Chattisgarh where women have got together to spread awareness and even make sanitary napkins themselves.

They have also worked towards designing toilets which dispose the napkins with privacy and dignity....using a sanitary pit which bio-degrades

The original paper is here http://www.irc.nl/page/51700

The video of the presentation made by Mariya with the Q and A session is here

Part 1 : http://www.youtube.com/watch?v=hTbAzHFt1t8

Part 2 : http://www.youtube.com/watch?v=x3wPC6ObjZ8

and

Part 3 : http://www.youtube.com/watch?v=OkaBgvVAyoI

Q and A and discussion

Is there a direct causal link established between reproductive tract and urinary tract infection and pond bathing?

Anecdotal evidence but no causal studies. Detailed studies needed.

Since menstrual health is not only about sanitary pads/napkins but also availability, disposal systems, etc etc what are the systemic interventions needed?

Knowledge, awareness, availability of products, disposal mechanisms many things needed . One intervention not enough.

How do we begin?

Let us look at our work places Govt. academia NGO's . Do we provide such facilities? Let us begin the change ourselves. In schools let us make sanitary facilities for availability of products/ disposal facilities and privacy all available. Think comprehensive and think with girls/women.

It was Bangladesh which spurred me to take this up in India.

Social taboos and breaking the silence is crucial. Start policy level debates, look at universal education if girls drop out during adolescence. Policy level debate is very very important. In Nepal also such work has begin.

The sanitary pads in Chattisgarh are bio degradable. They use cow dung and are able to compost it in two to three months.

More knowledge and open discussion including physiology of women...this has to happen.

Ignorance is widely prevalent on what is used to manage menstrual periods. Cloth, straw, ash, mud is all used.

Addressing adolescent girls is crucial.