Many thanks for these answers!

Caitlin

Dear CaitlinMcC,

Thank you for your questions. I Do apologize for my late reply. Regarding you question number one, I would say, yes. The project includes the discussion with the policy makers of agriculture and sanitation. Cross-sectoral policies are important as WATSAN-agriculture are inter-related. But we have more focus in the system analysis in the project where we try to identify how agri-ecological system such as different types of irrigation, land holding, livestock management affect the health outcome of households. The impact of government policies on WATSAN-Ag is still not dominant in our research. May be our colleagues from the project might have intention to do that research.

I know some government organization in Bangladesh are already working on providing irrigation water as well as drinking water to the rural households. To some extent they are more serious to provide potable water so that households do not need to take canal water or pond water to drink. Department of Public Health and the Agriculture ministry do have some compliance to promote water and sanitation services in Bangladesh. It is very difficult to say how receptive they are to new collaboration. But I must say government of Bangladesh has taken water and sanitation seriously and as a result we have almost stopped open defecation and we have potable water more than 90 percent.

Regarding you second question, as you said this is another link between agriculture and sanitation, this approach is compatible with watsan approach. Sanitation organic waste requires processing and rural households are incapable of doing that. A processing industry is required who can do that commercially so that the fertilizer can be used in the agricultural field. This approach is innovative and it needs proper methods of collecting faecal materials from households time to time from proper sanitation infrastructure with good incentives. I think this is a promising sector for public private partnership in the community level.

Regards,
Monirul

Thanks for your interesting presentation during the 'Community initiatives for sanitation and health' webinar last week. I had a couple of questions I didn't get a chance to ask at the time and I hope you might be able to answer them:

1. The project information mentions the need for 'cross-sectoral' policies to facilitate WATSAN. Has the work included any discussions with policy makers in agriculture and sanitation? How receptive are they to the idea of collaboration on inter-sectoral policies?

2. Are WATSAN approaches compatible with other approaches to recover sanitation organic waste and nutrients as agricultural fertiliser? This is another link between agriculture and sanitation, but perhaps with different requirements and objectives. I wonder if the two can be pursused at the same time.

Many thanks.

For those that missed it, or who want to continue the discussion, here are some questions that came up in last week's webinar on 'Community initiatives for sanitation and health' (took place on January 28th, 2016, see here: forum.susana.org/forum/categories/5-comm...sion-continues#16764).

-Elizabeth Korasare: Why is there a big gap for hand washing have you ascertain why people don't wash hands? and what did Bang. do to check open defecation?

-Penninah:Please explain a bit more how your Food Hygiene Education/promotion is structured. Who does the education sessions, apart from posters, how else do they do it?

-Penninah: I like that idea of showing people the results of the tests

-Henrietta: Can you give us some indication what the state of the communities is with regard to sanitation coverage when you bring the Food Hygiene Education to the community? are most communities ODF, do most HH have handwashing facilities already?

-darja.kragic: What is your experince/which approach would you take, when working with communities in (low income) urban areas?

-toyaz3112.naik: Apart from educating people what else we can do ?

You can watch Monirul Hasan's presentation and discussion in the webinar videos attached below:





and Monirul's powerpoint presentation is available here:

Dear Forum Memebers,

On August 17-18, the Sustainable Development Goals - A Water Perspective International Conference was held in Bonn.

Here's a link to the recommendations from the Bonn Water Conference on the SDGs.

You can access the presentations under the following link . In his Keynote Speech , Prof. Joachim von Braun presented first results from our surveys in Ethiopia, Ghana and India.

Regards,
Samantha

Dear Community,

Part of our WATSAN-Agriculture Team was at the 29th ICAE Conference in Milan in Italy earlier this month. I would like to draw your attention to the presentations given by:

Mohammad Malek: Water quality information, WATSAN-agriculture hygiene messages and water testing with school students: Experimental evidence for behavioral changes in Bangladesh ( PPT )

and

Charles Okyere: Strengthening the Capacity of Households and Communities for Improved Water, Sanitation and Hygiene: Water Testing Experiments with School Children and Adult Household Members in Ghana (PPT)

Regards,
Samantha Antonini

Dear Forum Members,

I would like to share with you a poster which Muhammed Usman has presented at the AAEA & WAEA Joint Annual Meeting in San Francisco, July 26-28 2015.



Regards,
Samantha

Experiences on Poster of BRAC AG-WATSAN team

Prepared by: Tahsina Naz Khan, Iktiar Mohammad and Mohammad Abdul Malek

1. What were your experiences for designing the poster? Do you have any advice on how to design a WASH poster (Dos/Don’ts)?

Designing the WASH poster was a pleasant experience apart from the dearth time allotted for the preparation during politically unstable situation of the country. Basically, such art works require flexible time frame for maximizing the aesthetic value and outlook of the content.
Contextualizing the poster to the local arena should be central to poster design. Pictorial expressions of the characters and other objects must be lifelike. Poster messages ought to be crafted reflecting the intended changes wanted. Professional cartoonist and material development people need to involve from the beginning. There might have some issues of branding compliance in case of working under an institutional platform. Last but not least, doing it with fun!
Too much objects and characters must be avoided so that the poster should not look cluttered in arrangement. Complex languages should be avoided in constructing messages. Finally, do not forget to meet the deadline!

2. What were your experiences in the field in terms of acceptance and understanding of the messages? Did people show interest or was the intervention work rather a nuisance for them as they had other things to do?

The poster has been greatly appreciated by the treatment households, as have been found during the field visit for the end line survey. No negative impression could be seen from anywhere, implying the wide acceptance of the poster. The general experience from all of the treatment households regarding the acceptance and understanding of the messages is as follows:
• Treatment households have been found to hang the posters on the walls of their homes mainly due to attractiveness of the posters.
• Even the household members who are illiterate and also the children have been able to understand the messages of the poster by watching the pictures.
• Many have commented that the six messages of the poster are very important and very useful to them. They have become aware about sanitation and hygiene after getting the poster.
• Treatment households have commented that the language and the pictures of the poster are easily understandable.
• According to the treatment households, this poster will play important role in raising public awareness. The neighbours of the treatment households have also become aware of the messages of the poster. People of other households also wish to get one. Prominent people in the villages have become satisfied with the poster. They think that this type of step is very important for educating the village people.
3. Do you have any preliminary results or observations at this stage?
The field visits during the end line survey has revealed some preliminary results or observations. These results may not depict the whole scenario of the effect of our intervention completely. The true picture is yet to come after comparing with the quantitative data. But at this stage, the general impressions can be described as follows:
• The practice of open defecation has reduced after the interventions and many of the treatment households have started to use latrines.
• In some areas, treatment households have not been able to follow the messages of the posters and other interventions to some extent. The households, including the farmers working in their farm fields, still practice open defecation, although somewhat less than before-intervention period.
• Women have become more aware about following the messages of the poster than men. Women are now washing hands using soaps or powdered soaps after work and after defecation. They wash hands and feet properly before cooking.
• Most of the men, even when they defecate at home, do not have the practice of using soaps.
• Female students have now become more aware about maintaining their hygiene than before.
• Households are now drinking water from tube well rather than unimproved sources.
• Many farmers now carry drinking water in bottles while going to the field for work. Many other drink water from deep tube well in the field.
• Before intervention, the households did not keep soaps in their hand washing places, but now they do.
• Treatment households are trying to drink safe water and to use fresh water in cooking. They are using detergent or soap in place of ash or clay for cleaning utensils.
• Most of the treatment households wash their hands with soap or detergent after taking care of livestock.
• The treatment households now practice washing their hands using soaps after defecation about which they were not much aware before the AG-WATSAN intervention.
• The children of treatment households used to defecate in the yards of their houses. Also, the discharges of households were disposed to the backside of the houses. But now, after the interventions, the discharges are disposed to specific places.
• Before the interventions, they did not use to cover their food. But now they preserve food in closed cupboards and high places.
• Brooms have been found for cleaning bathrooms in the treatment households. Also, soap and powdered soap have been found.
• As a matter of sorrow, most households cannot purify water due to lack of purifying kits- they fetch water from tube well and drink directly. Also, they still lack the awareness regarding purifying water for drinking water.
• In many areas, households still have latrines near tube wells.
• Students who got training on water quality testing have become aware about drinking water and they are also, to some extent, influencing their households to follow the messages of the poster.
• Treatment households now cover the water container after collecting from the source and also reserve in covered containers.
• They did not wash their hands after touching hens and ducks. But after the interventions, they do.
• Before intervention, they used to throw the wastes of kitchen and livestock here and there. Now they dispose those in specific places.
• Due to the students, treatment households wash their hands with soaps before taking meal.
• The number of Diarrhoea affected patients has reduced as a result of the interventions.

4. What are your lessons learned/recommendations if you had to prepare another WASH poster in the future?

If another WASH poster is needed to be prepared in the future, then we would recommend including more rigorous message on water quality, especially regarding drinking water and purification method. This recommendation comes from the fact that treatment households, even after going through the intervention procedures, have not become much aware about purifying drinking water. Also, there should be more focus on placing latrines far from the sources of drinking water, which the households are still deficient in following.

If you have questions/queries, pls post them here or write me at This email address is being protected from spambots. You need JavaScript enabled to view it.
……………….

Hello Kim and All

It is a pleasure to hear from you concerning your interest in our project. I will address your concerns based on the Ghanaian context. By way of information, the Ghana project was largely a randomized evaluation study on measuring the impacts of household water quality testing and information on health outcomes, and water, sanitation and hygiene (WASH) behavior changes.

Here are some of the preliminary results:

1) From our design, we wanted to show the most effective delivery channel for WASH information (experiment). On this note we had two treatment groups: 1. school children group and 2. adult household member group. The design fits into the traditional/cultural settings of Ghana based on roles played in the households. In Ghana and other sub-Saharan African countries, children provides labor and time for fetching water and also perform other household chores whilst parents provide logistics/resources in performing such task. The preliminary results show that participation rate which is used as a proxy for demand for WASH information is high among "school children" group than "adult household member" group. This is interesting results because it makes easier to target households for the delivery of such information. Further participation rate was slightly higher for females compared to males. This shows some traditional/cultural roles in the households.

2)The preliminary results based on intention-to-treat (ITT) analysis and instrumental variable (IV) estimation show that the experiment was effective in convincing households on the choice/use of improved water sources. For instance, participation in the experiment leads to choice of improved water sources as the main source of drinking water (based on JMP classification) by 6.6 percent whilst use of surface water as the main source of drinking water decreased by 6.3 percent. The use of sachet/bottled water as the main drinking water source increase by 6.2 percent. Differential impacts exist with "school children intervention group" households using more improved water sources (10 percent) compared to 2.8 percent for the "adult household member intervention group" households. Lastly, there are gendered treatment effects with male participants being worse-off compared to their female counterparts in most of the indicators for water source choices.

3)The results have implications on the proposed SDGs, particularly on use of improved water sources and microbial analysis of water quality.

4)Finally, there is huge potential for scale-up. The existing institutions including basic schools , teachers and community leaders could be the entry point for the dissemination of water quality improvement messages. I am still analyzing the willingness to pay for such information by the householders. Initial indications are that majority of the households are willing to pay for such information. How much they are willing to pay and the type of water testing kits will be presented as soon as I complete the analysis.

I am available for other discussions and suggestions in case the need arises.

Charles Yaw Okyere

Dear Kim,
Thanks for the interest you showed for our research activities.
I would like to highlight the general research questions we are trying to address in Ethiopian context. When we look into the watsan-agriculture nexus, we consider not only health but also nutrition outcomes. There is a strong linkage between watsan and nutrition in developing countries. Poor watsan is a leading causes of diarrhea and other infection which leads malnutrition especially for under five children while agriculture is a sources of more nutritious food to achieved improved nutrition.
Having said that, here we are specifically trying to look into the role of small scale irrigation as a source of domestic water supply (through multiple water use) and a source of more nutritious food to enhance improved health and nutritional benefits. However, there are also downside and unintended outcomes of irrigation. The quality and quantity of drinking water can easily become affected through irrigation agricultural practices (for instance, increased use of pesticides and chemicals). Moreover, irrigation might serves as a vector-breeding habitats which affect people’s health. Therefore, if we recognized the multiple use of irrigation water and both water supply, sanitation and agriculture are managed in a holistic view and in direct support for improved health and nutrition outcomes, multiple benefits such as improved health and nutrition outcomes might be achieved and trade-offs reduced.
Here I have put down some preliminary results from simple tabulation results. So far the data show us that:

• Controlling for distance to water sources, irrigator agricultural households had greater per capita per day water consumption compared to non-irrigator agricultural households.
• The mean values of Escherichia coli (E.coli) bacteria is higher for irrigator households
• Incidence of diarrhea and malaria diseases are higher in irrigator household members than non-irrigator household members
• Children living irrigator households are more likely to be underweight and stunted than children living in non-irrigator households which is basically what we are not expected.
• Among irrigators, however, households who use irrigation water for domestic purposes have poor domestic water quality but lower incidence of diarrhea diseases.

To answer your question regarding the behavioural change perspective, some of the challenges are, first, there is a lack of awareness of the need to treat drinking water. People’s perception regarding drinking water quality is that clean water is ‘clean water’. Second, open defecation is a norm and wide spread in the study areas and this might be dangerous as most community water sources are unprotected. Moreover, most households believe that child faeces is not as pathogens as adult ones and they do not contain them safely. Therefore, awareness campaign at community level and training program at schools may be helpful to bring the desired level of awareness in our context.
Finally, I would say my work is at an infant stage to come up with concrete policy recommendations or scaling-up issues regarding the watsan-agri nexus. But, I promise that I would update my new results and progresses on the forum in the next few months.
If you have any further questions or comments, I would be happy to discuss with you.

best,
Muhammed

Dear Kim,

Thanks for raising these very interesting questions - which we are acutally trying to address with our research activities! Most of our researchers just got back from the field and are still cleaning and evaluating their data! I think that we can give general answers to these questions only when data from the 4 countries is ready to be compared. Especially in terms of policy recommendations and upscaling, I hope that the results will show whether we can come up with "global" recommendations or if you really need to look at and adapt to local settings.

In terms of reaching more people, we are planning to organize a workshop later this year in each of the study countries to share our findings with local institutions and policy makers. We also would like to provide feedback to the communities that were involved in the surveys.

To give you an overview on first recommendations and challenges (esp. in terms of behavioural change and competition in water demand), I am calling on my colleagues who have been out in the field to share their impressions! As soon as a synthesis from the 4 countries is available, I will share the information on this platform!

Regards,
Samantha

Dear Samantha and all,
Thanks for introducing your interesting project on the links between watsan-agriculture, and for providing information of the different project components. Interesting to see how you are working with the watsan-agri nexus from a hygiene/health point of view. Currently at SEI we are looking more on the links from an integrated resource perspective (e.g. safe reuse of sanitation waste as fertilizers), so it would be interesting to see how these two approaches could complement each other.

I would therefore like to know more about your findings related to the goals and objectives you have set up.
With the progress you have had so far, how would you summarize your main policy recommendations regarding minimizing trade-offs and achieving synergies between watsan and agri? For example, have you encountered critical competition between water demand for irrigation and WASH-activities, if so how could these be mitigated?
From a behavioural change perspective, what have been the major challenges and how have these been tackled? Have you encountered significant differences between the countries you are working in?
Do you already have ideas on strategies how your initiative could be scaled-up to reach more people? E.g. are there existing institutional structures in the countries that could be used for up-scaling?

Looking forward to hear more about the lessons you are gaining from your project.

Best regards,
Kim