Why are support mechanisms in rural sanitation programming important?

01 November 2019

In this blog I give recommendations for introducing additional support mechanisms into rural sanitation programming. It includes some great case studies from Vietnam, Zambia and Tanzania where support mechanisms have been successfully combined with community-led processes to support the most disadvantaged people gain access to sanitation facilities. This newsletter is largely inspired by the recent edition of Frontiers: Support Mechanisms to strengthen equality and non-discrimination in rural sanitation (part 2 of 2).

Support mechanisms: what are we talking about?

Support mechanisms encompass both ‘hardware’ mechanisms (for example, financial and physical subsidies) and ‘software’ approaches (for example, inclusive sanitation training, research or policies), as well as various combinations of the two.

(Adapted from ISF-UTS and SNV 2018, WASHPaLS 2018, and Willets and Powell 2016.)

How do support mechanisms strengthen community-led processes?

Sustainable sanitation is a human right, therefore everyone should have equal and safe access to adequate sanitation and hygiene. The need to include support mechanisms into programming has grown stronger given recent evidence that in some circumstances disadvantaged households have been found to be more likely to revert to open defecation or fail to build and use a good quality latrine in the first place.

The first half of this two-part series, Frontiers: Equality and non-discrimination in sanitation programming at scale (part 1 of 2), builds on learning from the Global Sanitation Funds Equity and Non-Discrimination study. It highlights the challenges CLTS faces if it does not actively involve and consider the most disadvantaged and suggests good practices that would strengthen processes to benefit all.

Why are learning processes vital to successful support mechanisms?

Although targeted support for disadvantaged people is valuable, the evidence base on what works and what doesn’t is not as strong as it could be. Effective monitoring, evaluation and knowledge sharing processes are key to building this evidence base.These processes also help tailor programmes to better fit their contexts and ensure that the right combination of support mechanisms are in place, that hardware or financial subsidies aren’t undermining demand creation and that outcomes are sustainable over the long-term. Having a stronger and accessible evidence base will ultimately help to scale up successful support mechanisms.

What do successful support mechanisms look like in practice?

Case study one: Community Hygiene Output-Based Aid (CHOBA) in rural Vietnam (2012-1016)

This programme was designed by East Meets West (an international non-governemental organisation (INGO)) to follow an Output-Based Aid (OBA) approach to accelerate household ownership of hygienic latrines. This approach generally works by providing a cash reward for results that have been checked and verified. In this programme a key support mechanism was the provision of a cash rebate for those in the target population who had installed a hygienic latrine that had been confirmed by an independent verification agency. The poorest 40 per cent of the population were targeted with this support mechanism (alongside a mix of other mechanisms) to help the programme have greater impact. As a result, 113,500 latrines were built by the target population of 125,000.

Combination of support mechanisms used: Alongside the cash rebate outlined above, East Meets West also gave a Conditional Cash Transfer (CCT) to communes that achieved a 30 per cent increase in sanitation coverage over the baseline, and another CCT if they achieved 95 per cent sanitation coverage. The programme further supported the training of local masons to construct latrines and engaged the Vietnam Women’s Union to promote latrine ownership and good hygiene, assist poor households with accessing loans, and coordinate trainings for local masons. Commune People’s Committees (local government body) were also engaged to provide political and administrative support. The Vietnam Women’s Union and the Commune People’s Committees were given cash incentives for each latrine constructed by a poor household.

Key reflections/lessons:

  • The cash rebate for the poorest was found to be a more effective mechanism for increasing latrine ownership among the poor than the CCT or a separate sanitation marketing intervention.
  • The programme was effective at reaching households experiencing hardship but did not reach all poor households equally. This may be because the rebate amount was still insufficient for some of the poorest households to afford a latrine, and because the poorest households faced barriers in accessing informal and formal sources of credit to purchase the latrine in the first place.
  • The creation of a robust and comprehensive Monitoring and Evaluation (M&E) database was critical to the success of the programme and is an important component of any OBA approach.
  • Rigorous research was important to demonstrate the impact of the support mechanisms, but challenges with implementation of the study arose.

Read more about the research and planning involved in establishing this programme along with initial impacts, in this discussion paper written half way through the programme. The project completion report synthesises lessons learned from the implementation of CHOBA. And this independent verification report looks at the support mechanisms and verification processes used in the CHOBA programme and why they were so effective.

Case study two: Sustainable Sanitation and Hygiene for All (SSH4A) – Zambia and Tanzania

The SSH4A programme implemented by SNV ran between 2014-2017 and targeted four districts in the Northern Province of Zambia, and five districts across the Lake and Northern zones in Tanzania. As SNV had implemented SSH4A in other countries for nearly a decade, this programme was well informed from the start. It focused on districtwide sanitation outcomes and long-term engagement to sustain sanitation and hygiene behaviour change. In both countries programmes focused on districts that had relatively low rates of sanitation coverage and received limited support during recent national level sanitation campaigns. Within districts, the poorest quintile, female-led households and people with disabilities were identified as vulnerable by formative research studies.

Combination of support mechanisms used:
In Zambia, support mechanism activities included community champions advising households on latrines that meet government standards during CLTS triggering sessions. Sanitation marketing groups were also developed to pool financial resources at the village level to purchase latrine materials in bulk, thus lowering costs for poorer groups. And behaviour change messages were customised through formative research and tailored for specific audiences e.g. poorest quintile, female-headed households.

Tanzania also had multiple support mechanism activities, including, the support of local leaders to deliver sanitation behaviour change messages that were tailored for specific audiences e.g. female-headed households, households with people with disabilities. Local business entrepreneurs were supported to market and construct low-cost durable latrines and upgrades to basic latrines. Also, booklets were distributed to help households make informed decisions about inclusive sanitation designs for people with disabilities.

As a result, in Zambia, open defecation across the districts fell from 50 to 5 per cent overall and in Tanzania it fell from 36 to 2 per cent for all households.

Key reflections/lessons:

  • Achieving area-wide sanitation requires substantial effort and resources to be spent on disadvantaged groups relative to other groups, from the outset of the programme.
  • Focused studies on identifying vulnerable groups in collaboration with local government and civil society was key for targeting support and disaggregating data to monitor progress.
  • It is important to be realistic and realise that addressing systemic issues of disadvantage takes time and some barriers cannot be removed in the short-term.
  • There is tension between tailoring support to local contexts while keeping support standardised enough to efficiently go to scale.

Read more about these two programmes support mechanisms and the impact they had here: Tanzania Endline brief; Zambia Endline Brief. You can also read more about these two programmes alongside other SSH4A programmes in Bhutan, Nepal and Cambodia, in this SNV comparative study of approaches to Leaving No One Behind.

Looking for practical recommendations?

This recent edition of Frontiers: Support Mechanisms to strengthen equality and non-discrimination in rural sanitation (part 2 of 2) provides five steps to success when setting up your programme:

  • Step 1: Define ‘what success looks like’ for your programme in terms of equality and inclusion aims and objectives.
  • Step 2: Plan strategies for identifying which people might need support.
  • Step 3: Apply a combination of support mechanisms.
  • Step 4: Set up monitoring systems that track progress towards objectives.
  • Step 5: Set up processes for knowledge sharing and learning.

(This is the second half of a two-part series. The first half is Frontiers: Equality and non-discrimination in sanitation programming at scale (part 1 of 2))

You can also listen to this recent webinar (1hr 26mins) by the authors of the Frontiers mentioned above, Dr. Jeremy Kohlitz and Professor Juliet Willetts. They talk about different types of mechanisms, how they can be adapted, how to monitor and share findings, general recommendations for practice as well as answering specific questions from the audience.

Your thoughts please!

Are you using support mechanisms in your work? Or maybe thinking about it? We would love to hear from you! Tell us about the issues you face, approaches you’ve used (or plan to use), successes you’ve had and the questions that you are grappling with. It would be great to open up a discussion!

This blog was written by Elaine Mercer, The Sanitation Learning Hub, IDS