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LEARNING FROM EXPERIENCE WATER AND ENVIRONMENTAL SANITATION IN INDIA

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LEARNING FROM EXPERIENCEWATER AND ENVIRONMENTAL SANITATION IN INDIA

• Acknowledgements 22222

• Introduction 33333

• Coverage: Access to water and sanitation 55555

• Technology: Adapting to local conditions through innovation 77777

• Behavioural Change: Finding ways to improve WES-related practices 1010101010

• Partnerships: Working with others to maximize results 1414141414

• Lessons from India 1515151515

• A timeline of WES policy in India 1616161616

• Glossary 1818181818

• For more information 1818181818

• Notes 1818181818

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$ ince independence in 1947,India has been committed to pro-viding water and sanitation to itspeople, making substantialprogress in water supply begin-ning in the 1960s, and insanitation and hygiene educationstarting in the 1980s. This com-mitment has paid off in someremarkable results: Between 1980and 2000, water supply coveragenearly tripled, and sanitationprogress, though less remarkable,grew steadily. Largely as a result,India has seen a decline in dis-eases caused by unsafe water andpoor hygiene. One remarkableachievement, the eradication ofguinea worm disease by the mid-1990s, highlights the strength ofIndia’s commitment to WES.

India’s water and sanitationprogramme, strongly supported byUNICEF for nearly three decades,has provided not only services butalso long-term training and tech-nical support, especially in thecase of water supply. The pro-gramme has also encouragedtechnological innovation and inter-national expertise while at the sametime strengthening input from thecommunity and local private sector.

The WES programme in Indiahas evolved and expanded tocoincide with changing conditionsand priorities. In the late 1960sand 1970s, UNICEF, reflecting theGovernment’s priorities, devoted asignificant portion of its efforts inIndia to water supply coverage.Beginning in the mid-1980s, theprogramme expanded to includesanitation. In both water and sani-tation, the emphasis was initiallyplaced on the development oftechnical solutions and then turnedto quality control, operation andmaintenance of equipment, and the

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promotion of good hygiene andrelated behaviours. In recent years,programmes have increasinglyencouraged communities to definetheir own needs and participate inplanning and managing WESservices. Many pilot projects havebeen launched. Some becameinstitutionalized, while others did nottranslate successfully to full-scaleimplementation. All have been use-ful in learning more about what canand cannot work in the field, on asustainable basis.

���� ������� ������The successes and innovativeways of responding to social andenvironmental conditions of theIndian experience yield valuablelessons for other developing

countries. The Government ofIndia worked with UNICEF andother partners to develop and testpractical solutions to several chal-lenges: How can WES servicesbest be tailored to the physical,social and economic conditions ofeach locale and the needs of eachcommunity? How can peoplechange generations-old behavioursto create demand for services andthen use and maintain them mosteffectively? What roles should thegovernment, private industry, non-governmental organizations (NGOs)and other groups play in WES andhow can they best work together?

To capture some of the lessonslearned in India, UNICEF commis-sioned an independent evaluationof its WES programme in India overthe past 30 years. The evaluation,which took place in 1998 and1999, was conducted by a team ofindependent sector specialists, us-ing literature reviews, interviews,surveys and other methods. Theconclusions were published in areport.1

This publication, which pre-sents the team’s findings in a formataccessible to a wider audience, ex-plores lessons learned that can helpother nations in their efforts to pro-vide universal WES coverage fortheir citizens.

India shares with many otherdeveloping countries importantcharacteristics that affect demandfor and supply of WES services.These include various unfavorableconditions in terms of geology andremote locales, economic con-straints, and some long-standingtraditions that affect hygiene andhealth behaviours and create par-ticular burdens for the very poor andfor girls and women.

The WES programme in India

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is UNICEF’s longest-supportedprogramme in water and sanitation,providing a valuable long-termperspective. UNICEF began sup-porting India’s WES programme in1966 in response to a drought emer-gency (see Box 1). The programmesubsequently became one of theorganization’s most prominentWES efforts worldwide.

In searching for solutions totechnological, social and behav-ioural challenges, UNICEF hasvariously served as an innovator,capacity-builder, advocate andmobilizer. It has maximized itslimited financial contribution toIndia’s overall WES budgetthrough various means, includinga focus on pilot projects and tech-nical innovations, many of whichwere later applied on a much larg-er scale.

By recognizing where it couldbest complement others’ activities(including those of the Govern-ment, private sector, and NGOs),UNICEF widened its impact andstrengthened its credibility andreputation, and in turn, workedmore effectively in other sectors.

What UNICEF has learned inIndia has been important to itswork in other parts of the world.Partnerships with the private andpublic sector, now recognized asessential in human development,marked UNICEF’s involvement inWES in India from the beginning.Technological advances first de-veloped in India, such as theMark II handpump, have beenwidely applied elsewhere in theworld.

And as important as thesepractical applications proved tobe, the programme in India alsocontributed to UNICEF’s recogni-tion that water and environmentalsanitation are an integral part ofits mandate to secure children’srights. WES is a fundamental partof the right of the child to “theenjoyment of the highest attain-able standard of health” as ex-pressed in article 24 of the Con-vention on the Rights of theChild.

This publication looks at fourareas that are key to water andsanitation programmes in Indiaand worldwide:

1. Coverage: Access to water1. Coverage: Access to water1. Coverage: Access to water1. Coverage: Access to water1. Coverage: Access to waterandandandandand sanitationsanitationsanitationsanitationsanitationIndia almost quadrupled its watersupply coverage in just threedecades. Political commitment,technologically strong experimen-tation and long-term support totraining and quality controlcontributed to this remarkableprogress. The increase in access tosanitation has been far smaller.

2. T2. T2. T2. T2. Technology: Adapting to localechnology: Adapting to localechnology: Adapting to localechnology: Adapting to localechnology: Adapting to localconditions through innovationconditions through innovationconditions through innovationconditions through innovationconditions through innovationThe WES programme has beensuccessful in adapting drilling rigs,handpumps and latrines to localconditions. Moreover, local manu-facturing capacity has grown to thepoint where Indian companies notonly supply domestic rigs andhandpumps but have also built upa sizeable export market.

3. Behavioural Change: Improving3. Behavioural Change: Improving3. Behavioural Change: Improving3. Behavioural Change: Improving3. Behavioural Change: ImprovingWES-related practicesWES-related practicesWES-related practicesWES-related practicesWES-related practicesAttention has been shifting tobalancing the supply of ‘pumps andpipes’ and other hardware with effortsto understand and change the waypeople use and manage services.Strategies are now more community-based and gender-responsive, builton the recognition that disseminatinginformation alone rarely leads to achange in practices and behaviours.The WES programme in Indiapioneered ‘intersectoral con-vergence’ by establishing links withother facets of development – suchas health and income-generatingskills – long before UNICEF adoptedan integrative human rights-basedprogramming approach.

4. Par4. Par4. Par4. Par4. Partnerships: Wtnerships: Wtnerships: Wtnerships: Wtnerships: Working withorking withorking withorking withorking withothers to maximize resultsothers to maximize resultsothers to maximize resultsothers to maximize resultsothers to maximize resultsPartnerships are key to maximizingresources to provide WES servicesto a growing population. Throughmore than 30 years of collabora-tion as an innovator and capacity-builder, UNICEF has forgedparticularly strong partnershipswith India’s national and stategovernments and public andprivate sector groups.

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$urface water in India is scarceand groundwater is deep anddifficult to reach. Traditionally,most villagers used water from anysource available to them, such asponds, rivers, springs and wells.Water quantity greatly depended onthe season, and water quality wasgenerally poor. As late as 1980, lessthan a third of the population (31per cent) had ‘full coverage’2 ofclean drinking water, and virtuallyno rural households had access tosanitation facilities. Access to waterwas a prerequisite to the laterintroduction of latrines in bothrural and urban areas.

In 1966-1967, severe droughthit the states of Bihar and UttarPradesh in northern India. TheGovernment requested emergencyhelp from UNICEF, which re-

sponded by airlifting 11 borehole-drilling rigs into the country from theUnited Kingdom. These rigs coulddrill far below the earth’s surface totap into groundwater that wasotherwise unavailable. In additionto meeting the short-term need, theeffort showed the potential of whatare known as down-the-holehammer drilling rigs to reach waterunder India’s hardrock areas.

The Government of Indiasubsequently made the provision ofclean, safe drinking water acornerstone of its rural develop-ment programme and strengthenedits collaboration with UNICEF toprovide these services. By 1976,almost 300 rigs were in use, withthe Government of India andUNICEF each supplying about halfthe total.

Early success raised expec-tations of what the drilling pro-gramme could achieve. By the early1980s, at the beginning of theInternational Drinking Water andSanitation Decade, the Governmentidentified an additional 230,000‘problem villages’ in need of water.These ‘problem villages’ were veryremote; prone to drought, cholera,or guinea worm disease; or builtupon particularly unfavourablesites. To back up the commitmentto extend water coverage to moreof the rural poor, the Governmentconsiderably increased the fundsallocated to water and sanitation.

Besides having increasedfinancial resources and beingsupported with political will, theeffort to expand coverage achievedsuccess because of three otherfactors: new, locally adapted rigsthat could drill boreholes morequickly; the provision of long-termservice for the rigs and trainingsupport for the operators andengineers; and standardization ofdrilling specifications.

Until 1998, when the respon-sibility for water well drilling wastransferred to state agencies,UNICEF provided spare parts andservice on the rigs. UNICEF alsoprovided training over the years todrilling operators and engineers.This support reduced the downtime for rigs. Thus, they performedconsistently over the long term,drilling an estimated five to eightboreholes a month.

Standardizing norms for drillingalso helped widen coverage byincreasing the number of boreholesdrilled. Standards set on the depthand diameter of drilled boreholesprovided operators working inde-pendently throughout the countrywith simple, measurable indicators.

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Standards were set for minimumyield for a handpump, minimumsurface casing and the surfacesealing necessary to protect theborehole from the entry of pollutedwater. In some cases, conditionsdid not require the boreholes to bedrilled as deeply as specified.However, the standards encom-passed the different situations thathydrogeologists and engineersmight encounter, thus saving thetime and expense that would havebeen spent in setting specificationsfor each site.

$����� ��� ������UNICEF supplied more than 300drilling rigs to the rural watersupply programme in Indiabetween 1967 and 1997 at a totalcost (at time of purchase) of some$33 million. In doing so, theorganization contributed to aprogramme that now covers600,000 villages and provideswater to well over four fifths ofIndia’s population.

The provision of equipmentalone did not lead to the kinds ofresults seen in India over thepast 30 years. The elementscontributing to this expandedcoverage include:

Clear goal.Clear goal.Clear goal.Clear goal.Clear goal. Beginning in 1973,the Government set specific targets.Although these were refined overthe years and have not beenentirely attained, they clearlyestablished a national priority towhich the Government and itspartners could respond.

Role as an innovatorRole as an innovatorRole as an innovatorRole as an innovatorRole as an innovator. . . . . UNICEF,as an external partner to theGovernment of India, has had theflexibility to take risks, to undertakein-depth study to aid in decision-making and to test new equipment.

Long-term support.Long-term support.Long-term support.Long-term support.Long-term support. UNICEFmaintained support, such astraining of borehole drillers,service and provision of spareparts, for 10 years after supplyingeach rig. Standardizing thedrilling specifications also helpedensure consistent results over thelong term.

#�����In trying to extend coverage to somany people over such a largearea, inevitable tensions and trade-offs arose. One of the mostsignificant trade-offs related to thedelicate balance between meetingcoverage goals and maintainingquality. With so many new bore-

holes drilled per year, quality wascompromised in some cases, forexample, in cleaning out the drilledborehole or in measuring yieldbefore moving on to the next site.UNICEF worked with the Gov-ernment in exploring ways toimprove or ‘rejuvenate’ the outputof low-performing boreholes.

Beyond the drilling pro-gramme, India faced other waterquantity and quality issues. Overthe years, the water table dropped,primarily because of irrigation.This increased the risks ofdepletion of the water supply fordomestic use.

Water quality was also threat-ened. In some cases, this wasbecause of poor practices inmaintaining cleanliness around theborehole source. In other cases, thewater became contaminated fromnatural or human-caused pollutantssuch as arsenic, excess iron,fluoride and other substances thatdegraded the water in some areas.

UNICEF has been involved inthese issues through efforts inadvocacy as well as research anddevelopment, particularly dealingwith fluoride concentrations andwater conservation. In maintaininggains in coverage, sustainability ofthe groundwater resource must beaddressed.

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7evelopment of new technologywas critical in expanding rural watersupply and has played an important,though less successful, role insanitation. UNICEF has supportedtechnological innovations that haveled to:

Drilling rigs that operate onhydraulic power and are moreversatile and manoeuvrable, thusincreasing productivity and accessto remote villages

Handpumps that are stan-dardized, low cost and sturdy

Sanitary latrines that, althoughnever used as widely as hoped,paved the way for improvements inhygiene behaviour and sanitarypractices.

Drilling rigs. Drilling rigs. Drilling rigs. Drilling rigs. Drilling rigs. From the late 1960sonwards, as new targets were setto provide water to India’spopulation, UNICEF and theGovernment developed policies toexpand coverage and adapt rigs toIndian conditions. The rigs beingused in India at the time were

pneumatic, or air-powered, andcould not successfully reach waterin some areas. Hydraulic-poweredrigs were in use elsewhere in theworld, but it was assumed that inIndia they would be too difficultto operate, maintain, and repair.UNICEF challenged that assump-tion and successfully testedhydraulic rigs in India. After a trialintroduction in the late 1970s,

UNICEF was able not only to showthat the rigs could successfully beused in India but also to analysethe size and type best suited toIndian needs (see Boxes 3 and 4).

In retrospect, this may seem aneasy step, but with conventionalwisdom arguing against it, thedecision to test hydraulic rigs wouldhave been a very costly one if it hadfailed. UNICEF, as an externalagency, was in a better positionthan the Government to take sucha risk. Once hydraulic-powereddrills were proven suitable in India,drilling equipment was furtheradapted to suit Indian conditions.For example, the practice wasintroduced of using two smallertrucks, rather than one big truck,to mount a rig, increasing accessto remote villages. In addition,local companies quickly beganmanufacturing the equipment, andin some cases improving its design.

Handpumps.Handpumps.Handpumps.Handpumps.Handpumps. When handpumpswere introduced with the firstboreholes, there were frequent

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breakdowns. The cast-iron pumps,originally designed for family use,could not withstand the heavydemands at community watersources with pumping continuing10 to 12 hours a day. In 1974, aUNICEF survey showed that only25 per cent of the handpumpsworked at any given time. Inreviewing the findings, UNICEFrealized that a more reliablehandpump was needed, and evenconsidered withdrawing its sup-port from the drilling programmeif one was not developed.

Several NGOs had alreadybegun trying to develop a sturdy,low-cost, easy-to-manufacturepump. In 1975, UNICEF joined theeffort by working closely with localdesigners and manufacturers.UNICEF did not pay for researchand development but insteadprovided technical expertise andcoordination among the partners.UNICEF’s involvement providedan added incentive to manu-facturers, because they recognizedthe potential for higher sales ofhandpumps developed throughtheir research and developmentefforts.

Using a pump designed by aSwedish engineer for the SholapurWell Service as a point of de-parture, local designers andmanufacturers developed the IndiaMark II, or IMII, handpump.UNICEF used its technical andfinancial capability to quickly setup the pumps and monitor their usein large field tests.

The India Mark II design wasestablished by 1977, and demandsoon grew beyond the capacity ofthe initial producers. Newmanufacturers were identified in asystematic way: UNICEF engagedan independent inspection agency,Crown Agents, to verify thetechnical and financial capabilityof companies that applied tobecome Mark II manufacturers.Once their competence wasassured, UNICEF placed a trialorder. UNICEF and Crown Agents

worked with those that passed thetest to establish a functional,internal quality-control system.

By 1984, when the Mark II wasa countrywide standard, 36 Indianfirms were manufacturing the pump,and 600,000 pumps had beeninstalled. By 1998, 3 million pumpswere in operation and the Mark IIwas being exported to countriesthroughout the world.

Strict commitment to qualitywas a key factor in the success ofboth the domestic programme andthe export of Indian handpumps.For more than 15 years, UNICEFarranged and paid for pre-deliveryinspections of all handpumps. Italso provided technical support tomanufacturers to improve pro-duction techniques and strengtheninternal quality control systems.This approach created awareness ofthe need to procure high-qualityhandpumps and spare parts and itensured product monitoring andeffective quality control.

UNICEF collaborated on anumber of projects aimed atimproving the capacity of com-munities to manage their watersystems. In the late 1980s, incooperation with the UnitedNations Development Programme(UNDP)/World Bank HandpumpsProject, the Mark III, or IMIII,

handpump was developed andtested. Compared with the Mark II,the Mark III pump had higherinitial capital costs but loweroperation and maintenance costsover time (see Box 5).

Latrines. Latrines. Latrines. Latrines. Latrines. Sanitation issuesemerged as a priority in the 1980s.A Technical Advisory Group (TAG)was formed in 1983, drawingmembers from the Government ofIndia, the World Bank, UNICEFand UNDP. In part influenced bythe success of the water pro-gramme, with its MK handpumps,in 1986 TAG recommended astandard latrine design as the basisfor sanitation efforts around thecountry. The recommendationfocused on a technical solution –local construction of a specific typeof latrine – rather than on equallyimportant issues of cost recoveryor beneficiary contribution or evenon latrine use and maintenance.

The twin-pit pour flush latrine(TPPF) that the TAG promotedcould be built by local masons andseemed cost-effective for bothrural and urban areas. TheCentrally-Sponsored Rural San-itation Programme (CSRSP)launched by the Government in1985 as part of its focus onsanitation, accepted the TPPF

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what type of pump is used, broadchange is required that considersissues of ownership and control,technical back-up, financing, andfairness and equity.

The sanitation programmetaught different lessons. The first isthat, for the most part, communitymembers had not been sufficientlyinvolved in choosing the techno-logy or introducing it to others inthe community. Other importantlessons were drawn from the factthat many people were initiallyreluctant to use a new latrinebecause they feared breaking it,thought defecating in the fieldsaway from their village was morehygienic or preferred to use thelatrine as a storage facility. Inaddition, the cost of the facilityproved to be well beyond the meansof the rural poor, who tended togive little value to the service in thefirst place.

These experiences have led toa shift of focus in sanitation. Aswill be described in the nextsection, the new emphasis isplaced on offering lower-costlatrine options coupled with effortsto change behaviour.

9

design as well as the costs, whichwere expected to be reasonable.

However, sanitation coverage inIndia, particularly in rural areas,could not reach the levels of watersupply coverage. People initiallywere not prepared to bear the costfor the new latrines, especiallysince there was little motivation touse them. The programme event-ually achieved better results byintroducing latrines at lower costand placing greater emphasis onbehavioural change.

$����� ��� ������Technological innovation has playedan important role in extendingservices to the poor, as seen in thewidespread use of rigs andhandpumps. Yet, as the sanitationexample shows, introducing tech-nology does not guarantee its use.Certain factors that explain whysome of these technologicalinnovations succeeded include:

Partnerships.Partnerships.Partnerships.Partnerships.Partnerships. The partnershipsthat UNICEF developed with NGOsand the private sector were essentialin the development and manu-facture of the Mark II and Mark IIIhandpumps and drilling rigs.

Adaptation to local Adaptation to local Adaptation to local Adaptation to local Adaptation to local conditions.conditions.conditions.conditions.conditions.Drilling rigs and handpumps bothbenefited from close study ofconditions in India and fromadaptations such as the two-truckarrangement for rigs. The use oflocal components eliminated theneed to import spare parts, thusminimizing down time and costs.

Quality control.Quality control.Quality control.Quality control.Quality control. Paying closeattention to quality control, asUNICEF did in working withnew handpump manufacturers,led to India’s worldwide reputa-tion for durable and cost-effectivetechnology.

Acceptance by users.Acceptance by users.Acceptance by users.Acceptance by users.Acceptance by users. Drawingwater from a village handpumpsaves users, who are most oftenwomen, hours each day. When

people saw the immediate andevident benefits, the pumps be-came an integral part of village life.

#�����Even the best-performing equip-ment needs regular maintenanceand occasional repair. With morethan 3 million handpumps inoperation, the Government is facedwith rapidly mounting operationand maintenance (O&M) costs.Although the annual O&M cost perpump is not unreasonably high, thecumulative costs are onerous. Forthis reason, the Government beganto consider a more decentralizedapproach – sharing responsibilitieswith local governments andcommunities – that would not onlysave costs but result in betterservice, including less frequentbreakdowns and more timelyrepairs.

Over the years, different ar-rangements to manage communitywater supply have been proposed.A three-tier system, first suggestedin 1979, called for a caretaker ineach village, a block-level mechanicto look after 100 pumps and amobile repair team responsible for1,000 pumps. In fact, the systembroke down at the village level, inpart because the caretakers werevolunteers and did not have ad-equate time for the tasks requiredof them. Current arrangements varyfrom state to state, but generallythey involve state-level technicaldepartments working with com-munities. Asking communities toshare costs is obviously not apolitically popular stance, so it hasreceived little support.

In addition to the direct costs ofoperations and maintenance, thereare less apparent but still very realindirect costs. For example, re-pairing or maintaining a pumptakes time that a person couldspend on other activities, includingincome-generating enterprises.

One lesson learned is thatfor community-based handpumpmanagement to work, no matter

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10

�ommunity management ofWES services and the adoption ofgood hygiene practices are criticalto achieving sustainable im-provements in people’s lives.Encouraging health-promotingattitudes and behaviours plays amajor role in these efforts. At thecommunity level, for example,people’s willingness to take on newresponsibilities and costs will makeit more likely that communities willmanage their water systems and notdepend solely on outside assistance.Within the household, clean watermay be available, but if hand-washing and other practices are notroutinely followed, the promisedhealth benefits do not materialize.Likewise, access to latrines does notensure that people will use andmaintain them.

Behaviours related to sanitationare particularly difficult to bothunderstand and change. Theprivate nature of sanitation un-doubtedly accounts for some of thisdifficulty, as does the fact thatsanitary control and disposal ofexcreta may not be viewed as aproblem in villages surrounded bysubstantial open space. What ismore, UNICEF support to sanitationefforts in India, begun only twodecades ago, first focused almostentirely on latrine construction.

UNICEF has long supported aprogramme entitled Information,Education and Communication(IEC) to promote hygiene amongIndia’s large and diverse popu-lation. IEC materials include avariety of booklets, pamphlets,posters, videos and manuals inseveral national languages.UNICEF recognizes that the IECmaterials alone, no matter howwidely disseminated, rarely lead tobehavioural change. Their value is

in teaching people new conceptsand practices, which are thenreinforced through person-to-person contacts and other meansof communication (see Box 6).

To help people learn and adoptnew ideas and behaviours relatedto water and sanitation, WESprojects have trained localmotivators to visit families. Theseperson-to-person visits help changebehaviour, but evaluations from themid-1990s indicate that three orfour visits are required for everyinstalled latrine. So while the visitspay off and clearly have a place ina comprehensive behaviour-changestrategy, person-to-person contactis costly, slow and labour-intensive.

In recent years, UNICEF and itspartners have experimented withnew ways to engage people inplanning for, using and maintainingWES services, which encompass:

community participationgender considerationsintersectoral convergence, such

as linking sanitation with broaderhealth and economic concerns.

These three elements merge innew strategies and approaches. Forexample, if community membersare to participate productively inprogrammes, they must firstunderstand how gender consider-ations affect their roles andresponsibilities. Likewise, linkingsanitation with everyday concerns,such as diarrhoeal diseasecontrol, can increase communityinvolvement.

UNICEF has long been aware ofthe need for changes in the socialand behavioural aspects of WESservices. In 1987, guidelineson community participationand hygiene education stated,“[Providing] safe drinking water to

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the community [is] a very complextask… This…involves not only thechange of existing facilities but alsothe network of behaviour andbeliefs which is developed aroundthe ownership and use of water andwhich involves every person.”

Community participation. Community participation. Community participation. Community participation. Community participation. Con-certed efforts to involve com-munities in the WES programmein India date back to the early1980s, when community membersfirst helped ensure that boreholeswere drilled to specifications.After a borehole was drilled, avillage leader signed a completioncertificate on behalf of thecommunity. This established anearly system of accountability. Inthe 1980s, well-siting involvedconsultations with a larger groupof villagers, usually men. How-ever, these consultations were notmandatory and depended largelyon the decision of the engineerassigned to the project. In add-ition, the consultations generallyexcluded women, thereby ig-noring the views of the system’smain users.

Since then, efforts have beeninstitutionalized to encouragecommunities to define their needsand take part in the planning,operation and maintenance of theirwater systems. In some villages,water and sanitation committeeshave been charged with makingdecisions about handpump man-agement and have also promotedmessages about hygiene andsanitation.

Community involvement in-creased to some degree as a resultof an approach developed in the1980s called the Total SanitationConcept. Initially applied in thestates of Tamil Nadu and

Rajasthan, the Total SanitationConcept was a seven-componentpackage that included theprovision of latrines, soakpits fordrainage and other facilities.

Although the Total SanitationConcept did not take hold in abroader context, the pilot projectsadvanced the WES programmebecause they broadened thetechnological and cost optionsavailable to communities andbrought in NGOs as new partners.These projects also helped changethe emphasis from fully subsidizedsanitary facilities to those involvingcost-sharing with communities,which at the same time becamemore involved in determining whatbest suited their needs.

Over time, it became clear thatcommunity participation is alsocrucial to the success of school

WES programmes, which in turnserve as good entry points forintroducing beneficial hygienepractices and behaviour into thecommunity. By learning latrine use,hand washing and other hygienicbehaviours at school and thenpractising them at home, childrencan be strong agents of change, andthey are likely to continue thesegood practices later in life.

Several factors account forsuccessful school sanitationprogrammes: The programmes arebased on community demand forservices, with schools and parentscontributing to the cost of thefacilities; there are adequate ratiosof separate latrines to the numberof girl and boy students as well asto female and male teachers; andthe teachers and students acceptresponsibility for the way the

11

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12

latrines are used and maintained.

GenderGenderGenderGenderGender. . . . . Women are key to thesuccess of WES programmes, asthey are more likely than men totake care of household duties suchas collecting water for theirfamilies, washing clothes anddishes, cooking and handling food,and ensuring that children washtheir hands and bathe. Collectingwater can take up to four hours aday when water sources are notnearby. Because of these factors,women play a central role in effortsto create hygienic conditions in thehome and halt the transmission ofdisease.

In many societies, discriminationand traditional practices relating toWES have undermined women’shealth and well-being. For instance,where sanitary facilities do not exist,are of poor quality or are not inworking order, women in manysocieties habitually wait untilnightfall to relieve themselves, apractice that can cause ill health anddiscomfort. Lack of sanitationfacilities, especially separate onesfor girls, is also one of many barriersto girls attending school.

For these and other reasons, theWES programme has increasinglyincorporated a gender perspective:looking at the roles of women andmen as users and managers of waterand sanitary facilities at thecommunity and household level andmaking adjustments to suit theirneeds (see Box 7).

This can pose challenges,however. For example, when womenfirst became involved in themaintenance and repair of hand-pumps, it was considered quite arevolutionary step. Such respon-sibilities can lead to new skills andenhanced standing in the com-munity. They can also increasewomen’s influence over how WESservices are delivered. But since thewomen in many of these communityprogrammes were asked to vol-unteer their time, they and theirfamilies lost the income or other

benefits they could have enjoyed ifthe women had done other work.Paying the women for their workand/or providing literacy or otherskills training has been a way todeal with these concerns.

The issues concerning genderare large ones, with importantimplications for every community.They boil down to who in thecommunity – women, men or both– does the physical work, makes thedecisions and not only receives butalso controls the benefits ofimproved services.

Bringing the sectors togetherBringing the sectors togetherBringing the sectors togetherBringing the sectors togetherBringing the sectors together.....During the 1990s, UNICEF adoptedan approach to children’s deve-lopment and well-being thatconsidered the ‘whole child’. Theconcept is based on the principle,emphasized in the Convention onthe Rights of the Child, that achild’s rights are multiple,indivisible and interdependent.The approach stresses theimportance of a caring environmentfor children through the efforts offamilies and communities, and

ensuring access to quality socialservices – health care, education,water and sanitation – that arelinked to greatest impact.

Long before this whole-child andrights-based programming ap-proach was fully developed, theIndian WES programme hadalready adopted practices of‘intersectoral convergence’, inwhich development issues areconsidered to be inter-related andinter-dependent rather thanseparated by sector. The followingexamples illustrate this approach:

Control of diarrhoeal diseases:This effort is increasingly linkedwith efforts to promote sanitationand health education. For example,the Control of Diarrhoeal Diseases– Water and Sanitation Strategy,carried out in one district in eachstate in India, helps providecommunities with improved waterand sanitation facilities. At thesame time it supports health ed-ucation, oral rehydration therapy(ORT) and improved diarrhoealcase management at public health

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13

facilities. An impact evaluation in1999 showed slightly but con-sistently better disposal of excretaand better hand-washing practicesin communities covered by theprogramme compared with othercommunities. The evaluation alsoshowed increased use of ORT.

Eradication of guinea wormdisease: In Rajasthan – the statemost affected by this water-bornedisease – the Sanitation, Water andCommunity Health (SWACH)project funded by the SwedishInternational Development Co-operation Agency (SIDA), oversawthe promotion of safe water use andhygiene by health workers while

‘scouts’ tracked new patients. Theproject organized village infor-mation campaigns,,,,, trained womento filter water, and installed newhandpumps and wells. The debil-itating disease was eliminated inIndia by 1997.

Community health and de-velopment: Five years after theofficial end of the SWACH project,an NGO called SWACH continuesthe effort to combine communityhealth with nutrition, immuniza-tion, the development of income-generating skills and other inter-ventions. Female health workerstrained through the project stillwork with SWACH or with otherNGOs to promote family welfare,immunization, improved iron in-take, tuberculosis control andgeneral hygiene promotion. Amongthe many reasons cited for SWACH’ssuccess is the training and pay-ment of female health promotersand pump mechanics.

Employment generation andcredit: Self-financing of latrines,introduced for the first time in aproject in West Bengal in 1990, em-phasized promoting local employ-ment through the training ofmasons, and credit was provided tothe poor to purchase a latrine. Morethan 350,000 latrines have beenbuilt in Mednipore, and they are stillused and well maintained.

$����� ��� ������What has UNICEF learned aboutbehavioural change in water andenvironmental sanitation that maybe of use in other countries?

A balance must be maintainedA balance must be maintainedA balance must be maintainedA balance must be maintainedA balance must be maintainedbetween techno logy and thebe tween techno logy and thebe tween techno logy and thebe tween techno logy and thebe tween techno logy and thesocial aspects of WES services.social aspects of WES services.social aspects of WES services.social aspects of WES services.social aspects of WES services.As important as behavioural ap-proaches are, technology mustremain a strong element, especial-ly in areas where WES services arejust being introduced. In otherwords, without appropriate techno-

logy, the challenges associated withbehavioural change and improv-ed hygiene would not even arise.

Experimentation is needed.Experimentation is needed.Experimentation is needed.Experimentation is needed.Experimentation is needed.Some of India’s experiments havebeen less successful than others,but all have been instructive inpointing the way for future efforts.

Gender analysis plays a crucialGender analysis plays a crucialGender analysis plays a crucialGender analysis plays a crucialGender analysis plays a crucialrrrrrole. ole. ole. ole. ole. Women’s active participationin the programme is an importantfirst step, but making services moreresponsive to the needs of bothwomen and men requires a gender-sensitive examination of thesituation and potential solutions.

#�����Changing behaviours takes timeand resources. Behaviours thathave evolved over generationsrarely change overnight. Develop-ing methods to measure the cost-effectiveness of different ap-proaches to behavioural changewould help programme plannersdetermine how best to allocatescarce resources.

With the TPPF and with othersanitation initiatives, the tempta-tion to ‘solve the problem’ has ledto going to scale too quickly with-out adequate monitoring andevaluation. A project that works ina test situation or in a particulararea might not have success inwider applications. Because of this,UNICEF has learned the im-portance of monitoring andevaluation to ascertain whichapproaches work best over the longterm and on a larger scale.

Although UNICEF has stronglyadvocated a gender-sensitiveprogramming approach, there stillremains a need to better under-stand the complexity of genderrelationships, including who hasaccess to and control over services,who benefits from improvements inwater and sanitation, and howresponsibilities can be sharedequitably between women and men.

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�hrough partnerships, UNICEFhas been able to achieve a greatimpact by investing limitedresources. Instead of serving as an‘implementer’, the organization hasacted more as an advocate,innovator, guide and supporter.

GoverGoverGoverGoverGovernment of India. nment of India. nment of India. nment of India. nment of India. UNICEF’sstrongest WES partnership has beenwith the Government. It iscommonly acknowledged withinIndia that UNICEF has been a ‘true’friend of the Government bycollaborating on WES effortscontinuously over the last 30 years,achieving credibility and collegialaccess to officials in the process.UNICEF’s Country Programmes forIndia have always been closelyidentified with the correspondinggovernment priorities and planning.Rather than implement program-mes on its own, UNICEF hasprovided technology, training andother support through theGovernment. The organization hassupported on-the-ground imple-mentation, advocacy and policydialogue at all levels.

NGOs. NGOs. NGOs. NGOs. NGOs. UNICEF has establishedrelationships with many NGOs andprivate sector organizations but hasmaintained long-term partnershipswith relatively few of them. In manycases, the partnerships were project-specific and relatively short lived,involving perhaps a funding agencyand a contractor or a client and acontractor. Most close partnershipshave been developed with NGOsand private sector organizations thathave proved to be capable andaccountable agencies recognized byGovernment. In some cases, NGOshad pioneered approaches on asmall scale, and UNICEF developedthem further. The development and

successful marketing of the Mark IIhandpump shows how thesepartnerships worked best.

As UNICEF has started to helpbuild NGO networks and to havelonger collaborations with thoseorganizations that have performedwell, it has become easier to defineeach partner’s objectives, strategiesand inputs. Close cooperation witha core of reliable partners has madeoutsourcing more effective and hascontributed to better monitoring andevaluation.

Private SectorPrivate SectorPrivate SectorPrivate SectorPrivate Sector. . . . . UNICEF workedclosely with the private sector toencourage the local adaptation andmanufacture of drilling rigs,handpumps and other equipmentand accessories. It also cooperatedwith the Bureau of Indian Standardsto oversee quality control inhandpump production. The privateindustry’s involvement in watersupply equipment has grown andnow even includes production forexport. The partnership with theprivate sector has contributed tosustainable results in India and tobenefits beyond its borders.

$����� ��� ������UNICEF is recognized by itspartners and also by externalfunding agencies for its positivecontributions in the WES sectorand for its long-term commitmentat central, state and local levels.UNICEF programmes have beenclosely coordinated with the plansand policies of the Government.

Compared with governmentcontributions, UNICEF’s financialcontribution to water and sanit-ation in India, including whatUNICEF receives from donors, isminimal. UNICEF has used thisrelatively small amount of fundingto develop and test new ap-proaches and then help build localcapacity and community support,multiplying the value and impactof these funds.

#�����Coordination among partners hasnot always been close enough tomake best use of limited resources.In some cases, different organiza-tions have undertaken similar workwithout sharing information andlessons learned. The effectivenessof programmes in India’s decen-tralized setting could be improvedif organizations shared a focus anddefined common indicators formonitoring and evaluating results.

Another challenge is tomaintain a high level of qualitycontrol and effectiveness inservicing rigs and pumps asUNICEF hands over thesefunctions to local institutions, andsome private sector partners haveexpressed concern about this. Inorder to assume these respon-sibilities permanently, localinstitutions will need en-couragement and support.

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�he WES programme in Indiayields lessons that other countriesmay find useful in adapting aspectsof the programme to their ownconditions and needs:

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UNICEF has supported India’s WESprogramme for several decades,coordinating its activities closelywith the Government, NGOs and theprivate sector. The depth of thissupport contributes to UNICEF’scredibility and access in India.

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This relative freedom suggests animportant role for UNICEF in WESand in other sectors to develop andtest new approaches and buildcapacity among its partners.

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Partners should build on eachother’s capabilities, strengths andcomparative advantages to havegreatest impact.

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To be effective, a national policyframework must be shaped by localrealities, including behaviours andvalues.

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To ensure access to clean drinking

water for all children, it is especiallyimportant to create technicalsolutions that are feasible andsustainable.

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�Technological improvements mustbe accompanied by changes inbehaviours and a focus on howcommunities use and maintainsystems if lasting improvementsare to be made in people’s lives.

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These issues are key to communityparticipation, education, trainingand other aspects of WES.

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These data help programmesimprove decision-making, especial-ly in an era of limited resources andneed for greater accountability.

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Efforts to improve people’s lives havegreatest impact when they combinehealth, education, nutrition, waterand environmental sanitation. Forexample, improving sanitation andwater facilities in schools will helpincrease enrolment and retention,especially of girls.

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It is tempting to expand on pilotprojects that seem successful.However, i t is better to moveslowly to ensure that promising

approaches are replicable on alarger scale.

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years of support for India’s WESprogramme, UNICEF has had thesatisfaction of seeing millions ofpeople gain access to clean water,sanitation services and hygieneeducation. While behaviouralchange has not shown suchdramatic results, UNICEF hassuccessfully advocated the needfor children, women and men toplay a central role in long-termdecisions about WES services.

UNICEF has contributed mostwhere it has followed through andsustained its support over time.UNICEF has benefited from thesignificant store of knowledgegained during this period and hasalso shared lessons learned withkey partners. In the years ahead,partnerships with the Govern-ment, NGOs and others willbecome even more important.

It is hoped that India’s ex-perience will serve as a guide andinspiration for others helpingpeople fulfil their right to cleanwater and sanitation. India andthe rest of the world continue toface challenges in meeting thisgoal. In India, formidable logisticobstacles remain in expandingservice, and the sustainability ofthe achievements made so farcannot be taken for granted.Excess demand and pollutionendanger the groundwater supply,and the cost of maintainingquality services is rising. Thepublic sector cannot shoulder thecost of providing and managingfacilities in perpetuity. Involvingcommunities and other stake-holders in the search for solutionsis challenging but essential.

16

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�hree phases mark the evolutionof India’s drinking water policysince Independence in 1947,particularly from the mid-1960s.Although the timeline begins in1947, the water programme did notreceive major government supportuntil the mid-1960s. Support forsanitation is an even more recentpolicy issue, dating back about twodecades. Five phases mark itsevolution.

����� �� �1947-1980:1947-1980:1947-1980:1947-1980:1947-1980: Despite formal re-cognition of the importance ofuniversal access to water andsanitation, the central Governmentprovided little financial support untilthe 1966-1968 drought period inseveral northern states. AfterUNICEF airlifted 11 drilling rigs thatcould reach groundwater far belowthe earth’s surface in these areas,the Government made drilling acornerstone of its water supplyprogramme. A centrally fundedscheme for accelerated water supplywas developed from 1972-1977.This programme gave 100 per centassistance to states and centrallyadministered territories to extendwater supply to acute problemvillages (those built on hardrock orprone to drought or unsafe surfacewater), and particularly to thoserural people from traditionallyunderprivileged castes and tribes.

1980-1986: 1980-1986: 1980-1986: 1980-1986: 1980-1986: Serious planning foran expanded attack on the problemof water and sanitation took place,triggered partly by the increasedglobal attention that accompaniedthe International Drinking Waterand Sanitation Decade. The MarkII handpump was adopted country-wide and local manufacture firmlyestablished.

1986-present1986-present1986-present1986-present1986-present: Since 1986, theNational Drinking Water Mission(renamed the Rajiv Gandhi NationalDrinking Water Mission in 1991)has coordinated increased activity.The directness of support and therelative freedom from bureaucraticconstraint are frequently cited asreasons behind the Mission’ssuccess in improving watercoverage and eradicating guineaworm disease.

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����������Early 1980sEarly 1980sEarly 1980sEarly 1980sEarly 1980s: In 1983, the WorldBank formed a Technical AdvisoryGroup, with its members andfunds also drawn from theGovernment of India, UNICEF andthe United Nations DevelopmentProgramme (UNDP). The TechnicalAdvisory Group supported a variety

of sanitation studies and de-monstration projects.

1985-1986:1985-1986:1985-1986:1985-1986:1985-1986: The Governmentlaunched the Centrally SponsoredRural Sanitation Programme(CSRSP) in 1985. Through this keyprogramme, the Government all-ocated funds and preparedguidelines for a sanitation pro-gramme focused on rural areas

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under a wider housing programme.In 1986, the Technical AdvisoryGroup completed its work andrecommended adoption of locallybuilt twin-pit pour flush (TPPF)latrines as the most cost-effectiveoption for both rural and urbanareas. The Government acceptedthis recommendation as thestandardized latrine design for thecountry.

1986-1990: 1986-1990: 1986-1990: 1986-1990: 1986-1990: In 1986, the Gov-ernment approached UNICEF forfunding support and invited theorganization to become a full-fledged CRSP partner. UNICEFlaunched a series of area-basedmicro-projects in rural sanitationin 1986-1987, as an instrumentof advocacy and a way to learnfrom the field. As the results beganto emerge, informal dialoguescontinued between UNICEF and theGovernment about alternative

approaches to the TPPF.

1990-1995: 1990-1995: 1990-1995: 1990-1995: 1990-1995: In 1990-1991, thecoverage target of 25 per cent of allrural households was reviseddownwards, as government datashowed coverage at far less than 10per cent. A 1992 national-levelseminar played a critical role inmoving policy away from fullreliance on the TPPF design andtowards an approach that combinedother hardware options witheducation and health linkages. Thebudgetary allocation for sanitationcontinued to be small relative towater: India’s Eighth Five-Year Plan(1992-1997) allocated Rs 6,742million (approximately US$400million) for sanitation compared toRs 108,700 million (approximatelyUS$6,400 million) for drinkingwater supply. Nonetheless, san-itation finally developed its ownidentity in state governments’

plans, policy announcements andpolitical governance agendas.

1995-present: 1995-present: 1995-present: 1995-present: 1995-present: In 1996, the Gov-ernment issued a guideline on avariety of toilet/latrine designs,ranging in cost from US $10 to$100. The guideline also gaveinformation on sanitation up-grading, encouraging householdsto start with a simple design thatcould be upgraded later. Veryrecently, the Government of Indiaadopted the Restructured Central-ly-Sponsored Rural SanitationProgramme (RCRSP). The policy isa shift from paying high subsidiesto no or low subsidies andgeneration of demand for services.Women’s self-help groups and smallentrepreneurs help expand sanit-ation delivery; NGOs play a strongrole in mobilizing communities,promoting demand and managingrural sanitation centres.

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CCACCACCACCACCAConvergent Community Action

CDDCDDCDDCDDCDDcontrol of diarrhoeal diseases

CRSPCRSPCRSPCRSPCRSPCentrally-Sponsored RuralSanitation Programme

IECIECIECIECIECInformation, Education andCommunication (programme)

IMIIIMIIIMIIIMIIIMIIIndia Mark II (handpump)

IMIIIIMIIIIMIIIIMIIIIMIIIIndia Mark III (handpump)

NGONGONGONGONGOnon-governmental organization

O&MO&MO&MO&MO&Moperation and maintenance

ORTORTORTORTORToral rehydration therapy

RGNDWMRGNDWMRGNDWMRGNDWMRGNDWMRajiv Gandhi National DrinkingWater Mission

RCRSPRCRSPRCRSPRCRSPRCRSPRestructured Centrally-SponsoredRural Sanitation Programme

SIDASIDASIDASIDASIDASwedish InternationalDevelopment Cooperation Agency

SWSWSWSWSWACHACHACHACHACHSanitation, Water and CommunityHealth (project)

TTTTTAGAGAGAGAGTechnical Advisory Group

TPPFTPPFTPPFTPPFTPPFtwin-pit pour flush (latrine)

UNICEFUNICEFUNICEFUNICEFUNICEFUnited Nations Children’s Fund

VLOMVLOMVLOMVLOMVLOMVillage Level Operation andMaintenance

WWWWWAAAAATSANTSANTSANTSANTSANwater and sanitation

WESWESWESWESWESwater and environmentalsanitation

Mudgal, Arun Kumar. ‘India Handpump Revolution: Challenge and Change’. HTN Working Paper: WP 01/97.New Delhi: Swiss Centre for Development Cooperation in Technology and Management, 1997.

UNICEF. Division of Evaluation, Policy and Planning, Learning from Experience: Evaluation of UNICEF’sWater and Environmental Programme in India, 1966-1998. New York: UNICEF, 2000.

UNICEF. The State of the World’s Children 2000. New York: UNICEF, 1999.

UNICEF. Strategies in Water and Environmental Sanitation. New York: UNICEF, 1995.

UNICEF. WATSAN India 2000. New Delhi: UNICEF, 1995.

More information about the UNICEF WES programme is available at www.unicef.org/programme/wes

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1. UNICEF, Division of Evaluation, Policy and Planning, Learning from Experience: Evaluation of UNICEF’sWater and Environmental Sanitation Programme in India, 1966-1998, New York: UNICEF, 2000.

2. Full coverage of safe drinking water is defined, in non-hilly and non-desert areas, as access to at least 40litres per capita per day, 250 users per spot source, within 1.6 kilometres or less.

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Front cover photo: UNICEF/90-0641/GoodsmithBack cover photo: A 20-ton rig strikes water in southern India. This large rig is used for drilling in deepaquifers and complex geologic formations and also for motorized pump installations. In the 1980s, smaller,less costly and more manoeuverable machines were introduced to drill boreholes for the India MK II handpumps.The smaller rig became the UNICEF standard, although both types continue to be used. UNICEF India photolibrary

Copyright © 2002The United Nations Children’s Fund (UNICEF), New York

Permission to reproduce any part of this publication is required.Please contact the Editorial and Publications Section, Division of Communication, UNICEF New York. Mailaddress: 3 UN Plaza, New York, NY 10017, USA. Tel: 212-326-7513; Fax: 212-303-7985;E-mail: [email protected]

19

A study by the UNICEF Evaluation Office

UNICEFDivision of Communication3 United Nations Plaza, H-9FNew York, NY 10017, USA

E-mail: [email protected]: www.unicef.orgReprint September 2002

ISBN: 92-806-3767-3