Time to get serious about sanitation and hygiene in Madagascar

Diarrhoea is the second most prevalent cause of morbidity amongst Madagascan children. An estimated 60 percent of child deaths are due to poor sanitation or poor water quality. Madagascar’s Poverty Reduction Strategy Paper linked the fight against poverty with improved ‘access to infrastructure for evacuating excreta’. But is this intention being carried out in practice?

A paper from the Overseas Development Institute (ODI) and Tearfund, both in the UK, draws on interviews with residents of seven villages and one peri-urban area and meetings with government, non-governmental organisations (NGOs) and donor decision-makers in the Madagascar sanitation sector. The research was carried out in 2006 by the Malagasy Biblical Baptist Churches Association, the University of Antananarivo, and ODI.

The global WASH (water, sanitation and hygiene) initiative was launched in Madagascar in 2002. It seeks to bring about behavioural change regarding hygiene, promote recognition of the links between sanitation, hygiene and poverty, and integrate sanitation and hygiene in drinking water supply projects.

Three ministries share WASH responsibilities but their respective mandates remain unclear. Information on sanitation and hygiene needs is inadequate. Government figures state that 52 percent of rural households have access to sanitation, although these are disputed by NGOs. Health policies continue to focus on curing illness, rather than on tackling the lack of hygiene which causes so much of it.

Sanitation programmes prioritise major infrastructure projects, concentrating on problems such as urban drainage and stormwater removal whilst ignoring domestic sanitation. Water sector professionals receive no training on education/awareness-raising and community engagement.

The researchers found that:

• The level of use and maintenance of latrines lags behind the declared levels of knowledge.
• Most people are unaware of the health benefits of handwashing with soap after defecation.
• In isolated villages less than 30 percent of households use soap.
• Clean hands may be seen as shameful, a sign of laziness in communities valuing hard work.
• There is confusion about who is responsible for cleaning latrines.
• For most people the only affordable water collection and storage container is an uncovered plastic bucket.

Madagascar must make improved hygiene a national priority. Public funds are scarce, which means that external support is needed to achieve WASH goals, with coordination between donors. The part the Malagasy Government plays will include increasing the meagre budget allocation to sanitation, pushing forward the decentralisation agenda and building the capacity of local authorities (communes) to prepare development plans which incorporate sanitation and hygiene issues.

The author calls on the authorities to:

• build up people-based skills required for the sanitation and hygiene sector, both in government ministries and in communes
• use schools as entry points, develop teaching manuals on sanitation and hygiene for teachers and provide latrines whenever classrooms are constructed
• encourage the private sector to get involved, where possible, in rural sanitation and support non-governmental providers
• train community facilitators and prepare maintenance mechanisms before sanitation/hygiene interventions begin
• develop strong messages that encourage people to talk about latrines and help overcome reservations about the adoption of improved hygiene practices.

Source(s):
‘Sanitation and hygiene in developing countries: identifying and responding to barriers. A case study of Madagascar’, Overseas Development Institute/Tearfund, by Peter Newborne, February 2007 (PDF) Full document.
‘Sanitation and Hygiene: knocking on new doors’, Overseas Development Institute, Briefing Paper, by Peter Newborne and Katharina Welle, December 2006 (PDF) Full document.

Funded by: Tearfund

id21 Research Highlight: 27 April 2008

Further Information:
Peter Newborne
Water Policy Programme (WPP)
Overseas Development Institute
111 Westminster Bridge Road
London SE1 7JD
UK

Tel: +44 20 79220300
Fax: +44 20 79220399
Contact the contributor: p.newborne@odi.org.uk

Water Policy Programme, Overseas Development Institute, UK

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'Better hygiene: washing hands with soap in Ghana'

'Marketing water and sanitation to poor people'

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