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This powerpoint was presented by Julia Rosenbaum of FHI360 and WSP Water and Sanitation Specialist Kebede Faris,during AfricaSan 3 (Kigali, Rwanda - 2011) under the "CLTS in Africa: Experiences, Challenges and Ways Forward" session.This session provided a brief overview of CLTS and of its progress and status in Sub-Saharan African countries offering insights into current challenges and how they have been and can be tackled.
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Julia Rosenbaum, WASHplus (AED)Kebede Faris, World Bank Water and Sanitation Program
Orlando Hernandez, WASHplus (AED)Asrat Genet, World Bank Water and Sanitation Program
Belete Muluneh, WSP/WB (now UNICEF))
June 16, 2011
Applying a Mix of Community-led and Household-level WASH
Innovationsto Improve WASH,
Reduce Diarrheal Disease and Strengthen Health Systems
At scale Hygiene and Sanitation Improvement
in the Amhara Region of Ethiopia
through “Learning by Doing”
COMMUNITY-LED TOTAL BEHAVIOR CHANGE IN HYGIENE AND SANITATION
embedded in a national and regional process..• National Hygiene and Sanitation Strategy
Built around Health Extension Programme,…. carried out by HEWs
Supported by “the whole system” - emphasis on bridging and bonding
Implementing a hybrid of …
• Systems Approach to Change – engaging the multiples• (Community-led) Total Sanitation• Strengthened Home Visits Negotiation of Improved Practices• Robust WASH Friendly Schools component
DisgustShame
Fear
CLTSCLTS
Capacity Built in Household Behavior Change
and CLTS Tools • Health Extension Workers,
Development Agents, District WASH Teams and more trained
• Encouraged to go out and ignite, or support ignition
• Carry out a number of other mobilization and household BC activities
Were we effective?
Did we achieve scale?
Did combining individual and collective action work?
Results
Practices: Access to Sanitation Facilities
Baseline-Endline Comparison: All Respondents
**Source: Amhara LBD Evaluation Report, USAID/HIP-WSP/WB-AF, November 2010
ETHIOPIA
Knowledge of When to Wash Hands
Presence of HW Stations at
Latrines
17%
16%
Dimensions Factors p Odds Ratio
InterventionCharacteristics
Community participated in walk of shame .00 2.23
Household visited by health work to improve sanitation
.05 1.75
Intervention -related Perceptions
Having a latrine contributes to the community’s health
.00 2.6
Having a latrine contributes to the community’s development
.00 1.8
ALL of THESE …………………………………………….. >> 8.38
Predictors of Latrine OwnershipEndline
**Source: Amhara LBD Evaluation Report, USAID/HIP-WSP/WB-AF, November 2010
