Technical Breakout Session Hygiene 4: Engagement of PRIs for WASH social and behaviour change communication

Date: 24 February'22
Time: 5:00-6:30PM

Moderator: 
Name– Shalini Prasad
Designation-Social and Behavoiur Change Specialist, UNICEF, Delhi

Speakers: 
1. Shri Yugal Joshi
2. Mr.Vijay Shankar Kanthan
3. Ms. Sowmyaa Bharadwaj
4. Ms Zoya Rizvi
5. Ms Pratima Kumar
6. Ms. Rekha
7. Mr. Mukhiya Abhishek Arnav

Context
Panchayati Raj Institution (PRI)members are responsible for local, village-level development, and play a key role in connecting communities with key services around Water, Sanitation and Hygiene (WASH). PRI members’ role as basic units of local administration make them key enablers at the ground level, rendering them as a key stakeholder in driving WASH practices among communities.
 
As PRI members play a dual role in implementing and monitoring government services and programs, their ownership and engagement around WASH issues is essential to building grassroots-level action around WASH. The first step therefore is to build the capacities
of PRI members on technical issues of WASH, followed by skilling them on effectively communicating these in simple messages to communities through various channels and tools (conducting interpersonal communication, holding group meetings, demonstrating, and
promoting WASH practices). Since PRI members are elected representatives within a community, they are respected members of societies and maybe looked up to as role models and influencers of key behaviours. Thus, PRI members play an important role in engaging and mobilising their communities to adopt positive behaviours. They can balance the demand and supply and can create an enabling
environment at the ground level. It is therefore critical to optimize their role in driving Social and Behaviour Change (SBC), and improving uptake of WASH practices among communities.
 
Making the sarpanch and gram panchayat members well conversant with their responsibilities of integrating SBC communication as part of their plans, is key to ensuring improved and sustained use of WASH facilities and adoption of positive practices.  As PRI members have a unique potential to drive local community-led planning and action processes, investing in their leadership qualities is critical to bringing about large-scale community mobilization and engagement around WASH. As developers of action plans such as the GPDP, PRI members are also responsible for village-level agenda and priority setting around WASH, and well as bringing about convergent efforts to administer WASH service delivery on the ground.
 
Engaging with PRI members and establishing sustained communication with these key stakeholders and understanding their current gaps in capacity and knowledge around WASH Social and Behaviour Change is essential to improving WASH outcomes.
 
Session summary
Context:
1.     Enabling WASH behaviour
2.     Steps taken by the government to ensure the sustainability of handwashing practice
3.     Strategies for ensuring messages are effectively communicated by PRIs
4.     Ways to build skills of PRIS with respect to communicating hygiene and MHM related messages
 
Challenges
1.     Culture of silence around MHM due to taboos
2.     Lack of menstrual facilities compromising safety of girls and women
3.    Huge gap between access to soap and water
4.    Low involvement of males
5.    Lack of involvement of PRIs and community in designing communication
 
Key takeaways:
a) Solutions- Examples of what/where/how/who
1.     Improving access to safe water and sanitation facilities (Mr. Abhishek working towards installation of handwash stations in his village)
2.     Design locally and culturally relevant tools and resources for information dissemination, Nudge experiments in institutions
3.     Perpetuating myths/taboos/misinformation
4.     Capacity building of functionaries/GPs/community leaders
5.     Shift focus from campaign mode to integrating WSSH message in regular conversation
6.     Involvinglocal administration in SBCC activities
7.     CreatingGP level task force, MHM corners and WASH monitors
8.     Calendar of communication activities to be prepared
9.     Leverage on important contact days (adolescent health and wellness days) as a platform for service providers (such as doctors, ASHA workers) to interact with community and identify and break down barriers to
access to right information
b) The way forward or what needs to be done?
1.     PRAs critical to encourage community participation
2.     Map barriers to behaviours,integrated-evidence-based planning
3.     Capacity building of service delivery chain.
4.     Strategic partnerships with CSOs/youth networks/etc., to help build change processes at community level for leveraging resources, and creating platforms for advocacy initiatives
5.     Reaching tech and media dark populations
6.     Avoid information overload to prevent fatigue among communities
7.     Interpersonal communication capacity instrumental in changing mindsets and behaviour
8.     Discussion with stakeholders to develop tools
9.     Strengthen community feedback mechanism
10.  Promoting institutional communication activities with convergence and focused approach
11.  Creating enabling environment for dialogue, strengthening delivery of services
12.  Access to regular messaging on both hygiene and menstrual hygiene behaviours – through various forms social media, traditional art and folk songs, door to door etc.Taking a 360-degree approach in disseminating the messaging by creating and adapting content to culturally fit the context.
13.  Creating models of GPs that be scaled and replicated.
14.  Integrated planning, microplanning at the community level
15.  Use of participatory approach to understanding the needs of the community. This means look at each group differently, and trying
to understand their needs – so groups of women, men, person with disability etc – unpacking their needs in a participatory manner would give solutions from the ground up.
16.  Equipping the GP members with simple yet effective way to monitor.

Document: 
1. Presentation is prepared by Ms. Shalini Prasad 'Medium, channels and tools for communication on improving hand hygiene and menstrual hygiene management'-  www.susana.org/_resources/documents/defa...9-238-1646810631.pdf
2. Presentation is prepared by Praxis ‘Implementation of Social and Behaviour Change Programs for WASH at Ground Level’-  www.susana.org/_resources/documents/defa...9-238-1646811341.pdf

Technical Breakout Session Hygiene 3: Hygienic disposal of child faeces in rural areas - How can PRIs make it possible and feasible?

Date: 24 February
Time: 5:00-6:30PM

Moderator
Name: Dr Apurva Vijay Ghugey
Designation: Thematic Manager- Sanitation and Hygiene, Gram Vikas

Speakers: 
1.     Ms Gloria Sclar Public Health Researcher Emory University
2.     Mr. V.R Raman, Head of Policy, WaterAid India
3.     Ms Anju Khewar, Program Coordinator, State Health Resource Centre, Chhattisgarh
4.     Mr. Aloknanda Bisoyi, Research Manager, Emory University
5.     Mr Prabhakar Sahu, Secretary, Village Water and Sanitation Committee Laxmanpalli GP, Ganjam, Odisha
6.     Mr Narayan Sahu, President, Village Water and sanitation Committee Laxmanpalli GP, Ganjam, Odisha
7.     Ms Mamata Kumari Sahu, ASHA Worker, LaxmanpalliGP, Ganjam, Odisha
8.     Ms Sanjulata Pradhan, Anganwadi Worker,Laxmanpalli GP, Ganjam, Odisha
 
Context/ Problem Statement:
The world has made great progress in increasing access to basic sanitation and reducing open defecation, with only 9% of the global population open defecating as of 2017. In India, the percentage is as high as 15%. However, an often overlooked component of sanitation is safe Child Feces Management (CFM). Child feces may contain more pathogens compared to adult feces and are likely a significant source of fecal exposure in rural Indian households, and other similar settings. The latest National Family Health Survey (2015-2016) reported only 36% of Indian households safely dispose of their child’s feces into a latrine despite 61% of households having a latrine. There is a need for effective behavioral interventions that focus on safe CFM practices among caregivers, with the eventual goal of the child learning to use
the latrine, and to achieve the global commitment to ensure safe drinking water and sanitation for all.
 
Why PRIs are important for this issue:  
The PRIs are the immediate governance for the rural communities when it comes to getting aware, addressing and reporting any issues and ideas in the community. Active PRI in any panchayat leads to progressive rural communities. When it comes to Child Feces Management, it is of utmost importance for the people to learn, accept and be accountable for the new habits they need to inculcate in order to bring about sustainable health changes. PRI can help people to,
·       Be aware of the magnitude of the issue , and its connection to bigger picture
·       Believe themselves to solve the problem by facilitating to avail the provisions
·       Set up good monitoring practices ensuring the long term success of the CFM initiative.
 
Gaps, challenges, and issues:
In India,managing child faeces is often neglected due to many reasons, some of which are listed below,
·       Ignorance-considering child’s faeces as non-harmful
·       Lack of education to parents
·       Lack of proper healthcare facility focusing on children
·       Lack of institutions where parents can take guidance from.
·       Lack of access to proper infrastructure such as toilet, diapers, etcs
·       Lack ofpolitical will-power
Hence, it is very important to put a good amount of focus on Child Feaces Management.
 
What is the potential that we can gain with the involvement of PRIs?
Direct involvement of the PRI will ensure that their political activism for the issues and parents would get the sense of belongingness. This will bring a more focused approach towards all the schemes and initiatives the Government is taking to address the issues. This will also make the people aware of the grave health problems if the issue is not tackles with focus and seriousness. With roll-out of SBM-2, role of PRIs has become even more critical. PRIs, since they have significant impact on local people’s psychology, can play a very important role to make behavioral changes on ground possible and monitorable.
 
Session summary 
Context:
1. Child Sanitation is often overlooked component. It has direct impact on health. It is
usually considered as “not harmful”, a narrative created by the society.
2. Child faeces may contain morepathogens compared to adult faeces and are likely a significant source of
faecal exposure in rural Indian households.
3. Traditionally in rural area women are consideredresponsible for safe disposal of child faeces.
 
Challenges
1. Ignorance- considering child’s faeces as non-harmful.It’s part of the social conditioning
2. Lack of access to proper infrastructure such as toilet, diapers, etc.
3. Lack of institution where parents learn the preventive healthmeasures for children. Though the social media is available with many tips and
tricks but largely for urban parents.
4. Gender barrier– Over dependence on mothers as caregivers, this put undue pressure on mothers 
 
Key takeaways:
a) Solutions -Examples of what/where/how/who
1. Education, awareness programmes are needed to highlight the issues. Wall writings or nukkad natak can be done.
2. VHSC training can be done on child feces management (CFM). Chhattisgarh's model on working on CFM with Mitanin can be replicated.
3. There has been some piloting of programmes with Ekjut on providing community creches for children whose parents have to go out for work.
4. Gram Vikas model on training and involving male members in child-friendly latrines can be followed. Use of hardware like potty and latrine mat can also be very handy in inducing behavioral change.  
b) The way forward or what needs to be done.
1. Direct involvement of the PRI will ensure proactive political will, and may ease accessibility to the schemes and initiatives the Government is taking
to address the issues.  Sanitation must be seen beyond visible cleaning.
2. We must move beyond safe sanitation and disposal and consider Child Feces Management (CFM)
exposure pathway. Child feces can be called as second generational issue of WASH and hence convergence with SBM2 can be
explored.
3. PRI can help people to be aware of the magnitude of the issue, and its connection to bigger and facilitate in
solving the problem by utilizing the provisions or availing the schemes
4. PRI can also help in setting up a good monitoring practice ensuring the long-term success of the CFM initiative.
5. We need to explore how CFM can be incorporated in key mandated government programmes and the required materials like potty and
latrine mat can be subsidized.
c) Any Specific points to be added to call to action?
1. Safe Childfeces management should be put in national guidelines to declare the ODF status. As of now, this is ignored in the declaration of ODF status.
2. Disposal of diapers is also a bigger waste management issue. This can also be agenda for policy-level advocacy.
3. Disaster-specific planning needs to be done specifically during rainy season for safe disposal of child faeces.

Technical Breakout session Hygiene 2: Strengthening action on menstrual health and hygiene at the community level

Moderator:
Dr. Arundati Muralidharan, MHAI
Tanya Mahajan,The Pad Project and MHAI 

Context/ Problem Statement: Menstruation is a normal physiological phenomenon, yet millions of girls and women face numerous hurdles to managing their monthly menses in a healthy manner. Challenges include deep-set gender and social norms, low level of awareness, limited access to and unhygienic use of menstrual hygiene products, and lack of safe disposal and waste management options for used materials. Efforts by Government, non-Government and private sector stakeholders have strived to tackle these challenges, paving the way for improved menstrual health for all girls and women. Initiatives to improve menstrual health and hygiene have predominantly focused on improving awareness among adolescent girls and enhancing access to menstrual materials, notably disposable sanitary pads. These cumulative efforts have resulted in improvements, particularly with regard to the use of menstrual materials. The National Family Health Survey (NFHS) 4 (IIPS, 2015-2016) showed that 57.6% of young women ages 15-24 years were using a hygienic method of protection. The
NFHS-5, conducted five years later in 2019-2020, found a marked increase in the use of hygienic materials – 77.3% of young women were using safe materials, mostly sanitary pads (IIPS, 2019-2020). Innovations related to the safe disposal and management of menstrual waste have also been implemented in some geographies.  Addressing the deep-rooted taboos and misinformation related to menstruation amongst girls, women and those in their communities has provided the foundation for this progress. Implementation models adopted by state and district administrations and Gram Panchayats (GPs) for access and waste management have paved the way. To sustain this progress, we must learn from these models and ensure that they are replicated at scale. 
Role of PRIs in strengthening action on menstrual health and hygiene PRIs can catalyze action on menstrual health and hygiene (MHH) at the community level given their role in the overall development of Gram Panchayats. At the very least PRIs can facilitate discussions on MHH interventions during gram sabhas and mahila sabhas. PRIs are also in a position to address MHH through the gram panchayat development plans and allocate budgets for activities. Hence, it is also important to understand the specific roles that PRIs can adopt to further progress on MHH in their communities. 

Session: The session on “Strengthening action on menstrual health and hygiene at the community level” will highlight the MHH value chain, and delve into two aspects where PRIS can accelerate action, namely local access to quality menstrual materials, and disposal of menstrual waste. The session will also identify the underlying role that behavior change communication can play in furthering these objectives. The session aims to
1. Create awareness about the MHH value chain and corresponding areas of action
2. Facilitate sharing of programmatic good practices with regard to enhancing menstrual hygiene product availability and waste management solutions at the GP level 
During the session, the audience will hear from thematic experts and from implementers, who will share good practices from several states.

Session summary
Context: 
1. Decentralization of production models for menstrualproducts and
2.Menstrual Waste Management
Challenges
1. Gap inbetween the use of Pads in Urban and Rural area in terms of availability,
accessibility and affordability.
 
2. Setting uplocal production unit is a challenge.
 
3. Qualityassurance of menstrual Pads.
 
4.Safe disposal of menstrual products
 
Key takeaways:
a) Solutions - Examples of what/where/how/who
1. Addressing the first challenge “Gap in between the use of Padsin Urban and Rural area in terms of availability, accessibility and
affordability”. Mrs R Vimlaintroduced the Asmita yojna under Maharashtra State Rural Livelihoods Mission. Asmita is widely working in the state of Maharashtra. It is linked with the local SHGs for easy availability and accessibility and also it is cheap in comparison to other market products. It is available at subsidised price of 5 rupees per pad in Jila Parishad schools.
2. Ms Gayathri Prashanth explained the second challenge of “Setting up local production unit is a challenge and quality assurance” as the sourcing of raw material is difficult as most of it is exported from overseas and machineries are also not locally manufactured. The machines also required trained people for handholding. The local production unit will also require process like financing, marketing, sales, technical support, and quality assurance of pads. For financing cost of machines and raw materials can be financed through a financial institution like banks for marketing and sales SHGs can play a vital role. Technical supports are provided by the training agencies and for quality assurance, random checking of pads is done. One of the major challenges is the availability of electricity for production, so site selection for installing the local unit is very important.
3. Mr Devidas Kisan Nimje explains the topic of “safe disposal of Pads”. At first, the segregation of Pads from other waste is necessary. The Samarth is working in Chattisgarh state on Waste management and safe disposal of Pads is done by dividing the families based on survey into two categories one having space to construct deep burials and one with no space to construct deep burials. The families having no space to deep burials dispose sanitary napkins in a red box attached with the recycling vehicle, which is later dispersed in the deep burials.
4. Mr Kalachari B explained the model Pink toilet adopted in Karnataka state for school girls.
 
b) The way forward or what needs to be done.
1. Developing locally designed and produced pads.
2. Collaborative effort from local functionaries, PRIs and support group is necessary.
3. Eco-friendly products should be considered.
4. The use of Pads should be a holistic approach with respect to health.

c) Any Specific points to be added to the call to action?
1. Role of technical assistance, infrastructure and location accessibility is important when considering the site selection.
2. Locally design and produced pads need to be considered and promoted as it provides employment and bring self-reliance in women.

Document
1) Presentation by B.K. Kalachari on 'Menstrual Hygiene and Menstrual Waste Management in Rural Karnataka'-  www.susana.org/_resources/documents/defa...9-238-1646810179.pdf

Technical Breakout Session Hygiene 1: Making hand hygiene for all a reality in rural areas, building on the Covid experience- What PRIs can do? 

Date: 24 February'22
Time: 5:00-6:30PM

Moderator:
Name: Ruchika Shiva
Designation: Country Coordinator for India programme, IRCWASH

Speakers:
1.      Smt Parwati Sarpanch Urmul, Bikaner, Rajasthan
2.       Mr Rameshwar Lal Sarpanch Urmul, Bikaner,Rajasthan
3.       Mr Suresh Chandranayak Sarpanch Mayurbhanj,Odisha
4.       Mr Yogesh Kumar Executive Director Samarathan
5.      Mr Basant K Nayak Director Programme CYSD Odisha
6.      Ms Nabanita, Senior Researcher CYSD, Odisha
7.      Ms Urvashi Prasad Director, DMEO Niti Aayo

Context
Handwashing with soap is one of the cheapest and most effective ways to protect people against many common and life-threatening infections. This, in the last two years, has been highlighted globally due to the Covid-19 pandemic. It is important to reiterate that handwashing with soap provides protection against disease-causing bacteria and viruses, the simple act of handwashing with soap removes the bacteria and viruses from contaminated hands and avoids the transition of these into our body or spread to other people.  
 
The 76^th round of the National Sample Survey conducted in2018 found that the practice of handwashing in India is limited. According to
the survey, it was found that 25.3 per cent of households in rural India wash hands with soap or detergent and 70 per cent wash hands without soap or detergent before meals. Further, it found that 15.2 per cent rural households do not wash hands with soap or detergents after defecation. While this status can be a function of availability of facilities/space, water and soap of handwashing, the role and hence the requirement of hand hygiene promotion in communities cannot be ignored.
 
As per the Indian Constitution, the Panchayati Raj Institutions (PRIs) have a role to play with respect to provision of WASH services in rural
communities. Additionally, the 15^th Finance Commission provides 60%of the grant to PRIs earmarked towards WASH with the purpose of impacting public health in communities. We know from the response of COVID -19, the panchayats played a key role towards supporting with facilities and for the promotion of hand hygiene behaviors. As hand hygiene has public health and economic health impacts, it is an opportune time to leverage the efforts made during the COVID-19 pandemic to further strengthen (and institutionalize) the efforts to
promote hand hygiene behaviors. The Panchayats have a crucial role in ensuring hand hygiene, especially in public spaces and institutions within the PRIs jurisdiction. Institutions in rural communities include Anganwadi centers, schools and health care facilities. Evidence from the field shows that while schools have made progress in providing functional handwash facilities, this is lacking in Anganwadi centers and in health care facilities.
 
The discussion in this session will capture –
-       initiatives taken up by Gram Panchayats on hand hygiene during the COVID-19 pandemic,
-       gaps and challenges,
-       going ahead, how hand hygiene can continue to have the importance and leverage other social sector efforts.
 
The session will capture perspectives of gram panchayats leaders, NGOs that work closely with gram panchayats and government officials

Session summary
Context:
1.      Role of PRI in promoting hand hygiene during COVID is important as reflected by all PRI representatives.
2.      Awarenesspromotion activities under SBM -2 and JJM on handwashing required utmost attention.
3.      Access and use  to handwashing facilities and availability of Soap is major challenge in Rural and urban area
4.      Behaviouron handwashing have only received thrust in COVID -19. Collective effort is required to make it a non-negotiable behaviour.  
Challenges
1.      Role of panchayat in handwashing is hardly recognised. It remains as implementing agencies rather than as a Governance institution.
2.      GPDP plan have no reflection of facilities to be constructed and behaviour change to be made. 
3.      Non-functional handwashing station and non-availability of Soap is a major challenge in public spaces and institution.
4.      Non-availability of Water in drought-prone, Water scarce area fails the basic objective of hand hygiene.
5.      Collectiveeffort of all departments is missing in state for making handwashing as subject of importance.
Key takeaways:
a) Solutions - Examples of what/where/how/who
1.      Innovationin hand hygiene station with less amount of water by any agencies with government support.
2.      Re-use of water in drought-prone area after handwashing.
3.      Collective effort by Govt, CSO and CSR for making hand hygiene as important behaviour
beyond COVID through campaigns and awareness generation programme.
4.      Training of PRI members, Anganwadi Worker and ASHA on motivating people after assessing their barriers.
5.      GPDP plan should have complete emphasis of hand hygiene with its infrastructure.
6.      Properimplementation of JJM and SBM phase -2 is required to be implemented along with an emphasis of hand hygiene.
7.      Adequatehandwashing stations/facilities  to be placed in public institution, market as per number of user
b) The way forward or what needs to be done.
1.      GPDP plan should have elements of handwashing facilities and provisions referring 15^thfinance commission fund.
2.      SocialAudit of hand hygiene activities to be carried out in the panchayat.
3.      Wateravailability in all the GP in continuous manner to support hand hygiene activities. Special focus in drought-prone and water scarce area with re-use of water.
4.      Innovativemodels on handwashing station and facilities to be promoted for differently able. IEC for blind people to be made in braille. It should also cater adequate number of user.
5.      Behaviour change, access to handwashing facilities and functionality of handwashing facilities to be ensured in coordination with panchayats and community.
6.      Niti Ayog to document the models and success stories on hand hygiene.
c) Any Specific points to be added to call to action?
1.      Water need to get available and re-used in all the habitation after handwashing under JJM
2.      PRI should be fully empowered to include handwashing in the GPDP process.
3.      Social Audit should be important part to monitor the hand hygiene behavior and facilities.  
4.      Hand hygiene should be of utmost importance through long-term plan irrespective of pandemic. 

Document links: 
1) Presentation by Ms. Ruchika Shiva on 'Importance of Hand Hygiene'- www.susana.org/_resources/documents/defa...9-238-1646810051.pdf
2) Presentation by Centre for Youth and Social Development (CYSD) on 'Initiative by Gram Panchayats on Hand Hygiene'- www.susana.org/_resources/documents/defa...9-238-1646810084.pdf

Technical Breakout Session 4 Sanitation: Facilitating participation of PRIs for improved WASH infrastructure and practices in Health Care Facilities   

Date: 24 February'22
Time: 3:30-5:00PM

Moderators: 
Pratibha Singh, UNICEF ICO
Dr. Asad Umar, Aga Khan Foundation

Speakers: 
1.     Dr DeepikaSharma, NHSRC
2.     Dr Manjeet SinghSaluja, Technical Officer, Environment & Health, World Health Organisation
3.     Mr. Nageshwar Patidar, Officer, UNICEF MP
4.     Mr. Jairam Pathak, Aga Khan Foundation
5.     Mr PankajMathur, WASH Specialist
6.     Dr Yogesh Kumar, Samarthan

Context/ Problem Statement:
In India, 130 mothers die for every 100,000 babies born, and 28 out of every 1,000 newborns do not survive beyond their first month [1][2]. A leading cause of this is sepsis, an infection associated with poor hygienic practices during delivery and soon after. The Government of India has taken steps to improve maternal and child health under the National Health Mission. For instance, the Janani Shishu Suraksha Yojana entitles all women to a free delivery at a public health care facility to ensure safe childbirth. As a result of concerted efforts, the proportion of women who give birth in a health care facility in India has improved significantly from 38.7% in 2005-2006 to 78.9% in 2015-16 [3][4]. Additionally, the launch of the Swacch Bharat Mission in 2014 also saw the participation of the MoHFW to prepare a programme for swachh health care facilities which culminated in the launch of KAYAKALP in 2015. The KAYAKALP programme of MoHFW has been a
pioneering initiative in the country that aims to improve situation of sanitation, safe water, hygienic practices and waste management in health facilities by assessing and rewarding health care facilities based on indicators related to the status of WASH infrastructure, general hygiene, laundry, biomedical waste management and environmental sustainability. To improve health outcomes, health care must be safe, effective, timely, efficient, equitable and people-centred [5]. Deaths and illnesses from maternal and early neonatal sepsis are suggestive of substandard quality of care [6]. When health care facilities have an unhygienic environment, with an inadequate supply of running water
and handwashing facilities, and poorly maintained or dysfunctional toilets, women may avoid or delay seeking care and are likely to leave such facilities sooner than they should after delivery [7]. Health care providers working under such conditions are unable to maintain hygiene and prevent infections. The landmark 2015 report of the World Health Organization (WHO) and UNICEF on WASH in health care facilities states that 72% of HCFs in India have water and only 59% have sanitation amenities. WASH in healthcare facilities (HCF) has become an international priority in recent years. Sustainable Development Goals (SDGs) Three and Six (“Good Health and Well-Being” and “Clean Water and Sanitation”, respectively) place a new emphasis on universal health coverage and access to WASH services. Improving WASH in institutions like health care facilities is critical to achieving adequate and equitable sanitation for all, especially women and children. Not only does the lack of WASH services in health care facilities compromise patient safety and dignity, it also has the potential to undermine efforts to improve child and maternal health. Adequate WASH infrastructure and hygiene behaviour (i.e., handwashing at critical times, infection prevention and control practices) are an important component of the quality of care framework defined by the World Health Organization (2016).

The role of PRIs in enabling WASH in health care facilities:   The Fifteenth Finance Commission (15thFC) has recommended a total of Rs 2,36,805 grant to local rural bodies and panchayats for the next five years (from 2021–22 to 2025–26) to ensure adequate water supply and sanitation services in villages [8]. As per the guidelines issued by JJM, the nodal agency determining the allocation of funds under the
grant to local rural bodies and PRIs, 60% of this grant would be tied and be earmarked for national priorities like ensuring drinking water supply, rainwater harvesting, water recycling, sanitation, and maintenance of open defecation-free status in the village. Even the National Health Mission that has been closely involving the PRIs at various levels of health care delivery. The formation of Village Health, Sanitation and Nutrition Committees (VHSNCs) for decentralised health planning at the village level is a case in point. Formed at the revenue village level, these committees comprise of the elected member of the Panchayat (who leads the committee) and representatives from all
vulnerable community sub-groups, NGOs and ASHAs. Functioning as a sub-committee of the Gram Panchayat, VHSNCs serve as platforms to raise awareness on health and nutrition and take adequate measures to improve and ensure access of community members to standard health services. The upgradation of CHCs to Indian Public Health Standards (IPHS) has been another significant strategic
intervention under the National Health Mission (NHM) to provide sustainable quality care to community members. To this end, the constitution of Rogi Kalyan Samiti (RKS)/Hospital Management Committee (HMC) has been introduced as an effective management structure to ensure proper functioning and management of the hospital/ Community Health Centre / First Referral Unit. Consisting of
members from local Panchayati Raj Institutions (PRIs), NGOs, local elected representatives and officials from Government sector, the RKC functions as a group of trustees that manages the affairs of the hospital to ensure quality health services to the community, while maintaining accountability and transparency in the utilisation of funds. A key inter-sectoral collaborative initiative of the Health Department in partnership with PRIs, the chief purpose of these committees is to jointly plan, implement and monitor health activities at various levels by providing a platform to elected PRI members and health officials to collectively work towards putting in place efficient public health institutions [9].

Gaps, challenges, and issues:  Although the government has taken varied measures to involve PRIs in healthcare, there has been limited evidence regarding their role in influencing health services. Some studies evaluating different NHM schemes and programmes have reported a lack of coordination between PRIs and other stakeholders [10]. While others have cited certain challenges associated with the functioning of VHSNCs that include insufficient funds, lack of people's interest and unfair behaviour of the Panchayati Raj leaders [11].The lack of role clarity of different stakeholders, absence of structured capacity building programmes for PRIs, obscurity in the understanding of financial guidelines, lack of understanding regarding the linkage of WASH in health care facilities with community health
and lack of suitable programmatic support to PRIs have been some of the primary challenges that have prevented PRIs from functioning as effective public health delivery institutions. However, improved leadership and capacities of PRIs has the potential to not only make village action plans, but also proper planning of untied funds and interventions to strengthen HCFs (including the channelization of funds towards WASH infrastructure) that would lead to improved health delivery and outcomes at the village level for the most marginalised. In addition, sensitization of PRIs on the KAYAKALP awards’ scheme for their respective health care facility is another gap, filling which, would
help them gain recognition for their entire community.

What is the potential that we can gain with involvement of PRIs?  
10% of the global disease burden has been a consequence of inadequate WASH services, that has resulted in women and girls missing out on school, or opportunities to earn their own income, because they bear more of the burden when it comes to unpaid care and collecting water.  However, investment in water and sanitation leads to significant economic benefits as evident from a report by WaterAid
that estimates annualised net benefits of $86 million from 2021-2040 owing to provision of safely managed sanitation services [11]. The approach to improving WASH in healthcare facilities is rooted in partnership, collaboration, and knowledge-sharing, however, an improvement in WASH service delivery and health outcomes of HCFs requires both financial and technical resources. The close involvement of PRIs will help reap meaningful health benefits for at-risk rural communities, particularly women and children, through the much-needed investments in WASH services by leveraging and channelizing funds allocated under the 15th Finance Commission. At the same time, advocating for WASH services in HCFs by PRI members during VHSNC and RKS meetings is another approach for strengthening HCFs.  Collaboration PRIs would contribute to sustainable improvements in the quality of healthcare services, while supporting core aspects of Universal Health Coverage (UHC) including dignity and equity and ultimately, to positive health and empowerment outcomes for women and their families [13].  

Contributors:
1.      Dr. Asad Umar, Sector Lead &Senior Programme Officer – WASH, H&N, Aga Khan Foundation India
2.      Dr. Pratibha Singh, Programme Specialist, UNICEF India
3.      Niyati Tripathi, Programme Officer –WASH & Health and Nutrition, Aga Khan Foundation India
4.     Ram Chandra Singh, Consultant, WASH in Institutions, UNICEF India

[1] NITIAayog. Maternal Mortality Ratio (MMR) (per 100000 live births). Retrieved from niti.gov.in/content/maternal-mortality-r...r-100000-live-births
[2] Sankar, M. J., Neogi, S. B., Sharma, J., Chauhan, M.,Srivastava, R., Prabhakar, P. K., … Paul, V. K. (2016). State of newborn health in India. Journal of Perinatology, 36(Suppl 3), S3–S8. doi.org/10.1038/jp.2016.183
[3] International Institute for Population Sciences (IIPS) andMacro International. 2007. National Family Health Survey (NFHS-3), 2005–06:India: IIPS
[4] International Institute for Population Sciences (IIPS) and ICF. 2017. National Family Health Survey(NFHS-4), 2015-16: India. Mumbai: IIPS
[5] WHO. What is Quality of Care and why is it important? Retrieved from www.who.int/maternal_child_adolescent/to...-care/definition/en/
[6] Bhutta, Z.A., Das, J.K., Bahl, R., Lawn, J.E., Salam, R.A.,Paul, V.K., ... Walker, N. (2014). Can available interventions end preventable
deaths in mothers, newborn babies, and stillbirths, and at what cost? Lancet,384(9940):347–370. doi.org/10.1016/S0140 6736(14)60792-3
[7] Bouzid, M., Cumming, O., Hunter, P.R. (2014). What is the impactof water sanitation and hygiene in healthcare facilities on care-seeking
behaviour and patient satisfaction? A systematic review of the evidence from low-income and middle-income countries. BMJ Global Health2018;3:e000648. doi.org/10.1136/bmjgh-2017-000648
[8] Chitravanshi,R. (2021), Rs 1.42-trillion tied grant to villagesfor water, sanitation: 15th FC, Business Standard, 30 August. Available at www.business-standard.com/article/econom...to%202025%E2%80%9326 ).
[9] Rout, S.K., Nallala, S., (2016). Catalysing the role of panchayatiraj institutions in health care delivery in Odhisha. Odisha review. Available
at magazines.odisha.gov.in/Orissareview/201...Mar/engpdf/19-22.pdf
[10] Ibid
[11] Kumar V., Mishra A.J., VermaS., (2016). Health planning through VillageHealth Sanitation and Nutrition Committees. National Library of Medicine. pubmed.ncbi.nlm.nih.gov/27298066/  
[12] WaterAid (2020).Mission-critical: Invest in water, sanitation and hygiene for a healthy and green economic recovery. Available at washmatters.wateraid.org/sites/g/files/j...nomic-recovery_0.pdf  
[13] WaterAid (2019).Water, sanitation and hygiene in health care facilities: driving transformational change for women and girls. WaterAid (Canada). Available at www.wateraid.org/ca/sites/g/files/jkxoof...%20Briefing_Note.pdf

Session Summary
Context:
1. Having improved sanitation structures in healthcare facilities
2. Role of Panchayats could be strengthened to improve WASH service delivery. Need to be duty bearers for improving WASH services in public
institutions at village/ community level.
3. Need to see WASH services as public and private partnership along with members of the Community.
4. Health Care facilities can be sight for disease dissemination instead of sight for treatment
 
Challenges
1.     Need for improving WASH services through health lens. Lack of WASH comprises our healthcare and maternal and childcare health.
2.     Increased burden of expensive hard-to-treat life threatening infections without adequate WASH services. Need for reducing spread of infections in healthcare facilities.
3.     Decrease and lowering of patient confidence in healthcare facilities.
4.     Unless Panchayats are responsible for managed of healthcare facilities jointly, things will not improve. PHC and CHC don’t have a way to engage with the District administration at present.
5.     No separate toilets for women
6.     Rogi Kalyan samiti/ committees are managed by the doctors largely. Members have only token presence

Key takeaways:
a) Solutions- Examples of what/where/how/who
1. WASH Fit tool as methodology and framework for empowering primary healthcare facilities for small primary, and in some instances
secondary, health care facilities in low and middle-income countries.
2. Exit interview with patients to understand challenges and scope of improvement. This will help in understanding actual scenarios and
issues
3. Participatory monitoring
b) The way forward or what needs to be done.
1. Let Panchayats be in control to establish health care facilities. Trust them and sensitise functionaries that they have to work in
close proximity with Panchayats. Eg: Rogi Kalyan Samitis are managed by
doctors.  We need to give them agency to take decisions.
2. Strengthening Gram Sabhas.
3. We need to work on community behaviour of community providers

Document
1) Presentation by Dr. Deepika Sharma on 'Improving WASH services in Public Health Care Facilities: An overview of Kayakalp Program'- www.susana.org/_resources/documents/defa...9-238-1646809948.pdf
2) Presentation by Mr. Pankaj Mathur and Mr. Nageshwar Patidar on 'Creating Safe Environments for Newborns in Madhya Pradesh'- www.susana.org/_resources/documents/defa...9-238-1646809991.pdf

Technical Breakout Session 3 Sanitation: Repair and retrofitting of sanitation infrastructure for sustainable sanitation: Challenges and solutions for PRIs

Date: 24 February'22
Time: 3:30-5:00PM

Moderator
Amulya Miriyala (she/ her), Officer-Policy and Technical Support (Sanitation), WaterAid India

Panelist:
1.     VR Raman, Advisor– Policy, WaterAid India
2.     Prabhakar Sinha, WASH Specialist, UNICEF Bihar
3.     Rushabh Hemani, WASH Specialist, UNICEF Rajasthan
4.     Narendra Singh Chauhan, WASH Officer, UNICEF Odisha
5.     Eklavya Prasad, Managing Trustee, Megh Pyne Abhiyan
6.     V GGopinathan, Adviser, IRTC, Kerala
7.     Ruhil Iyer,Research Officer, Sanitation Learning Hub, IDS Sussex
8.     Amulya Miriyala ,Officer-Policy and Technical Support (Sanitation), WaterAid India

Context/ Problem Statement: Safe, terrain appropriate and sustainable sanitation infrastructure is critical for the overall success of the sanitation initiatives at all levels. Such infrastructure includes toilet substructures, superstructures and related fixtures and fittings. However, while the country was pursuing the universal sanitation targets, the vast scale of implementation has affected supply of materials as well as construction quality. In many places, gaps in design and among the implementers with reference to understanding about terrain appropriate toilet technologies has also led to the construction of substructures that can challenge environmental safety associated to the sanitation infrastructure in the long run. While such gaps are normal for a campaign with such a huge scale of outreach as the Swachh Bharat Mission (SBM), it is important to note that the mission has accepted and acknowledged these and included necessary course corrections as part of the Swachh Bharat Mission 2.0, in the form of repair and retrofitting of toilet infrastructure, as they are required. It is important to ensure that stakeholders at the grassroots level are well informed in this context for the sustainability of an initiative such as the SBM 2.0.  
Why PRIs are important for this issue:  Since Panchayat Raj Institutions (PRIs) are the ultimate implementers or regulators on ground
for all WASH related issues; it is important that they are taken on board, informed and made aware of the sanitation safety and related environmental health issues, as well as the potential generational challenges of improperly designed and constructed toilet super and sub structures; Furthermore, building their understanding and abilities, coupled with allocating necessary resources, will help will help
overcome these challenges sustainably. The Fifteenth Finance Commission’s prioritisation of water and sanitation in its key agenda is an important way forward in this regard, wherein PRIs will be able to locate some resources for necessary actions in this regard.
Gaps, challenges, and issues: - While most of the rural households and common areas at the community level have a toilet infrastructure constructed as part of the Swachh Bharat Mission, a considerable proportion of them would require some kind of repair or correction of technological details, in order to make them safe for the environment/ ecology and for regular usage. SBM – II has emphasised on repair and retrofitting of the toilet infrastructure as part of its guidelines. 15^thFinance Commission has asked the PRIs to prioritise WASH up to the level of 50% of the grants allocated as well. However, there is lack of clarity at the district, block and PRI levels about undertaking this initiative, in terms of technical and operational and financial steps, hence the agenda is yet not taken up widely.  
What is the potential that we can gain with the involvement of PRIs? : As the local self-government and the closest public body for the people, The PRIs can intervene and prioritise this issue at local levels across rural India, towards ensuring the safety and sustainability of a huge number of toilets came into existence in rural India, and thus contributing to the meaningfulness of SBM. The PRIs, if guided and supported properly, can play a pivotal role in addressing most of the challenges in this regard and deploy their solutions and resources for the issue, at the grassroots level operationalization of this agenda. 

Session Summary
Context:
1.     To provide a broad understanding for PRIs about the tasks at hand about toilet repair and retrofitting as part of the SBM 2.0,
with focus on current situation of infrastructure gaps in terms of
substructures, superstructures, fixtures and fittings.
2.     To highlight various practical challenges related to fulfilling these tasks- in terms of potential size of the problem,
technical knowhow at PRI level, human resource capacities for getting the
corrective measures done, willingness related issues for working on the used
toilet infrastructure when it comes to a campaign, funds availability, and so
on.
3.     To list some actionable solutions for these challenges, by way of knowing about some of the important initiatives in this
regard and discussing with experts who has worked on these issues.
4.     To suggest potential next steps for this agenda under the SBM 2.0, by way of prioritising specific action points.

Challenges
1. Single leach pits are built across all states without considering terrain specific appropriate technology resulting defunct toilet
and contaminating water body.
2. The toilet technology either is over-simplified or over-complicated which also led
to technology gaps.
3. Toilet are not inclusive which required retrofitting to make it accessible for all category
4. SBM-2.0 doesn’t have provision for fund for retrofitting and left out household. There is absence of financial support and alternative
finance around WASH.
5. There capacity gap for retrofitting of existing toilet especially single leach pit, lesser involvement of PRI.

Key takeaways:
a) Solutions- Examples of what/where/how/who
1. UNICEF, Bihar has demonstrated a solution called Toilet Clinic- to provide all sanitation services in on window like hardware and hygiene supply, construction and repair, cleaning and maintenance and faecal sludge management. Team of masons and sanitation janitors trained and equipped. Sanitation Janitors tagged with CSCs. Service charge of Rs.50 per seat for cleaning toilets and Rs.100 per hour for cleaning and sanitising a building fixed by DWSC Muzaffarpur. State to scale up to all the districts. 5 districts being taken up in the first phase in next 3 months.
2. State-wide Repair and Retrofitting initiative in Rajasthan Unicef. The need for retrofitting toilets were varied – 41% of single pit needed repeated emptying and unsafe disposal. The first important thing was to understand the problem, piloting of saturation approach; there was also a need for the development of resources, step by step construction of retrofitting of toilets. 900 engineers were trained in 3 batches and transfer of learning happened to other states – West Bengal, Chhattisgarh, and Haryana.
3. Financing retrofitting through a partnership between Water.org, UNICEF and field level SHGs in Odisha. the issue was there were mostly single leach pit which required retrofitting but lack of additional financing support or alternative financing were challenges. The purpose of this project is to strengthen the capacity of WSHGs under Odisha Livelihood Mission to enable awareness and uptake of alternative
financing for their long-term WASH need. 31 loans out of 434 water quality improvement loans have been disbursedof Rs. 2.73 L. 403 loans out of 434 are sanitation loans, of which 340 toilet improvement and retrofitting loans and 63 new toilet loans were disbursed, of
Rs. 35.77 L.
4. Kerala where the septic tanks are converting to bio-gas plant which giving solution for both solid waste and faecal waste management. Also, this providing additional cooking gas for household
5. In Rajasthan, Director, SBM shared that the administrative order given for 4500 INR for retrofitting through GP and also provided through finance commission grant for retrofitting.
b) The way forward or what needs to be done.
1. PRI are the key to identifying, innovating and contextualizing toilet infrastructure and their usage. So, PRI should engage for toilet retrofitting.
2. Having PRIs within nigrani samitis makes sure that the Samiti has both local and govt people so that sanitation and retrofitting doesn’t lose its importance. 
3. Let us ensure there are no retrofitting of the retrofitted
4. PRIs can provide awareness on this, can advocate on retrofitting toilets with the district administration and highlight this.
5. There was a need for reflection and course correction where technology is one of the most important gaps. So adequate capacity
building on toilet retrofitting along with technical resources should generate.
6. WASH financing should promote linking community who need financial support for long term WASH. PRI can play critical role in this.

Documents:
1) Presentation by Dr. Prabhakar Sinha on 'Why Toilet Clinics?' - www.susana.org/_resources/documents/defa...9-238-1646809841.pdf

Technical Breakout Session 2 Sanitation: Management of organic solid waste and plastic waste by PRIs: Experiences, Challenges and Way Forward
Date: 24 February'22
Time: 3:30-5:00 PM

Moderator: 
R Ramesh, Associate Professor, National Institute of Rural Development & Panchayati Raj (NIRD&PR), Hyderabad

Speakers:
1. Mr Muthukumar Maganti
2. Dr Mangalam Balasubramaniam
3. Ms Archana 
4. Mr Gaurav Nigam 

Context/ Problem Statement: Waste is a mounting problem not only in Corporations and Municipalities, but also in rural areas. The Solid Waste Management Rules amended in 2016 has brought in Gram Panchayats also in its purview. It means whoever generates waste – be it
households, institutions, or marketplaces – at the end of the day all such waste fall on the lap of Gram Panchayats to clean up. This necessitates Gram Panchayats to put in place a waste management system. In other words, the Gram Panchayats must be equipped to plan, organise, and implement waste management as a regular practice – and not as a project to place dust-bins in street corners without a system in place for collection, and scientific treatment. Without a functioning waste management system in place, it doesn’t augur well
blaming the households of being irresponsible.  
Why are we talking about this? Solid waste management is a vital component under the Swachh Bharat Mission (SBM-G) Phase – II. Under SBM-G funds are made available to Gram Panchayats for setting up solid waste management units at GP level, and Plastic Waste Management Units at block level. All that is required is the Gram Panchayats need to get prepared either to carry it out themselves or to get into a service contract agreement with a third party agency, which might be versed in waste management service provision. However the challenges are many. 
Gaps, challenges, and issues: As per the 73^rd Constitutional amendment, the XIth Schedule of the constitution demands the Gram Panchayats to take up sanitation and village cleanliness. However, the fact remains that the Panchayats do not have the technical capacity to make plan for proper collection of waste, nor do they have the logistics, and the financial capacity to take up scientific treatment of waste. Lack of trained manpower, absence of technical capacity, and financial constraints do not allow many Gram Panchayats to come forward to take on this challenge. We must understand that getting involved in waste management - unlike provision of Individual Household Latrines - is not a one-time affair. This is an endless affair, which will have to go on and on on a daily basis. The lesson so far is that some Gram Panchayats that are reportedly doing successfully are either backed by an NGO or CSR, or by a committed officer of the Government, who goes out of the way to ensure that it becomes a success in one or two, or in a few villages. The main challenges, thus this conclave has to address on solid waste management in rural context are: Any success stories or brilliant models on Gram Panchayats managing waste scientifically in a financially self-reliant way? The idea of waste to wealth that sounds fascinating to listen to in conferences and seminars. Does it work in reality anywhere, which can be spoken about without underplaying the assumptions and limitations?  What seems to be the best way to put in place a scientific waste management system in Gram Panchayats that will be
financially sustainable? How do we match, or modify the institutional arrangement for waste collection and management bearing in view a practicable operational scale? What kind of support / facilitation need to come from the SBM-G –II or from the private players and NGOs involved in waste management so that Gram Panchayats become capacitated to either manage waste in a scientifically acceptable way, or involve a third party agency who shall do it for a price, for which the GPs must have source of funds to pay from.      

Session Summary 
Context:
1. SBM phase II has given higher a focus to waste management and the journey from waste to wealth.
2.  Technologies are available to manage waste in more scientific manner.
Challenges
1. Wet waste, dry waste, plastic waste management are not being practiced in all Gram Panchayats or Block level?
2. Is waste management a financially sustainable business?  
3. What are the possible ways of recovery from waste?
Key takeaways:
a) Solutions- Examples of what/where/how/who
1.  Case studies of solid waste management/ Ramayampet and Velichala Gram Panchayats /Medak/ 2018/ Muthu Managanti
How this was possible?
1.1. Interest was shown by political leadership who invited the consultant to take on challenges of waste management projects in two Gram
Panchayats
1.2. People’s participation must be ensured. Monitoring by the use of IoT devices for door to door collection process, use of slow-moving
vehicles, non-polluting equipment and the application of appropriate technologies for the location are the good practices. 
1.3. SLWM project of each Gram Panchayat should be part of annual Action Plan (AIP) of each district. These project must have approval by
State Level Sanctioning Committee.
1.4. Dedicated WASH Consultants for the State and districts must be in place.
2. Case studies of solid waste management business by GramPanchayat/ Kalibillod Indore/
How this was possible?
2.1. Profitable business is possible if Gram Panchayat(authority), Self-help groups (to take care of the operations) and Third party
(technical consultant) work in sync.  It can be a win-win situation.
2.2. User fee is the main source of revenue. Selling waste contributes only a part of the total income. The balance sheet for the business is
maintained.
2.3 Wet waste should be managed in decentralised manners.
3.  Experiences of solid waste management in Karnataka and Gujrat/ Saahas/ Archana Tripathy
How this was possible?
3.1 Recognition of waste as a resource like water.  
3.2 Segregation at source, management of dry waste at GP level, non-recyclable waste to reach appropriate industries are the key takeaways.
3.3. Monitoring and support from the State/Unicef and CSR donors can make it happen.
4.  Experiences of behaviour change promotion in sustainable ways/ Coimbatore/ Exnora Green/ Dr.Mangalam Bala Subramaninam
How this was possible?
4.1. Behavioural change programme for waste management should have the Gram Panchayats, Educational and Religious Institutions as the pillars. 
4.2. Recovery of resources from waste such as Govardhan should be the guiding principle.   
b) The way forward or what needs to be done.
1. Extended producer’s responsibility (EPR clause) for non-recyclable waste should be enforced.
2. Small-scale incinerator facilities are not safe options.
3. Plastic waste cannot be handled in decentralised manners. All villages should do this.
4. Interpersonal communication on home composting.
c) any specific points to be added to call to action?
1. Technologies can play important roles in waste management.  The project management teams must take care of groundwater conditions, soil structures, sources of supplies of water, and availability of commonplaces.
2. Preventive maintenances of vehicles, machineries etc. can reduce the operational costs. For instance, opting for non-diesel vehicles will
have lesser reduced operational cost. The time and cost to repair the non-diesel vehicles (e-rickshaw) will be less.
3. The project management team must have the ability to have a dialogue with the stakeholders and the people and should ask the right questions. 

Documents:
1) Presentation by Mr. R. Ramesh on 'Management of Organic Solid Waste & Plastic Waste by PRIs: Experiences, Challenges and Way forward'- www.susana.org/_resources/documents/defa...9-238-1646809658.pdf
2) Presentation by Dr. Mangalam Balasubramanium on 'Promoting Behaviour Change for Sustainable Waste Management in GPs through Information, Education and Communication' - www.susana.org/_resources/documents/defa...9-238-1646809698.pdf
3) Presentation by Mr. Gaurav Nigam on 'Operations and Maintenance: A challenge and opportunity'- www.susana.org/_resources/documents/defa...9-238-1646809738.pdf
4) Presentation by Ms. Archana on 'Sustainable waste management in Gram Panchayats – success stories and challenges' - www.susana.org/_resources/documents/defa...9-238-1646809771.pdf

Technical Breakout Session 1 Sanitation: Implementation solutions for PRIs on, improved Liquid Waste and Faecal Sludge Management

Date: 24 February'22
Time: 3:30-5:00PM

Moderator: 
Binu Arickal, Head of Strategic Projects, WaterAid India

Speakers:
1.     Ms. Anita Gopesh Sahu- Sarpanch Gram Panchayat, PatoraChhattisgarh
2.     Mr. Shrikant Naverkar- Director Nirmal Gram Nirman Kendra,Maharashtra
3.     Dr. Ravikumar Joseph- Sr. WASH Specialist World Bank
4.     Ms Sandhya Haribal- Senior Project Manager, CDD Society
5.     Ms. Misha Singh- Chief executive officer, Zilla PanchayatShajapur  

Context/Problem Statement:
Swachh Bharat Mission has been able to make significant strides by providing underserved areas access to toilets and encouraging their sustainable use. Local bodies in rural India have declared themselves Open Defecation Free with a reported 100% toilet coverage. However, the work on sanitation does not end with a cent percent coverage of households with toilets. India now is bracing to deal with the 2^nd generation challenges in sanitation viz. liquid waste management and faecal sludge management in the rural areas. This needs coordinated efforts and action, wherein the leadership and proper implementation of appropriate solutions by the local panchayats are critical, in order to address the emerging challenges.
 
Why PRIs are important for this issue:  
The 73rd Constitutional Amendment has vested powers with the three-tier panchayats to take up several development activities. Sustainable sanitation is one of them and this can only be ensured if there is appropriate knowledge, access to proper technologies and proper implementation is assured by the panchayats and they are able to build complete ownership by the community. There are several
examples across the country where sustainable sanitation services have been made possible by the active role of gram sabha and the Panchayats. Various sources of funds like the 15tth FC grant, SBM, NREGS etc., are available at the panchayat’s disposal to address water and sanitation issues in the villages, in addition to the conventional sources of funds. In order to realise sustainable sanitation across the country in scale, it is important that the know-how and capacities of the panchayats on sanitation sustainability need to be improved
including in the health, technological and social aspects of the same.
 
Gaps, challenges, and issues:
Liquid waste management in rural area
-        Wastewater generated from household has remained one of the most menacing sanitation challenges in rural areas, that affects health, water quality as well as the visible environmental cleanliness of the locality.
-        SBM– II has emphasised on treatment of greywater at the nearest point of its generation. Without adequate capacity building and handholding support it may be difficult to address this issue for the rural local bodies.
-        With the increase of access to piped water to every rural household by 2024 under JJM, there will be an increased generation of greywater.
Faecal sludge management
-        In a population where a vast majority were defecating in the open, the Swacch Bharat Mission has generated the aspiration to build toilets. While most of the toilets constructed in rural area are the standard twin pit latrines, there are a sizable number which have either single leach pits, simple holding tanks or septic tanks.
-        Dense villages and peri-urban areas with limited space for in-situ toilets will also face a daunting task to deal with Faecal Sludge and septage.
-        SBM-II has made provisions for the state to introduce variety of options to deal with Faecal Sludge in rural area.
-        However, the lack of comprehensive understanding of this issue and its solutions at the local level is a bottleneck in recognising the need for FSM and to identify and opt for appropriate solutions.  
 
What is the potential that we can gain with the involvement of PRIs?
With adequate investments in building capacities of the panchayats and demystifying the technicalities in dealing with Liquid waste and Faecal Sludge management, there is a greater possibility of addressing the 2^nd generation challenges of sanitation more efficiently. Just like SBM-I where panchayats led the way to make India ODF, leadership and involvement by panchayat will be able to address the next level of challenges in sanitation.
 
The proposed session on this topic as part of the National WASH Conclave will present a broad idea of the need, gaps and various solutions available towards eliciting knowledge and action at the panchayat level, including tips from experts and administrators on how to address implementation bottlenecks.

Session Summary
Context:
1.     Achievements of SBM 1
2.     Need for grey water management and Faecal Sludge management in villages.
3.     Demystification of entire process- situational analysis, understanding the problem and waste mapping.
4.     Wise management of grey water is dire need of the hour, grey water is not a problem but an asset.
5.     FSM- need for proper planning, importance of technology, roll out/road map for implementation and sustenance
Challenges
1.     We need to know the ground realities, so much many money is spend on the structures, which are not technical. It is the responsibility of the panchayat to ensure that panchayat implements correct solutions
2.     Centralised system preferred over decentralised systems- component of concurrent quality monitoring and user orientation is completely missing.
3.     Population(dense and scarce population) Land/space availability, simple and economical specific to a context geo-climatic condition, improper drainage, use of untreated waste water, pollution of water bodies
4.     Floating Population is another challenge and they need to be included in planning and implementation of the process.
Key takeaways:
a) Solutions- Examples of what/where/how/who
1.     Demystification of the entire process, categorising the villages (population, topography and location), understanding the need and then planning accordingly.
2.     Constant training of PRIs is important to make the model self- sustaining. Tax collection is necessary in maintenance and sustainability
3.     We look at JJM as increase in the inflow of water, we have to look at it from the perspective of water conservation and sustainability is equally important.
b) The way forward or what needs to be done.
1.     Retrofitting of toilets is very essential
2.     Magnitude of GWM should be expanded to Liquid waste management, GWM should be linked with water conservation programme, decentralised/semi centralised technologies should be preferred over centralised ones. Reuse and recharge should be given
priority, selection of right technology and concurrent quality monitoring should be observed scrupulously. 

Technical Breakout Session 3 Drinking Water: Strengthening roles and capacities of KRCs & ISAs for effectively supporting local bodies

Date: 24 February'22
Time: 2:00-3:30 PM

Moderator
Apoorva Oza, CEO, Aga Khan Rural Support Programme

Speakers
1.     Mr. Vishwakanan-  E- Jal Shakti (Govt of India)
2.     Mr. Jayesh Bhai- Member, Pani Samiti VWSC, Isador, Dang Gujarat
3.     Mr .Yogesh Kumar -  Director Samarthan
4.     Mrs Urmila Ben  - Member Pani Samiti 
5.     Mr. Badruddin- Member Pani Samiti, VWSC, Bhalchhael, Junagadh Gujarat
6.     Mr. Sunil Kumar Udia – Executive Engineer (Indore ) 

Context/Problem Statement:
·       Context of the topic in India: The Jal Jeevan Mission is an ambitious programme which seeks to provide Functional Household Tap
Connection (FHTC) to every rural household in this country. At the village level, the programme envisions empowering panchayats, and women, to design, implement and manage the drinking water systems. Empowering and capacity-building processes are time consuming, and require skills and competencies other than what classical Public health engineers are trained for. Also, the staff available with most states for JJM is inadequate to the huge task. Hence the need for Resource Agencies and Implementation Support Agencies to capacitate the panchayats ,especially women, to play their role effectively.
·       While an elaborate process has been followed in selection of the KRC, their acceptance at the state level is still facing hesitancy as its early days. The ISA model has worked very well in some states ,and lessons from such
states need to be shared and adopted wider. The advent of COVID almost as soon as JJM started has affected capacity-building activities to some extent. While knowledge transfer can be possible in an online mode; issues of attitude and behavior change face-to-face interaction and exposure visits which have been badly affected  by COVID.
 
FHTC have reached 46% of the households as per the JJM website: many of the larger states like UP, Bengal, Rajasthan ,MP, etc., have low coverage. Only 64000 out of the total 2,50,000 gram panchayats are fully covered, which means that many households in the remaining 1.86 lakhs panchayats need to be covered. Capacitating these panchayats is critical, as even after full coverage unless there is maintenance, slippage can happen. Therefore sharing best practices and addressing the challenges faced by KRC and ISA is critical for the sustainability of JJM.

Session summary
Context:
1. Under JJM there is a provision for supporting local bodies by building their capacities to adhere to the challenges in implementing the mission. As we are dealing with heterogeneous and complex society there is a need for different skill sets, most implementing members do not have the set skill sets. 5% of the fund is reserved for awareness development and skill development.
2. Whole mission aims at building capacity at all levels:
·      Top Level- Policy makers
·      Mid level- Engineers,
·      Community level and stakeholders- Gram Panchayat, Pani Samiti and VWSC
3. Capacity building training should not be seen as an event, it should be seen as a process
·      Knowledge building- guidelines, technical and operational aspects
·      Perspective building- behaviour change, change in approach, Panchayat and institutions should process and reflect on their own bias.
·      Skill building- ISAs should be trained on PRA method, engineers on how to make DPR simple so that community can understand it. 

Challenges
1. 50% of ISA members have less experience on the subject and methods, only 10% ISAs have experience on WASH, the selection criteria need to be reflected and ISAs should have extensive trainings on the subject. Monitoring and supervision aspect of KRCs and ISAs is not clear. 
2.  Capacity of Panchayat, gram Sabha and skill building of people who are implementing it needs to be designed comprehensively and holistically.  
3. PHED or RWSS needs to change their attitude and perspective from engineering solution centred approach to participatory approach and respect the view of communities and other stakeholder’s as JJM aims for change in mindset and behaviour.

Key takeaways:
a) Solutions- Examples of what/where/how/who
1 Integrate initiatives like WASMO initiatives &    AKRSP-I women’s federation in Pani Samiti for O&M and tariff collection and managing the water supply at ground level. This has been tried and demonstrated successfully in Dang district of Gujrat by AKRSP-I
2. All state should on-board and empanel KRCs and ISAs as soon as possible 
3. Pani samiti should decide and modify charges of tariff asper their context and requirements for sustainable O&M  
4. Daily video call with ISAs, PHED officials and contractors has helped immensely in Indore as they are doing it for last seven months (as shared by Executive Engineer –Indore). It has helped monitoring progress on real time basis and in resolving bottlenecks such as community apprehensions, reservation of GP on taking the scheme also to resolve any conflicts or dispute in community.    
5. Importance of engaging community in preparing VAP, panchayat and ISAs both play an important role.
b) The way forward or what needs to be done.
1.  Whole capacity-building aspect needs to be to be geared up, should start with district team.
It should not be seen as event, but as a process.  
2. KRCs should be used for supervision and monitoring of ISAs and to build their capacities  
3. ISAs should become master trainers for gram panchayats, pani samitis /VWSCs  
c) Any specific points to be added to call to action?
1. Right agencies with appropriate experience and expertise should be selected in KRC & ISAs. Intensive training should be provided and
monitored. 

Technical Breakout Session 4 on Drinking Water: Ensuring WASH services in rural Schools and Anganwadi Centres: Potential roles of PRIs
Date: 24 February'22
Time: 2:00-3:30PM

Moderators:
Name: Dr. Pratibha Singh, WASH Specialist, UNICEF Delhi;
Mr. Sudhakar Reddy Ontari, WASH Officer, UNICEF Bihar Field Office

Speakers
1.     Mr. Ramaswamy Krishnan,SNEHA NGO
2.     Mr.Shyam Dhave, UNICEF
3.     Mr.Sudhakar Reddy, WASH specialist 

Context/Problem Statement: The provision of WASH facilities in schools secures a healthy school environment and protects children from illness and exclusion. It is the first step towards a healthy physical learning environment, benefiting both learning and health. Children who are healthy and well-nourished can fully participate in schools and get the most from the education being imparted. The COVID-19 pandemic re-emphasized the significance of handwashing with soap and personal hygiene for the prevention of diseases. It is important that the schools have adequate water supply, functional gender-segregated toilets, handwashing facilities, environmental cleaning, solid and liquid waste management, physical distancing measures in the context of COVID-19. These protocols need to be institutionalized in the school administration as a daily routine to fight any such emergencies in the future.

Policy environment for WASH in Schools and AWCs in India:
 
·       The RTE Act (Right to Education) 2009 provides a legally enforceable rights framework with certain time targets that Governments must adhere to. The Schedule to the RTE Act lays down the norms and standards (including drinking water and sanitation) for a school building. A school building has to be an all-weather building comprising at least one classroom for every teacher, barrier free access, separate toilets for boys and girls, safe and adequate drinking water facility for all children.
·       Swachh Bharat Swachh Vidyalaya is the national campaign driving ‘Clean India: Clean Schools’. A key feature of the campaign is to ensure that every school in India has a set of functioning and well-maintained water, sanitation, and hygiene facilities.
·       The Swachh Vidyalaya Puruskar (Clean School Award) was instituted by the Ministry of education (erstwhile Ministry of Human Resource Development), Government of India in 2016 to recognize, inspire and celebrate excellence in sanitation and hygiene practice in schools. The explicit purpose of the awards is to honour schools that have undertaken significant steps towards fulfilling the mandate
of the Swachh Vidyalaya Campaign.
·       WASH is an integral part of the National Policy on Early Childhood Care and Education (ECCE), 2013, encompasses care, health, nutrition, play and early learning within a protective and stimulating environment created by caregivers. The policy seeks to universalize the provision of ECCE for all children, mainly through the Integrated Child Development Scheme (ICDS) in the public sector and other service provisions across systems. Convergence is in-built in the Scheme which provides a platform in the form of Anganwadi Centre for providing all services under the Scheme. The Anganwadi Centers have been repositioned as a “vibrant child-friendly Early
Childhood Development Centre” with adequate infrastructure and resources for ensuring a continuum of the ECCE in a life-cycle approach and child-related outcomes.
 
Statistical scenario – WinS in India: (Source:UDISE+2019-20)
o   % of Government Schools with drinking water facility within school premises - 97.1%.
o   % of Government Schools with functional toilet facility – 95.05%.
o   %of Boys and coeducational Government Schools with functional boy’s toilet facility – 89.88%.
o   %of Girls’ and coeducational Government Schools with functional Girl’s toilet facility – 92.95%.
o   %of Government Schools with functional CWSN friendly toilets - 19.79%.
o   % of Government Schools with handwash facility –90.55%.
 
Gaps, challenges, and issues: The provision of drinking water and toilet facilities in schools has steadily increased over the last few years in the country. However, it is necessary to focus more to ensure basic quality, adequacy and gender norms, operation & maintenance and to improve equitable access. Above all, water and sanitation facilities must be used every day and for this to happen these facilities must be functional – and this also includes the provision and maintenance of handwashing with soap facilities.
 
Role of PRIs: Adequacy, functionality and operation &maintenance has been critical for ensuring sustainable WASH services in educational institutions. Though the Samagra Shiksha Abhiyan mandates to spend minimum 10% of the composite school grant for Swachhata related activities, the operation and maintenance has been challenging in Schools due to limited human and financial resources. As far as Anganwadi centers are concerned, majority of them are being operated in rent- and rent-free buildings. Availability, accessibility, and functionality of the WASH facilities has been challenging during the years in AWCs as well. Therefore, PRIs can mobilize resources from internal (finance commission grants, MGNREGS) and external (CSOs, CSRs, Public representatives MP/MLA grants) sources to create adequate WASH infrastructure in schools and AWCs. PRIs can take ownership of the WASH infrastructure and its operation and maintenance in Schools and Pre Schools to ensure sustained functionality. Regular monitoring by the PRIs can help protect the WASH infrastructure in these institutions. This would help schools and AWCs maintaining adequate, functional and sustainable WAH facilities and practices to be able to create a child-friendly environment in Schools and AWCs. 

Session summary
Context:
1. With COVID pandemic the need for WASH in schools (WiS) has become ever more prominent. The ensuing period has seen many initiatives by Union and State governments towards furthering WASH in schools. Although WASH in schools programming started earlier in 1994, two major points in WiS India’s history has given it prominence. First one was the Right to Free and Compulsory Education Act 2009, which gave the legal backing for WASH programming in schools, gender segregation toilets and drinking water. Secondly, the Swachh Vidyalaya guidelines in 2014 and the Swachh Vidyalaya Puruskar ensured that the WASH in school component which was till now with the Department of Water and sanitation, now had a firm footing in the Department of Education.  
2. However, it is the participation and role of Gram Panchayats and PRIs which have more scope for the improvement of WASH in schools. Over the various states, there have been various models of designs, participation and mobilization which could be replicated and contextualized. States like Jharkhand and Bihar despite being poor performers earlier have shown considerable improvements in WASH in schools indicators and have adopted unique state specific strategies for the same. Contextualizing is therefore key to achieving the standards and strategies suggested under Swachh Vidyalaya guidelines.
3. Among the various initiatives, monitoring of WASH in schools, O&M of WASH facilities and creating hygiene behaviour change have been a constant focus and various successful case studies and models have been shared as part of the session. Much of the successful models are those where there has been a three pronged approach of working with state governments while simultaneously working with the PRIs and school/community level. Best practices and case studies were discussed from Jharkhand, MP, Uttar Pradesh, Bihar, Odisha, Tamil Nadu and Karnataka.
Challenges
1. There is need to look up to scaling up the existing models with regard to WASH in schools. Good Practices/Models are currently functioning in isolation. However how we can make them easily replicable and state specific is an area which requires much focus.
2. Coverage of toilets is not the issue. But what needs focus is regular Operation and Maintenance (O&M). Ensuring participation of PRIs towards O&M in schools is something that needs focus on. Along with that funding is required for the
 
Key takeaways:
a)     Solutions – Various unique models or success stories were discussed with regard to WASH in schools/AWCs
1. Jharkhand has adopted certain excellent practices:
-       JalSahihyas (frontline workers in community that work on WASH) were given additional incentives to concentrate on WASH in
schools. While being equipped with knowledge of hygiene behaviour and WASH standards, the Jalsahiyas are also empowered to conduct water quality testing with FTKs, support sessions on Swasthya Diwas.
-       Water Quality in schools has been significantly focused in schools in the state since they face issue of high levels of Arsenic. Period testing and treatment has therefore been a major agenda with the PRIS also.
-       Child Cabinet training and strengthening has been another area of focus in order to ensure accountability and participation of the cabinet as well as school authorities.
2.  Tamil Nadu:
-       Development of robust WASH infrastructure along with operation and maintenance has really helped Tamil Nadu.
-       Monthly meetings with various departments working on WASH for WASH in school programming has worked well.
3.  Madhya Pradesh: There has been remarkable role of PRIs in ensuring WiS.
-       O&M funds were mobilized from stamp duty funds with a total of Rs.337.37 million raised. Nearly 1.4 Lakh schools have
benefitted. Demonstration of how to use toilets, handwashing practice was key. This meant that the demonstrators practice with children, take them to the bathroom and talk and show exactly how to use the bathroom and keep it clean. Group hand washing exercises has been identified as an important way to promote hand washing behaviour with children who then go on to influence their parents as well.
4.In Bihar, the government has added another thematic area in WASH in schools as part of the Swachh Vidyalaya Puruskar. This is the theme of ‘Support mechanism and community ownership’. This encourages all schools to seek out community partnerships and participation.
5.In Ramanagara, Karnataka, in schools where there was emphasis given on hygiene behaviour change, the children went on to become
motivators to their parents for building toilets in their homes. The gram panchayats at these points came forward to provide support to families in building the toilets.
b) The way forward or what needs to be done.
1. Documentation and sharing of these unique best practices or models is a definite way forward.
2. Assessing the extent to which increase in O&M funds in certain states has influenced the improvement of WASH environment in the
schools needs to be assessed so as to strengthen the case for increase in O&M funds to school at a national level.
3. Climate Resilient schools which needs to be a focus area in the coming years. Gujarat has successfully roped in gram panchayats to
furthering such a programme.
4. Digital monitoring of WASH through a digital platform –which helps with data collection, analysis and ensures compliance. The digital
platform developed in Gujarat “Shala Swachhata Guale” allows for real time monitoring and now has been integrated with the Education MIS.
5. Strengthening and capacity building of the Child Cabinet. They can provide a source of leadership in spearheading the efforts (like in the
case of Bihar)
6. For sustaining of the efforts:
- Demonstration of how to wash hands, and use and keep a toilet clean is very important.
- Knowledge sharing amongst children is very important. For instance, in Ramnagragh district, a friendly competition was organized and the children were asked to make paintings on how to keep a toilet/village clean – or what does a clean village and toilet look like. The drawings then were digitised, printed and distributed as a part of books in the entire district. This was done through the efforts of CSR.
7. Convergence of grassroot NGOs, local leadership and CSR is very critical in leveraging of available resources and sustaining and
ensuring WASH infrastructure in schools. It also becomes important to specify the roles and responsibilities of each of the stakeholders.
8. Looking at toilet in a holistic manner – meaning coverage of toilet is not the purpose of WASH in schools. What matters is the
functionality of the toilet, quantity (ratio of student to the toilet), gender segregation of toilets, quality (maintenance of hygiene), accessibility (disability access), access to soap and essential supplies, water quality, availability and training of staff for cleaning the toilets etc.
9. PRI can play an important role – PRIs can lead the Swachhata Action Plan and try to understand the challenges, PRIs can be responsible
for community mobilization and promotion of hygiene and health at home, school,
community.

Document links: 
1. Presentation on 'National perspectives and best practices from other States on role of Gram Panchayats in WASH in Schools' - www.susana.org/_resources/documents/defa...9-238-1646811495.pdf
2. Presentation on 'Learning from WASH on School from Gujarat'-  www.susana.org/_resources/documents/defa...9-238-1646811599.pdf

Technical Breakout Session on Drinking Water 2: Ensuring source protection, security and sustainability under Jal Jeevan Mission
Date: 24 February'22
Time: 2:00-3:30 PM

Moderator: 
A Muralidharan, Deputy Adviser, Department of Drinking Water and Sanitation, Government of India
Speakers:
1.     Mr. Vishwanath Srikantaiah (Director,Biome Environmental Solutions)
2.     Shri. Parmeswaran Hegde (Director,RDWSD, Govt. of Karnataka) on behalf of Dr. Prakash Kumar, (Commissioner, RDWSD, Govt. of Karnataka)
3.     Dr. Snehalatha Mekala (RegionalDirector, FANSA)
4.     Mr. Bishwadeep Ghosh (CountryDirector, Water for People- India)
5.     Mr. Rajesh Rangarajan (State ProgramDirector for AP & Telangana, WaterAid India)

Context/ Problem Statement: ·In India Majority of rural water supply systems are dependent on groundwater. With the same aquifer catering to agriculture and water supply, depletion of groundwater aquifers would seriously threaten water availability for drinking. Pollution of surface water sources from point and non-point sources also reduces the freshwater availability. With functionality of tap under Jal Jeevan Mission linked to water quantity, quality, the regularity with adequate pressure, ensuring water security inter alia sustainable access is key to the success of the mission.·       
Why are we talking about this? The provisions made in the programme guidelines for source sustainability through convergence, field
observations and water conservation practitioners views on ensuring sustainability involving Government Departments, Local Governance Institutions and grassroot community organizations for strengthening and sustaining sources.· Data on groundwater availability, scheme details and field data on water conservation through relevant data points.  
Why PRIs are important for this issue:  As per the Constitution, PRIs are vested with water supply and sanitation functions at village level and they are key enablers in delivery of water and WASH services. It is imperative that they are sensitized and onboarded for the success of JJM. 
Gaps, challenges, and issues: Currently, water supply service delivery is considered as a government’s responsibility. There is the necessity to involve community ab initio and make them own the scheme so that local governance institutions can function as small self-sustaining utilities at the gram panchayat level to manage the water supply and sanitation services.  Capacity building and IEC tools have to be extensively used for this transition.
 What is the potential that we can gain with involvement of PRIs?  Sustaining the benefits of tap water supply with full participation of community in ensuring the O&M, water conservation and demand management for the sustenance of water and WASH provisioning so that water becomes a shared responsibility i.e. making water everyone’s business.  

Session summary
Context:
1.     JJM – the scheme stands on 4 pillars – quality, quantity, regularity and on long term
basis.
2.     It envisages 19.1 Cr FHTCs and it is the world’s largest investment schemes by any
government amounting to $ 48 billion commitment by GoI.
3.     In current context - under JJM, most of the schemes are ground water based – although in some states there has been a shift towards surface water based solutions but predominantly around 80% of the schemes are GW based.
4.     Source to Resource approach.
5.     Groundwater: Making the invisible visible.
6.    Ownership of solutions imperative for the sustainability of schemes.
Challenges
1.    Double groundwater consumption in India that of China.
2.     Rising geogenic contamination.
3.     Service Delivery
4.     North East Indian States (except Sikkim and Meghalaya) face water crisis even after receiving abundant rainfall.
5.     Urban Sewage
6.     Agriculture is the biggest external on drinking water which needs to become the part of the equation.
7.    Basic Services, Climate Change and Employment.
8.     Indiscriminate depth of borewells(leading to leaching of pollutants from deep geological formations).
Key takeaways:
a) Solutions - Examples of what/where/how/who
1.    Water availability is a human right, but cost recovery for the state is necessary as well (Metering and Tariff). This helps in conscious use of water resource as well.
2.    Shallow aquifer (wells)is going to be important as a back-up plan for long term sustainability.
3.     Involving greywater treatment and Tertiary treated sewage water for groundwater recharge.
4.     Interconnection of Dams as being done in the Vidarbha region.
5.    Approaches that help building social capital to support maintenance at decentralised level.
6.     On ground water budgeting - Concept of water budgeting needs to be looked into more closely to increase water availability at the local level. Water security essentially would shift the gear from water source to water resource management.
b) The way forward or what needs to be done.
1.     Involvement, capacity building, and monitoring of VWSC, Water User Associations, Panchayats etc.
2.     Shift to surface water from excessive groundwater use (Telangana, Karnataka, Kerala, A.P etc doing already).
3.     Intensification of recharge efforts.
4.     Restoration and monitoring of existing bore wells.
5.    Cadre of grass root technocrats.
6.     Better utilisation of outlays from other government schemes (convergence).
7.     Sustainability can only be ensured if it is viewed through the lens of social, technical, institutional, financial, legal, and environmental sustainability of the schemes that are being implemented.
8.    Increasing the gambit of information and knowledge of VWSCs and PRIs – it would have to move beyond O&M towards aquifer understanding, mapping and understanding of recharge zones.
9.    Democratise data collection and usage – data must be used more for decision-making and
empowerment rather than for meeting compliances.
c) Any Specific points to be added to call to action?
1.     Transfer of surface water from abundant to deficit places as a part of water grid.
2.     Ensuring benefits actually reach the most marginalised sections of the society. Policy must be translated to actual impact on field.
3.    When it comes to water sources “Go Local”.
4.    Change from infrastructure approach to participatory approach for piped water supply.
5.     Aquifer Mapping Exercise.
6.     While recharging – it is important to ensure that the aquifer water quality matches the recharge water quality to prevent environmental disasters – contamination of aquifers.

Technical Breakout Session 1, Drinking Water. Sustainable FHTC models for local bodies to deploy in water quality affected locations
Date: 24 February'22
Time: 2:00-3:30PM

Moderator: Sunderrajan Krishnan, Inrem Foundation
Speakers: 
1.     Mr AjayKumar- Director- WQ, NJJM
2.     Ms Khileshwari Sahu. - WQMS District Coordinator- District JJM Team, Rajnandgaon, Chattisgarh
3.     Mr Nanak Santdasani- WASH Officer- UNICEF Jaipur Field Office
4.     Dr Urmila Chattejee- Senior Economist, Water Global Practice- World Bank
5.     Dr PriyankaJamwal- Fellow, Centre for Environment and Development- ATREE
6.     Dr Pawan  Labhasetwar- Scientist and Head- Water Technology and Development, NEERI
7.     Dr TNVV Rao- Project Advisor- ICCW
8.    Er Hemanta Koley- Superintendent Engineer (Water Quality)- WSSO, PHED, West Bengal

Context/ Problem Statement:
●       Ensuring FHTC for Jal Jeevan Mission needs the supply of safe water at the household and point of use. Given that the quality of local groundwater resources have shown a wide variety of Water quality problems over the years (100 million and more affected from Parliament responses), this puts a pressure on scarce surface water resources that otherwise need to be supplied for ensuring FHTC. Sustaining infrastructure for such water supply along with effective disinfection till the point of use, is necessary. In absence of such surface water or alternative sources, treatment of local chemical contamination becomes the only option.
●       Either of the possibilities for FHTC in Water quality affected areas, requires strong community participation in O&M and sustainability. Experience till now shows that schemes are unable to be effective in the long term, both in ensuring effective disinfection by chlorination or otherwise; or with local water treatment plants; both needing effective participation of VWSC in PRIs.  
●       Given that either Chlorination and/or local Water treatment is a necessity for every Water supply scheme, Water quality has now emerged as an important problem to be solved with 1.42 lakh (out of 17.72 lakh) FTK results showing contamination (as of Jan 21, 2022 in JJM dashboard). Only 5954 of these 1.42 lakh reported points, are reported as those were remedial action has been taken, as of date, which says that 96% of the reports are still unresolved.
 
Sustaining this effort of Water quality monitoring and surveillance (WQM&S) with the participation of laboratories and PRIs along
with VWSCs and women, children and youth testing water in villages has now become core to the JJM. Some states such as Chhattisgarh are now outperforming (6.33 lakh/17.72 lakh total FTK tests in 2021-22), whereas many states as lagging behind. The status of NABL laboratory certification is also an aspect that plays a big role in laboratories being able to produce reliable and accurate data.
 
Bringing together laboratories, PRIs and PHED/RWSS onto a single platform on WQM&S, and together enabling effective water quality
monitoring , surveillance and action is critical. Unless each Water quality data point that shows a problem is taken seriously and acted upon, we will soon have a massive pile of unsolved problems (already 96% unresolved, as shown earlier). The year 2022-23 for JJM will be critical in resolving these Water quality issues, for which the collective problem solving between these institutions within the district will help address the problems for JJM.
 
This session will help address these core issues for JJM. Apart from Data governance issues, we will have communication and behavioural
problems being addressed, Water safety planning, along with institutional capacity and system strengthening goals put forward by the speakers. 

Summary
Context:
1.     Discuss the progress of JJM in terms of the larger context of Water Quality and Water Quality affected habitation.
2.     Role and importance of Water Quality Monitoring & Surveillance and reporting  - focus on water quality testing from community to Water Quality Lab.
3.     Water Safety planning as input monitoring process for mitigating and preventing water contamination.
4.     Importance of Water Safety and Security Planning and role of data in planning
5.     Uniformity in data collection methods for more transparent data Governance.
6.     Role of community and panchayat in Water Quality surveillance and monitoring mechanism
7.     Grey Water is one of the primary contributors of Water Quality problem. 
Challenges
1.     Low levels of awareness about water quality among people hence the test of household water is hardly done.
2.     Absence of organised capacity building plan for the PRI, frontline Govt functionaries.
3.     Reliability of Field testing kit as a viable testing system through it is used at field  
4.     False positives and negatives result of microbial test through  H2S Strip.
5.     Water Safety plan is not prioritised in most of the panchayat.
6.     Panchayat have no motivation to undertake  sanitary assessment and water security plans
7.    Absence of organised platform on Water Quality data at National level. There is non-coherence in the data from 4 platforms ( CGWB, JJM, CPCB and state department)
8.    Contamination through other sources such as livestock waste are critical but more often than not ignored
9.    Grey water frequently mix into the open stormwater drainage system, thereby adversely affecting the quality of stormwater
10.  Limited studies/evidence on new water testing and treatment solutions a hindrance to scaling-up potential models on safe water access.
11.  Community knowledge is hardly recognised on Water Quality with science of WQ.
Key takeaways:
a) Solutions- Examples of what/where/how/who
1.     Create awareness on the importance of water quality testing for community.
2.     Training calendar on Water Quality testing for frontline functionaries and block-level Govt officials.
3.     Panchayat level GPDP plan should include Water Quality monitoring as one of the component.
4.     Transparency on use of digital Water Quality data at panchayat level.
5.     Water Safety plan should be  integral part of planning and execution of any water supply system.
6.     Community knowledge on Water Quality to be valued with science of Water quality.
7.     Data integration across departments
8.     Piloting solutions and undertaking studies for evidence generation paves way for scaling up
9.     Adoption of decentralized wastewater treatment system at Gram Panchayat level.
10.  Quick Availability of Water Quality tested data as required.
11.  Creating cadre of Jal Bandhu for decentralised water quality testing.
b) The way forward or what needs to be done.
1.      Audit of FTKs for quality and reliability.
2.     Bottom-up approach decision making process is key to ensure adoption and sustainability for accessibility to safe water
3.     Focus on behaviour change
4.     Collaborative efforts for collective impact among public, CSO and Govt on WQ.
5.     Effective and efficient dissemination of Water Quality data to people
6.     Data driven decision-making for effective implementation of JJM.
7.     Affordable sensor based technology to test water quality for quick reporting
8.     Capacity building of Jal Bandhu and devising plan for testing & surveillance.
9.     Developing common source for referring water quality data.
10.  Sharing of knowledge among all the stakeholders and Govt department.
11.  Evidence-based study on Greywater problem with Water quality contamination.
c) Any specific points to be added to call to action?
1.     Gram Panchayat should be empowered through capacity building and FTK.
2.    Common source for referring  water quality data at national level
3.     Capacity building and awareness among community members and PRI on WQ with health problems.
4.     Collaborative effort among CSO, Govt, PRI and community for ensuring utility of safe access to contaminated free water.