1. Background

Safe, adequate and accessible supplies of water, together with sanitation, are basic needs and essential components of primary health care. Inadequate provision of safe drinking water and sanitation are directly and indirectly related to the communicable diseases, health risk, poor health and environmental pollution. The direct benefits of water supply and sanitation can be exemplified by reduced incidence of water-related diseases. Sanitation is particularly effective in protecting water and soil and controlling worm infections. The indirect benefits include improvement of hygienic conditions and promotion of a state of well being conducive to social development. Economic benefits result from good health, low incidence of diseases and increased life expectancy.

Water and Sanitation has direct and indirect impact on Income and Consumptions too. The Lack of Water forces one to collect water from a distant public source, leading to spending time collecting Water. It may also require people to pay for preparing surface water to drinkable standards or buy water from private vendors and pay higher prices for water. All these leading to reduced Incomes and Consumptions. On the other hand, Lack of Sanitation leads people to defecate in open environment which further results in polluted surface water, polluted ground water and polluted land. All these lead to reduced productivity of labour and increased sickness, leading further to reduced Incomes and Consumption. Thus Water and Sanitation has an effect on Poverty Reduction also.

It is pertinent to note that around 50 % of population of Bangladesh is Poor and around 20 % Hardcore poor, who do not have sufficient Income levels even to maintain a level of subsistence. The current sanitation coverage is only 33.22 %. On the Water front, due to generous endowment of with shallow ground water resources, most of the households have been have been successful in accessing water by investing in hand pumps for individual supply. In contrast to many other countries, gross coverage levels of water supply are greater than 90 % in rural areas. On the other hand, Health Statistics indicate that mortality rates for infants and children under five years of age, are 66 and 94 deaths per thousand live births respectively. Roughly 125,000 children below 5 years are dying each year, 342 children are dying everyday and 14 innocent children are dying every hour, for lack of proper sanitation. In addition, arsenic contamination of ground water has become a serious health hazard that must be addressed with highest priority.

Thus, Government of People’s Republic of Bangladesh is using Water and Sanitation for improving Health conditions of people and also for reducing Poverty. The improvement in Water and Sanitation facilities would help us achieve the Millennium Development Goals (MDGs).

It is in this light government has promulgated its National Policy on Safe Water Supply and Sanitation, 1998, Arsenic Mitigation Policy, 2004. It has formulated the National Water Management Plan in 2004, with more than 60 % Investments earmarked for the Water and Sanitation sector. It has also prepared its interim Poverty Reduction Strategy Paper with great attention to Water and Sanitation. The country has also resolved of attaining “Total Sanitation” by the year 2010, with support from NGOs, Private Sector, Local Government Institutions (LGIs) and Development Partners.


2. The National Safe Water Supply and Sanitation Policy, 1998

2.1 Objectives:

The Government of People’s Republic of Bangladesh promulgated its National Policy on Safe Water Supply and Sanitation in 1998. The objectives of this policy are to improve the standard of public health and to ensure improved environment. For achieving these objectives, steps need to be taken for facilitating access of all citizens to basic level of services in water supply and sanitation; bringing about behavioral changes regarding use of water and sanitation; reducing incidence of water borne diseases; building capacity in local governments and communities to deal more effectively with problems related to water supply and sanitation; promoting sustainable water and sanitation services; ensuring proper storage, management and use of surface water and preventing its contamination; taking necessary measures for storage and use of rain water; and, ensuring storm-water drainage in urban areas. One of the basic Strategies enunciated in this policy was the ‘Decentralization of administrative and financial authority to Local Government Institutions (LGIs)’. Participation of users was to be ensured in planning, development, operation and maintenance through LGIs and CBOs of stakeholders.

2.2 Policy Principles:

The strategy of National Drinking Water Supply and Sanitation Policy has been developed on the principles of Sector Coordination; User’s Participation; Development of sector through local bodies, public-private sector, NGOs, CBOs and women groups; Gradual community cost-sharing; Economic Pricing; Assigning priority to un-served/ under-served areas; Region specific technologies; Improvement in technology through continuous R & D; Social mobilization through publicity campaigns; Capacity Building at local and community level; Mobilization of Resources from users; government and development partners; Providing Credit facilities for the poor to bear costs of Water and Sanitation services; Preference to surface-water over ground-water; Prevention of Contamination of Drinking Water by regular and coordinated Water Surveillance; and, Prevention of contamination of ground and surface water by solid and liquid wastes.

The Community led Total Sanitation campaign will be implemented in this institutional framework.

2.3 Rural Sanitation Policy:

According to the Rural Sanitation Policy of the government, Local Government and communities shall be the focus of all activities relating to sanitation. All other stakeholders including the private sector and NGOs shall provide inputs with Department of Public Health Engineering (DPHE) ensuring coordination. The Users are responsible for operation and maintenance of sanitation facilities and bear its total cost. Users are required to bear increased cost of sanitation services, with a ‘safety-net’ for the hardcore poor. The sanitation services for educational institutions, mosques and other places of worship is partially subsidized. Behavioral change for improved hygiene practice is being done through Social Mobilization, and, hygiene education is being imparted in coordination with ministries of Health, Education, Social welfare, Information, Women and Child Affairs along with DPHE, NGOs, CBOs, Local government bodies and other related agencies.

2.4 Urban Sanitation Policy:

According to the Urban Sanitation policy of the government, the sanitation system has to be self-sufficient and self-sustaining. Sanitary Latrine in every household is being promoted. The public and community latrines are being developed by City Corporations and Pourasabhas that being leased to private sector for maintenance. The City Corporations and Pourasabhas are also responsible for solid waste collection, collection and their management. The Drainage system in cities and municipalities is being integrated with overall drainage system in coordination with Ministry of Water Resources. Behavioral Development and changes in user communities is being brought about through social mobilization and hygiene education.

3. The Sector Development Framework

In this policy, all sector development activities shall be planned, coordinated and monitored on the basis of a ‘Sector Development Framework (SDF)’, which has been approved by the government in April 2004. The SDF interprets policy principles into generic operational interventions; assesses compliance or lack thereof of ongoing projects to policy interpretations; prepares a Project- Compliance matrix; and, identifies gaps for short, medium and long-term interventions. SDF is an evolving and a ‘dynamic’ document that is flexible, continually adjusting to internal and external changes and new ideas and lessons. The heart and soul of the Sector Development Framework is that the role of government will be transformed from being a ‘provider’ of services to a ‘facilitator’. The role of facilitator will be performed as follows:

While the government would decentralize its decision-making authority to LGIs, it would have the Vision for the country and draft long-term macro-plans and strategies, with micro-management left to LGIs. The government as a facilitator would do Sector Development activities, Information, Education and Communication, Capacity Building, Quality Control, Process Monitoring, analyze Time and Cost-over-runs and take appropriate mitigation measures in consultations and partnership of LGIs. The Community led Total Sanitation campaign will be implemented by the government as a “facilitator”. If we consider the problems and related strategies for Water Supply and Sanitation sector, they can be addressed in two ways. Firstly, at the “Macrolevel”, and secondly, at the “Micro-level”. We shall first examine this at the Macro level. Clearly, the Macro strategies should be based on two broad categories-firstly, the Towns and Rural Areas, and secondly, the Major Cities. Also, we must address the problem comprehensively, including Water, Sanitation and Hygiene, rather than in isolation. Let us take them one by one. In Micro Strategies, we shall deal exclusive with Sanitation Strategies.

4. Macro Strategies for WATSAN sector

4.1 Strategy for Towns and Rural Areas

In the towns and rural areas, the main aims are, to the extent feasible and affordable, to satisfy increasing demands for safe drinking water and sanitation, and within the towns to provide adequate flood protection and storm water drainage. To achieve this, the principal objectives will be to provide a safe and reliable supply of potable water and sanitation services to all the inhabitants in the towns and rural areas, along with effective facilities for wastewater disposal to safeguard public health and protect the environment. In selected towns with facilities of economic importance, flood protection will be provided as a priority, and phased implementation of reasonable flood protection facilities will be introduced in Zila and Upazila towns.

Significant sustainable improvements will be targeted in operational efficiency and service delivery with prime responsibility decentralized to local government with active community participation and consultation, and special emphasis given to the role of women. Both community and private sector participation in the provision of water supply and sanitation services are to be promoted with an overall intention that affordable and financially sustainable services are offered to all levels of society, with particular emphasis on the poor and disadvantaged sections of the community.

4.1.1 Main Focus of Activities:

(a) Water supply - Considerable progress has been made in the provision of potable water supplies in towns and rural areas in the 1990s. However, arsenic contamination of groundwater has become a serious health hazard that must be addressed with the highest priority. Present estimates indicate that at least 30 million people are at risk and about half the total population face a potential risk. The areas most seriously affected are the South East, South West, South Central and North East Regions. Short-term interventions are being tested (arsenic filters and household removal facilities), and medium- to longer-term solutions are being studied to access long-term safe sources of water. In arsenic-affected areas alternative sources, such as surface water, are to be considered. In addition to other water quality issues such as the occurrence of iron and boron in groundwater, other important regional water supply constraints that will be addressed are: (a) seasonal draw-down of groundwater causing shortfalls in potable water supplies in the rural areas of parts of the North West, North Centra and South West Regions; (b) saline intrusion in ground and surface water sources in the coastal belt of the South West, South Central, South East and Eastern Hills Regions; and (c) inequity of access to safe water sources in the North East, North Central, South West and Eastern Hills Regions. The main options for water supply in the towns and rural areas cover a mix of technical alternatives that will address the issues of poverty, equity of access, affordability, sustainability and service improvements over the plan period. Local area systems (small piped systems based on water drawn from arsenic- and pollution-free sources and community level systems) for both peri-urban and rural areas should offer medium- to long-term water supply improvements, coupled with a framework for active community and private sector participation with the primary focus on the poor and disadvantaged sections of society. Towns (large and small) should also benefit from the progressive development of municipal water supply systems that will be the responsibility of the local municipality or a regulated private sector operation.

(b) Sanitation - Adequate and appropriate sanitation in towns and rural areas will have important public health, poverty alleviation and environmental impacts. Viable options are expected to be: (a) rural areas - pit latrines and household latrines with septic tanks; and (b) towns - pit latrines, household latrines with septic tanks, community sanitation facilities, and small bore sewerage systems. Delivery of the required improvements will involve the active collaboration of local municipalities, community based organizations and the private sector in all regions of the country.

(c) Flood protection and stormwater drainage - These options are directed only at towns (large and small) in the medium- to long-term. For flood protection, the main choice is whether to raise land or develop peripheral protection. Land raising is attractive because it limits the requirement for Government investment, but is generally only practicable in areas of urban expansion, new towns or specific urban sites. In most instances, peripheral embankment protection will be the most expedient solution, but will require full stakeholder consultation, and appropriate local revenue raising to ensure adequate maintenance. Adequate storm water drainage should be an integral component in municipal infrastructure, but it is often inadequate or overlooked in the planning process. The Government will address this issue in the medium- to long-term, with a preference for gravity systems wherever possible. Financing of towns and rural area service infrastructure is expected to come from a variety of sources. Whilst the satisfaction of demands requires initially a catch-up first, as well as substantial investments for the future.

4.1.2 Cumulative Targets:

Indicative service targets for provision of water supply, sanitation, flood protection and storm water drainage in the towns (large and small) and rural areas have been finalized as follows in the country’s National Water Management Plan. Targets for private sector participation have also been included as these also have bearing on funding and implementation capacity.

4.2 Strategy for Major Cities

The major cities considered are the Statistical Metropolitan Areas (SMA), namely Dhaka, Chittagong, Khulna and Rajshahi. One of the major challenges is to address the development requirements of the urban sector, particularly Dhaka, which is expected to become one of the mega-cities of Asia. As in the preceding section, the main aims for these major cities are, to the extent feasible and affordable, to satisfy increasing demands for safe drinking water and sanitation and provide adequate flood protection and storm water drainage. Options for wastewater management and recycling will be explored. The overall objectives are similar to those in the towns and rural areas, namely provision of effective facilities to safeguard public health and the environment, attainment of significantly improved standards of operational efficiency and service provision with active community participation and consultation, promotion of private sector participation in water supply and sanitation, and provision of affordable and sustainable services to all city dwellers with particular emphasis on the poor and disadvantaged.

4.2.1 Main Focus of Activities:

(a) Water supply and sanitation - The four major cities are expected to triple in Population over the next 25 years. Dhaka is expected to absorb most of the increase, rising from nearly 9 million in 2000 to 27 million by 2025. Major efforts will be needed to develop bulk water supplies and efficient delivery systems. Groundwater is already over-exploited in Dhaka and surface water systems. National Water Management Plan 51 will be needed from the Padma and possibly from the Brahmaputra rivers. Future configurations will depend on urban expansion plans, but development of the Dhaka–Tangail axis may be a likely outcome, favoring bulk supply system from near the Bangabandhu Bridge. The other cities will continue with a mix of groundwater and some surface water. Various options are open for expansion of delivery systems. These may include Local Area Systems (FM hand pumps and small piped systems) to meet water demands in localised and peri-urban areas, particularly poor and disadvantaged communities, and Main Water Supply Systems (distribution systems supplied by, as appropriate, a combination of DTWs, well-fields and major surface water development) that would be progressively developed to serve an increasingproportion of each city’s population. Local Area Systems will also provide the focus for direct individual and community participation in financing (partial), owning and operating community-based systems.

The growth in urban water demand will stimulate the need for expansion and improvement in the full range of sanitation options throughout the planning period. The main driving forces will be public health safeguards, environmental protection and the living conditions of the urban poor. The appropriate sanitation options identified for the four major cities are individual and local community facilities (pit latrines, household latrines with septic tanks, community sanitation facilities and small bore sewerage systems) that will satisfy hygienic sanitation requirements in localized and peri-urban areas, particularly poor and disadvantaged areas, with conventional waterborne sewerage systems with wastewater treatment offering the main long-term solution for effluent disposal in the four major cities. The main constraints to the full development of these measures that will need to be overcome are expected to be institutional and financial.

(b) Flood protection and stormwater drainage - Most of the necessary flood protection structures for the four major cities are in place and adequate for the next 25 years. The only exceptions are the Dhaka Eastern Flood Embankment and modest additional works for the three other cities. However, as the major cities continue to expand, appropriate urban planning along with improved, extended stormwater drainage systems will be necessary to mini mise the socioeconomic impact of storm water flows. The main options are gravity and pumped drainage systems, although the final choice will be site specific.

(c) Institutional and financial reform - Important issues to address are (a) the pace and focus of institutional change; (b) widening private sector participation in the provision of water and sewerage services; and (c) setting tariffs that more appropriately reflect real resource costs. A sustained programme to implement changes in the institutional and financial framework is required, based on the principles of effective demand management and improved incentives through appropriate governance, ownership and organizational structures, and through appropriate financing systems. The improved incentives will encourage operational efficiency and improved service delivery; and, coupled with realistic tariffs set at full cost recovery levels, develop sound commercial and financial viability of the urban water sector agencies, enable private sector participation, and attract funding for capital investment in the sector.

The main components of a demand-lead incentive-based strategy may include the following: (a) creation and/or strengthening of autonomous municipal enterprises, allowing in practice full responsibility for the management, operation and financial viability to an autonomous municipal company with its own board of directors and experienced technical managers; (b) commercialization of the urban water and sanitation sector to encourage and promote private sector participation through management contracts, BOOT schemes and concession agreements; (c) introduction of market-oriented financial systems to promote financial viability and efficiency in the utilisation of resources mobilized on market terms; and (d) establishment of the necessary Regulatory Framework. Financing of major city service infrastructure is expected to come from a variety of sources.

4.2.2 Cumulative Targets:

Indicative targets for levels of service have been finalized in the country’s National Water Management Plan as follows, for the provision of water supply, sanitation, flood protection and storm water drainage in the major Cities.

 

5. Micro-Strategies for Community led Total Sanitation

The country’s strategy for Community led Total Sanitation is based on the principles of National Policy on Safe Water Supply and Sanitation 1998, the Sector Development Framework, National Water Management Plan and the Dhaka Declaration.

5.1 The Dhaka Declaration

The Heads of Delegations from the 9 countries participating in the South Asian Conference on Sanitation (SACOSAN) in Dhaka, Bangladesh, October 21-23, 2003, which was attended by 4 ministers, State Ministers, senior Civil Servants, professionals from sector institutions, academia, civil society, NGOs, Development Partners, and, the Private Sector, unanimously agreed that the focus of proper sanitation and hygiene in the region should be on the paradigm that is: “people-centered, community-led, gender-sensitive and demand-driven” and that the following principles should facilitate this new paradigm, wherein the thrust :

1. Should be on the elimination of open defecation and other unhygienic practices, as well as the promotion of good hygienic practice;

2. Should provide hardware subsidies only to the poorest of the poor, who have no means of helping themselves, to be given under appropriate and effective monitoring and evaluation arrangements;

3. Should recognize the need for community subsidies for promotion, awareness, capacity-building and the creation of funding mechanisms for scaling up sanitation and hygiene programmes;

4. Should focus on understanding and creating demand and sustaining attitudinal and behavioural change and encouraging wider community participation, as opposed to top down approaches to subsidized sanitation programmes;

5. Should consider giving proper and appropriate acknowledgement and rewards to Local Governments and communities demonstrating tangible success in the elimination of open defecation and other unhygienic practices, intensifying advocacy through political and religious leadership; 6. Should focus on the hygienic disposal of children’s faeces, other hygienic practices and the development of hygienic education in schools and community sanitation programmes;

7. Should recognize the need for gender-sensitive programmes;

8. Should be on the research and development of a range viable, locallyappropriate, technological options that should be available at affordable costs;

9. Should create an enabling environment for small scale private providers and innovative technical and financial mechanisms to be mainstreamed to promote better, faster and cheaper service delivery; 10. Should encourage Local Governments to engage in strategic partnerships with community based organisations (CBOs), NGOs, and other concerned actors so as to facilitate scaling up of this new paradigm;

11. Should recognize the need for special arrangements when dealing with sanitation programmes in conflict and emergency situations.
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5.2 The Government Initiatives so far to achieve Total Sanitation by 2010

1. The Government of People’s Republic of Bangladesh has resolved that it would reach 100 % Community-led Total Sanitation by 2010. The term ‘Total Sanitation’ means: (a) Safe Disposal of Human Excreta, (b) Safe Disposal of Solid Wastes, (c) Safe disposal of Wastewater, and, (d) Improved Hygiene Practice.

2. The Government of Bangladesh has taken up an extensive program of “National Sanitation Campaign” in order to ensure construction of sanitary latrines, its use and personal hygiene practice by 100 % of the population by the year 2010. The aims of this campaign are to:

• Change the attitude and practice of population towards use of sanitary latrines by creating awareness through cooperation and collaboration of the government, and Non-Government Organizations, Development Partners and better-off people of the society with full commitment at all levels;

• Encourage setting out targets by Local Government Institutions (LGIs) and NGOs in three phases of the years 2005, 2008 and 2010 to achieve the goal of 100 % sanitation coverage;

• Discourage open defecation; and

• Provide importance to maintenance of personal hygiene and capacity
building of the population.

3. Local Government Division of Ministry of Local Government, Rural Development and Cooperatives has allocated 20 % of its budget for sanitation.

4. Observance of “Sanitation Month” each year as part of National Sanitation Campaign.

5. Task Forces/WatSan Committees with definite terms of reference have been formed in the National, City Corporations, District, Hill District, Municipality, Upazila, and Union levels to implement objectives of national sanitation program.

6. Government of Bangladesh has completed the nation-wide baseline sanitation survey and acquired relevant information to prepare a comprehensive plan to achieve goals.

 

The Plan of Action would be based on Current Situational Analyses within the framework of above Objectives and Strategies while abiding by the principles of National Policy on Safe Water Supply and Sanitation 1998, the Sector Development Framework, National Water Management Plan and the Dhaka Declaration

5.4 The National Baseline Survey, 2003

The government launched a nationwide baseline survey under leadership of Local Government Division of Ministry of Local Government Rural Development& Cooperatives to understand the Current status of Sanitation Coverage and Reasons for Non-coverage for designing interventions to achieve the target of Community-led Total Sanitation by 2010. Accordingly, UNICEF conducted this Survey with support from the DPHE. The Objectives of this survey were twofold: firstly, to learn about the current sanitation condition at the Ward, Union, Upazila, District and National levels, and secondly, to set the targets for achieving 100 percent sanitation at the different levels in three phases (2005, 2008 and 2010).

The Data was collected countrywide to know Whether the Household was using a Latrine. If yes, what type of latrine? (Hygienic or un-hygienic), and, what the pattern of use was? (Used by all, by female members, or occasionally). If no, then why not? The Data was collected from urban (city corp., Pourasabhas) and rural households with almost identical forms in separate colour-coded forms for households using latrines and those not using latrines. Nationwide, a total of 2,13,94,093 households (1,83,26,332 households in rural areas and 30,67,761 households in urban areas) were surveyed.

6. The Plan Of Action

The Plan of Action is based on findings of Baseline Survey and other Research studies along with the Lessons Learnt in the sector. Let us take them one by one.

6.1 Plan of Action based on Baseline Survey and other Researches

6.1.1 The Sanitation Coverage: Formulating Rural and Urban plans differently

 

It is evident from above findings of Baseline Survey that although there are 57.95 % households in the country who have a Latrine, but there are only 33.22 % of households, which have hygienic latrines. The remaining 24.80 % households have unhygienic latrines (which are pre-dominantly hanging latrines). The remaining 41.99 % households do not have any latrine and usually follow open defecation. Clearly, the challenge is more in rural areas where coverage with sanitary latrines is only 28.77 % as compared to 59.77 % coverage in urban areas. Within the urban sector too, the problem is more severe in Pourasabhas with 53.10 % coverage of sanitary latrines, when compared with City Corporations with 69.92 % coverage. While in City Corporations only 2.53 % of households do not have a latrine, in Pourasabhas, the 19.24 % households do not have latrines.

 

6.1.2 The Geographical Spread of Sanitation Coverage: Determination of Regional Strategies:

While we find that there is a wide differences in coverage between Rural and Urban regions, and within urban regions, large differences lie between City Corporations and Pourasabhas, we also find the range of difference in different levels of administrative units is also strikingly large. The district wise Sanitation Coverage is as follows:

 

From the GIS, it is clear that maximum number of districts, with low (10-20 %) Sanitation coverage, are situated in the northern part of Bangladesh. This region is also infested with maximum poverty. This region is also infested with waterlogged areas, which result in low agricultural production and water-borne diseases. The government has recognized the location disadvantage of the region and the challenge it poses. The government would now focus all its energy in this region. Whether it is Social Mobilization, establishment of Rural Sanitary Marts and Production Centres, or directing government grants for the hard-core poor, this area deserves and would be prioritized. It is evident that most of its better performing districts, with greater than 30 % sanitation coverage, are in Central and Southern regions. While the reasons are understood, they will be further strengthened to reap benefits of their location advantage.

6.1.3 The Best & Worst areas of Coverage: Support low performing& motivate high performing:

The best and worst areas of coverage are as follows:

 

From above table, it is clear that the range of coverage across the country is very large for every level of analyses. The range being maximum in Upazilas, ranging from 98.58 % in Rajarhat Upazila in Kurigram district to only 2.0 % in Thanchi Upazila in Bandarban district. Amongst districts, the range is between 52.60 % coverage in Jhalokathi district to 7.08 % in Bandarban district. The persons responsible in implementation of this programme are being made accountable.

The Deputy Commissioners, Upazila Nirwahi Officers, Union Parishad Chairman and the DPHE Engineers of best performing regions would be given national recognition and rewards and the officials and LGIs representatives of low performing regions would be motivated to do better.

6.1.4 Reasons for Not Having Latrine: Determination of result-oriented strategies:

Now, that we have seen wide spectrum of coverage across the country, let us now analyze what the reasons for low coverage are. The district wise findings are attached as Annexure I to this paper. The Summary of Findings, depicting the “Reasons for not having a latrine” are as presented below:

From above figure, important Conclusions emerged, based on which we have
drafted our strategies.

6.1.5 Lack of money: Subsidy for Hardcore poor and Micro Credit for others:

It is evident that 73.23 % of households do not have a hygienic latrine because of lack of money. Surprisingly, it is more in urban areas (80.47 %) than rural areas (72.9 %) that people find lack of money as the major reason for not having a latrine.

The fact that the Lack of Money has emerged as a major reason for not having a latrine, it establishes the need for partial subsidization of hardcore poor and also necessitates the need for establishing a good network of micro-credit system for the non-poor. The Government of Bangladesh has accordingly taken a decision to earmark 20 % of its Annual Development Programme (ADP) Grant for Sanitation. Of this, 90 % is for hardware subsidy for the hardcore poor, and, 10 % for the software activities. The funds flow is directly to Upazila Parishads, which have been given the responsibility of implementation. The Union Parishads have the responsibility for identification of hardcore poor.

There is also a lack of knowledge regarding actual cost of latrine, and, more often than not, it is lower than the perceived cost. Hence the need for increasing awareness about low cost affordable technological options, suited to their environment.

6.1.6 Lack of Awareness: Formulating messages & Selecting vehicles for the media campaign:

As high as 25.13 % households do not have a hygienic latrine, due to lack of awareness about relationship between Diarrhea and Excreta disposal. Not so surprisingly, lack of awareness is more (25.32 %) in rural areas than urban areas (20.85%). The high Lack of Awareness requires aggressive multi-media campaign highlighting the linkage between sanitation and health. The government has recognized this and started its multi-media campaign in 2003. It also got the Evaluation done by professionals. The summary of the findings are presented below.

(a) Media-Exposure:

 It is clear from the above that people heard/ observed about the campaign most from the Radio/T.V., followed by Local government representatives, local people, health, NGO and government workers. Accordingly, government is formulating its media plan based on these findings. The emphasis now is more on Radio/ Television; Local government representatives; Local people, health, NGO and government workers; and, Miking. (b) Media messages: The government has also evaluated major messages that were absorbed by target audience during the national sanitation campaign. The major messages absorbed are presented below

The major messages that were absorbed by most of the people in the country were: Use of Sanitary Latrine, Not to defecate in open place/hanging latrine, open defecations increase disease and Hand wash after defecation with soaps/ash. These were the messages that the government wanted to communicate. Now with the focus being on Community led Total Sanitation, with 100 % cost sharing by non-poor, the messages will be slightly modified. The Cost-sharing principle, role of LGIs, community incentives, and role models shall be highlighted in messages.

6.1.7 Lack of Space: Establishment of Community Latrines: Around 10.63 % of households do not have latrines because of lack of space. The lack of space is felt more in urban areas, by 18.26 % of households, as compared to 10.3 % of households of rural areas. An attempt is being made to provide land to as many as possible under land reforms but to the extent there is limit to surplus government land and it would take sometime to cover each one of them, such households are being covered through community latrines.

6.1.8 Preference to open defecation: Public Hygiene Education on Environmental Pollution: Around 4.23 % households do not have latrines due to their preference for open defecation. This preference is more so in rural areas (4.27 % households) as compared to urban area (3.32 % households). The damage that is caused to fresh water bodies through indiscriminate open defecation and disposal of waste including bio-medical is still not widely disseminated to the general public and elected representatives. Concerned effort to elevate this critical issue on the logical development agenda and regular monitoring are imperative to protect the earth and children who will inherit it from present generation. These households will also be a target for awareness campaign highlighting the linkages between sanitation and health. Also, with the support of Local Government Institutions, NGOs, CBOs, and mass-media campaign, an environment of social disincentives and public boycott will be created.

6.1.9 Lack of Material: Creation and maintenance of a ‘Supply-Chain’:

Around 1.99 % households do not have latrines because of lack of material. This lack of material is more in rural areas (2.05 % households) as compared to urban areas (0.59 % households). The Lack of material is in spite of the fact that not many latrines are being constructed over a year. Once the programme gains it momentum, there will be huge demand for both sanitary supplies (RSMs and PCs) as well as ancillary services (masons). No amount of communications and demand generation will be successful unless easy access to sanitation supplies and ancillary services such as trained masons are available. As such, the importance of supply chain mechanisms such as Rural Sanitary Marts (RSMs) and Production Centres (PCs) are vital to success of sanitation program. Considering that as per Baseline Survey, the national coverage by sanitary latrines is only 33 %, and that the rest 67 % households are to be covered by 2010, approximately 25 lakhs latrines will need to be produced per annum. Extremely special efforts will need to be put in to enhance the supply, in addition to enhancing the demand for sanitation. The role of private sector will be vital. As per Say’s law, Demand creates its own supply. On one hand government will have to create demand and on the other create enabling environment for private sector to make gainful investments. The government of Bangladesh is aware about it and would ensure that an adequate ‘Supply chain’ is created and maintained. As per our estimates, DPHE has 900 production centers, which can produce at an average of 2 units per day. DPHE can also assign the task on contract system. In addition, there are approximately 4,500 private producers in the country who can produce at an average of 1 unit per day. Accordingly, the requirement of 25 lakh latrines will be met as follows:

How to Produce 25,00,0 00 Units per annum DPHE Capacity: 900 Centres X 2 Units X 300 days = 5,40,000 Units per annum Through Contract System (from DPHE Project) = 6,00,000 Units per annum (From Upazila block allocation latrine units will be purchased From DPHE Production centers Private Producer: 4500 Units X 1 Unit X 300 days =13,50,000 Units per annum

It is clear that of the 25.00 lakhs latrines requirement per annum, responsibility of supplying 18.50 lakhs rests with the private sector, as even the 6.00 lakhs units per annum, which the DPHE would supply through Contract System, would be supplied by private sector itself. Considering that Private sector has to play a major role in the supply of sanitary latrines, it is necessary to understand the long ‘Supply-Chain’ that would ensure this service. The delivery mechanism of private sector is as follows:

The adequate number of each and every actor in this chain will have to be established in all the regions of the country and their sustainability ensured by creating appropriate enabling environment.

6.2 Plan of Action based on Lessons Learnt

6.2.1 Technological Choices:

Lack of water has been a natural deterrent in acceptance and therefore dry improved pit latrines and ecological sanitation needs far more attention. Related designs of good quality and skills for construction are essential at outreach locations (RSMs and PCs) and will be integrated in the communication/IEC plan.

6.2.2 Facilities in Workplaces:

Even where 100 % saturation of household latrines has been achieved, many still are forced to resort to open defecation, as it is impractical for them to return back home from their work places such as agricultural fields to use latrines. Suitable institutional public latrines in carefully chosen locations would be necessary.

6.2.3 Facilities in Schools:

Nearly two-thirds of government primary schools are without latrines. There is a need to cover all of them with appropriate latrine construction as well as handpumps.

6.2.4 SHGs as Partners:
Emerging experiences show that Self help groups (SHGs) can be powerful local institution to manage sanitation and hygiene delivery. Government of Bangladesh has created a conducive environment and policy decisions to keep SHGs as partners in the process.

6.2.5 Gender in communication:

In general, women are more acutely aware of the need for improved sanitation and hygiene behaviour, and use existing facilities. On the other hand, open defecation is more popular among male members owning household latrines. Communication strategies must target both men and women for specific responses.

6.2.6 NGO-Participation:

NGos will be one of the major Implementation agencies for community-led total sanitation campaign. The Implementation process of NGO sector would be as follows:

6.2.7 Driving and Constraining Forces for people:

The Driving and Constraining forces have been identified through an Institutional Review (IR I) study conducted by UPI. Through a series of Focus Group Discussions (FGDs) and Key Informant’s Interviews, following conclusions have emerged, which will be the guiding principles of our plans of action.

 

 

6.2.8 Decision-making at Union Parishad level:

The Union Parishads have been entrusted with the authority to plan, implement and manage all of their WATSAN works. Recently, Gram Sarkars have also been notified and empowered to support Union Parishads. The Insititutional Framework at the Union level would appear as follows:

6.2.9 Target-Segmentation :

Clearly, the country strategy for Community led Total Sanitation by 2010, would vary for different target groups. The two major target groups are (a) Hardcore Poor, and (b) Non Hardcore Poor. The Strategies can be depicted in the following schematic diagram:

7. Assessment of Resource Requirements

The Government would only invest in hardware subsidy for the hardcore poor. The others will invest their own money to build their latrines. Their resource constraints would be released by creating a network and delivery mechanism for Micro-credit. The Government would of course invest also in Information, Education, Communication and Capacity Building. The support of NGOs, Private Sector and Development Partners would be taken in this purpose. Hence, government investment would mainly be in Hardware Subsidies and Social Mobilization grants to Local Government Institutions. For assessment of Resource-requirement in this paper, we shall primarily focus on requirement for hardware subsidies and by which year we can saturate the hardcore poor families with sanitation coverage. The assessment would be done in two steps: (a) Estimation of Hardcore poor households and (b) assessment of fund requirements based on unit rates. Let us consider them one by one. 7.1 Estimation of Number of Hardcore poor households For estimation of targets, following assumptions are made: • Rural Population is 74 % of the total population. • Hardcore Poor in rural areas are 19 % of the total.

 

• Average size of a family is 5.5
• Rural Sanitation coverage is 28.77 %

In this analysis, it is also assumed that none of the rural hardcore poor households are covered by hygienic latrines. Although it is an extremely simplistic and unrealistic assumption, it should be viewed in the light of the fact that 71.23 % of country’s households do not have sanitation cover, and that hardcore poor households are 19 % of the total population, who do not have means even to have a square meal per day. It is difficult to believe that some hardcore poor have sanitary latrines, but rich do not. To the extent that this assumption is incorrect and there are a few hardcore poor who do have a sanitation cover, this exercise would result in overestimating their number and resource requirement. However, considering that resource requirement, for even 100 % coverage (assuming zero % coverage today), can be easily met by the government to saturate all of them by the year 2008, we are going ahead with this assumption.

7.1 Estimation of Number of Hardcore poor households

For estimation of targets, following assumptions are made:

• Rural Population is 74 % of the total population.
  
• Hardcore Poor in rural areas are 19 % of the total.
  
• Average size of a family is 5.5
  
• Rural Sanitation coverage is 28.77 %
  
  

In this analysis, it is also assumed that none of the rural hardcore poor households are covered by hygienic latrines. Although it is an extremely simplistic and unrealistic assumption, it should be viewed in the light of the fact that 71.23 % of country’s households do not have sanitation cover, and that hardcore poor households are 19 % of the total population, who do not have means even to have a square meal per day. It is difficult to believe that some hardcore poor have sanitary latrines, but rich do not. To the extent that this assumption is incorrect and there are a few hardcore poor who do have a sanitation cover, this exercise would result in overestimating their number and resource requirement. However, considering that resource requirement, for even 100 % coverage (assuming zero % coverage today), can be easily met by the government to saturate all of them by the year 2008, we are going ahead with this assumption.

Based on these assumptions the following situation emerges:

 

 

7.2 Estimation of Resource requirements

As per decision of government, Hardcore poor are to be given subsidy at the rate of BDT 390.00. Thus Hardcore poor are to be covered in a ‘Supply-driven’ mode. As per Government Notification dated 17th January 2004, 20 % of Annual Development Programme (ADP) grant has been earmarked for Sanitation. Of this grant 90 % is earmarked for hardware subsidy and 10 % is earmarked for software activities. The ADP grant is BDT 200.00 Crores per annum. Hence, on an average BDT 40.00 Crores is available for Sanitation per annum. Of this 90 %, or BDT 360.00 crores, can be spent on Hardware subsidy. With Average Subsidy being BDT 390.00, 9.23 Lakhs household-latrines can be subsidized per annum. Thus, it would take 3.68 years or approximately 4 years to cover all the 35.78 million households hardcore poor households. To the extent that some of them do have hygienic latrines already, the time taken would be lesser. Therefore, by 2008, all hardcore poor households residing in rural areas will be covered by the hygienic latrine.

7.3 Resource Availability and Target completion date

Thus, all hardcore poor will be covered by the year 2008. The coverage of hardcore poor will be done in a ‘Supply-driven’ way, mainly by the DPHE. But the non-poor will be covered through ‘Demand-driven’ manner. Through IEC campaigns, Social mobilization, Public education, availability of affordable technology options and capacity building, demand will be generated. The demand would be met mainly by the Private sector. Those having lack of money would be provided with micro-credit. The Private sector, NGOs and Development partners would be mobilized for this purpose.

7.4 Supply Chain

The maintenance of “Supply-Chain” of approximately 25 lakh latrines per annum for this purpose would be a pre-condition, which would be met through coordination with government, Private and NGO sector. Considering that main beneficiaries of increased demand would be the private sector manufacturers themselves, they will be also mobilized to do media campaign and social marketing with the government.

8. Achievement of Millennium Development Goals

By achieving above milestones, Bangladesh strives to achieve the MDG goals as per following major goal posts:

The Poverty Reduction Strategy has been worked out to achieve the major goal posts, in line with the Millennium Development Goals. Clearly, the achievement of Community-led Total Sanitation will be a major land-mark achievement towards this.

Annexure - I

 

 

 

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