Poor sanitation is one of the leading causes of diarrhoeal diseases, which kill hundreds of people including children around the world everyday. The story in Bhutan is not any different either. The sanitation coverage in terms of presence of toilet in Bhutan is 91% and in the case of water supply, 84.5% of households had access to water supply in 2009, and 80.1% of the households had functional piped water schemes. However despite these good figures, the incidence of illness due to water and sanitation-related diseases is still high and the figure for under-five child mortality is one of the highest in South Asia (85/1000 live birth).
This is thought to be due to continued poor hygiene practice and in particular the poor state of latrines and associated facilities. Although the construction coverage of latrines is relatively high, the conditions are thought to be very poor and the amount of use low.
The Rural Sanitation and Hygiene Programme (RSAHP) co-ordinated by Public Health Engineering Division (PHED) under the Ministry of Health with technical assistance from SNV Netherlands Development Organisation had been assisting the primary client in rural areas by developing new approaches to improving the overall sanitation and hygiene practices in the rural communities in Bhutan. The initial programme area starting in 2008 was in the four pilot Geogs of Nanong (Pemagatshel), Hiley (Sarpang), Laya (Gasa) and Jarey (Lhuentse). The programme was later upscaled to the whole Dzongkhag of Lhuentse covering 7 more Geogs (Kurtoe, Khoma, Gangzur, Metsho, Menbi, Minjay and Tsenkhar) in June 2010.
There were two primary objectives under the RSAHP. Firstly, to explore, adapt and pilot best international practices to develop a model that can be rolled out country-wide. The model to be explored and piloted included an approach termed Community-Led Total Sanitation (CLTS), of which the outcome is measured in a complete end to open defecation and unsanitary conditions for entire communities rather than in terms of individual household latrine construction coverage. Secondly to study, explore and pilot sustainable, affordable and appropriate sanitation technologies in the programme areas. This handbook is a result of this second primary objective of the programme.
Workshop report of the regional inception workshop 'learning by doing: capacity development approaches at the local level, which took place on 26-27 November 2007 in Bangkok, Thailand, and was organised by UNDP and SNV (Netherlands Development Organisation), with support from the UNDP Asia Regional Governance Programme (ARGP). The primary workshop objectives were 1) to share lessons learned on capacity development strategies and development efforts aimed at contributing to the MDGs at the sub-national/local level; and 2) identify critical knowledge gaps that need to be addressed to support sub-national/local capacities for reaching the MDGs.
In the remote area of Lhuentse in Eastern Bhutan, lack of access to improved sanitation and a high incidence of poverty continue to persist. SNV Bhutan, together with the Rural Sanitation and Hygiene Programme of the Ministry of Health, collaboratively engage in qualitative research to identify support mechanisms to assist people living in poverty to meet their aspirations for improved hygiene and sanitation.
This paper highlights an approach that employs a research methodology based on inclusion and participation, which allows communities to define their own access barriers and suggest possible solutions for improved sanitation. This community reflection results in raised awareness of the collective responsibility for sanitation,promotes the mobilisation of local leaders to source materials and labour for construction, and encourages transparency at a local level by enabling open discussion.
The paper is part of a new publication "Towards Inclusive WASH: Sharing evidence and experience from the field" supported by AusAID’s Innovations Fund. This publication is a record of the sector's efforts to achieve equity and inclusion in WASH programming around the world. It includes one keynote paper and 16 case studies from a wide range of organisations in 13 countries and with examples from urban, rural and school WASH programming. The case studies provide stories of policy, technology and process innovations through four lenses: Poorest of the poor, Living with HIV and AIDS, Disability and Gender.
This work on Rural Sanitation Supply Chains and Finance is part of the SNV/IRC Sustainable Sanitation and Hygiene for All programme, which aims to improve the health and quality of life of rural people in five Asian countries (Bhutan, Cambodia, Laos, Nepal and Vietnam) through enhanced access to improved sanitation and hygiene practices. It has four integrated technical components, strengthening local capacities for a rural sanitation service delivery with a district-wide approach. An additional cross-cutting regional component of the programme focusses on analysis, dissemination, and learning.
This Brief shares some of the lessons learned from working on the Rural Sanitation Supply Chains and Finance. It also introduces the thinking behind its design and its main activities.