The effectiveness and sustainability of two demand-driven sanitation and hygiene approaches in Zimbabwe

Abstract

Since 2000 a number of community-driven sanitation approaches have emerged that counter a historical trend to subsidise the provision of latrines to the poor. This study reports on a set of findings and conclusions concerning the effectiveness and sustainability of two such approaches operating in Zimbabwe, the community health club (CHC) approach and community-led total sanitation (CLTS). Surveys, interviews and focus groups were conducted in a total of ten project communities from three districts. Results show that, despite little resistance to the idea, a household's ability to own a latrine depends heavily on its ability to afford one. Affordability is also key in moving up the 'sanitation ladder', which is necessary if behaviour change is to be sustained in the long term. Whilst both approaches effectively encouraged measures that combat open defecation, only health clubs witnessed a significant increase in the adoption of hand washing.However, CLTS proved more effective in promoting latrine construction, suggesting that the emphasis the CHCs place on hygiene practices such as hand washing needs to be coupled with an even stronger focus on the issue of sanitation brought by CLTS.

Approaches to promote handwashing and sanitation behaviour change in low‐ and middle‐income countries: a mixed method systematic review

“…In this way, the effect of specific additional elements to a promotional approach could be studied. We discuss the different comparisons below (Contzen et al, 2015a/2015b; Dickey et al, 2015;Graves et al, 2011; Guiteras et al, 2015a; Lhakhang et al, 2015;Whaley & Webster, 2011; Zhang et al, 2013).…”

“…Whaley & Webster (2011) compared two different types of community‐based approaches, Community Health Clubs versus Community‐Based Total Sanitation. Both interventions contained all WASH components.…”

“…The most frequent reported barrier, identified in different community‐based approaches (such as the MTUMBA approach in Tanzania, RUWASA in Uganda, and CLTS in Zambia) and social marketing programmes, was the limited financial, technological or facilitation capacity . An example of this is the lack of construction materials, expensive loans, insufficient programme funding, increased governmental charge, or inadequate budget allocation (Bruck & Dinku, 2008; Jimenez et al, 2014; Katsi, 2008; Lawrence et al, 2016; Malebo et al, 2012;Emerging Markets Consulting, 2014; Whaley & Webster, 2011, Kiwanuka et al, 2015; Schouten & Mathenge, 2010). During 2 community‐based sanitation programmes performed in Tanzania (Jimenez et al, 2014) and India (Hueso & Bell, 2013) specific payment modalities (e.g.…”

Promoting handwashing and sanitation behaviour change in low-and middle-income countries

“…The approaches were equally effective in improving latrine use and open faeces disposal, 30 but no information was available to quantify the effects of either approach. We conclude that it is important to involve the community when designing behaviour change programmes, but currently there is no comparative effectiveness evidence about which method is better.…”

Continuation of Health Behaviors: Psychosocial Factors Sustaining Drinking Water Chlorination in a Longitudinal Study from Chad

“…Even slight declines in compliance, for instance small amounts of untreated water consumed on a few days in the year, can cause up to 90% of the expected beneficial effects of water treatment to vanish [9]. It is therefore essential to couple the provision of technological solutions with behavior change campaigns [10][11][12].…”