SWASTH Sanitation Approach
First TSC project in Bihar was sanctioned for Vaishali district in 1999. By 2006, all the districts of the state had the sanction with a total outlay of Rs.2,04,090.57 Lakhs. However, the physical progress for different components under TSC in the state has not been satisfactory.
Against the Census 2001 targets, state had coverage of 26.44% in March 2009. There was an increment increase of 5.71% 2010-11. Similarly, till date (as on 27-07-2011) only 19.32% (1384 out of 6595) anganwadi toilets have been constructed. Though on the school toilets front, about 69% school toilets have been constructed against the target of 76581. But out of the total 8471 Panchayats of the state, only 211 Panchayats have received the prestigious Nirmal Gram Puruskar.
Despite the above progress, the actual usages of the toilets are too low. Still, around 6 out of every 10 person in rural Bihar do not have access to any sanitary toilet and open defecation is rampantly observed across the state.
DfiD SWASTH Intervention in Bihar
Aimed at improving the health indicators and subsequently the quality of life in Bihar, DFID-UK has joined hands with Government of Bihar to address this problem by initiating SWASTH. The Sector Wide Approach to Strengthening Health (SWASTH) is an effort to improvise the health situation through an integrated health, nutrition and water & sanitation intervention. The goal of SWASTH is ‘to improve the health and nutritional status of people in Bihar, particularly the poorest and excluded’.
With regards to water & sanitation sector, SWASTH would be addressing the following 3 components – adequate quantity of safe drinking water, access to improved and safe sanitation and promotion of safe hygiene practices. In order to address the sanitation issues, SWASTH-WATSAN has adopted a multi-faceted approach detailed out under the appropriate heads below.
Community Mobilization
i. CLTS Intervention
B-TAST has introduced the CLTS approach in the State through a one day state level workshop facilitated by Dr. Kamal Kar, the founder & promoter of CLTS. B-TAST intends to extend resource support to organize similar workshops at the district level as well.
Further, BTAST is going to hire services of specialist agency for intensive CLTS intervention in one block each of 4 different districts. The agency would be extending training, capacity building & hand holding support to the respective districts/blocks with a clear mandate to make the respective blocks ODF and create a replicable and scalable model of CLTS intervention to be used in the state.
ii. SHG Involvement
The self help group movement in Bihar is picking up at a great pace. In terms of reach, BRLP’s Jeevika Project alone has more than 32000 women SHGs in 9 districts of the state. B-TAST is going to work with SHGs of Jeevika for reaching out to the larger community.
Jeevika SHGs would be trained in CLTS techniques and would be made instrumental in making their respective villages ODF. Based on the learning from these interventions, concerned departments would be encouraged to scale up these efforts at the state level.
Besides, the selected SHGs would be identified to be trained by Ekjut on the PLA cycle intervention for addressing the sanitation and hygiene promotion issues together with nutritional issues in their respective villages.
iii. Theatre Intervention
An innovative approach of using participatory theatre for mobilizing communities to make their villages ODF is also going to be tried out by BTAST in selected 2 blocks/districts. Services of an expert agency would be hired to pilot the intervention in the selected blocks/districts of the state. This would include mapping & capacity building of small theatre groups and conducting script development & theatre workshops.
Capacity Building
i. Training VHSNC & Field Functionaries
In order to bring sanitation & hygiene promotion issues on the agenda of the Village Health, Sanitation & Nutrition Committees (VHSNC), BTAST is going to seek technical support from an expert agency to capacitate VHSNC members and field functionaries (ANM/AWW/ ASHA) on need and importance of hygiene & sanitation and their roles. They would also be oriented on using VHNSD as a platform for hygiene & sanitation promotion in the villages.
ii. NGO Scoping & Training
B-TAST is currently doing NGO assessment in all the districts of the state with a purpose to prepare a data base of the agencies functional in the state. Selected NGOs identified from the data base would be shortlisted on the basis of certain parameters and would be trained to provide varied support for smooth implementation of TSC in the state.
iii. District BCC Plan Development
BTAST is going to facilitate development and implementation of district level BCC Plan in Banka and Jamui, on request of the districts. If required, support would be extended for development of communication material, trainings and monitoring of the communication intervention.
Hygiene Promotion
i. Integrated BCC Strategy
The Watsan Team of BTAST is working with other core teams in house for development of an integrated BCC strategy. The proposed strategy aims at promoting a set of messages from the 3 core areas of health, nutrition and watsan.
ii. Hand Washing in PPP Mode
BTAST would be working shortly with a Private Sector partner on development and implementation of a PPP model hand washing campaign in the primary & middle schools of the state. A concept note is already ready that proposes a base line as well an end line to gauge the impact of the campaign.
School Sanitation
UNICEF-Patna has been supporting PHED for strengthening school sanitation interventions in the state. BTAST is supporting 2 key demonstrations in school sanitation for developing model watsan complexes and alternate school toilet system.
i. Model School Watsan Complexes
BTAST is going to develop framework for construction of model watsan complex in schools. The framework would include detailed design and costing for the proposed structures. Further, 40 such model school watsan complexes would be constructed in partnership with BEP with FA support.
ii. School Ecosan Intervention
BTAST is going to make a piloting intervention in 1 school in Gaya on school ecological sanitation
Alternative Sanitation
Considering the specific need of flood prone areas two models of alternative sanitation intervention will be piloted. The models are eco-san and Lajja toilets piloted by BTAST and UNICEF respectively.
Research & Studies
BTAST has instituted 2 studies that would separately be looking into the community perspectives and the impact of TSC in different areas.
i. BCC Baseline
BCC Baseline Study would be trying to understand hygiene & sanitation related perspectives, existing awareness, behaviour and practices of communities, women, facility-based service providers, and community frontline health workers. The study would specifically look into water and sanitation perception and key hygiene practices at household level, including myths, misconceptions, barriers and enabling factors that restrict or may influence sanitation behaviors. This study would reach about 3-4 districts.
ii. NGP Impact Assessment
NGP Impact Assessment aims at assessing the impact of sanitation interventions in NGP awarded PRIs in Bihar, especially its open defecation free status, quality of facilities created, the extent and sustainability of behavior change, and the extent of local government / CBOs/SHGs involvement.
The proposed NGP Impact Assessment would be studying at least 1 GP in all the districts of Bihar receiving NGP thus in a way would provide a clear picture of the entire state vis-à-vis quality of construction, usage of toilets and hygiene practices.
Concurrent Monitoring
SWASTH log frame indicators as well as the TSC monitoring mechanism do not track the usage status of the household toilets and safe hygiene practices at the community level. Considering this, 2 parallel interventions are proposed for monitoring of the above indicators.
Usage of toilet and safe hygiene practices have been included in the set of indicators to be tracked periodically through the proposed concurrent monitoring mechanism for the SWASTH Project.
Besides, BTATS would be introducing the ICT enabled physical monitoring of the toilet usage to be tried out in two block of the state on pilot basis.
It is expected that the above interventions would not just lay out a blue print for hygiene & sanitation promotion in the state, but would also set the pace and direction for the same.