Positioning WASH services within a systems framework and demonstrating achievement of open defecation free status at scale : an example from the Indian State of Bihar

The Pusa block of Samastipur district in the Indian state of Bihar accounted for very low sanitation coverage of 16%. This was coupled with poor understanding of roles and responsibilities among government functionaries as well as a lack of knowledge on the benefits of safe sanitation among community members. The Aga Khan Development Network's Initiative demonstrated the impact of effective partnerships with government functionaries and communities to achieve open defecation free (ODF) status at scale. Adopting a systems approach of WASH services, which included strengthening institutional systems and service delivery models, while also introducing robust monitoring systems, the partnerships with key actors has demonstrated an improvement in sanitation access at scale. A key differentiator of the AKDN Sanitation programme is the introduction of mobile monitoring tool - AKVO Flow, which allows project teams to undertake real time tracking of household sanitation coverage as well as monitoring improvements in key hygiene behaviour over time. The key results of this programme have been to create ODF communities at scale and sustained hygiene behaviour. [author abstract]