Safe hygiene practices and access to sanitation are crucial for combating the main health threats to children. However, nearly twice as many people lack access to sanitation compared with water supply. Is it time to stop aligning sanitation and health (S&H) policies so closely with water management policy?

A paper from Tearfund, researched and written by ACCEDES, one of Tearfund’s local partners, together with the Overseas Development Institute, in the UK, investigates barriers to sanitation and hygiene promotion in five villages in Burkina Faso. Researchers focused on safe disposal of human excreta and safe hygiene practices – the elements of basic S&H that are lacking in most sub-Saharan and other developing countries.

In Burkina Faso demand for sanitation is low to non-existent and hygiene behaviour is lax. This is due to a lack of knowledge of the health benefits of safe hygiene practices and sanitation facilities, combined with the prevalence of socio-cultural attitudes that support open defecation. Researchers found most villagers could not make the link between contaminated water and disease. For instance, the general reason given for diarrhoea was malaria.

Most households lack the financial means or technical expertise to construct latrines. Some cannot even afford soap. Local officials lack capacity to help. Some bureaucrats interviewed did not perceive sanitation as a public responsibility, saying latrine construction was a private household affair.

Problems that Burkina Faso shares with many other developing countries include:

• overlapping mandates and shared responsibility for S&H by multiple ministries
• failure of decentralisation reforms to clarify responsibility for sanitation in rural areas
• weak advocacy on behalf of S&H, leading to low investment priority given to sanitation by both government and donors
• failure to link government and civil society sanitation initiatives
• women often have greater enthusiasm for improvement in S&H facilities than men but their voices remain unheard
• the absence of of reliable information on the condition of existing sanitation infrastructure and extent of safe hygiene behaviour.

Sanitation has been incorporated alongside water supply in Target 10 of the Millennium Development Goals. The increasingly popular ‘water, sanitation and hygiene’ (WASH) concept argues for integrating improved water sources with better household handling and storage of water and management of human excreta. However, a key challenge for policymakers is to agree what is meant by ‘sanitation’ and ‘hygiene’. Uncritical use of ‘sanitation’ risks blurring the distinction between on-site methods of handling human waste and connections to sewer systems. There is also a danger of separating WASH issues from other problems faced by poor people such as lack of safe housing and insecure land tenure.

Lessons learned in Burkina Faso include:

• Changes in practices take time and S&H programmes need to be supported significantly longer than water supply projects.
• Encouraging demand and changing behaviour is a human resource-intensive task which government cannot do alone: religious leaders, non-governmental organisations and other opinion leaders must be engaged.
• The government and donors must take a common stance about whether to subsidise latrine construction or not.
• Local government human and financial resources to support S&H must be boosted.
• Arrangements for cleaning and maintaining latrines must be put in place if villagers are to continue to use them.

Source(s):
‘Sanitation and hygiene in developing countries: identifying and responding to barriers. A case study from Burkina Faso’, Overseas Development Institute, by Katharina Welle, February 2007 (PDF) Full document.
‘Sanitation and Hygiene: knocking on new doors’, Overseas Development Institute, Briefing Paper, by Peter Newborne and Katharina Welle, December 2006 (PDF) Full document.

Funded by: Tearfund

id21 Research Highlight: 14 March 2008

Further Information:
Katharina Welle
Water Policy Programme
Overseas Development Institute
111 Westminster Bridge Road
London SE1 7JD
UK

Tel: +44 20 79220300
Fax: +44 20 79220399
Contact the contributor: k.welle@odi.org.uk

Water Policy Programme, Overseas Development Institute, UK

Other related links:
'Addition to water bill stimulates household sanitation investment in Burkina Faso'

'Cut out the waste says WaterAid report'

'Water, sanitation and hygiene: primary concerns for public health'

'Sustainable worm control to protect school children in Burkina Faso'