“behavior change”, CLTS, Community Led Total Sanitation, PHAST

water, sanitation, hygiene, WASH, USAID

Talking Shit: Translating Sanitation and Hygiene from Discourse to Details

It has been an on-and-off trend in the water, sanitation, and hygiene (WASH) sector to Talk Shit in order to move the dial forward in terms of access to sanitation.  In 2008, for example, The Year of Sanitation had this forceful message to use the word shit in order to spur change.  Same thing with the well-received “The Big Necessity: The Unmentionable World of Human Waste and Why It Matters.”

After the advocacy community is rightfully reinforcing the importance of access to sanitation and motivating donors and governments to budget more to the WASH sector, the time comes to acknowledge the complexity that’s necessary and translate from clear and concise advocacy messaging to muddy, wonky, and often intractable challenges that show up in design and implementation phasesThese include some of the difficult, grinding realities – such as poverty and/or lack of affordability, the lack of incentives to invest in sanitation, the lack of soap and water for necessary hygiene, unaccountable governments, market imperfections, etc.

As an example, Community-Led Total Sanitation (CLTS) and other behavior change interventions are often paired with latrine building initiatives.  The perfectly logical idea is that once you build increased demand, you help build the supply to meet it and then connect the two.

In this regard, a really useful study on the effectiveness of such sanitation and hygiene initiatives came out of Plan International in 2013.  It showed that ‘slippage’, or reverting back to open defecation went from 13% to 92% once the criteria for slippage were changed from simply the presence of a functional latrine to include criteria such as a latrine superstructure and lid, the absence of excreta nearby, and the use and presence of water and soap or soap substitute.

 Reasons for failure/de-motivators were numerous and included:

  • Financial constraints (18%)
  • Lack of technical support (18%),
  • Inconvenience/discomfort (14%)
  • Repairs (13%),
  • Having to share facilities with others (12%)

Other barriers included:

  • Lack of land, material, or labor (32%)
  • Soil conditions (25%)
  • Lack of technical knowledge (13%)
  • Water availability issues (13%)
  • Poor construction quality (11%)

Without diving into any of the muddy, wonky, or often intractable details of any of these at this point, each one of these issues warrants serious consideration when designing interventions, it’s critical to acknowledge that the right translation to complexity be made at the project design and country-level planning stages.  Ignoring this prevents the sector from learning from its mistakes.