Sustainable total sanitation in Ethiopia?

Published on: 04/06/2013

Ethiopia has undoubtedly done a lot in the last years to start to win the battle against poor sanitation access. Policies have been drawn, action plan shared, and the Health Extension Programme (HEP) launched. Started in 2002, the HEP aims at every household in Ethiopia receiving a package of hygiene and sanitation advice.

An ambitious programme…

As part of the HEP, Sanitation is tackled through Community Led Total Sanitation, named in Ethiopia CLTS-H (H for Hygiene). Triggering sessions are being organized as a way to increase latrine coverage, in addition to a “Hygiene sessions” package conducted by Health Extension Workers at household level.

Statistics show that latrine coverage has improved over the last 20 years, although there are disparities between (1) rural and urban areas and (2) data presented by the Ethiopian government and the JMP (Joint Monitoring Programme).

Current national strategies aim at reaching 100% Open Defecation Free (ODF) communities by 2015, far beyond the targets set by the MDG. But beyond statistics, what are up-to-date the “real“ achievements on the ground?  Beyond coverage, what are the progresses made towards access to sanitation services for all?

.. to be confronted with access to sanitation services

As part of its Sanitation framework (to be published in June 2013), IRC has identified 4 key components that a sanitation service should provide:  (a) easy access to a durable sanitary latrine; (b) hygienic use by all when in and around the house; (c) adequate operation, maintenance, and replacement; and, (d) safe and final disposal of faecal sludge.   

However, studies review reveal that despite sound policies and strategies for sanitation and hygiene, access to services is still low in Ethiopia. Many people – especially in rural areas, cannot enjoy the benefits of safe sanitation. Toilets are built but break down or are not in use due to insufficient operation and maintenance. Finally, there is still a big gap when it comes to proper collection and disposal of faecal sludge.

Interviews conducted by IRC with key informants in November 2012 illustrated this with many examples of villages where latrines had been constructed after triggering, but are not in use anymore. This points out the need for follow-up activities and support to sustain Open Defecation free status and continue to improve facilities. 

Limitations of CLTS-H as a single approach

CLTS-H is used as the main tool to reach the MDG target and 100% coverage by 2015. However, it is recognized that CLTS-H requires much more than the initial triggering to have a sustained and positive outcome. Triggering is a powerful tool to initiate sanitation awareness and increase latrine coverage in the medium term, but does it ensure sanitation services in the long term? Probably not.

The use of CLTS-H also raises the question of sanitation in urban areas, a context in which CLTS-H has its limitations, especially in regards to the collection and disposal of sludge. The private sector has an important role to play in both rural and urban areas to address both problems in the supply chain and final disposal of sludge.

In Ethiopia, sanitation service delivery is not supported today by a strong private sector. This is a major obstacle to roll-out of the national sanitation strategy, in a country where woredas (districts) and kebeles (municipality) are responsible for implementing ambitious national strategies, but with limited human, financial and material capacities.

In the SAP (Sanitation Action Plan), sanitation marketing was already identified as a pillar in order to link triggering with sustainability access to sanitation.  Marketing improved options is funda­mental if the goal of climbing the sanitation ladder is to be achieved. To do so, UNICEF is currently working on the setting-up of sanitation marketing strategy which will be implemented in 20 pilot districts in partnership with IDI and SNV. If it is a success, it will be scaled-up to other districts. The idea is to fill in the gap by enhancing the supply chain, putting in place Sanimarts, linking the private sector, etc. The sanitation marketing strategy is currently under validation by government.

Innovating and learning from international good practice

While moving ahead at national and policy level is key for supporting initiatives on the long term, local initiatives should also be encouraged. Why not be innovative and re-think the sanitation business? Emptying of latrines is a major issue and the weakest link of the sanitation chain today. Old, half-broken trucks with little suction power struggle to conduct the work.

There is the example of an enthusiastically employee of the Addis Abbeba Water Supply and Sewage Authority, who - while on a trip to India - saw rickshaws and thought that they would make a perfect fit to the narrow streets of Addis. The WSSA now owns 10 motorized rickshaws which are used for latrine emptying/sludge management.

These initiatives and others, at both national, regional and local levels, for practitioners and policy makers, will be shared during a “Learning and Exchange workshop” to be organized by IRC in February 2014 in East Africa.  These workshops will emphasize the roles of hygiene/sanitation behaviour change and the enabling environment around CLTS and other sanitation improvement approaches. Details of the event (and a similar event in West Africa) will be announced shortly.

(Written by Melanie Carrasco)