We've also heard from Kitchinme Bawa on the WSSCC CoP with his experiences and thoughts going forward.
Thank you Kitchenme!

I am delighted to see the synergy between the WSSCC network and the SuSanA. These kind of synergy is very good for the sector and though these discussions may not have an outcome in form of a silver bullet for the sanitation sector, I believe most of us here like me understand that dialogue is the beginning of solution to common problems.

From about a decade of sanitation programming, I want us to learn from what we have done so far. If one looks at the sanitation scenario globally, only a few programmes at scale have been sustainably successful, if any. Perhaps we should begin to look at it differently. What we have been doing to me is to have a one-size-fits-all approach whereby the programme does not give room for flexibility to temper with the original design. My suggestion is that we need to design at-scale programmes with a flexibility to fit into the livelihood issues or projects. I have observed that for people with improved livelihoods, the chances of adopting a new sanitation and hygiene habit is high that otherwise. Hence, we must begin to integrate our sanitation programmes into activities that are targeted towards improving the livelihoods of the people.

Another issue we need to also deal with is the involvement of anthropologists, sociologist and psychologists in sanitation programming. It is very clear that most times we are focused on construction of toilets (even the UNICEF New York HQ sanitation team calls itself 'The Toilet Team'; which I understand may be targeted at raising the awareness and facilitation discussion and removal of the stigma associated with toilets). (May be it should consider calling itself the Sanitation Behavior Change Team). Hence we in our monitoring also count the access in terms of the possession of a toilet. I believe that we may have to study mass behavior patterns like widespread corruption among a people; the love for a particular car in a country or among a particular people; the mode of dressing for a group of people and the determinants or the drivers of mass behavior. Or perhaps we need more specialists to analyze and help us find the best way to reach scale with sanitation programmes. That to me may be the best way to ensure that by 2030 everyone in Africa and the rest of the underdeveloped and the developing world have access to sanitation for all.

Our colleague, Anand Shekhar, on the WSSCC CoP has responded saying:

Thanks Suvojit for these interesting questions!

Let me start by saying that partnerships and convergent action are central to scaling up. Recently Ministry of Drinking Water and Sanitation, Government of India and Global Sanitation Fund have come out with a "Shillong Declaration" which realizes the need for effective partnerships for going to scale and commits to provide an enabling framework for effective partnerships. The declaration can be seen at the website of Ministry of Drinking Water and Sanitation, Government of India.

We have some very interesting examples here in India on convergent action guided by enabling partnership frameworks that have yielded results at scale. Nadia District in West Bengal is a good case to look at. The key learning from Nadia- a district which has recently declared itself ODF is that the stakeholders need to be conscious of "key values" that ensure success at scale. Decentralization, conjoint planning, co-financing and collective action were some of the values agreed for scale up in Nadia and every partner and actor in the district worked on promoting these values in their work. This contributed to the entire district becoming free from open defecation.

Generally, programs of development organizations are guided by values which may or may not match and converge with others. Scaling up demands scaling up of core set of values that promote sustainability of benefits. The moot point being that multi stakeholder action must commit to and agree to promote key values. Only then we can take programs to scale.

Suvojit added:

Thanks for joining the conversation, Anand!

For the benefit of the group, here is the link of the Shillong Declaration on 'Promoting Sustainable Partnerships' that Anand referred to: www.mdws.gov.in/sites/upload_files/ddws/...long_Declaration.pdf
(Attached for ease of reference also.)

Also, a link on the sanitation efforts in Nadia district sabarshouchagar.in/
Sabar Souchagar (in Bengali), means 'toilets for all'

Vous pouvez également lire mon message en français - s'il vous plaît voir le commentaire ci-dessous à partir de Tracey (23 Octobre : # 15094 )

Fortunately, there is no argument any longer about how critical ‘scaling up’ is when it comes to sanitation. However, unlike many other public health interventions, the sanitation challenge is complex, sometimes also called a ‘wicked problem’ – a challenge foremost, of inducing lasting behaviour change. The very nature of careful social engineering required to bring about this behaviour change seems to run contrary to some of the factors that make an intervention scalable – an ability to standardise inputs and break programme components down to easily replicable bits.

In the rush for scale, there is the real risk of perpetration of target-driven hardware interventions which will neither change behaviour, not create social cohesion. It is not unusual for organisations that rush to scale end up compromising on exactly those key design elements that made their pilots a success. For instance, government-led sanitation programmes in India have continued to fail over two decades precisely because of a narrow focus on construction. Construction is important, but even there, there is a lot one needs to get right: usable and lasting designs, and implemented in a way that promotes, rather than detracts from local ownership.

The other issue is that of total inclusion. As is now widely understood and accepted, without the inclusion of all households in a community, gains from improved sanitation cannot be realised. Unless all families adopt hygienic sanitation practices, we will not make a dent on the incidence of disease prevalence. In sanitation, (say) 70% of those currently practising ODF switching to safe disposal of faeces would not be a success if the remaining 30% are uniformly distributed across the communities that have made the switch. So models that scale on the basis of willing consumers/ participants, rather than a focus on each person adopting it (such as micro-credit or cola or condoms) may not be easily transferable to sanitation. Therefore, comparisons with the number of mobile phone users aren’t really valid at a fundamental level. But we might have a lot to learn from effective marketing (social or otherwise), as demonstrated by say, the success of the polio vaccine campaigns around the world.

In sum, we have learnt that conventional approaches are not working: those that set up a false dichotomy between hardware construction and behaviour change; those that are content with pit latrines as opposed to functional toilets; those that use reductionist conceptions such as communities being open defecation free rather than focusing on personal and environmental sanitation and hygiene as a whole; and those that settle for incremental coverage instead of full coverage from the start.

All of this raises important questions for ‘going to scale’. Through this thread, it will be great to see a free-ranging discussion on the key operational challenges. To initiate the conversation, I will set out a few leads:

1. What are some successful examples of successful scale-up? How did these models address the issues of inclusion and equity? In terms of implementation, how have these models been able to create an iterative model that avoids blueprints?

2. In the cases of successful scale-up, were programmes initiated and sustained by governmental or non-governmental actors? What are the key elements of a successful partnership? How can we strengthen national ownership?

3. What is the role of the private sector – for example, in financing, communications, sanitation marts – in implementing sanitation at scale?

Looking forward to an exciting and enlightening conversation!