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Editor’s Note: PSI and Unilever announced a new initiative with local governments in Kenya, Vietnam, and Zimbabwe to improve hand-washing behaviors in schools. A version of this story originally appeared here.

A mother washing her child’s hands in Benin. Credit: Ollivier Girard

A mother washing her child’s hands in Benin. Credit: Ollivier Girard

Although many people around the world wash their hands with water, very few wash their hands with soap at critical moments — such as after using the toilet, while cleaning a child, and before handling food. If hand-washing with soap became a standard practice, health experts estimate that deaths from diarrhea could be reduced by one half and that one in four deaths from acute respiratory infections would be averted.

This year, a new initiative launched between Lifebuoy (Unilever’s leading soap brand), PSI (one of the Unilever Foundation's global partners), and local governments is focusing on establishing behavior change programs in schools and communities across Kenya, Vietnam, and Zimbabwe — three countries where hand-washing with soap practices are low. In Kenya, for example, 28 percent of school children report washing their hands with water at key times during the day, yet only 1 percent report using soap.

The new Unilever-PSI initiative will help children get into a habit of correctly and consistently washing their hands with soap at critical times of the day. Using Lifebuoy soap products and communication materials, teachers and community health workers will work to change behaviors among school-aged kids through hand-washing programs and activities, such as song writing, comic books, and even hand-washing pledges. When children learn and understand healthy behaviors, they help pass life-saving information to their families at home and to future generations — setting off a powerful ripple effect.

Together PSI and Unilever aim to reach more than 250,000 school-aged children and their families in Kenya, Vietnam, and Zimbabwe over the next year. Through these three pilot programs, Lifebuoy, the Unilever Foundation, and PSI hope to prove the efficacy of this approach, and replicate the program at scale across a number of countries.

PSI joined Unilever and CSRWire for a Twitter chat to discuss the importance of hand-washing. Check out the highlights from the conversation, including questions and discussion from the audience. Continue the conversation with Unilever, PSI, and its partners at #IWashMyHands and become part of a worldwide dialogue to push hand-washing up the global health agenda. 

Editor’s Note: This guest blog was authored by Trupthi Basavaraj and Rachel Findlay of the charity think tank and consultancy NPC, which provides strategic support to the Stone Family Foundation and has coordinated the Stone Prize for Innovation and Entrepreneurship in Water. Here they share some of the key lessons that NPC has learnt from running the Prize. A version of this story also appeared in Alliance magazine.

Chlorine dispensers used by communities in Kenya. Credit: Dispensers for Safe Water

Chlorine dispensers used by communities in Kenya. Credit: Dispensers for Safe Water

Prizes have long been successful at inspiring technological innovation, from determining a ship’s longitude to creating a toilet that costs less than five cents per user per day to operate. What is less common is using a prize as a tool to stimulate innovation in service delivery. So when the Stone Family Foundation set up the Prize for Innovation and Entrepreneurship in Water, it was all about doing just that.

As a part of our wider strategy to support entrepreneurial initiatives in the water, sanitation, and hygiene (WASH) sector, we launched the £100,000 Stone Prize earlier this year. After an extensive eight-month process of identifying and short-listing candidates, we finally found our Prize winner — Dispensers for Safe Water (DSW) in Kenya — and four other organisations that we hope to support outside of the Prize.     

The Prize came about as a way to identify early stage water initiatives that the Foundation could support, and eventually help scale up. The search was for innovative approaches to delivering safe water in a sustainable and cost-effective manner to those without access in sub-Saharan Africa, and South and Southeast Asia. For the Foundation, running the Prize has been an exciting process, and one that has taught us several key lessons, three of which we have highlighted here.

Firstly, to attract the right type of initiatives and ultimately short-list candidates, it was important to set clear criteria — without being overly prescriptive. We identified six criteria for the Prize, but with a particular emphasis on two areas: a) innovation in technology or service delivery, typically in response to a specific need, and b) innovation in financial model, looking to harness the power of the private sector.

Dispenser’s valve releases metered dose of chlorine into jerricans. Credit: Dispensers for Safe Water

Dispenser’s valve releases metered dose of chlorine into jerricans. Credit: Dispensers for Safe Water

DSW meets both of these requirements. It addresses a clear need in rural Kenya: its water purification technology, a simple dispenser, is filled with chlorine and placed near a communal water source, allowing individuals to treat their water free of cost with the correct dose of chlorine. (To learn more about DSW's work, read this post.) But what makes this initiative truly exciting are two innovative financial models. First, the dispensers generate carbon credits by reducing the demand for boiling water using firewood, which DSW will eventually be able to sell. Second, DSW is able to bundle the dispenser as part of a wider package of agricultural goods sold by its partner, One Acre Fund. If successful, both models offer new ways of making water purification accessible and sustainable for low-income communities. It will also allow DSW to expand the Kenya Chlorine Dispenser System program into other countries.

Secondly, running a prize scheme is not just about funding. It’s also about generating publicity in a way that reactive grants programmes cannot. Getting publicity right is important not only for attracting applicants, but also for promoting the winning candidate and its approach. Our strategy was to identify the right partners and to leverage their extensive networks, reaching out to organisations both within the WASH sector and outside it. At the end of the first round, the Foundation received 179 applications from 39 different countries. We hope the Prize will not only help DSW gain recognition and attract further support from other funders, but also stimulate wider discussion on what innovation means for the water sector.

Finally, we also learnt that it was important to have the right reward in place. The promise of £100,000 for scaling up the winning initiative attracted a pool of strong applications, but as we narrowed down the candidates, it became clear that the level and type of funding offered through the Prize was not necessarily appropriate for all. As a result, the Foundation is now looking at the best way to support four highly commended candidates outside the Prize framework — this could be through providing investment or smaller grants to further test an aspect of the approach, or simply by helping to identify partners to move an initiative from pilot to scale.

For the Stone Family Foundation, the Prize has been a successful endeavour. It has enabled us to find some exceptionally strong grantees for the Foundation that we might not otherwise have discovered. It has also given us a sense of the wide range of innovations within the WASH sector, especially in countries such as Kenya, India, and Cambodia where the local environment has led to a growth in entrepreneurial initiatives. Much depends on what a funder is looking for and how a prize is structured, but we feel prizes can be an incredibly powerful tool for identifying and driving innovation.

Editor’s Note: This guest post was authored by Malaika Cheney-Coker, the learning and influencing advisor of the Water Team at CARE USA. Her work includes support on internal and external communications, the application and use of monitoring and evaluation tools, and technical guidance on learning strategies and activities within partnership programs of the Water Team. In this post, Malaika discusses the implications of a school WASH project study on action-research projects.

Latrines, like the one pictured here, and improved school WASH conditions help reduce girls’ absenteeism — just one important finding from SWASH+ research. Credit: CARE / Brendan Bannon, Kenya, 2012

Latrines, like the one pictured here, and improved school WASH conditions help reduce girls’ absenteeism — just one important finding from SWASH+ research. Credit: CARE / Brendan Bannon, Kenya, 2012

In the summer of 2007, SWASH+, a school WASH project in Nyanza Province, Kenya, with a large and complex research operation, conducted a small study. The study was a simple identification of the recurrent costs needed to pay for materials and for labor to maintain and repair water containers, stands, taps, and to re-purchase soap and water purification items. Very different from the larger randomized controlled trials and studies being conducted by the project, this study  cost little and did not require a large research team (it was conducted by a graduate student over the course of a summer) or complex design and analysis. However, the findings of this simple cost research were immediately adopted by the Ministry of Education and resulted in a doubling of the Ministry’s Free Primary Education allotment for electricity, water, and conservancy — a budget line item that schools have traditionally used to pay for WASH costs. 

From this experience, the SWASH+ team gained some important insights into how action-research projects can achieve results:

  • Various forms of inquiry are needed to produce and buttress an evolving story. The simple study on WASH costs was a logical next step after a study on the sustainability of a safe water systems pilot in 55 schools identified adequate financing as one of four domains of sustainability. A problem tree analysis also identified inadequate or poorly planned financing as a key threat to sustainability. Similarly, SWASH+ findings from a randomized controlled trial on the effects of school WASH on pupil absence provided evidence for one of the potential impacts of improved school WASH (an average of six days less of absence for school girls) and helped make the case for increasing investments in school WASH.
  • Research needs to be made available to policymakers in practical terms. The budget for operations costs drafted by SWASH+ offered specific and practical recommendations that could be more readily adopted than a general injunction to the Ministry of Education to increase its funding.
  • To make research available in practical terms, action-research organizations need to be adept at canvassing entry points and opportunities for influence. A SWASH+ review of the national school WASH strategy draft revealed that the cost estimates related to school WASH seemed arbitrary. By having had cultivated relationships within the Ministry, SWASH+ was able to point this out and suggest that these numbers be revised using figures provided by the research.
  • Action-research is an iterative process. While the Ministry of Education endorsed the budget amount for WASH operations provided by SWASH+, it later asked that these costs be expressed as a percentage of the total budget allotment to schools. In addition, the initial research only looked at operations costs for WASH and not maintenance costs for infrastructure repairs. Further research will be needed to address these issues. 
Parent volunteer helps monitor school WASH conditions by ensuring soapy water is available for hand-washing, drinking water is treated, and latrines are clean. Credit: CARE / Brendan Bannon, Kenya, 2012

Parent volunteer helps monitor school WASH conditions by ensuring soapy water is available for hand-washing, drinking water is treated, and latrines are clean. Credit: CARE / Brendan Bannon, Kenya, 2012

Through this experience, the SWASH+ team concluded that by their very definition, action-research projects must be agile and resourceful. Rigorous studies are needed for an evidence base that can be credible to policymakers and present a compelling argument for change. Yet rigorous methods, such as randomized controlled trials or longitudinal studies, can be costly and take years to execute. They are not always responsive to opportunities for influence in the here and now. When the main objective is influence, rather than the accumulation of evidence, action-research projects should use all means at their disposal, including relationship building, advocacy, smaller non-experimental research studies, and audience-sensitive interpretation of research results, to get the attention of those able to catalyze widespread change.

Learn more about SWASH+ research at our new website. Highlights of the site include journal publications and summaries, photo and video galleries, and other helpful resources.

Editor’s Note: This guest post was authored by Shalini Nataraj, director of advocacy and partnerships at Global Fund for Women. Shalini discusses why it is important to address human rights, specifically women’s rights, on the local level to determine context-specific and appropriate WASH solutions. She also highlights the work of three Global Fund grantees based in Vietnam and Kenya who serve as examples of organizations successfully tackling these issues. 

Participant at Global Fund convening in Kenya learning about indigenous plants and organic farming methods. Credit: Global Fund for Women / Margaret Youngs

Participant at Global Fund convening in Kenya learning about indigenous plants and organic farming methods. Credit: Global Fund for Women / Margaret Youngs

A well is a well, right? As a funder, you fund the digging of a well for a community that lacks access to clean water, and the hoped-for outcome is that the problem is now solved. Unfortunately, in many parts of the world, it is not so simple. The well’s location might make women more vulnerable to sexual assault, for example. 

As a funder, Global Fund for Women supports organizations that seek to address access to water as a fundamental human rights issue. These organizations address the inequities, and ensure that the rights of the local women are respected.

In July 2010, the General Assembly of the United Nations and the Human Rights Council formally adopted a resolution calling on States and international organizations to provide financial resources, build capacity, and transfer technology, particularly to developing countries, and to provide safe, clean, accessible, and affordable drinking water and sanitation for all. While this recognition of the human right to water is based on many legal principles, what does ensuring the right to water look like at the local level?

Unless those of us who fund WASH understand that access to water is fundamentally about power relations and systemic societal inequities, with national priorities often working in favor of the powerful and wealthy, funding access to clean water and sanitation is going to be piecemeal and unsustainable.

The first question that needs to be answered is, “Who benefits?” The answer is not simple. In answering that question, the conceptual framework of the human right to water can challenge the underlying structural inequalities plaguing the poor and powerless communities around the world who lack access to water. It offers these communities the tools and arguments to hold the State accountable for implementing its human rights obligations, and to demand that the basic needs of the communities are met over the wishes of the few who have the power and money. It is about funding a range of strategies and interventions that create the enabling context for sustainable WASH programs.

Global Fund prioritizes funding women-led organizations that not only seek to address the immediate needs of communities, but also advocate for the rights of communities. We enable women to access the training and tools to advocate on their own behalf.

Global Fund grantee, Center for Water Resources Conservation and Development (WARECOD), in Vietnam, operates projects to improve water access in several poor riverine communities. Using a holistic approach, it educates the public and the government on the social and environmental impacts of dams and the benefits of alternative methods of energy development.

Women and girls in remote and rural areas of Vietnam are excluded from the decision-making processes in local development projects, especially with regard to natural resource management. WARECOD is particularly focused on fishing villages along the Red River in northern Vietnam that provides water and nutrition to millions of people. WARECOD says that, “social customs and traditional responsibilities relegate fishing women to lower social levels than males, lower even than social levels of other women in rural areas.” In a world where the Food and Agriculture Organization states that women are most often the collectors, users, and managers of water in the household, as well as farmers of crops, WARECOD recognizes the need to ensure women are supported in their vital role in managing environmental resources. WARECOD’s water management projects are designed to increase the capacity and decision-making power of women in the community, and by transferring critical skills and knowledge in their water management program, WARECOD hopes to create a channel for women to exercise their participation and rights.

WARECOD operates several projects to supply local communities with access to clean water, help rebuild elementary schools, and aid farmers in obtaining advanced farming technology to increase their income. Staff are also gathering data on the livelihoods of fishing women and their access to clean water. WARECOD plans to use the research findings to support future advocacy work, so that it can use concrete data in pressuring local governments to improve the living conditions for women and girls in the area. The findings will also be documented and distributed to local authorities and agencies, and presented at conferences.

A long-time Global Fund grantee, Groups of Women in Water & Agricultural Kochieng (GWAKO), works in Kochieng, western Kenya, to improve women’s health, protect girls’ right to education, and boost women’s economic status. The overwhelming majority of Kenyans don’t have access to clean water. Girls’ participation in education is severely restricted because they must spend hours fetching water for their families. Water-related diseases continue to be among the four top causes of death among women on the African continent.

GWAKO activities have resulted in wells in rural communities where women previously traveled for three to six hours to fetch water. The organization also conducts community education about hygiene and sanitation, improves farming methods for women, and installs washing facilities and latrines in schools. It has grown into a consortium of forty-one women’s groups in more than fourteen villages. GWAKO has also improved women’s access to food by training the women in modern farming methods that produce higher yields. Such changes are critical in a region where severe poverty increasingly forces girls into transactional sex to obtain food.

Also based in Kenya, Grassroots Organizations Operating Together in Sisterhood (GROOTS), builds demonstration plots to train women in improved agricultural practices. GROOTS works with women farming groups to provide training on sustainable agricultural practices, such as greenhouse use. More importantly, GROOTS created watchdog committees to safeguard women’s property and advocate for land tenure, housing, property, and inheritance rights of women and children. GROOTS facilitates direct participation of grassroots women in various national, regional, and global conferences, creating a platform for women most impacted by development policies to be heard by decision-makers. Its efforts have resulted in increased women’s representation as village elders, provincial administrators, members of local development funds, and in the management of educational institutions.

These examples seek to illustrate Global Fund’s approach to funding WASH — one that acknowledges the realities in which communities operate — and to creating systemic change in order to ensure long-lasting solutions to WASH issues. Using women’s rights, especially the right to water, as a lens to fund WASH programs is a sustainable way to build just, equitable, and peaceful societies. 

Editor’s Note: This guest post was authored by Alexandra Fielden, policy coordinator for Dispensers for Safe Water at Innovations for Poverty Action (IPA). In it, she discusses the benefits of IPA’s Chlorine Dispenser System, an innovative water treatment solution, and how the system has been implemented in villages in western Kenya. (Names have been changed to protect the identity of the individuals involved.)

Caroline, the dispenser promoter in Laban Springs, shows a community member how to use the chlorine dispenser. Credit: Jonathan Kalan

Caroline, the dispenser promoter in Laban Springs, shows a community member how to use the chlorine dispenser. Credit: Jonathan Kalan

Following the death of her daughter, Adimu was left to take care of her HIV-positive granddaughter, Tabia. 

HIV has severely weakened Tabia’s immune system, making her especially vulnerable to waterborne diseases. “She would always need to go to the hospital,” says Adimu, “due to her weak immunity, she suffered from diarrhea regularly.” Visits to the local clinic to treat Tabia’s diarrhea were costly, uncomfortable, and time-consuming. 

But since IPA’s Chlorine Dispenser System was set up in her community in Khasolo, western Kenya, Tabia has experienced far fewer cases of diarrhea and she is doing extremely well in school. “Chlorine has improved my granddaughter’s health since she no longer suffers from diarrhea,” says Adimu, with a smile.

In poor rural areas where constructing piped water systems are prohibitively expensive, the government and donor response has generally been to fund new water sources such as wells or boreholes.  

However, this approach fails to ensure the safety of water during transportation and storage at the home. Because of unhygienic water collection behaviors and unsafe storage practices, re-contamination presents a major challenge in many settings. A study in western Kenya showed that spring protection led to a 66 percent reduction in fecal contamination at the water source, but the reductions were only 24 percent in water stored in people’s homes. 

One inexpensive, safe, and effective option to improve water quality while protecting against re-contamination is to treat water with chlorine using IPA’s innovative Chlorine Dispenser System.

Installed at a communal water source, users simply turn a valve on the dispenser to release a metered dose of chlorine into their jerricans, which they then fill with water as usual. The chlorine mixes with the water and kills the germs that cause many diarrheal diseases. The chlorine provides protection from recontamination for up to 48 hours, and achieves an average diarrhea reduction of 41 percent.

Five-and-a-half miles northeast of Adimu and Tabia’s village lies Laban Springs, another community with access to the Chlorine Dispenser System. Here, Caroline explains that “the dispenser is easy to use, and being next to the water source reminds you to use it.” To encourage adoption, IPA partners with community volunteers, like Caroline, who serve as “dispenser promoters.” They work to educate the community about the dangers of contaminated water, to encourage use of the technology, and to ensure that a consistent supply of chlorine is available. 

Results from a randomized trial in western Kenya documented that the CDS increases chlorine use six-fold compared to the existing approach of selling small bottles of chlorine through retail outlets. In target communities, preliminary studies showed that 50-61 percent of households had sustained detectable chlorine levels in household drinking water during unannounced visits over 3 years after CDS implementation, compared to 6-14 percent with access to the standard retail model. 

A majority of the funding for CDS programs to date has been provided by the Bill & Melinda Gates Foundation. In addition, some early funding commitments were made by local governments in Kenya, the Kenyan Ministry of Education, and a Kenyan water services board for CDS pilot projects. The World Bank, the Japan International Cooperation Agency, the International Initiative for Impact Evaluation, as well as private foundations and individuals, have also contributed to start-up costs of the program.

Over the last several years, Dispensers for Safe Water (DSW) has been working in close collaboration with national ministries and local governments, as well as non-governmental organizations, to implement its programs in Kenya. Together, DSW and its partners have installed enough dispensers to provide access to safe water for more than 400,000 people across western Kenya.

DSW conducts regular spot checks to monitor the condition of the dispenser and its source, and to test that the dispenser is stocked with chlorine at the correct concentration and quality. In addition, the selection of responsible dispenser promoters and set-up of a local “hotline” for communities to report issues ensure that problems with the dispenser hardware are rapidly identified and remedied. 

In 2012, DSW will continue to work with its partners to expand dispenser coverage; to pilot dispensers in other high-priority regions of Kenya; and to explore new areas where dispensers could lead to a significant reduction in diarrheal disease rates.  

DSW also works in Haiti, Somalia, India, Bangladesh, Swaziland, and Uganda, and continues to explore the possibilities for piloting and scaling up dispensers in a number of target countries in sub-Saharan Africa. DSW aims to provide access to safe water for millions of people like Adimu, Tabia, and Caroline through the innovative Chlorine Dispenser System, a Proven Impact Initiative at IPA. To find out more, contact Dispensers for Safe Water: safewater@poverty-action.org.

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