SuSanA - Forum Kunena Site Syndication http://forum.susana.org/ Sun, 26 Apr 2015 02:48:20 +0000 Kunena 1.6 http://forum.susana.org/components/com_kunena/template/default/images/icons/rss.png SuSanA - Forum http://forum.susana.org/ en-gb Re: New Study from Bangladesh - finds CLTS ineffective without subsidies - by: pkjha http://forum.susana.org/forum/categories/5-clts-community-led-total-sanitation-and-other-community-led-approaches/12946-new-study-from-bangladesh-finds-clts-ineffective-without-subsidies?limit=12&start=12#13052 http://forum.susana.org/forum/categories/5-clts-community-led-total-sanitation-and-other-community-led-approaches/12946-new-study-from-bangladesh-finds-clts-ineffective-without-subsidies?limit=12&start=12#13052 Problem with single pit is that after the pit gets filled (in 3-5 years, depending on number of family members) toilets become non-functional. Such Households have no option except to go for defecation in open. There is no mechanical device readily available to clean faecal sludge in many cases. Even it is cleaned, there is no infrastructure available to treat it, in most of the cases.
For high ground water table areas leach pit is not suitable at all due to chance ground water. In fact this technology in such areas may cause irreversible affects on environment and community health.

pawan]]>
CLTS (Community led total sanitation) and other community led approaches Fri, 24 Apr 2015 11:37:06 +0000
CLTS with inclusive WASH programming (Malawi) - by: rochelleholm http://forum.susana.org/forum/categories/5-clts-community-led-total-sanitation-and-other-community-led-approaches/13045-clts-with-inclusive-wash-programming-malawi#13045 http://forum.susana.org/forum/categories/5-clts-community-led-total-sanitation-and-other-community-led-approaches/13045-clts-with-inclusive-wash-programming-malawi#13045
The overall research strategy is to carry out data collection in the context of an intervention to improve the inclusiveness of WASH programmes.

Over the last few months, observations of standard CLTS, including pre-triggering, triggering and follow-up, were documented by researchers from Mzuzu University Centre of Excellence in Water and Sanitation.

This week in Rumphi, Northern Malawi, Hazel Jones, of Water, Engineering & Development Centre (WEDC) provided training and support for inclusive WASH programming. The training included people with disabilities, NGOs, extension workers, and Government officials.

The next phase involves observations of this new CLTS with inclusive WASH programming, including pre-triggering, triggering and follow-up, to again be documented by researchers from Mzuzu University Centre of Excellence in Water and Sanitation and further comparison to standard CLTS.]]>
CLTS (Community led total sanitation) and other community led approaches Fri, 24 Apr 2015 06:07:34 +0000
CLTS photo case-study - Malawi - by: joeturner http://forum.susana.org/forum/categories/5-clts-community-led-total-sanitation-and-other-community-led-approaches/13036-clts-photo-case-study-malawi#13036 http://forum.susana.org/forum/categories/5-clts-community-led-total-sanitation-and-other-community-led-approaches/13036-clts-photo-case-study-malawi#13036
There are lots of interesting things here, but I thought the final photo was particularly interesting.

www.globalcitizen.org/en/content/a-villa...n-to-end-open-defec/]]>
CLTS (Community led total sanitation) and other community led approaches Thu, 23 Apr 2015 09:39:46 +0000
Re: New Study from Bangladesh - finds CLTS ineffective without subsidies - by: JKMakowka http://forum.susana.org/forum/categories/5-clts-community-led-total-sanitation-and-other-community-led-approaches/12946-new-study-from-bangladesh-finds-clts-ineffective-without-subsidies?limit=12&start=12#13027 http://forum.susana.org/forum/categories/5-clts-community-led-total-sanitation-and-other-community-led-approaches/12946-new-study-from-bangladesh-finds-clts-ineffective-without-subsidies?limit=12&start=12#13027 CLTS (Community led total sanitation) and other community led approaches Wed, 22 Apr 2015 10:22:12 +0000 Re: New Study from Bangladesh - finds CLTS ineffective without subsidies - by: joeturner http://forum.susana.org/forum/categories/5-clts-community-led-total-sanitation-and-other-community-led-approaches/12946-new-study-from-bangladesh-finds-clts-ineffective-without-subsidies?limit=12&start=12#13026 http://forum.susana.org/forum/categories/5-clts-community-led-total-sanitation-and-other-community-led-approaches/12946-new-study-from-bangladesh-finds-clts-ineffective-without-subsidies?limit=12&start=12#13026
This definition is based on the Government of Bangladesh’s (GoB) 2005 National Sanitation Strategy, which defines a hygienic latrine as “a sanitation facility the use of which effectively breaks the cycle of disease transmission”

This requires the confinement of feces (i.e. a sealed pit) and a sealed passage between the squat hole and the pit, blocking insect vectors.


Fig S2 (a) "Model 1" seems to imply that the latrine was sealed, but the text also implies that vent was not compulsory.



The other models have more rings, but it is not clear whether they are supposed to be sealed at the bottom.]]>
CLTS (Community led total sanitation) and other community led approaches Wed, 22 Apr 2015 09:46:38 +0000
Re: New Study from Bangladesh - finds CLTS ineffective without subsidies - by: JKMakowka http://forum.susana.org/forum/categories/5-clts-community-led-total-sanitation-and-other-community-led-approaches/12946-new-study-from-bangladesh-finds-clts-ineffective-without-subsidies?limit=12&start=12#13025 http://forum.susana.org/forum/categories/5-clts-community-led-total-sanitation-and-other-community-led-approaches/12946-new-study-from-bangladesh-finds-clts-ineffective-without-subsidies?limit=12&start=12#13025 CLTS (Community led total sanitation) and other community led approaches Wed, 22 Apr 2015 09:33:33 +0000 Re: New Study from Bangladesh - finds CLTS ineffective without subsidies - by: joeturner http://forum.susana.org/forum/categories/5-clts-community-led-total-sanitation-and-other-community-led-approaches/12946-new-study-from-bangladesh-finds-clts-ineffective-without-subsidies?limit=12&start=12#12992 http://forum.susana.org/forum/categories/5-clts-community-led-total-sanitation-and-other-community-led-approaches/12946-new-study-from-bangladesh-finds-clts-ineffective-without-subsidies?limit=12&start=12#12992
Hygienic latrines:

A hygienic latrine safely confines feces in order to prevent disease transmission. To accomplish this in our context requires a seal to block flies and insects and a sealed pit to store fecal matter for safe disposal. We classify a latrine as hygienic if it (1) has an intact slab, (2) has a functional seal, and (3) conveys feces to a sealed pit. The following types of latrines are included, provided they satisfy the three criteria above: direct pit latrine (slab directly above the pit); offset single pit latrine (pit is offset from the slab); offset double pit latrine.


On the differences between this intervention and CLTS (in addition to the point made about latrines):

The timeline for “ignition” in CLTS is open-ended, and typically takes up to 5 days ofmeetings. In LPP, we fixed the length of the intervention, such that the initial period leading to ignition lasted 2 days, with a fixed schedule of follow-up visits thereafter. This was to maintain comparability between the LPP components of the LPP Only
and LPP + Subsidy treatments. Without a fixed timeline, the intervention might go
on for longer in LPP Only villages, meaning that the comparison between LPP Only
and LPP + Subsidy would no longer represent the marginal effect of subsidies.


On the supply side:

It was not feasible to randomize an intervention directly with latrine suppliers. First, therewere only 11 in the project area. Second, there was no clear correspondence between communities and suppliers. Instead, we designed a community-level intervention intended to improve the functioning of the sanitation market. VERC identified, trained and hired individuals in randomly chosen neighborhoods to work as Latrine Supply Agents (LSAs) in that neighborhood. VERC recruited residents who worked in fields such as masonry, construction or carpentry, and therefore were likely to have adequate technical ability and knowledge.

VERC trained LSAs to act as technical and sales agents, in particular to:
1.Provide information about where an improved latrine can be purchased
2.Enable households to assess the quality of latrines offered for sale
3.Assist with delivery and installation
4.Provide technical support after installation, e.g., for maintenance, repairs and improvements.
LSA assistance was available to all residents of designated neighborhoods, regardless of
voucher eligibility or winning status. LSAs were hired for 12 weeks, including the 6 weeks
during which households could redeem their vouchers, plus additional time to assist with
installation. LSAs were instructed to provide information only about purchase, installation and maintenance, and not about the benefits of latrine use. VERC paid LSAs a flat salary.
]]>
CLTS (Community led total sanitation) and other community led approaches Mon, 20 Apr 2015 13:38:45 +0000
Re: New Study from Bangladesh - finds CLTS ineffective without subsidies - by: joeturner http://forum.susana.org/forum/categories/5-clts-community-led-total-sanitation-and-other-community-led-approaches/12946-new-study-from-bangladesh-finds-clts-ineffective-without-subsidies?limit=12&start=12#12991 http://forum.susana.org/forum/categories/5-clts-community-led-total-sanitation-and-other-community-led-approaches/12946-new-study-from-bangladesh-finds-clts-ineffective-without-subsidies?limit=12&start=12#12991
www.sciencemag.org/content/suppl/2015/04....DC1/Gutieras.SM.pdf]]>
CLTS (Community led total sanitation) and other community led approaches Mon, 20 Apr 2015 13:19:34 +0000
Re: New Study from Bangladesh - finds CLTS ineffective without subsidies - by: mobarak http://forum.susana.org/forum/categories/5-clts-community-led-total-sanitation-and-other-community-led-approaches/12946-new-study-from-bangladesh-finds-clts-ineffective-without-subsidies?limit=12&start=12#12990 http://forum.susana.org/forum/categories/5-clts-community-led-total-sanitation-and-other-community-led-approaches/12946-new-study-from-bangladesh-finds-clts-ineffective-without-subsidies?limit=12&start=12#12990
Science articles, unfortunately, have to be very short (with strict guidelines from the journal), and have to written in a specific style (with a tough anonymous peer review process mediating the stiff competition for space on the journal), so it was not possible to answer all the relevant questions that have come up, in the text of the short article. The journal therefore allows us to link to an "online supplementary materials" document that provides more details. I have attached the supplementary materials doc here*, and this is much longer than the article itself. Many of your questions will get answered if you read this document.

As you read it, it is useful to keep in mind that the various interventions described were not dreamt up solely by the research team, but were co-designed with, and implemented by the inventors of CLTS: the NGO Village Education and Research Committee (VERC) and Wateraid, Bangladesh. Kamal Kar was a consultant at VERC, I believe, where the CLTS model started. All interventions described were implemented by these organizations with no interference from the research team (except to ensure scientific rigor), in order to maintain research and evaluation independence.

Finally, each community was randomly assigned to just ONE particular intervention arm, as is standard in any randomized controlled trial. VERC and Wateraid did a fantastic job implementing, as far as we (the research team) can tell using the five rounds of data we have collected from these 18,000+ households. So I don't think the interventions in any one village or community was "confused" in any way.

I have to teach today, and then present at a seminar, but I'll try to come back and answer questions.


Note by moderator:
* Or see here in the SuSanA library: www.susana.org/en/resources/library/details/2246]]>
CLTS (Community led total sanitation) and other community led approaches Mon, 20 Apr 2015 12:59:13 +0000
Re: New Study from Bangladesh - finds CLTS ineffective without subsidies - by: muench http://forum.susana.org/forum/categories/5-clts-community-led-total-sanitation-and-other-community-led-approaches/12946-new-study-from-bangladesh-finds-clts-ineffective-without-subsidies?limit=12&start=12#12986 http://forum.susana.org/forum/categories/5-clts-community-led-total-sanitation-and-other-community-led-approaches/12946-new-study-from-bangladesh-finds-clts-ineffective-without-subsidies?limit=12&start=12#12986
Project: Does sanitation behavior migrate? Evidence from seasonal migrant workers in Bangladesh
www.susana.org/en/resources/projects?sea...ion+behavior+migrate

and
Project: Bolstering demand for improved sanitation when adoption decisions across households are inter-linked
www.susana.org/en/resources/projects?search=Bolstering+demand

Sounds like they are doing interesting research there at Yale University.

And I do think that the journal title was most likely chosen by the authors, not by the journal (unless Science is different to other academic journals, I am not sure). Joe, do you have the URL for the press release that you posted at the beginning of this thread?]]>
CLTS (Community led total sanitation) and other community led approaches Mon, 20 Apr 2015 11:12:42 +0000
Re: New Study from Bangladesh - finds CLTS ineffective without subsidies - by: joeturner http://forum.susana.org/forum/categories/5-clts-community-led-total-sanitation-and-other-community-led-approaches/12946-new-study-from-bangladesh-finds-clts-ineffective-without-subsidies?limit=12&start=12#12985 http://forum.susana.org/forum/categories/5-clts-community-led-total-sanitation-and-other-community-led-approaches/12946-new-study-from-bangladesh-finds-clts-ineffective-without-subsidies?limit=12&start=12#12985
I agree with Giacomo that latrine building is not necessarily a good measure of "sanitation", but I think it is a fair way to compare the treatments under discussion. What systems could we expect CLTS to construct which were better than latrines?

Finally, the title might have been decided by the journal, so I'm not sure we should blame the authors for a title which might claim wider relevance than it deserves. Clearly this only applies to a particular situation in Bangladesh, but the debate is whether it is illustrative of CLTS as a whole.]]>
CLTS (Community led total sanitation) and other community led approaches Mon, 20 Apr 2015 10:34:45 +0000
Re: New Study from Bangladesh - finds CLTS ineffective without subsidies - by: ggalli http://forum.susana.org/forum/categories/5-clts-community-led-total-sanitation-and-other-community-led-approaches/12946-new-study-from-bangladesh-finds-clts-ineffective-without-subsidies?limit=12&start=12#12984 http://forum.susana.org/forum/categories/5-clts-community-led-total-sanitation-and-other-community-led-approaches/12946-new-study-from-bangladesh-finds-clts-ineffective-without-subsidies?limit=12&start=12#12984 Overall, I find this an interesting article. However, it does leave some issues unanswered as Joe and Marijn already pointed out. The chosen language also lightly irritated me, especially given that Science is quite an influential journal.

First, I would like to help answer one of your questions Joe. In the the article the "supply treatment" is described as follows:
The Supply treatment was intended to improve the functioning of markets by providing technical assistance and information. In communities assigned to the Supply treatment, VERC selected a local resident with technical skills and trained him as a Latrine Supply Agent (LSA). The LSA received a fixed salary to provide information to neighborhood residents on (i)where to purchase a hygienic latrine; (ii) how to assess the quality of a latrine offered for sale; (iii) how to install and maintain a latrine.
(page 2)
My question here is, how comparable is this to 'typical' sanitation marketing approaches? Anyone with experience who can comment on this?

Now, on to some other issues that sort of bother me (other than the use of incomprehensible acronyms).

1) The article is named "Encouraging sanitation investment in the developing world: A cluster-randomized trial", while the experiment is clearly only taking place in Bangladesh. I know it's tempting to have one fix-it-all solution, but please let's refrain from making such generalist assumptions. Even in the accompanying commentary article it is stated
But others say an encouraging result in Bangladesh may not say much about India, where the hygiene problem is much bigger. A survey released last year by the Research Institute for Compassionate Economics (RICE) in New Delhi found that many Indians who have access to a hygienic latrine still prefer open defecation, particularly Hindus, who were not represented in the Bangladesh study. The reasons may involve Hindu caste system beliefs that allowing feces to accumulate in a latrine is impure and that only an “untouchable” can remove them, says RICE Executive Director Dean Spears. He adds: “I would just say we should be very careful about generalizing [the Science findings] to Hindu rural north India.”
(Kaiser, Jocelyn "For toilets, money matters" Science 17 April 2015:Vol. 348 no. 6232 p. 272)

2)This article is about increasing access and use of latrines by promoting construction of latrines. Is this 'sanitation'? To many, yes. To me (and others), no. As the quote above also makes clear, we all (should) know by now that sanitation is more than just building a latrine. There's a whole sanitation chain that needs to be taken into account if we want the actual service to keep running for more that 2 years. This also comes at a higher cost (as the WASHCost project of my former employer pointed out). Articles like this, published in influential journals, perpetuate in my view the idea that once a latrine is built all problems will be solved. Maybe we should really start to make the distinction between 'sanitation' and building latrines and make it into a point of importance for example when reporting or doing peer-review.

Best,
Giacomo]]>
CLTS (Community led total sanitation) and other community led approaches Mon, 20 Apr 2015 10:23:00 +0000
Why don't we see much pits made out of car tires ? - by: ben http://forum.susana.org/forum/categories/5-clts-community-led-total-sanitation-and-other-community-led-approaches/12966-why-dont-we-see-much-pits-made-out-of-car-tires-#12966 http://forum.susana.org/forum/categories/5-clts-community-led-total-sanitation-and-other-community-led-approaches/12966-why-dont-we-see-much-pits-made-out-of-car-tires-#12966
I'm sure a discussion already took place about this subject, but is there a reason we don't see that many latrine pits made out of old car tires ?
This is discovering a documentary about "" from michael reynolds, that I discovered car tires potential with a bit of shame not having though of it before for pits construction.

Wishing you a good day,

Ben]]>
CLTS (Community led total sanitation) and other community led approaches Sat, 18 Apr 2015 11:21:26 +0000
Re: New Study from Bangladesh - finds CLTS ineffective without subsidies - by: joeturner http://forum.susana.org/forum/categories/5-clts-community-led-total-sanitation-and-other-community-led-approaches/12946-new-study-from-bangladesh-finds-clts-ineffective-without-subsidies?limit=12&start=12#12958 http://forum.susana.org/forum/categories/5-clts-community-led-total-sanitation-and-other-community-led-approaches/12946-new-study-from-bangladesh-finds-clts-ineffective-without-subsidies?limit=12&start=12#12958
On the specific point you are asking: the paper says that 380 communities of 18,254 households in 107 villages in the Tanore region were randomised to three different treatments. First the Latrine Promotion Programme, a "community motivation and health information campaign", second the programme with subsidies, third something described as "a supply-side market access intervention linking villagers with suppliers and providing information on latrine quality and availability", fourth, the supply intervention with subsidies and finally a control group which received none of the interventions. The researchers followed up a year after the intervention to see the effects.

It says the LPP followed "closely" the principles of CLTS, with a course over several days to raise awareness of sanitation issues. But it does say that the difference to the standard model was that it focussed on the importance of hygienic latrines rather than just ending Open Defecation.

In the subsidy treatment, the poorest three-quarters were entered into a lottery to receive vouchers for subsidies which represented 75% saving on the instillation of facilities. The number of winners was randomised to 25%, 50% and 75% to see the impact of intensity.

It doesn't seem to say much about what the "supply" intervention involved.

In terms of results, it says that at the baseline 78% of households had access to a latrine, and the subsidy had a 9.4% increase on latrine access. The effect on ownership was higher, with a 20% increase over the baseline.

The LPP and supply treatments (ie without subsidy) had no effect on adult OD, but adding a subsidy to the LPP led to a 22% reduction in OD rates compared to the control group.

Voucher winners were more likely to own hygienic latrines than households in communities that only had LPP, or lottery losers in subsidy villages, and voucher winners were more likely to invest it in a latrine if more neighbours also won the lottery. A lottery winner in a high intensity village is 20% more likely to own a hygienic latrine than someone in the LPP only treatment.

On this point the authors say:

The move from subsidizing 25% to subsidizing 50% of the poor produces the largest demand spillovers in our context. Asking community members to make a joint investment commitment, as in CLTS, is a potentially useful intervention, but our results suggest that this should be accompanied by targeted subsidies.


Finally they say that the study has limitations because it might not give a general indication to other populations outside of the one studied in Bangladesh, only considered one level of subsidy, did not include a subsidy-only treatment (as considered bad practice to give subsidies without education) and based OD rates on self-reporting, which could be biased. They also did not consider health outcomes.

They also say that the study allows

us to document some of general equilibrium changes operating via a social influence mechanism, but our results remain silent on wider general equilibrium effects operating via price mechanisms.


My observations are:


  • I wonder if the emphasis on latrines may have put off people who might have taken up other kinds of cheaper intervention if it had been offered
  • I wonder how they are defining 'hygienic' latrines
  • The complexity of the treatments seems to me to give quite a confusing story
  • It is not clear to me whether the reduction in OD is related to the increase in latrines (are people using subsidised latrines of their neighbours? or finding some other non-latrine way to reduce OD?)
  • I don't really understand what the 'supply' treatment is
  • Other than stating that CLTS principles were closely followed, it does not seem to indicate exactly what was involved, who did it, the quality of the intervention or if there was any variability across the group
  • I also wonder if the groups knew about each other, and whether there was any kind of disapproval effect. If the non-subsidised groups knew about the subsidies others had access to, did this mean that they were less likely to participate in the LPP programme?


If I was to write about this study, these are the kind of questions I would be asking the authors about. But, all of that said, it seems to be a properly (although rather oddly) randomised trial which compared CLTS behavioural techniques with controls and subsidies, and so perhaps addresses some of the complaints recently levelled at the World Bank report and the Indian Total Sanitation campaign study.]]>
CLTS (Community led total sanitation) and other community led approaches Sat, 18 Apr 2015 08:59:43 +0000
Re: New Study from Bangladesh - finds CLTS ineffective without subsidies - by: Marijn Zandee http://forum.susana.org/forum/categories/5-clts-community-led-total-sanitation-and-other-community-led-approaches/12946-new-study-from-bangladesh-finds-clts-ineffective-without-subsidies?limit=12&start=12#12957 http://forum.susana.org/forum/categories/5-clts-community-led-total-sanitation-and-other-community-led-approaches/12946-new-study-from-bangladesh-finds-clts-ineffective-without-subsidies?limit=12&start=12#12957
Thanks for posting this. It says in the article, that the community motivation program (LLP) was modeled after CLTS. Is there more info in the document as to how close it resembles "pure CLTS"?]]>
CLTS (Community led total sanitation) and other community led approaches Sat, 18 Apr 2015 06:16:19 +0000