In some of the lowest-income, rural districts of Cambodia’s Battambang, Siem Reap, and Pursat Provinces, SNV, with funding from USAID and in partnership with Save the Children and the Manoff Group, is implementing the Integrated Nutrition, Hygiene, and Sanitation (NOURISH) project to improve the health and wellbeing of more than 500,000 people in 555 villages. NOURISH takes an integrated, multisectoral approach to reducing malnutrition and childhood stunting through interventions in three interrelated sectors: water, sanitation, and hygiene (WASH), nutrition, and agriculture.
Through support from NOURISH, three villages in Cambodia’s Battambang Province were recently declared open defecation free (ODF). To get a better understanding of what this means, let’s take a closer look at what happened, why this matters, and how it was accomplished.
In October 2016, Tuek Sab, Svay Chuor, and Andeuk Heb villages were among the first villages in Cambodia’s north-western Battambang Province to be declared open defecation free (ODF), as certified by the Provincial Department of Rural Development (PDRD). To be recognised as ODF a village needs to have full sanitation coverage, with at least 85% of the households having access to and using improved latrines and the remaining 15% having access to and using shared latrines.
Krum Mong, the Chief of Tuek Sab village is quick to say how proud he is of his community, which achieved 100% access to improved toilet facilities. “Before working with the NOURISH project, my village had 52% sanitation coverage[i], but now 100% of the households own and use latrines” said Krum Mong when his village was declared ODF by the PDRD.
Svay Chuor and Andeuk Heb villages made similar achievements. Both villages previously had sanitation coverage of 74%, but achieved 100% coverage with support from NOURISH.
Why does this matter?
Access to and use of sanitation facilities protects and promotes community health, and can break the cycle of diseases within a village, by ensuring a clean and sanitary environment. Achieving ODF also goes a long way in preventing stunting within communities, a terrible condition in which malnutrition and diseases such as diarrhea among children and mothers leads to the diminished growth and development of children. The effects of stunting are most often permanent, and can lead to impairments in growth, health, and cognitive ability throughout the affected child’s life.
What was it like before?
According to the Cambodia Demographic and Health Survey of 2014, 60% of rural households in Cambodia still lacked access to improved latrines. Prior to interventions like NOURISH, nobody in Battambang Province thought much about using toilets or the implications of open defecation, let alone changing their sanitation practices. But that changed dramatically in 2014, when highly committed community members decided to participate in NOURISH.
How did we do it?
To help open minds and change habits in Battambang Province, SNV, working through NOURISH, used Community-Led Total Sanitation (CLTS) to guide villages to become their own sanitation champions. CLTS is an innovative methodology used to mobilise communities to completely eliminate open defecation. CLTS begins with a triggering event, which often involves showing communities the truth behind the damage open defecation can cause. SNV then works with communities to create and sustain demand for improved sanitation infrastructure (like latrines and hand-washing stations) and habits. From there, SNV helps communities self-monitor instances of open defecation and encourage change from within their own villages to achieve full sanitation coverage and ODF.
Local leadership and ownership are key in capitalizing on the initial interest in improved sanitation that is generated through CLTS triggering. Following the triggering, NOURISH continues to support each village in the target areas of Battambang Province by forming sanitation committees consisting of five members: three from the village (of which one must be female) and two from the Commune Council (of which one must be female). These sanitation committees thereafter continue to motivate households to maintain sanitary practices, and monitor their villages’ progress towards achieving ODF.
Inviting some people who had and some people who did not have access to toilets to CLTS events to share their experiences and discuss the benefits of having a toilet also proved successful in creating demand for improved sanitation. As did door-to-door visits to households that did not have access to toilets to encourage them to buy and build them.
Once demand was created among villages, NOURISH negotiated with sanitation suppliers to accept payments for toilets in instalments, making them accessible for rural communities. By opening up channels for the supply of sanitation products to meet this newly created demand, NOURISH is creating a market for improved sanitation. Because this new market is beneficial to both the supply and demand sides, the market for improved sanitation and the benefits it brings to rural communities are expected to be sustainable and last long after the project has finished.
[i] NOURISH Project Baseline Survey Report, Save the Children, June 2016.