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'Nothing about us without us!': the Philippines' approach to Zero Open Defecation

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Following the workshop facilitated jointly by the CLTS Knowledge Hub at IDS and UNICEF which looked at how best to support the poorest and most vulnerable in sanitation at scale, the Ministry of Health and UNICEF facilitated a one-day workshop for Government and partners in the Philippines on the 29th May 2017. The purpose of this workshop was to share the learning from the first few days discussions and to consider the opportunities and challenges to applying different subsidy and reward schemes in the context of the Philippines in supporting the poorest.

Maria Francia M. Laxamana, MD, The Assistant Secretary for the Ministry of Health, gave an introductory speech providing an overview of the commitments and priorities of the Government of the Philippines and the Ministry of Health including its 12 legacies. Number 6 of the legacies is to reach Zero open defecation. She also described the MoH’s approach of considering the lifecycle approach ‘from womb to tomb’ recognising the different issues for people at different stages of their life cycle.

Engineer Rolando Santiago provided an overview of the sanitation situation in the Philippines and the National Sustainable Sanitation Plan and shared that in the Philippines 81.6 percent of people have a sanitary toilet but with approximately one fifth of the population not yet having a service and 7 million defecating in the open. As is common in other countries, there is also a wide disparity between the poorest and wealthiest with only 40 percent of the poorest population having access to a sanitary toilet but 91 percent of the wealthiest. He also shared that in the Philippines that rather than the term Open Defecation Free (ODF), the term Zero Open Defecation (ZOD) is used. This is because the term ODF was sometimes understood to mean that open defecation is free, i.e. with no cost! This is something that I had not considered before but totally understandable and made me wonder whether this confusion is also happening in other countries?

Presentations were also made on the recommendations for principles from the previous workshop, on some of the findings from the Global Sanitation Fund Equality and Non-Discrimination (EQND) study and on a number of other programmes that utilise a range of approaches including external support. Dr Kamal Kar and Professor Robert Chambers also provided inputs on the risks to CLTS from the introduction of external support and on ways that can be used to strengthen the existing CLTS processes to ensure increased engagement of and benefit for the poorest and most vulnerable. They were also part of a panel discussion together with Andy Robinson, Engineer Roland Sanitago and Sudha Shrestha of UN-Habitat Nepal. She shared the success of the Government of Nepal and partners in moving from 6 percent coverage of improved toilets in the 1990s to around 90 percent today, with greatest progress since the introduction of the CLTS approach; as well as the level of commitment and government-led coordination structures that have contributed to this significant achievement.

It was very positive to have the involvement of Ranilo Sorongon in the workshop, who is the convener of the Philippine Partnership on Children with Disabilities, an informal network of individuals and organizations working for children with their families. The benefits of his participation highlighted the importance and value of engagement between the sectors, both for the WASH and the disability sectors in the Philippines and also elsewhere. It helped us to reflect on the relevance and importance of considering “Nothing about us, without us!” when discussing the situation, needs and priorities of the poorest and most vulnerable.

Representatives of government, UN and civil society organisations and participants from the previous workshop, discussed in groups the relevance of the earlier presentations and discussions. They came up with recommendations for practical actions that should be undertaken in the context of the Philippines.
One issue discussed included the need for increased communication and harmonisation of approaches to support for sanitation across sectors i.e. in relation to subsidy and alignment to ensure that interventions do not disrupt community momentum to reaching ZOD. Of particular interest, and with opportunities for learning for other countries is well, is how to enable CLTS, non-subsidy based approaches as supported by the Ministry of Health, to be effectively complemented by financial support mechanisms already provided under interventions by the Ministry of Social Welfare. 

It was also discussed that micro-finance mechanisms do not usually reach the very poorest people who may not have collateral and be able to repay and the need to ensure that such mechanisms are linked to government systems if they are to make a difference at scale. A number of issues were also discussed related to the need to improve monitoring on this issue, including a suggestion to double check if the least able to construct, use and maintain a latrine, have been effectively been reached by returning to a small sample of the 1,000 Barangay’s that have reached ZOD to-date.         

It has been great to have the opportunity to learn from the representatives from the Philippines. I hope that they will document their continued learning so that other countries will continue to benefit from their efforts, their successes and solutions found to respond to the challenges they face.

Sarah House is an independent consultant

Date: 9 June 2017