Change that lasts: access to sanitation and hygiene for all

For his whole life, senior citizen Ujarnath Chaudhari from Nepal’s Saptari district had never laid eyes on a toilet before and thus had no idea what it might be used for. But through SNV’s Sustainable Sanitation & Hygiene for All Results programme, he has become both a proud toilet owner and an inspiration to his fellow villagers – proving change can come at any stage of life!

In partnership with DFID, the Sustainable Sanitation & Hygiene for All (SSH4A) programme is working to enable access to improved sanitation and hygiene for over 4 million people across Asia and Sub-Saharan Africa from 2014-2017, benefitting not only communities, but whole countries. “Access to sanitation and hygiene is a human right,” says Anne Mutta – SNV’s SSH4A Results Programme Leader. “Too often though, sanitation is not given enough prominence, even though it has huge potential to turn around people’s lives if we put proper focus on it and people practice safe hygiene.”

“One of the aspects of the SSH4A Results programme is that it creates awareness in terms of ensuring that communities understand how they can solve some of the issues that they are facing in relation to bad sanitation and hygiene,” Anne Mutta explains. “The solutions are doable, accessible for rural people and relatively low-cost compared to other things we do in terms of promoting good health practices in communities.” In a report from 2012 on the global costs and benefits of drinking water supply and sanitation interventions, the World Health Organization estimates that the lack of access to sanitation costs the world an estimated US$260 billion annually. “From a government perspective, an investment in sanitation and hygiene could thus have huge value for money because it is crucial to so many public health issues, such as diarrheal diseases and nutrition status.”

As well as enabling access to improved sanitation (meaning a toilet that actually protects public health by separating human waste from human contact) for over 1.9 million people so far, SSH4A Results has reached almost 5.8 million people with hygiene promotion activities, such as hand washing with soap. This is more than double initial targets. But it’s not just the scale of the programme that is making waves, it is also the focus on sustainability.

The SSH4A approach has proven to be effective in achieving sustained sanitation and hygiene practices at household level through integrating best practices in sanitation demand creation, strengthening of sanitation markets, implementing hygiene behavioural change communication , governance, and gender and social inclusion. Moreover, it builds capacity of local governments, local implementing organisations and private sector, resulting in long lasting institutional changes and sustained changes in local work processes.

SSH4A is a Payment by Results (PbR) programme which implies that SNV only gets reimbursed by DFID after results on the ground have been validated by independent, external assessors – thereby also making our impact more tangible. PbR is a relatively new form of financing for the WASH sector, but SSH4A Results is proving it can work – with stringent verification requirements strengthening the programme’s monitoring and evaluation systems and the flexibility of financing enabling us to determine how best to mobilise our resources and activities in order to achieve the results we committed to.

“One of our strengths is our on-the-ground experience,” says Anne. “We are using internationally validated approaches, but these can be adjusted to meet the specific needs of each country context. New learning is constantly being generated in each country, and the scale of the programme means some of that is applicable across other countries.” But change has to come from within, and ultimately SSH4A Results is about supporting local governments to empower their people to take charge of their own sanitation situation – and to maintain the behaviours that lead to healthier, happier communities.

SNV supports health workers to provide technical information and advice on different toilet options and works with entrepreneurs to develop the sanitation supply chain. However, we do not promote one single latrine model, rather we ensure that people can make an informed choice for a design that suits their situation. “Once they understand the need for change,” says Anne, “I am often impressed by people’s abilities to come up with their own creative solutions.” From using locally available construction materials, to working together as families and communities to build sanitation and hygiene facilities, to adapting latrine and handwashing station designs to meet their own needs, it is this commitment to taking charge of their own sanitation situation that enables communities to achieve lasting change.

In the early stages of the programme intervention, Ujarnath Chaudhari was not an exception in showing his reluctance to build his own toilet. But now he is leading the way, showing that whatever your situation and however old you are, change is always within reach. “I never imagined that having a toilet and defecating in it at this age would bring me dignity and the respect of my fellow villagers, government officials and development workers. This has brought me an immense happiness which I can’t express in words.”

With millions of lives already changed, SNV is looking to expand its SSH4A programmes and to create the foundations for future scaling up. The evidence gathered through our programmes is being used in our ongoing advocacy for increased donor and government priority for sanitation and hygiene.

This is an extract from our annual publication, SNV Connect 2016. Read the full magazine to find out how our work in Agriculture, Energy and Water, Sanitation & Hygiene is improving the lives of millions of people around the world!