14/07/2020

The ins-and-outs in achieving ODF in rural villages

In some of the lowest-income, rural districts of Cambodia’s Battambang, Siem Reap, and Pursat provinces, USAID in partnership with SNV, Save the Children, the Manoff Group, and two local NGOs, 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 reduce malnutrition and childhood stunting through interventions in three inter-related sectors: water, sanitation, and hygiene (WASH), nutrition, and agriculture.

With USAID support, three rural villages in Cambodia’s Battambang Province were among the first to be declared open defecation free (ODF). To gain 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 some of the lowest-income, rural districts of Cambodia’s Battambang, Siem Reap, and Pursat provinces, USAID in partnership with SNV, Save the Children, the Manoff Group, and two local NGOs, 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 reduce malnutrition and childhood stunting through interventions in three inter-related sectors: water, sanitation, and hygiene (WASH), nutrition, and agriculture.

With USAID support, three rural villages in Cambodia’s Battambang Province were among the first to be declared open defecation free (ODF). To gain a better understanding of what this means, let’s take a closer look at what happened, why this matters, and how it was accomplished.

What happened?

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 ODF, based on the Ministry of Rural Development’s certification standards. To be recognised as ODF, a village needs to have full sanitation coverage, with at least 85% of 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 was quick to say how proud he was of his community’s achievements. Having had achieved 100% access to improved toilet facilities, he said ‘Before working with the NOURISH project, my village had 52% sanitation coverage, [1] but now 100% of the households use latrines.’

Svay Chour 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 clean and sanitary environments. Achieving ODF also goes a long way in preventing stunting within communities, a terrible condition in which malnutrition and diseases such as diarrhoea 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 abilities throughout an 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 lack access to improved latrines. Prior to interventions similar to NOURISH, nobody in Battambang province thought much about using toilets or the implications of open defecation; let alone changing their sanitation practices. But all these have 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, applied the Community-Led Total Sanitation (CLTS) and sanitation demand generation approaches to guide villages to become their own sanitation champions. CLTS is an innovative methodology used to mobilise communities to eliminate open defecation. CLTS begins with a triggering event, which often involves showing communities the damage that open defecation can cause. SNV then works with communities to create demand for improved sanitation and habits. From there, SNV helps communities to 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 enablers in following through initial sanitation interest secured by demand generation approaches. Following demand triggering, NOURISH would then continue 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 a woman) and two from the Commune Council (of which one must be a woman). These sanitation committees, thereafter, continue to motivate households and monitor sanitation progress at village levels.

Inviting some people who have and do not have access to toilets to demand generation activities to share their experiences and discuss the benefits of having a toilet have also proven successful in creating demand. As did door-to-door visits to households, especially for those with no access to toilets; to encourage them to buy and build one.

Once demand is created among villages, NOURISH negotiates with sanitation suppliers to accept payments for toilets in instalments, making sanitation facilities 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 for 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 to last welly beyond project completion.

Written by: Sunetra Lala/SNV in Cambodia

Photo by: Him Pao/SNV in Cambodia

Notes
[1] NOURISH Project Baseline Survey Report, Save the Children, June 2016.