Despite great strides in improving sanitation in developing countries, some 2.4 billion people worldwide lack access to adequate sanitation facilities and the poorest and most vulnerable members of society are often not reached. Sustainability is one of the key challenges in CLTS and the wider WASH sector. Whether sanitation improvements endure depend on issues of equity and inclusion, social norms, physical infrastructure, sanitation marketing, monitoring and verification, post-ODF follow-up and the roles and responsibilities of governments, NGOs and donors. The achievement of “open defecation-free” status is now recognised as only the first stage in a long process of change and sanitation improvement.
This book, edited by the Sanitation Learning Hub, examines these challenges, asking questions such as how we ensure that people access sanitation and sustain related behaviours, and how we reach the poorest with toilets that are suitable for their needs. It develops key themes by exploring current experience, innovations and insights, as well as identifying a future research agenda and gaps in current knowledge, and making recommendations and practical suggestions.
A team of researchers from the Community Led Total Sanitation (CLTS) knowledge hub at the Institute of Development Studies, WaterAid and Praxis adopted an Immersive Research Approach (IRA) to try to gain in-depth understanding of ground realities and community perspectives relevant for the Swachh Bharat Mission-Gramin (SBM-G). They sought to learn and be open to emerging findings, while keeping a focus on behaviour change.
This note describes what they did, what they learnt, challenges they faced, and lessons and guidance for its use by others.
Do we really need debiasing, yet another word? Yes, unless anyone can improve on it, because we need a word to describe a rigorous discipline we development professionals need for grounded realism. This has been coming on me slowly. But now explorations and ‘aha!’ moments in India have accumulated and combined into an epiphany. For me, things will never be the same again. Let me explain.
The biases of rural development tourism
The biases of rural development tourism are old news. These are biases in brief rural visits from urban centres. They were a collective discovery and articulation at IDS in the early 1980s. They have now receded into the mists of history and been largely forgotten. Few in later generations of development professionals have heard of them. But with rapid change, they are now more relevant than ever.
The biases are spatial (main tarmac road, roadside, accessible from an urban centre…) , project (special villages and places where there are projects, good things to show, contacts…..), person (males, elite, adults, government and NGO staff….), seasonal (during the dry season, not the rains…), professional (questions and curiosity limited to specialised professional mindsets and interests) and diplomatic (being tactful, not inquiring about sensitive subjects) and (an addition since the 1980s) security (confined to places considered safe, and limited to those accessible in daylight….).
The biases interlock and reinforce each other to exclude those people who are most remote, powerless, vulnerable, poor, stigmatised, discriminated against – those whom the SDGs are not to leave behind. With the intensifying capital trap – being stuck in a capital city or urban centre by meetings, emails, visitors, demands for accountability, reporting, and the like – the biases combine now more wickedly than ever.
‘Competitive campaigns’
And there is a new distorting influence to add: competitive campaigns. This is high profile campaigns in which districts and organisations compete to achieve, and to be seen to have achieved, more than others. This last bias is striking with the Swachh Bharat Mission-Gramin in India, the impressively massive and hugely ambitious campaign driven by political commitment and priority which seeks to make rural India open defecation free by 2 October 2019.
Systemically, with almost every brief rural visit, there is a special reason for where the visitor is taken, who is met, what is said and what is shown. This is most brazen with atypical model communities such as the Millennium villages in African countries. It is also manifest in visits to successful projects, or where the Government or an NGO works or has contacts, somewhere easily accessible and so on. This leads to a scattered archipelago of islands of special cases and contacts that are seen, studied, quoted, and then quoted again and again back and forth by visitors, with the authority of their personal experience of rural, or for that matter urban, reality.
Visiting these islands is better than not visiting at all. But it results not in representative ground truth but in a take-off through repetition into sustainably biased myth. The expanses of sea between the scattered islands are overlooked, unvisited and unexplored, but are many times larger, and more typical, than the islands. Even those who demand representative rigour in statistics are themselves through such visits systemically vulnerable to grossly unrepresentative views of reality. And all this is accentuated when there are competitive target-driven campaigns.
How to offset bias
We need a systematic, timely and cost-effective approach offsetting the biases and for finding and exploring the seas between the islands. Here is what, again and again, I have found works astonishingly well, and far better than one might suppose.
Ring fence a day. Take a day’s leave if necessary. Do not have any government or NGO person with you – just a driver, perhaps a colleague, and (in my case usually) an interpreter.
Hire an unmarked vehicle.
Drive out from your urban centre in any direction for 15-20km.
Turn off left or right and drive for 5-10km.
Turn left or right again and stop anywhere, perhaps a poor or typical village or other settlement.
Wander around on foot, meet people, explain who you are and your interests, notice and ask about things, be friendly and interested, ask what people would like to show you, seek out those we might not meet – women, children disabled, low status, living on the fringes, key informants like teachers, local representatives, masons, health workers and so on.
Tea shops can be brilliant. Go to a tea shop and chat. A male bias can be expected, but discussions can be immediately frank and revealing. You can carry out quick order-of-magnitude surveys based on people’s knowledge of different villages and other questions.
Follow up on offers to show you things, or take you to see people or things.
Go to several contrasting places during the day.
Chai shop, India. Credit: Axel Drainville / Flickr (CC BY-NC 2.0)
Discover the unexpected
Using this approach here is a tiny sample of what I have stumbled on in India. All happened to be in States or Districts that had been declared open defecation free (ODF). Except for one that was affluent and exceptional being on a main road, all were very far from ODF.
A community of 40 Dalits in government-constructed housing with no toilets. In one was a pregnant woman with both legs paralysed who had to pull herself with her hands and crawl to a road and cross it to defecate. The only toilet in the whole community was just being completed, having been constructed by a woman entirely from her family resources.
A mason who boasted that he had demolished over a hundred twin pit toilets (the cheaper and more sustainable type favoured by Government) and replaced them with more expensive and less sustainable septic tanks. This was good for his income but bad for the owners of the toilets.
A village where a number of toilets each bore a painted statement that the government incentive money of Rs 12,000 had been spent on their construction. All were raised up because of seasonal flooding. They had walls but neither roof nor door nor pit! One was used for urination and stank.
In a relatively affluent roadside village, beautifully decorated toilets. A mason said the absolute minimum for a toilet was Rs 80,000. A woman with no toilet said she could not afford this. She had to practise OD. The mason had never constructed a twin pit toilet which should cost less than the Government incentive of Rs 12,000. No way was a septic tank an option for the poor woman.
A village with 175 households, 35 defunct toilets built by an earlier programme, and about 14 septic tanks entirely paid for and built by their owners. In this village it emerged from conversations with the village head, then with a group of men and then separately with a group of women, that they knew nothing or had barely heard about the SBM-G campaign, then near the end of its fourth year. No one had ever come to the village to tell them about the campaign. They had never heard of twin-pit toilets.
The point of these is not to denigrate the programme but to illustrate how the vast sea can differ from the scattered archipelago normally visited.
A challenge to all development professionals
So let me invite all, yes all, development professionals who see this to look in the mirror and be wary of visits which systemically reinforce misperceptions and generate and sustain myths. Ring fence days for you to ground truth through de-biasing. It is fulfilling, informative, fascinating and fun, to explore, to meet people casually, to wander, observe, ask, listen and gain new insights. Every single de-biasing visit I have done has made me wonder – will it happen again? Will I learn anything new this time? Will there be aha moments? Or will this be a wasted day? And every time, every single time, I have been startled and provoked by unexpected revelations. This has always happened. The insights have been intense and memorable, and the implications for policy, practice and research significant. The use of time has been extraordinarily cost-effective.
So let me challenge all fellow professionals who are engaged with rural or urban development – in government organisations, NGOs, training and research institutes, academics, the media, and funding agencies – all who have the scope to do so – to de-bias. Let me challenge all who can to encourage or require others in their organisations to do likewise. Escape the cognitive trap and help your colleagues to escape theirs. Be a devil. Straight away ring-fence a de-biasing day for yourself. Be systematically rigorous. De-bias, enjoy and tell others what you did and what you learnt.
The CLTS Knowledge Hub, based at the Institute of Development Studies, WaterAid, WSSCC and UNICEF co-convened a regional workshop in Saly, Senegal, 25th-28th June 2018 with support from AGETIP. The event brought together those engaged in rural WASH programming from 14 countries across the region (Benin, Burkina Faso, Cameroon, Chad, Democratic Republic Congo (DRC), Gambia, Ghana, Liberia, Mali, Mauritania, Niger, Nigeria, Senegal, and Togo) alongside experts working at regional and global levels. Over the course of four days participants shared latest experiences, innovations, challenges and research, mapped knowledge gaps and discussed ways forward with the aim of improving capacity and knowledge.
This learning brief presents the common challenges identified across the region, summarises some of the discussions held, highlights some promising practices and considers priority actions moving forward.
The CLTS Knowledge Hub, based at the Institute of Development Studies, convened a regional workshop in Arusha, Tanzania, 16-20 April 2018 with support from SNV Tanzania. The event brought together those engaged in rural WASH programming from eight countries across the region (Burundi, Eritrea, Ethiopia, Kenya, Malawi, Tanzania, Uganda and Zambia) alongside experts working at regional and global levels. Over the course of five days participants shared experiences, innovations, challenges and learning, and mapped gaps in knowledge with the aim of improving capacity and future learning, and building consensus on the way forward. SNV Tanzania also facilitated a field visit to its Sustainable Sanitation and Hygiene for All (SSH4A) project areas in Babati and Karatu districts.
This learning brief presents the common challenges and barriers to achieving Sustainable Development Goal (SDG) 6.2 that the workshop participants identified across the region. It summarises discussions held across the week, highlights promising practices and considers priority actions moving forward.
The brief is available to download in English (to the right) and also in French here.
In this WASH Talks video, Robert Chambers talks about the use of Rapid Action Learning (RAL) workshops, immersive research and participatory mapping methodologies in India with the purpose of checking what is actually happening on the ground, and learning from this, in relation to the national Swachh Bharat Mission (Gramin) (SBM-G) (clean India mission).
These methodologies have been developed and implemented with the Institute of Development Studies (IDS), the Water Supply and Sanitation Collaborative Council (WSSCC), WaterAid, Delhi University and the Indian government.
Over the past few years, the Sanitation Learning Hub, in collaboration with the Government of India, Praxis, WSSCC and WaterAid India, have been developing Rapid Action Learning approaches. Multiple approaches have been trialled, with flexible formats, but the essential criteria is that learning is timely, relevant and actionable.
These learning approaches are the focus of the latest edition of the Frontiers of Sanitation series. This Frontiers explains the advantages and disadvantages of the approaches trialled and sets out a challenge to those working in the water, sanitation and hygiene sector to:
Reflect on what, for you, constitutes rigour.
Adopt and adapt approaches to fit your context and needs.
Develop your own approaches.
Record your experiences and lessons learnt.
Take the time to share your experiences with us. (Email the Hub on SLH@ids.ac.uk)
To commemorate and reflect on the publication, the Hub sat down with colleagues and partners WaterAid India and WSSCC to discuss lessons learned and the future of Rapid Action Learning. You can watch these five short videos in the playlist below.
This paper focuses on an Immersive Research Approach designed by Praxis, the Sanitation Learning Hub at IDS and WaterAid whereby researchers lived in villages in recently declared open defecation free districts, to gain an in-depth understanding of ground realities and community perspectives of the Swachh Bharat Mission-Gramin.
The study shed light on key aspects and dynamics influencing local ownership, behaviour change and construction quality, and also revealed multifaceted exclusion processes. The immersive approach helped build trust with villagers and allowed a unique insight into the SBM in its ‘real life’ context, necessary to explore hidden dynamics and diverse perspectives, and understand the complexities involved.
Despite some practical challenges, undertaking immersive studies and experiences would be beneficial for improving the Swachh Bharat Mission and other sanitation programmes. The approach could be adopted pragmatically, but always respecting some basic principles and ethical behaviour.
The Disabling Menstrual Barriers research aims to investigate and address the barriers to menstrual health and hygiene that adolescents and young people with disabilities face in the Kavre district in Nepal.
It is a collaboration between WaterAid and the London School of Hygiene and Tropical Medicine (LSHTM), with funding from the Bill & Melinda Gates Foundation. During September 2017, qualitative data was collected using participatory methods, including PhotoVoice.
This Learning Note presents the research questions, timeline, data collection methods and ethics. It also captures the preliminary findings from PhotoVoice and highlights the emerging research themes from this.
Recent debates on ensuring equity and inclusion in sanitation and hygiene provision in the Global South have begun to explore the needs of excluded groups of individuals. Yet, the sanitation and hygiene needs of perimenopausal (PM) women, who are making the transition to menopause, are neglected.
This study explores this new field of research and aims to provide recommendations to meet the sanitation and hygiene needs of PM women. Opening the doors to these needs warrants the use of adaptive, participative, feminist methodologies, placing PM women at the centre of the study to enable them to share their experiences. This research uses a six-stage case study methodology: a literature review, a phenomenological review, research design, case study selection, data collection, and data analysis.
This research identified several sanitation and hygiene needs as crucial to PM women’s health. This research concludes that the hidden sanitation and hygiene needs of PM women require participatory techniques to reveal them. Relationships with certain people allow PM women to discuss and meet the sanitation and hygiene needs to a degree. PM symptoms vary in nature, between women and day to day. This research demonstrates that the sanitation and hygiene sector needs to become more attentive to bathing and laundry issues overall, learning from the needs of PM women.
With PhotoVoice research participants can express themselves in a visual medium instead of using words, which is beneficial for those who can’t communicate their WASH needs as easily or find it difficult to speak about taboo issues.
This Sanitation Learning Hub Learning Paper explores the potential of an innovative participatory visual method known as PhotoVoice to help to achieve universal access to water, sanitation and hygiene (WASH) by 2030. The paper outlines what PhotoVoice is, and shares learning relating to its use in the WASH sector around the world for research, programming and advocacy.
It draws on lessons learned from these experiences to show how PhotoVoice can be used for learning in WASH, how it can be used with other methodologies to explore topics which are neglected or taboo, and the benefits and drawbacks of PhotoVoice to consider. It includes practical recommendations for using PhotoVoice in WASH and the ethical considerations to make when it is used. The paper reflects on how PhotoVoice is important for exploring new frontiers in WASH, and can help us gain a deeper understanding into how people experience, interpret and respond to their realities.
This paper explores the idea of learning from failure in the sanitation sector. The recent trend of ‘admitting failure’ in aid and development forces sanitation practitioners, researchers and policymakers to ask if we can and should address failure more openly in order to improve our work.
The ideas in this paper developed from discussions at a workshop on ‘learning from failure’ convened by the UK Sanitation Community of Practice (SanCoP) designed to kickstart this debate. We first discuss the concept of failure itself and identify different approaches to learning from failure relating to sanitation.
These include acknowledging past failures in order to learn and adapt, and planning for ‘safe’ future failures through deliberate experimentation and innovation. We also argue that a series of further steps are required: understanding relevant previous approaches to learning from failure in the sector; recognising different types of failure; seeking different actors’ perspectives on failure; and framing the debate about failure constructively rather than negatively.
In the second part of the paper we examine different practical examples of how actors in the sanitation sector have tried to learn from failure, to assess how this happened and what changes resulted. In the final section of the paper we conclude with suggestions for how individuals and organisations working in sanitation and international development more widely can learn from failure. We also propose SanCoP itself as one example of a ‘safe space’ in which people can meet to discuss and learn from failure.
As a sector, we want to be better at reaching the unreached and not only ensure that the rights of people who may be disadvantaged are met, but also make better use of their skills, knowledge and contributions as part of sanitation programmes globally.
A well-facilitated Community-Led Total Sanitation (CLTS) programme that proactively considers and involves disadvantaged people has been shown to have many benefits. Absence of such programmes can often have negative impacts and make it difficult to sustain open defecation free status.
This issue of the Sanitation Learning Hub's Frontiers of Sanitation looks at who should be considered potentially disadvantaged, how they can effectively participate, and how to address diverse needs in order to make processes and outcomes sustainable and inclusive. Using a range of examples from Global Sanitation Fund programmes that were part of a recent study on equality and non-discrimination, it explores the challenges that may occur and concludes with suggested good practices that can strengthen processes to the benefit of all.
Looking at 50 programmes that used support mechanisms, this rapid review emphasises the importance of monitoring, evaluating and knowledge-sharing processes in building an evidence base for facilitating equitable rural sanitation outcomes.
The benefits of conventional rural sanitation programming and service delivery are often not spread equally, and risk leaving disadvantaged groups behind. Greater attention needs to be paid to these groups to achieve adequate and equitable access to sanitation for all, and an end to open defecation.
This issue of the Sanitation Learning Hub's Frontiers of Sanitation (the second in a two-part series) examines support mechanisms designed to help disadvantaged groups access and use hygienic toilets as part of efforts to drive more equitable rural sanitation outcomes. It covers the latest thinking on the opportunities and challenges of support mechanisms, and explores what works remains to be done.
The issue uses a broad definition of ‘support’ for creating equitable outcomes. Although financial and physical subsidies often come to mind, a broader practical understanding of support needs to encompass both ‘hardware’ mechanisms and ‘software’ approaches, as well as various combinations of the two.
Developed primarily for UNICEF staff and its partners, these field notes can be used to learn about specific aspects of Community Approaches to Total Sanitation (CATS) programmes in different contexts. For example, learning on CATS monitoring was captured in the Zambia and Mali cases, while the Philippines and Nepal have good experiences on strengthening sub-national governance for sanitation.
The Haiti and Mali cases meanwhile capture lessons on improving and maintaining CATS effectiveness (defined as the number of communities ‘triggered’ that went on to become open defecation free [ODF]). The issue of what happens beyond ODF certification is addressed in Mali and in the Philippines.
In addition, application of components of Social Norms Theory to strengthen CATS programming was also captured in some of the cases – notably in Nepal and Zambia. Experiences on implementing CATS after humanitarian crises can be learnt from the Philippines and Haiti. With regards to equity, Mali has experience in working to leave no community behind, while Nepal has developed a programme that resulted in mobilising support for the most vulnerable households.
