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Making sanitation inclusive: reflections from the 39th WEDC Conference

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The theme for this year’s WEDC Conference was Ensuring Availability and Sustainable Management of Water and Sanitation for All. The theme reflects the ambitions at the heart of the Global Goals for Sustainable Development to ensure that no one is left behind in efforts to achieve universal access to WASH by 2030. It’s now a critical time for ensuring that WASH research, programmes, policies and services are designed and delivered in ways that promote Equity and Non-Discrimination.

Ahead of the Conference, Equity and Non Discrimination were themes discussed in the CLTS Sharing and Learning workshop in Kumasi with specific attention to menstrual hygiene, facilities for people with disabilities and disposal of child faeces. In the workshop we discussed practical guidance for governments, facilitators, natural leaders and programme managers on mainstreaming gender, disability and ageing in CLTS programmes.

Menstrual Hygiene: Agencies and ministries have (increasingly) been designing school infrastructure to support girls to manage their periods in school. But MHM in CLTS programmes has received comparatively less attention (perhaps because intervening on MHM at the household-level level is more difficult without prescribing technologies?). In rural Nigeria, we heard how women may be excluded from using household latrines during menstruation or may have difficulties in washing menstrual cloths and keeping them clean between periods. Yet, we also heard how the CLTS process can be facilitated in a way that breaks taboos on MHM (e.g. around cooking and sleeping in the same room as a husband when menstruating). Separate triggering for women and adolescent girls can be an opportunity to ask women and girls what they know about menstruation, how they are managing, whether hygiene practices can be improved and ideas for alternatives. Collectively sharing that discussion with the men in the community can lead to a community action plan that includes MHM. It was reported that men have been selling the reusable sanitary pads in rural Uganda, and this has proved persuasive in male household head decisions on whether to buy pads for their wives and daughters. Through school–led total sanitation children have become agents of change on MHM with peers in schools and in their homes and communities, changing MHM practices, taking learning back home and breaking the taboos. How to keep girls with disabilities in school during menstruation, especially if they cant manage by themselves, is a particularly neglected issue and requires further attention.

Inclusive facilities: Household innovations have been seen in rural communities in Ghana including raised seats on pits, made from clay or concrete, for older and disabled people to sit. These households have built their own seat with local materials, and thought to be based on WCs seen in urban areas.

Child faeces disposal: A belief that children’s faeces are not dirty or that children don’t need privacy in the same way as adults (because children don’t have shame) means that children can be excluded from using toilets. As they get older, children might be scared to use pit slabs with large holes or more basic latrines for fear of falling down the pit. A keyhole pit slab might be more child-friendly. Faeces disposal for babies and infants is another important issue for CLTS to consider. It’s difficult to dispose of nappies as they don’t burn. Mothers have been seen washing diposable nappies to re-use them. People often dump nappies in the refuse but if goats get to them they often pull the dirty nappy apart: this kind of litter makes it difficult to declare a community ODF. Handwashing (and anal cleansing) for infants as they start crawling is another key issue for care-givers.

At the conference participants continued to share success and learn from those of others, reflect on where they have failed, and strengthen networks. Over the week we heard examples of efforts to make CLTS and sanitation more inclusive within the household in Uganda and Zambia as well as through the community triggering process in Malawi; through public private partnerships in Ouagadougou; through market based approaches in Cambodia; and how research frameworks can be designed for improving equity. We heard how equity and inclusion considerations have been integrated into policies and plans and budgets. We also heard examples of how citizens were mobilised for their rights and in changing public attitudes and expectations over access to services for vulnerable and marginalised groups.

At the Conference, the CLTS Knowledge Hub launched a new book at the conference ‘Sustainable Sanitation For All’. Chapter 15 is entitled: Putting the hardest to reach at the heart of the SDGs. Written together with Sharon Roose, Cathy Stephen and Jane Wilbur, in the chapter we give practical steps to integrate inclusion in the CLTS process with examples of how to integrate attention to vulnerable groups – disabilities, MHM, children and aging and violence as well as those taking multiple and overlapping disabilities - through the CLTS process. As we all start working towards the 2030 Agenda for Sustainable Development, we hope the book will spur efforts for more cross-sector collaborations to share our learnings and experience to continue to improve practice on sustainable sanitation.

Sue Cavill in an independent WASH consultant.

Date: 19 July 2016