Government-led water and sanitation initiative in southern Ethiopia

In Ethiopia’s Southern Nations Nationalities and People's Region (SNNPR) an innovative programme has promoted latrine construction and use, hand washing and safe water storage and handling. The intervention is an example of how visionary government leadership can create the political momentum for low-cost sanitation and hygiene (S&H) and reach out to rural communities.

Papers from the Overseas Development Institute, in the UK, and the IRC International Water and Sanitation Centre, in the Netherlands investigate the SNNPR approach. The research was undertaken by Ethiopian researchers on behalf of the Research-inspired Policy and Practice Learning in Ethiopia and the Nile Region (RiPPLE) project.

SNNPR is located in the south-west of Ethiopia, bordering both Sudan and Kenya. In 2003 the SNNPR Bureau of Health (BoH) began a new community health strategy, including S&H. The approach aimed to reach households through paid health extension workers (HEWs) and volunteer community health promoters (CHWs). Instead of the previous approach of providing households with latrine slabs, the BoH promoted latrine construction without any form of subsidy.

A combination of political promotion and institutional mobilisation was successful in launching and expanding the regional government’s strategy as a ‘movement’. Development of the strategy coincided with rallies for the 2005 national election, which provided a political ‘launch pad’ for the new S&H initiative. Documents were written with a strong communication orientation to persuade politicians, motivate civil servants, and build consensus for action by a range of stakeholders.

The key elements of the S&H strategy were designed to be politically attractive and administratively feasible, and were written in non-technical language. The strategy was set out in brief and general terms, flexible enough to incorporate new initiatives that were successfully piloted. In the outreach to households, a mixture of command and encouragement was used. Local government and party cells were given quotas of latrines to be built. Households were told what to do, but they were also informed and educated as to why.

The researchers found after the project:

• The proportion of households having latrines increased by a factor of eight.
• There was less acceptance of open defecation.
• Questionnaire results indicated better knowledge on hand washing, although actual practice remained poor.
• There were hand washing facilities in 82 percent of households, but only 6 percent were near the household latrine and few people used soap or detergents.
• Water storage and handling practices also remained poor.
• Men mostly decided latrine design, siting and construction, although women were involved in providing materials and plastering.

Despite these positive developments, doubts remain about sustainability and some latrines have collapsed. Due to poor design and improper use, many are infested with flies. As CHWs are unpaid and receive little follow-up support or training, many have lost motivation. Higher levels of government have not provided enough technical support or monitored changes in household S&H behaviour.

Between 1990 and 2006 the proportion of people, globally, without improved sanitation decreased by only eight percent. At that rate, by 2015, the world will miss the Millennium Development Goal sanitation target by over 700 million people. Aspects of the SNNPR experience which might help improve the situation include:

• promoting local, rather than donor-driven, S&H programmes and technology designs
• using community promotional change agents coordinated by local authorities in command and facilitation roles
• reviewing local S&H progress within wider health sector review processes
• ensuring that strategising, political positioning and communication are based on solid evidence
• realising that sanitation workers cannot make their case to high-level politicians without  understanding the political dynamics around S&H.

Source(s):
“Promoting sanitation and hygiene to rural households: the experience of the Southern Nations region, Ethiopia”, RiPPLE, by Peter Newborne and Jo Smet, July 2008 Full document.
Technical issues of Sanitation and Hygiene in Mirab Abaya and Alaba: A case study report from the Southern Nations Region (‘SNNPR’) of Ethiopia’, RiPPLE Working Paper 2, Addis Ababa: Research- inspired Policy & Practice Learning in Ethiopia and the Nile Region, by Worku Tefera, 2008 Full document.
‘Policy and Institutional Factors affecting formulation and implementation of Sanitation & Hygiene strategy: a case study from SNNPR’, RiPPLE Working Paper no. 1, by Bethel Terefe and Katharina Welle, March 2008 Full document.

Funded by: UK Department for International Development (DFID)

id21 Research Highlight: 1 April 2009

Further Information:
Peter Newborne
Research Associate
Water Policy Programme
Overseas Development Institute
111 Westminster Bridge Road
London SE1 7JD, UK

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

Overseas Development Institute, UK

Jo Smet
Resource Centre Development Section
IRC International Water and Sanitation Centre
P.O. Box 82327
2508 EH The Hague
The Netherlands

Tel: + 31 70 3044000
Fax: +31 70 3044044
Contact the contributor: smet@irc.nl

IRC International Water and Sanitation Centre, Netherlands

Research-inspired Policy and Practice Learning in Ethiopia and the Nile Region (RiPPLE)
c/o WaterAid Ethiopia
Kirkos Sub-city, Kebele 04
House no 620
Debrezeit Road
PO Box 4812
Addis Ababa, Ethiopia

Research-inspired Policy and Practice Learning in Ethiopia and the Nile Region (RiPPLE), Ethhiopia

Other related links:
Further details about this research project ‘Research-inspired Policy and Practice Learning in Ethiopia and the Nile Region (RiPPLE)’ can be found on the DFID Research for Development website

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