Africa AHEAD presents on the Sustainable Development Goals at the UNC Conference

The Annual Water and Health Conference hosted by the Water Institute at University of North Carolina, in the USA, has become a landmark of the year for international academics and practitioners working in developing countries. The conference this year remained as technical as ever, with many papers focused on hardware issues e.g. the water quality and different sanitation technologies, rather fewer on  what we consider the critical aspect that alludes most effective community development – how to achieve integration and sustainability at scale.  Africa AHEAD concentrated on ‘people-centered’ research, and our side event on the 30th October was entitled, ‘Sustainability through Civic Organisation’,  show casing examples of the Community Health Club Approach.

With the Sustainable Development Goals having come fresh out of the United Nations ‘think tank’ hardly one month before this conference, we felt it was appropriate  to focus on how the Community Health Club Model is an ideal vehicle for a range of development issues –gender equity,  early childhood growth and development and girl child education, youth employment, nutrition and stunting, environmental challenges, as well as the usual hygiene water and sanitation which we can use as an entry point to all of the above.

Download  more information: SDG in CHC pamphlet

The side event was chaired by Darren Saywell, the Head of WASH from Plan International, and the CEO, Dr. Juliet Waterkeyn kicked off with a presentation of how 8 out of 17 SDG goals could be addressed in some way at village level, with concrete examples from past projects.

Link to the presentation

Having shown how the CHCs can assist practitioners to have a genuine integrated project, the next presentation demonstrated the sustainability of the approach. A Masters Student researcher from University of Leeds, Louis Tobergte, had been in Zimbabwe this year at an Africa AHEAD project which was completed 5 years ago. Nigel Stuart presented new and objective information on his behalf, which showed for the first time that CHCs were still operational 7 years after the hygiene training in 2008, and five years after all external assistance had ended in 2010. The five villages all had functional communal gardens and 85% of the CHC still met regularly as a club.

Link to the presentation

Highlights of the quantitative research showed that there was a significant difference in sanitation and handwashing practice between CHC and non-CHC members, as well as a distinct difference in CHC members who had graduated, i.e. completed 20 sessions, and CHC members who had attended less than 8 sessions and had not finished the course.

Despite the economic hardship throughout the country in this period of hyper inflation, it was exciting to find that toilet use amongst CHC ‘graduates’  had actually increased from 47% to 60% . By contrast in the non-graduate control groups latrine coverage actually fell by 4%, which is in line with the rest of the country’s steady decline in sanitation coverage nation-wide since the economic collapse of the country in 2000. Open defecation in CHC group decreased from 40% to 10 %, whilst the control remained almost the same, only dropping slightly from 45% to 38%.

Other interesting facts showed that the CHC are more likely than non CHC to rebuild latrines if they collapse. The results showed that 42% of all CHC graduates and 39% of non-graduates reported a latrine that had either collapse or filed up during the past 7 years, but whilst nearly 60% of CHC members had rebuilt their facilities, only 36% of non-graduates had done so.

As for handwashing practices, 82% of CHC graduates  compared to 62% of non-graduates reported washing hands with soap after the toilet but only 10% of CHC and none of non-graduates reported washing hands at the 4 most critical times.

So the CHC the conclusion was clear – the CHC is a means of organizing villages which has a life of its own long after the NGO has gone home. Surely this news should hit the headlines in the conference?

So as to enable comparison, Tobergte’s study of CHCs purposely used the same survey tool as was used in the recent evaluation (funded by Gates) of PLAN International CLTS projects in  7 countries . Therefore parallels should and can be drawn. The sustainability of this outcome in the CHC programme after 5-7 years should surely be compared to  that of the CLTS in  PLAN’s programmes which shows there is a average of   92% regression rate from ODF status only 2 years after triggering and little evidence of rebuilding of collapsed latrines.

One would hope that the representatives who were present at the Africa AHEAD Side Event from the Water Institute, the Bill and Melinda Gates Foundation, Plan International and the Aga Khan Foundation were joining the dots, and noting the difference between what can be achieved with a CHC proamme and what the popular modus operandi through ‘classic’ CLTS still lacks – sustainable behavior change. Or is this too hard a pill to swallow? Is the behaviour change we advocate at community level, possible at managerial level?  How long will it take for the sector to change tack?