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- New Study from Bangladesh - finds CLTS ineffective without subsidies
New Study from Bangladesh - finds CLTS ineffective without subsidies
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Re: New Study from Bangladesh - finds CLTS ineffective without subsidies
citiscope.org/story/2017/how-dhaka-won-f...886ae27d03-118055621
says:
NGOs worked closely with the government and used their grassroots networks to build sanitary latrines in infomal settlements like the Sattola area of Dhaka.
Volunteers work with community members one-on-one and in groups to encourage healthy hygiene.
The efforts have helped reduce incidence of diarrhoea and mortality for children under age 5.
While in Pakistan, OD is rampant, it is extremely encouraging to note that Bangladesh is now OD free.
Please see this UNICEF report:
www.unicef.org/publications/index_96611.html
F H Mughal
Karachi, Pakistan
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You need to login to replyRe: New Study from Bangladesh - finds CLTS ineffective without subsidies
www.firstpost.com/india/casteism-is-the-...-coffey-3925663.html
Anyone got an idea where this data could be found in a scientific publication?CLTS was invented in 2000 and people talk about how it was an important part of what happened in Bangladesh. But open defecation in Bangladesh in 1991 was much less than what it is in India today. It was already going down in Bangladesh and if you look at open defecation before and after CLTS, it is going down at the same rate. That doesn’t definitely prove that CLTS doesn’t work but we need to think about it carefully.
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You need to login to reply- vishwanathdalvi
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- I am a chemical engineer interested in developing sustainable technology solutions to address problems of access to energy, clean-water and sanitation.
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Re: How to sell toilets: what really works.
Here is another excellent study published in Science magazine (www.sciencemag.org/content/348/6237/903.abstract). I can only access the abstract, but that is enough. *
What they have found is:
1. Community motivation did not raise toilet ownership.
2. Subsidies by themselves did not increase toilet ownership.
3. Subsidies to the landless poor increased ownership among the subsidized.
4. Subsidies to the landless poor increased ownership among unsubsidized households.
5. These subsidies greatly reduced open defecation.
Hence the way to get the poor to use a toilet is to buy them a toilet. And if you buy enough, people will go out of their way to get one. Scope for positive government intervention here.
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Note by moderator:
* Encouraging sanitation investment in the developing world: A cluster-randomized trial
Raymond Guiteras1, James Levinsohn2, Ahmed Mushfiq Mobarak2
R. A. Mashelkar Assistant Professor
Department of Chemical Engineering
Institute of Chemical Technology, Mumbai
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
LinkedIn: in.linkedin.com/in/vishwanathdalvi
RTTC Project: forum.susana.org/forum/categories/141-ot...gy-mumba-india#13252
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You need to login to reply- eendres
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- Senior Program Associate
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Re: New Study from Bangladesh - finds CLTS ineffective without subsidies
I also question the LSA model used, but not necessarily the use of salaries to compensate LSAs (see iDE's awesome summary of the HYSTRA report attached--having a full-time, dedicated sales force can reduce turnover and increase efficiency). My real concern is that they weren't use effectively. Their roles are described in the supplemental document as: 1) providing information about where to buy a latrine; 2) enabling households to assess the quality of latrines being sold; 3) Assist with delivery and installation; and 4) Provide technical support post-purchase. But they were also instructed not to provide information about the benefits of latrine use!
There was no intervention tested that combined demand creation (either through village level sanitation promotion like LPP, or through IPC or DCC via sales agents) with supply. Just as the success of CLTS is limited without a functioning supply chain, the supply chain cannot function without a sufficient level of demand. I wonder what the results would have been if LSAs were able to have conversations about the benefits of latrine use and the difficulties of OD AND connect people with aspirational and affordable products?
I'd also be interested to see what the use rates are in, say, six months to a year. Did the size of the subsidy make the product cheap enough to buy, whether or not the purchaser really intended to change OD habits? Maybe. But I think there's room to explore how subsidies could actually benefit the private sector, if used in the right way. For example, could these subsidies, in the form of vouchers, actually support the private sector by giving them access to a portion of the market that they wouldn't have without the help of subsidies? Could those vouchers give the poorest the ability (and the dignity) to purchase a latrine that they can be proud to use, AND help make sanitation a more viable business (which would not only help current sanitation businesses survive and grow, but also encourage more entrepreneurship in the sector)?
Senior Program Associate
Results for Development Institute
Washington, DC
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You need to login to reply- Guy
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- Director of Research & Evaluation, WSUP
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Re: New Study from Bangladesh - finds CLTS ineffective without subsidies
Guy Norman
of Water & Sanitation for the Urban Poor (WSUP) and Public Finance for WASH initiative (www.publicfinanceforwash.com), opinions are my own
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You need to login to reply- former member
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Re: New Study from Bangladesh - finds CLTS ineffective without subsidies
Quite an interesting and lively discussion. I can weigh in and provide a couple answers/reflections from the SanMark point of view, as iDE brings experience implementing SanMark in 6 countries to date. Please note that all of these points, and my reflections, are in regards to the 'supply side interventions' mentioned and not a reflection on the whole study (thats not my place).
The study mentions "These results counter the concern among many development practitioners that subsidies undermine intrinsic motivation. Rather, this research shows price is a primary barrier, which is consistent with a growing body of research on adoption of health products." Of course price is a major concern for these households. However, this research concludes that subsidy is the only way to deal with price barriers. The other option is that the latrine itself was not deemed valuable enough by customers to be worth the price. So instead of concluding that subsidy is the only way to tackle this, I would argue that making investments in the latrine itself to make it more desirable by customers and/or professionalizing the sales force to make them effective sales agents could also over come the price barrier.
The Study mentions "The subsidy vouchers could be redeemed for a 75 percent discount on available models of latrines, priced (after subsidy) from $5 to $12. The households were responsible for their own transportation and installation costs." Building off the point above, in SanMark the essential piece is that the product you are selling is truly desirable. These latrines seem pretty cheap and if they don't meet the needs/wants of the customers (aspirational, comfortable, etc.), then its not surprising you can't sell them. I also don't buy things I dont want. I can't assess if the latrines do or don't meet customers' needs, but an important thing to consider with any SanMark approach is designing/selling a product that people want and are thus willing to pay for.
The last point is simply that the supply side intervention seemed very, very light touch - primarily engaging masons for a couple weeks to provide technical and sales support (i.e. convince people to buy a latrine). The study also mentions these LSAs were hired for 12 weeks and were paid a full salary. In iDE's experience, this is extremely light touch and not something I would classify as Sanitation Marketing. SanMark is about creating a market for a product/service, and that inherently takes multiple years (not multiple weeks) and adoption follows the typical product adoption curve. SanMark is far bigger than pointing someone in the direction of a latrine supplier. Its about identifying customers needs, designing products that satisfy them, building suppliers capacity to produce them at a good price, and helping households understand the consequences of not having a latrine so they are motivated to buy one. Often this motivation is NOT health, but dignity, pride, and 'keeping up with the Jones'. Sales agent training is also a major component requiring recruiting specific people, weeks of classroom & field training, and months of ongoing coaching and support. These sales agents are also paid on commission, motivating them to actually close sales, as when sales agents receive a salary they have no motivation to actually follow up/close deals. Plus the product has to be right, the price right, and the sales messaging right. All in all, I don't think its fair to extrapolate the results of this study on more robust SanMark efforts.
It seems there are some important learnings from the study and things not to be discredited. It also seems like a complicated undertaking trying to compare 3 different approaches in an RCT. In the end, I think the results are valuable for those projects studied but we should be careful extrapolating them more widely as they are heavily dependent on the effectiveness of the original approaches in the first place.
Best,
Blake
* abbreviations:
LSA = Latrine Supply Agent
RCT = Randomized controlled trial
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Note by moderators: This post was made by a former user with the login name BlakeMcK who is no longer a member of this discussion forum.
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You need to login to replyRe: New Study from Bangladesh - finds CLTS ineffective without subsidies
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
Chairman
Foundation for Environment and Sanitation
Mahavir Enclave
New Delhi 110045, India
Web: www.foundation4es.org
Linked: linkedin.com/in/drpkjha
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You need to login to replyRe: New Study from Bangladesh - finds CLTS ineffective without subsidies
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You need to login to reply- joeturner
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Re: New Study from Bangladesh - finds CLTS ineffective without subsidies
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.
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You need to login to reply- joeturner
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Re: New Study from Bangladesh - finds CLTS ineffective without subsidies
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.
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You need to login to reply- joeturner
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Re: New Study from Bangladesh - finds CLTS ineffective without subsidies
www.sciencemag.org/content/suppl/2015/04....DC1/Gutieras.SM.pdf
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- New Study from Bangladesh - finds CLTS ineffective without subsidies