Sanitation practitioners attending the East and Southern African Regional CLTS and rural sanitation workshop visited the districts of Babati and Karatu, in the north east of Tanzania, in April 2018 to discuss the implementation of CLTS and WASH approaches under the Sustainable Sanitation and Hygiene for all (SSH4A) project run by SNV in partnership with the Government of Tanzania (GoT) and the UK's Department for International Development (DFID).

(Photo: An improved sanitation facility in Loto village, Babati.)

CLTS and WASH in the East and Southern Africa region
A five-day regional workshop was held by the CLTS Knowledge Hub in Arusha, Tanzania, in order to foster sharing of knowledge and learning, ideas and innovations, challenges and approaches to CLTS and rural WASH among 36 sanitation practitioners working for international NGOs, cooperation agencies, research centres and at different government levels across eight countries1 from east and southern Africa.

Based on SNV and GoT's work in the districts, one of the main goals from the visits to Babati and Karatu was to understand and further discuss how CLTS and WASH programming are responding to the need to make the approaches more equitable and inclusive as well as more sustainable in order to deal with the lack of access, the slippages and the low rates of improvement of sanitation facilities which make rural communities strive to reach and maintain Open Defecation Free (ODF) status. 

Experiences from the field
The trips started with an early morning visit to a health centre where women with their children were being triggered about hygiene promotion by a local health worker. When we sat down in Magugu Health Centre in Babati, a common scenrio was being acted out by a young mother - she changes her baby's nappy in front of the group but when she is finished doesn't go to wash her hands - which prompted the audience to discuss what the problem with this was and what could have been done better. The triggering session then focused on the other critical moments for handwashing throughout the day. During the process the participants learnt about of the main hygiene hazards and procedures, and the health worker emphasised the importance of sharing these messages with the rest of the community.

The trips continued by visiting the local workshops where SNV builds and sells pit latrines, based on a market approach. In terms of innovations, a wooden seat with a lid was shown to us which could be located above the slab and simply removed after defecation, there was also an aluminum drop hole cover which could be easily placed using the foot in order to avoid slips and flies. Some of the participants pointed out that the china pit latrine on display had a slab placed on the edge of the structure, a common design inaccuracy which makes it difficult to maintain balance while squatting. The price of a pit latrine started in 170,000 Tanzanian shillings (74.5 USD) for a basic design and rose to 450,000 Tanzanian shillings (197 USD) for an improved one which despite its price was possible to pay in small installments.

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(SNV's workshop appears in the back where also different latrine models are on displayed in Magugu village, Babati.)

During the afternoon one village from each district was visited in order to learn about the implementation process of SSH4A. SNV and GoT started to work in Loto village, Babati district, in 2014 and at that time only 160 households from a total of 6,025 were declared ODF. SNV's implementation phase consists of triggering campaigns, behaviour change communication strategies and also training four artisans per sub-village in the construction of toilets and handwashing facilities. There are also sanitation supervisors who volunteer to monitor on average 25 households by doing weekly visits and running monthly surveys. Currently, every household from Loto village has a toilet, 53 per cent of the population has improved latrines and 95 per cent has handwashing facilities.

However, there were some challenges to face post-triggering. Toilet roofs were mainly made from leaves and branches and were frequently damaged by rains, the walls of many toilet structures were made from mud and easily collapsed and also children had frequently play with and damage handwashing facilities. Some of the solutions found by SNV were to look for other stronger local materials, use cement slots instead of mud and also create better awareness in schools and at the household level.

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(Anna, a volunteer supervisor from Loto village, holds in her hands her designated households' quarter surveys)

Key learnings

After the field visits, the following insights were shared among the participants:

• Monitoring and sustainability: One of the main advantages of SSH4A project is the fact that many of the villages already have a tool for data collection allowing new and supplementary evidence for sanitation and hygiene programming as well as for advocacy and decision-making. Furthermore, large communities are being divided in smaller units for better monitoring. Babati's sustainability plan was highlighted as a relevant contribution for villages to maintain ODF status as well as for households to improve their sanitation facilities as it fosters: i) community sanctions and bylaws; ii) sanitation and hygiene education programmes and iii) new strategies for neighboring villages to become ODF.
• Reaching the last mile: Participants also discussed the equity and inclusion aspect of the SSH4A project arguing that it is still necessary to think further about how to give access to different community groups. Furthermore, even some loan schemes were in place, latrines were found too expensive to be afforded by the most vulnerable. It was also discussed that baby WASH interventions, like the ones seen in the local health centres, need to foster not only women but men's involvement and participation within sanitation and hygiene promotion.
• Moving up the ladder: The campaign Nyumba Ni Choo ("Our latrine is the same as our house") formulated under the Tanzanian National Sanitation Campaign (NSC) was perceived as an effective way to introduce the importance of moving up the sanitation ladder as it encourages communities to build and maintain their toilets to the same quality and standards as they maintain their own houses. However, participants agreed that as the CLTS approach is not only about creating awareness, a cost analysis is needed as well as a deeper study on how to sell sanitation facilities; especially improved ones as there are still many basic toilet structures in place. Also discussed was the need to focus further on handwashing facilities as they were not user-friendly in some households and in others it was unclear if they were being used at all. The standarisation of sanitation facilities was presented as a beneficial measure as artisans agree on the design of the facilities in order to make stronger and longer lasting toilet structures. Furthermore, even the aluminum drop hole cover was found as a useful innovation, participants agreed on the need to encourage community members to share their own innovations. 
• Government involvement: The democratisation of the SSH4A implementation phase by the GoT was recognised as a positive intervention as the local government allows the lower levels to do the monitoring of the sanitation interventions. This contributes to a more accurate data collection and follow-ups pre- and post-triggering. At the same time, it was highlighted that the high commitment of the local leaders and the motivation of the volunteers are key factors for GoT achieving its main sanitation targets.

All in all, after the visits to Babati and Karatu districts, sanitation practitioners agreed on the need for SSH4A to move faster on the improvement of basic sanitation facilities. For this, awareness is not enough. There is a strong need to use most recent evidence to include every community member in the process, to understand needs and also to foster the creation of facilities that can easily adapt to users' needs, contexts and time.

Florencia Rieiro is an independent WASH consultant

(All photos in blog post taken by Florencia Rieiro)

• 1. 1. Burundi, Eritrea, Ethiopia, Kenya, Malawi, Tanzania, Uganda and Zambia.