Global Lessons Learned from Taking CATS/CLTS to Scale

Evolution of Community Approaches What have we learned? In the past 40 years the WASH sector has been involved in 21 different “software” approaches Confusion over the difference between the provision of information, advocacy, behaviour change, social change and changing social norms. Limited formative research on “insights” Converting “insights” to action Focusing on collective action and Public reasoning Sequencing of activities

Moved from To Building Toilets Individual/family Health Message Focused Top – Down & Externally Driven Didactic Technologies predetermined Subsidized Don’t mention the S*** word Changing Social Norms Social/Community Economic, Social, Health, disgust, Community led –Internal, demand driven Participatory – natural & traditional leaders Local technologies, community capacity Rewards – PRIDE – celebration Talk SHIT – faeces, Poo, Kaka, toilets, latrines Various efforts and approaches to improve sanitation coverage have been taken over the years. Through these experiences much has been learnt, particularly in terms of engaging communities, creating demand for sanitation, behavior change, developing appropriate technologies and fostering sustainability of systems. While the learning curve has been steep, new approaches have evolved which address sanitation from a social rather than a technical perspective In the past sanitation was seen as a purely technical problem which would be solved by building toilets. The types of toilets to be used were predetermined by “outside engineers” who felt they knew what the best solution was from a technical perspective. Where families could not afford these technologies various systems were established to subsidize or build these toilets for families. Many projects were thus externally driven and while efforts were made to ensure community involvement, the messaging was often health focussed and didactic. Even where more participatory approaches were used the target was individual/family behaviour change without considering the broader context of the social norms in the community. So while there were some “islands of success” there were few open defecation free communities. Some members of the community did change and these were often the early adaptors who saw the benefits of having a toilet for their families (Privacy, Health) or others who were driven by the social status of being a toilet owner. In some instances toilets were subsidized and built but never used by individuals or their families and while it was always considered that the reason for this was lack of understanding or behaviour change – in hindsight – one of the key reasons for this may have been that there was no empirical expectation for the family to use the toilet and there is some anecdotal evidence of families being ridiculed by others when their child gets diarrhoea or for defecating in the same place as their daughters-in-law, etc.   New approaches have shifted the focus to the creation of a new social norm where entire communities become open defecation free. It is a community focussed approach which is internally led by the community and demand driven. It is participatory by design and facilitates community led discussions and interactions concerning open defecation - it’s economic, social and health implications for the community, while also allowing for deeper discussions on more traditionally held beliefs about sanitation (sharing toilets, defecating in a room, witchcraft, etc) that the community as a whole can address themselves. It builds on established networks (schools, traditional leaders, religious elders, women’s groups, etc) while also encouraging “natural leaders” who emerge from the various groups during discussions. Disgust is a powerful emotive experience which is built upon during community interactions and used in the triggering process with communities with the key reward being pride. Technologies are locally developed and built requiring no external support, (once a new social norm has been established local capacities can be developed and markets explored to ensure people have access to enhanced technologies and services to better sustain the social norm) and no external subsidies are provided to individual households but communities plan and decide themselves what needs to be done to become open defecation free.

Community Approaches to Total Sanitation Lesson 1: BUILD Consensus among all partners and implementers Community Approaches to Total Sanitation UNICEF supports Community Approaches to Total Sanitation (CATS) with the goal of eliminating open defecation in communities around the world. CATS is an umbrella term developed by UNICEF Sanitation practitioners in 2008 to encompass a wide range of community-based sanitation programming. The CATS ‘Essential Elements’ are the common foundation for UNICEF sanitation programming globally. These principles provide a framework for action  and a set of shared values which can be easily adapted for programming in diverse contexts.

PATS SLTS PhATS PPHE AC-CLTS Etc Lesson 2: Make informed adaptations as needed to ensure comfort and ownership of the approach at community level PATS SLTS PhATS PPHE AC-CLTS Etc

Lesson 3: Capacity Building and knowledge management Not just about the triggering process or the topic Developing skills Strengthening confidence “Facilitating” must be constantly reinforced if not you get “Facipulation” Power dynamics Document mistakes and failures as well as successes

Define Target Audience Lesson 4: Ensure all components of the process are given appropriate emphasis Network s Define Target Audience Community engagement Triggering Public Declaration Community M&E Incentives Diffusion Pre-triggering Triggering Post Triggering Reinforcement

Lesson 5: No two communities are exactly the same

Lesson 6: Actual scaling up can take many forms The probability of an individual owning a latrine increases as the proportion of their social contacts owning a latrine increases.

Lesson 7: Subsidies, Markets, Finance Getting people on the sanitation ladder Moving people up the sanitation ladder Supply systems Marketing activities Equity and reaching the poorest Social Targeting & Social Safety nets BUT – Sequencing is important or you will undermine the norm change

Lesson 8: TOTAL is a very important word Everyone, everywhere…….

Acceptable Non acceptable CATS intervention “Natural” erosion of ODF status due to newcomers, collapse of facilities, etc. Adherence to ODF status measured as % of households having and using latrines Acceptable 100% Drop-out effect due to the non-adherence to the new social norm Non acceptable Pre-CATS situation in terms of OD XX% Intensity of reinforcement efforts CATS intervention Triggering ODF certification Time

Lesson 9: Policy, planning and enabling environment Overall, CATS have contributed to achieving fast results in reducing the practice of open defecation, primarily through: Re-orienting Government policies and strategies towards demand-led approaches; Aligning partners towards reducing open defecation and demand-led approaches; Creating the enabling environment to take CATS to scale.

Lesson 10: Reflect, revise and innovate – but monitor, monitor, monitor, monitor New learnings from the field Opportunities to exchange information but also experiences Informed Adaptations Regional/ Global How do we compare? National Are national strategies working? District Community Effect of programming on target population. Quality of programming design and implementation

Recommendations Continue what is working, for example: implement CATS through government channel whenever it is feasible; engage at policy level to build a sound enabling environment; integrate social norms concepts into CATS design and implementation; use non-monetary, pride-based community awards as positive motivation; integrate the CATS M&E system into the overall M&E framework of the WASH sector.

Recommendations (ctd.) Provide across-the-board capacity building for staff and implementing partners, including on social norms concepts and indicators. Refine sustainability considerations regarding CATS, especially in terms of (a) durability of infrastructure and supply mechanisms as part of the enabling environment and (b) planning and making resources available for the post-certification period. Take stock of pilots such as “CATS+” or “ODF+” that combine CATS with sanitation marketing and social policy approaches, learn lessons and develop further.

Recommendations (ctd.) Develop current M&E systems to capture (and demonstrate) sustainability of results, focusing on the post-certification period, by building on the Sustainability Check tool and social norms indicators, and ensuring longer-term funding for post-ODF phase. Design and commission an impact evaluation to research the relationships between social norm adoption and the level of post-ODF support required in order to stabilize social norm adoption. Develop a learning initiative to document and highlight good practices, share local innovations and tools and disseminate them at global level.