January 2014 - PowerPoint Presentation

Slide1

January 2014

Investing in improved Sanitation:

key to achieving the MDGs?Slide2

Outline

Impact of Sanitation on development indicatorsCurrent status of sanitation in Tanzania

Programs and approaches to address the

problemSlide3

2

Sanitation matters

because it’s more than toilets

MGD 7c: Access to improved basic sanitation and water

MDG1: Poverty

Up to 7%

of annual GDP loss in lagging countries

results from poor sanitation, driven by health costs and lost productivity with poor households bearing the burden

MDG4: Reduction of child mortalityDiarrhea is the 3rd leading cause of death in children under 5

MDG2: Education443 million school days are lost every year due to WASH related diseases. Girls are disproportionately affected by lack of privacy and cleanliness during their period

MDG3: Gender equityImproving sanitation impacts on reduction of violence against women during open defecation

MDG4: Reduction of child mortality1,800 children under 5 die every day from fecal related diarrheal disease

MDG4: Reduction of child mortality50% of childhood malnutrition is associated with repeated diarrhea and nematode infections

Poor sanitation costs Tanzania US$ 206 million each

year…..

equivalent of US$ 5 per person in Tanzania per year or

1% of the national GDP.Slide4

Feces

Fluids

Fingers

Flies

Fields/Floors

Food

Sanitation

Clean

w

ater

Handwashing/hygiene

Handwashing/hygiene

3

It’s not the water that makes children sick and malnourished,

it’s the feces -

sanitation is the primary barrier to stopping the consumption of human feces

SanitationSlide5

UNICEF: “The first two years are forever”

Indian children, 2005 DHS

height relative to healthy normsSlide6

as we all know, there are germs in feces, which get onto children’s fingers and feet,

into water and foods, and wherever flies go

even in rural places, open defecation is not always far from homes

diarrhea

 direct loss of food

enteropathy  no aborption

energy consumption fighting diseaseSlide7

small kids? big deal!

Height is not the only thing developing in the first few years lifeThe same early life health that helps bodies grow tall also helps brains grow smart

Height predicts (

on average

):

Cognitive achievement

Adult occupation class, employment, wagesAdult health, mortality, and happinessPromotion of people in large organizations (!)Slide8

change

over time in BangladeshSlide9

height and cognitive achievementSlide10

merely wealth?

wealth

w

ithin IndiaSlide11

Short and Long-term outcomes from stunting

In Eastern and Southern Africa, 24 million children under five or 

39% suffer

from stunted

growth

(UNICEF, Nutrition Profile)

.More likely to die from diarrhoea, pneumonia, measles and other infectious diseases (Black, 2013)Are more likely to have poorer cognitive and educational outcomes in later childhood and adolescence (Walker et al., 2011, Grantham-McGregor et al., 2007). Making another generation less productive than they would otherwise be (Black, 2013)Have higher levels of depression and anxiety and lower self-esteem (Walter et al., 2007), increased risk of suicidal ideation (Cheung et al., 2009), and higher levels of hyperactivity in late adolescence

and attention deficit in adults (Galler, 2012). Slide12

Evidence of WASH on stunting

Lin (2013) Markers of environmental enteropathy in children are associated

with a

decrease

in

height for age Z score supporting the hypothesis

that environmental contamination causes growthBased on a randomized field experiment in Maharashtra, India, Hammer and Spears (2013) found that children living in villages randomly assigned to receive sanitation motivation and subsidized latrine construction grew taller than children in control villages.Spears (2013) found that the differences in child height between India and Africa are explained by differences in sanitation.Cameron et al (2013) found that a Total Sanitation and Sanitation Marketing project in Indonesia increased average height of children living in households without access to sanitation at baseline. Slide13

0

500,000

1,000,000

1,500,000

2,000,000

2,500,000

3,000,000

1.1 billion Defecating in the open

- 90% occurring in rural areas

754 million using Unimproved Sanitation

– 75% occurring in rural areas

761 million using Shared sanitation – 61% occurring in urban areas4

Because of service delivery failure in both urban and rural areas, 2.5 billion people lack access to sanitation– resulting in one of the most off-track MDGsSlide14

Government led 1970

’s

Mtu

ni

Afya Campaign, helped reduce OD

and achieve high coverage of traditional pit latrines – from 5-20%

in 1973 to over 80% in 1978

THE SANITATION STATUSSlide15

Sanitation practices are getting worse in rural Tanzania

5.1 million people

24 million peopleSlide16

Sanitation access is not drastically different across expenditure quintiles

Source: Analysis by K. Mdadila using income/expenditure data from National Panel SurveySlide17

Stunting is worse off in children that are poor and who live rural areas of Tanzania

Source: UNICEF Nutrition ProfileSlide18

Childhood stunting varies by level of local area open defecation and unimproved sanitation

Tanzania

(2010) – Height-for-age z-score by age and

local area open defecation and unimproved sanitationSlide19

Open defecation is becoming more prevalent in the north over time

Souce

: Ending Open Defecation in Rural Tanzania, Which Factors Facilitate Latrine Adoption. J Graham, S. SaraSlide20
Slide21

NATIONAL SANITATION

CAMPAIGN

Campaign

conducted

across

the country

Knowledge Sharing Forum

What works at scale? Distilling critical success factors for scaling-up rural sanitationSlide22

WSP Theory of change

Improve health and socio economic conditions

for poor rural households and communities (Vision 2025)

Increase access to, and

use of improved sanitation

(Draft National S&H Policy, MKUKUTA II)

Increase demand at community level to stop open defecation

and increase the supply and demand of household sanitation solutions

Strengthen the enabling environment needed to sustain improved sanitation at scale Slide23

WSP Theory of Action

Positive Impact on health, economy and education

Local Governments (Districts, Wards, Villages) Implement and Monitor

National Sanitation Program, Regulates Private Sector

National Government Supervises and Monitors

National Sanitation Program Implements Activities with National Scope (Core concepts, Media), Improves Enabling Environment

Households install and use

improved sanitation facilities

Local Private Sector

offers sanitation goods and servicesRegional Authorities Monitor and Supervise Local National Sanitation Program Activities

Communities (sub villages) ignite and commit to 100% coverage and usage (ODF)

 WSP Support:

 Programmatic approaches for supply and demand Performance reviews 

With related support to enable: PolicyLeadershipDonor coordination

Financing

Capacity development  Slide24

Thank you, open for discussion!!