KCCI / 2006-017

Sanitation and Hygiene in Rural

Jharkhand
Experiences in Programmatic
Implementation

Bindiya Chakraborty
Sara Keene
Praveen Kumar Bharti
Oscar Mora Lopéz

In collaboration with
Xavier Institute of Social Service (XISS)
Ranchi, Jharkhand

For every child

Health, Education, Equality, Protection
ADVANCE HUMANITY
Disclaimer

The views expressed in this case-study are those of the authors alone and do not
necessarily reflect the policies or the views of UNICEF and/or the Xavier Institute of
Social Service (XISS).

Design & Printing : Rajdhani Art Press | 98102 45301

Table of Contents

List of Tables and Figures 2

Acknowledgements 3
Acronyms 4
Foreword 5
Executive Summary 6
Introduction 8
Profile of the State of Jharkhand and the District of Dumka 10
Water and Environmental Sanitation: A Historical Sketch 13
Total sanitation campaign 14
Swajaldhara 16
Methodology 18
Case Studies 20
Quality of life 21
Limiting and enabling factors 22
Programme implementation: Generating demand 24
Construction and maintenance of sanitation and hygiene facilities 26
Behavioural transformation 28
Enabling factors 30
Motivation and receptivity to change 30
Health and hygiene education 31
Conclusions and Findings 34
Key drivers of change 34
References 40
Appendix 41

1
List of Tables and Figures

Tables
Table 1: State and District profiles 10
Table 2: Economic Activity in the State of Jharkhand 11
Table 3: Key Players in the Implementation of Sanitation Programmes 12
Table 4: Implementation of Swajaldhara and the TSC and degree of water 17
and sanitation coverage in each of the four villages studied
Table 5: Contributing Factors to Achievement of Full Sanitation Coverage 35

Charts
Chart 1: Water Sources to Househilds 37

2
Acknowledgements

First and foremost, we are deeply grateful to the communities of Asansol, Basmata,
Jonka and Sikandra for welcoming us into their villages, providing us the utmost
hospitality, and willingly sharing their experiences on a somewhat sensitive and private
topic.

For their academic and professional support, we would like to thank Dr. Anirudh Prasad
of XISS, Ranchi, Mr. S.N. Singh and Ms. Sumaira Chowdhury of UNICEF.

For generously offering us their time and experience during our fieldwork, we are grateful
to Upendra, Praveer and Vilash. A very special thanks to Mr. Mishra, who remained by
our side for the duration of our fieldwork in Dumka.

For their lively company, wit, humour and insightful observations, we are indebted to
Abha, Roshni, Atreyee, Anita and Professor Sarkar.

We are highly appreciative of all those who ensured our sustenance, provided us a
comfortable and tidy stay, and introduced us to the natural wonders of Ranchi.

3
Acronyms

CSRSP Centrally Sponsored Rural Sanitation Programme

FGD Focus Group Discussion
GoI Government of India
GoJ Government of Jharkhand
IEC Information, Education and Communication
NGO Non-Governmental Organisation
PDDJ Planning and Development Department of Jharkhand
PHED Public Health and Engineering Department
PRA Participatory Rural Appraisal
RSMPC Rural Sanitary Marts and Production Centres
SC Scheduled Castes
SHG Self-Help Groups
SSHE School Sanitation and Hygiene Education
ST Scheduled Tribes
TSC Total Sanitation Campaign
UNDP United Nations Development Programme
UNICEF United Nation Children’s Fund
VWSC Village Water and Sanitation Committees
WES Water and Environmental Sanitation

4
Foreword

The KCCI internship case studies are a UNICEF India initiative under the umbrella of
the Knowledge Community on Children in India (KCCI). A partnership between
UNICEF and the Government of India, the Knowledge Community on Children in India
aims to fill knowledge gaps and promote information sharing on policies and programmes
related to children in India. Under the aegis of this project, 101 interns from across the
world visit and document UNICEF assisted and other projects focused on child rights
and development. Their fresh perspectives, commitment and hard work are reflected in
the case studies produced by them, which are published by UNICEF.

UNICEF recognises the potential and power of young people as drivers of change and
future leadership across the globe. The KCCI Summer Internship Programme aims to
develop a cadre of young research and development professionals with interest,
commitment and skills relating to children’s development in India.

The case studies cover key sectors linked to children and development and address
important policy issues for children in India. These include: primary education,
reproductive and child health, HIV/AIDS, water and sanitation and child development
and nutrition, social exclusion and child labour. Based on desk research and field work,
these case studies tell the story of innovations in service delivery, what works, why, and
under what conditions and put a human face to the successes and challenges of
development in India.

UNICEF endeavours to continue this collaboration with young researchers so as to bring

fresh perspectives and energy to development research and our ongoing efforts towards
the upliftment of women and children in India.

Representative
UNICEF India

5
Executive Summary

Water and Environmental Sanitation Programmes have been in operation in India since
the early 1960s. Though significant gains have been made in the expansion of access to
water among rural communities, improvement in sanitation and hygiene coverage over
the last four decades has been less impressive. Rural sanitation coverage had only
reached 22 per cent of the population as of 2001 and has expanded at a discouraging rate
of 1 per cent per year for two decades: 1981-2001 (UNICEF, 2004). However, of late, it
has accelerated, but even if the current trend of 3.25 per cent continues, total sanitation
coverage across India will take another 20 years to achieve. In Jharkhand, these figures
are even more disappointing with sanitation coverage expanding at a rate of only 3.5 per
cent per decade.

This study attempts to assess the implementation of Water and Environmental Sanitation
(WES) programmes in the Dumka district of Jharkhand, where over 38 per cent of the
total population belongs to the marginalised communities and sanitation coverage reaches
merely 4 per cent of the rural population.

The study has the following objectives:

· To analyse the processes by which Water and Environmental Sanitation (WES)

programmes have been implemented,
· To assess the effects these interventions have had on residents’ quality of life,
· To identify the factors that have constrained and/or enabled achievement of full
sanitation coverage.

The study covers four marginalised rural communities in the Dumka district of Jharkhand,
utilising participatory techniques comprising of a combination of household surveys,
interviews, and focus group discussions (FGDs) involving both adult and child residents,
Panchayat Heads and representatives of the NGOs working in the area.

Findings from the study verified what has been acknowledged for some time among
academics and development practitioners, that community participation and ownership
are crucial to programmatic success and long-term behavioural change. However, the
team found that these essential pre-requisites are highly influenced by other factors:

· the degree to which the community is receptive to new information and motivated to
create behavioural changes;

6
· the level of community organisation already prevalent in the community;
· communication between the NGO and community members regarding the nature of
the programme and channels of implementation;
· sustained programmatic support by the Government and facilitating NGOs;
· and, perhaps most important for long-term, sustainable behavioural change, the need
to invest in children’s sanitation and hygiene education.

Though the findings presented here are mixed, there is much to be learned both from the
successes and challenges experienced by the respective communities. Central to this
analysis are the context-specific dynamics in which these programmes are embedded.
Though these are diverse and complex, it is believed that generalisations can be drawn
from the experiences of the four communities yielding valuable insights for future WES
programming.

7
Introduction

Following a sustained movement for separation from Bihar, Jharkhand became an

independent state on 15 November 2000. In the six years since its inception, the state
has been the target of considerable governmental attention, particularly in the area of
water, sanitation and hygiene. To date, programmes such as the Total Sanitation Campaign
(TSC) and Swajaldhara have been implemented with varying degrees of success across
the state’s twenty-two districts (Planning & Development Department of Jharkhand
(PDDJ), 2006) and according to the Government of India (GoI) (2001), approximately
98 per cent of Jharkhand’s population has “access” to safe drinking water. However,
this figure reflects only the presence of hand pumps and other water sources, rather than
their actual usage (GoI norms are of one spot source for each 250 people). Due to problems
associated with maintenance of water sources as well as facilities, time taken to obtain
water from these sources and/or low water tables, only 42 per cent of households in
Jharkhand use improved drinking water sources (GoI, 2001).

Access to (and knowledge of) proper sanitation and hygiene facilities lags even further
behind, especially for the rural poor and particularly those belonging to Scheduled Castes
and Scheduled Tribes (SC/ST), who together comprise more than 38 per cent of the
state’s total population (PDDJ, 2006). Sanitation coverage reaches only 4 per cent of
Jharkhand’s rural populations (PDDJ, 2006). A marginal 6.6 per cent of the state’s rural
households use toilets and more than 95 per cent of schools do not have separate toilets
for girls (UNICEF, 2005; PDDJ, 2006), a major determinant of female dropout rates.
Sanitation-related diseases such as diarrhoea continue to plague rural communities.
Diarrhoea, a preventable disease, remains a prominent cause of child death in India,
claiming the lives of more than 400,000 children under-five, per year (UNICEF, 2005).
Prevalence of diarrhoea in children under-three in Jharkhand is 22 per cent among STs
and 26 per cent among SCs (Ekka, 2005: 1185).

As education has been acknowledged as a key driver in raising awareness and changing
behaviours with regard to sanitation and hygiene practices, the state faces additional
challenges. Primary school attendance and completion rates among children between
six and thirteen years of age are 57.4 per cent and 46.5 per cent, respectively, and adult
illiteracy remains a persistent challenge, particularly among women (of whom only 32.5
per cent are literate) (GoI, 2001).

While these broad-based statistics are available in much of the literature on rural
development in India, the individual experiences of those participating in and facilitating

8
these programmes are often underrepresented. It is the aim of this report to capture and
document the ways in which sanitation and hygiene programmes have been experienced
– particularly by SC and ST communities – as well as specific conditions that have
resulted in the success or failure of such programmes. The research team has sought to
understand the ways in which water and sanitation coverage have enhanced quality of
life, especially that of women and children, the concrete behavioural changes that have
promoted successful programmatic implementation, the key drivers of change and the
degree to which these changes are sustainable, including the factors that influence or
constrain behavioural change. The team has focused on four different tribal villages in
the Dumka district of Jharkhand. As such, the findings presented here are context-specific,
although generalisations may perhaps be made with regard to other programmes operating
under similar conditions and geographical settings.1

The case study begins with a brief introduction to Jharkhand followed by an examination
of Water and Environmental Sanitation (WES) programmes that have been implemented
in the state by the GoI and local and international NGOs (including the role played by
UNICEF in facilitating these programmes). Attention is then directed to specific
experiences with these programmes in four different villages: Asansol, Basmata, Jonka
and Sikandra. Following a brief outline of the research design and methodology, both
the successes and failures of these programmes, as perceived by the beneficiaries of the
projects are highlighted. The aim is not to present a quantitative assessment of rural
WES programmes; instead the emphasis is on the qualitative aspects of residents’
experiences with the goal of illuminating best practices, as well as factors that constrain
successful programme implementation. As a result, it is hoped that these findings can be
applied to future WES projects, thus improving the quality of service delivery and
promoting the expansion of sustainable water and sanitation coverage.

1
The four villages included in this study are not meant to be a representative sample of SC/ST communities
in Jharkhand. They were chosen on the basis of access to the community and level of sanitation coverage
achieved, to be elaborated in further detail in the methodology section.

9
Profile of the State of Jharkhand and the
District of Dumka

Nestled between the states of Bihar and Uttar Pradesh to the North, Chhattisgarh and
Orissa to the South and West Bengal to the East, Jharkhand occupies 79,714 square
kms. and is inhabited by nearly 30 million people, the majority of whom live in rural
areas (78 per cent of the total population). Jharkhand is unique in its social composition
– the state has the third largest ST population in the country, comprising 26 per cent of
the total population (Prasad, 2001). Of these, the Santhals are the largest group,
representing 35 per cent of the total tribal population (Oraon, 2003), followed by Oraons,
Mundas and Hos (together, these four groups account for 60 per cent of the total ST
population) (Prasad, 2001). The primary religions practised include (often a mixture of)
Animism, Hinduism and Christianity.

Table 1: State and District profiles

State of Jharkhand Dumka District

Districts 22
Villages 32,615 Villages 2,943
Total Population 26,945,829 Total Population 1,754,571
Rural Population 78% (of total) Rural Population 93.4%
SC Population †† 12% (of total) SC Population † 4.2%
ST Population †† 26% (of total) ST Population † 44.8%
Sex Ratio (F/M) 941/1000 Sex Ratio (F/M) 932/1000
Literacy Rate 54.1% Literacy Rate 48%
® Female 39.4% (of total) ® Female 32% (of total)
® Male 67.9% (of total) ® Male 67.9% (of total)
® Rural 46.2% ® Rural 45%
® Urban 79.8% ® Urban 80%

Sources: Census, GoI, 2001; † Official Dumka Website; †† Jharkhand: A statistical

profile; GoI, 2005

The district of Dumka is upland, located between the river Ganga and the river Barakar.
Both these rivers have had an important contribution in shaping the landscape and human
development in the area, as agriculture depends heavily on the flow of these rivers.
Dumka is culturally and linguistically diverse; Hindi and Bengali are widely spoken

10
throughout the territory but formal education has not reached all regions. Only 699,682
people are literate, which accounts for 48.31 per cent of the total population of Dumka
(GoI, 2001). The district of Dumka has been considered the sub-capital of Jharkhand
since 2002 and is a predominantly rural area, with only 6 per cent of the 1,754,571
inhabitants living in an urban setting (Dumka District, 2006). The district is inhabited
by a large number of tribal groups including Santhals, Mundas, Paharias, Ghatwals and
other ethnic groups in a lesser proportion.

Table 2: Economic Activity in the State of Jharkhand

Economic Activity
Cultivation & Agriculture 00.7%
Household Industries 4.3%
Other 29.1%

Per cent of Population below the poverty line † 43%

Sources: Jharkhand: A statistical profile; GoI, 2005; † UNICEF in Jharkhand, 2005

It is not surprising, given the distribution of rural and urban populations, that cultivation
and agriculture are this region’s primary economic activities, accounting for nearly 67
per cent of the total economy (PDDJ, 2005) and 89 per cent of ST employment (Prasad,
2001). However, and as is evident in each of the villages in the sample, wage labour
has become an important source of income in rural communities, particularly in times
of drought.

Approximately 43 per cent of the state’s population lives below the poverty line (UNICEF,
2006), the majority of whom are SC/ST. In response, government interventions have
been implemented to raise standards of living and promote social inclusion for these
marginalised populations. Special provisions have been made for these groups to ensure
that they receive (among other things) access to education, subsidised housing, enhanced
livelihood opportunities and water, sanitation and hygiene facilities. The following section
provides a brief history of water, sanitation and hygiene in India.

11
Table 3: Key Players in the Implementation of Sanitation Programmes

SWAJALDHARA
&
TOTAL SANITATION CAMPAIGN

GOVERNMENT OF
JHARKHAND VILLAGE WATER AND
LOCAL SANITATION
GOVERNMENT OF COMMITTEES
NGOs
INDIA (VWSC)

UNICEF

IMPROVEMENT IN SANITATION AND HEALTH

PRACTICES IN RURAL JHARKHAND

PROGRAMME PROGRAMME PROGRAMME

DESIGN IMPLEMENTATION MAINTENANCE

12
Water and Environmental Sanitation: A
Historical Sketch

Although WES programmes have been implemented in India since 1947, it was not
until 1968 that they became an integral component of government policy (UNICEF,
2002). Since that time, WES programmes have undergone significant transformation.
In the mid-1960s, water supply coverage via expansion of access to facilities was the
centrepiece of programmatic operations. UNICEF became involved at these early stages
with the drilling of wells in drought-stricken regions of northern India. While access to
water facilities expanded with considerable success, maintaining water quality and
quantity proved challenging. In response, the GoI and UNICEF directed their attention
to technological innovation and policy development. UNICEF collaborated with other
NGOs to develop an affordable, reliable hand pump that was relatively easy to
manufacture. Combined with improved drilling technology, coverage and accessibility
of hand pumps increased markedly.

Target Areas of Support in Jharkhand, 2003 – 2007

1. Strengthen Government, NGO and village capacity for decentralised planning,

management of water and environmental sanitation system.

2. Improve the environmental sanitation situation at community level.

3. Improve environmental sanitation and hygiene practices at home level.

4. Improve hygiene behaviour of school-going children

By the 1980s, governmental and NGO programmes expanded to include sanitation. In

1983, the GoI, UNICEF, World Bank and UNDP formed A Technical Advisory Group to
support sanitation research and project implementation. In these early stages, efforts to
increase sanitation coverage were almost exclusively driven by technical assumptions,
largely ignoring the social, behavioural, and economic factors that influence sanitary
and hygienic practices. Community members played a limited role in the choice and
maintenance of sanitation facilities, had inadequate knowledge of the relationship between
health, sanitation and hygiene and were generally reluctant to use latrines. While access
to water had expanded significantly, sanitation continued to lag behind.

13
Learning from these experiences, the GoI, UNICEF and partner NGOs modified their
strategies and began to employ a more holistic approach to the problem. In 1986, the
GoI launched the Centrally Sponsored Rural Sanitation Programme (CSRSP) to expand
rural sanitation coverage. UNICEF became a partner in the project in 1986, initiating
micro-projects in rural sanitation as well as advocacy campaigns. By the 1990s, sanitation
programmes started to take on a multifaceted character, combining culturally and
geographically appropriate technology with heightened advocacy efforts and an emphasis
on Information, Education and Communication (IEC) and School Sanitation and Hygiene
Education (SSHE). This programmatic reorientation sought to promote community
participation and ownership alongside sustainable behavioural changes. Intersectoral
convergence became an integral part of programmatic design and implementation, linking
sanitation and hygiene projects with programmes related to the control of diarrhoeal
diseases, community health and development and employment generation, and credit
schemes (to promote the self-financing of latrines). Programmes attempted to promote
more participatory, gender-responsive (acknowledging the role women play in promoting
sanitary and hygienic practices among children) and child-centred programming,
particularly with regard to health and hygiene education.

In 1996 and 1997, the CSRSP conducted comprehensive baseline surveys to assess
knowledge, attitudes and practices in rural sanitation. According to these surveys, only 55
per cent of private latrines were built due to demand from the recipients of the technology,
only 2 per cent of the respondents claimed that the existence of a government subsidy was
a motivating factor for building the latrines, 54 per cent cited convenience and privacy as
reasons for building the latrines and 51 per cent were willing to spend Rs. 1000/- to acquire
sanitary toilets (GoI, 2004). These findings, in part, prompted budgetary shifts from
subsidised to participatory programmes that required cost-sharing between the GoI, state
governments, NGOs and the communities themselves. A greater role in project
management was also created for women’s self-help groups (SHGs) and community
committees to promote demand, and community-driven monitoring and evaluation.

The most recent manifestations of efforts to facilitate universal water and sanitation
coverage – criteria for which includes both the presence of hand pumps and toilets in the
village and year-round usage of the facilities by all community members – are the Total
Sanitation Campaign (TSC) and Swajaldhara, initiated by the GoI in collaboration with
local, national and international NGO partners.

Total sanitation campaign

The TSC was created in 1999 as a comprehensive, alternate delivery system that stressed
demand over supply-side factors, shifting the emphasis from installation of technology

14
to increasing knowledge in health, hygiene and sanitation and generating demand for
the corresponding programmes. This approach combined several components ranging
from advocacy campaigns (awareness-raising) to participatory budgeting. Government
subsidies were replaced with incentives for the poor to bolster community ownership
and participation and technological options were expanded to provide residents with a
wide range of sanitation facilities to choose from. An emphasis on community
participation encouraged more cost-effective and appropriate sanitation technology and
promoted a proactive role for residents in choosing what technologies and programmes
best suited their needs. In terms of institutional support, NGOs became responsible for
IEC and awareness-raising activities, ensuring appropriate use of the latrines, conducting
baseline surveys and Participatory Rural Appraisals (PRA) and opening and operating
Rural Sanitary Marts and Production Centres (RSMPC).2

The role of children became integral to the TSC, as their knowledge and practise of
proper sanitation and hygiene became recognised as essential to long-term and sustainable
behaviour change. As such, the creation of separate toilets for girls and boys in rural
schools and Anganwadis (early childcare centres) along with the inclusion of health and
hygiene education in primary school curricula has been central to the campaign.

The GoI established the Nirmal Gram Purushkar award as an incentive to actively
participate in the programme. This award was created to recognise the villages that
demonstrated a collective and proactive commitment to achieving full sanitation coverage
in their community, on all levels of the project’s implementation. In addition to receiving
a financial reward (to be spent on sanitation and hygiene-related activities), a ceremony
is held in the village whereby a government official from the state of Jharkhand personally
presents the community with the award. This activity (particularly the visit from the
Government) has proved to be a significant motivating factor among community members
to implement the TSC and practice proper sanitation and hygiene.

By 2004, the TSC was implemented in 374 districts in India and the entire country was
expected to have sanitation coverage by 2006. However, current trends are not
encouraging, particularly with regard to rural communities. Rural sanitation coverage
had only reached 22 per cent of the population as of 2001 and has expanded at a
discouraging rate of 1 per cent per year for two decades: 1981-2001 (UNICEF, 2004).
However, of late, it has accelerated, but even if the current trend of 3.25 per cent continues,
total sanitation coverage across India will take another 20 years to achieve. The figures
are even more disappointing in Jharkhand. At present, only 8.7 per cent of the state’s
rural households have toilets, an increase of only 3.5 per cent in the last decade (presence

2
These centres serve as outlets for the construction of latrines, providing materials, service and guidance.

15
of in-home toilets for ST families is a mere 4 per cent) (GoI, 2001). Thus, one of the
primary goals of current sanitation and hygiene efforts has been to develop ways in
which programmes can be implemented with greater speed and efficiency.

Swajaldhara

Swajaldhara (which literally translates as “our water”) emerged as a replacement for

the technologically-focused attempts to expand water access that had been undertaken
by the Public Health and Engineering Department (PHED) since the late 1960s.
Swajaldhara was launched in December 2002 based on the results of a pilot project,
which found that stakeholders become more involved in the operation and maintenance
of WES facilities and programmes when they pay for them. The programme adopts a
demand-driven approach and promotes community participation by including
beneficiaries in the decision-making process.

Swajaldhara Six Step Cycle

1. Start-up phase
2. Sensitisation and identification pahse
3. Training phase
4. Scheme / system planning
5. Implementation and commissioning
6. Operators and maintenance

Swajaldhara embodies several characteristics that mark a shift in approach to rural

development. The role of the Government has been modified from that of a service provider
to a facilitator of services. The communities’ role has also been transformed: to encourage
participation, they are expected to absorb 10 per cent of the associated costs, which can be
provided in cash or in labour. In return, they receive full ownership of the resources and
the management of the programme. Villagers are also entirely responsible for operation
and maintenance of the resources, contributing to the sustainability of the project. General
guidelines of the programme are provided, but each community can adjust the programme
to their specific needs. As in the TSC, each village is responsible for choosing the kind of
technology they deem appropriate for their unique conditions and needs.

Swajaldhara specifies that supplied water should be safe and free from bacterial and
chemical contamination. It is intended that the programme will improve the quality of
life by: increasing health standards due to safe drinking water; reducing levels of sickness;
minimising time spent collecting water; providing more opportunities for girls to attend
school (because time spent fetching water, which is their responsibility, is minimised)
and by encouraging water conservation. Swajaldhara is usually implemented in two

16
broad stages. The first stage seeks to increase education and awareness: NGOs promote
the formation of Village Water and Sanitation Committees (VWSC), so residents can
decide how they will work and organise their resources. The second part of Swajaldhara
is the installation of infrastructure in the village, according to the residents’ specifications.

Table 4: Implementation of Swajaldhara and the TSC and degree of water and
sanitation coverage in each of the four villages studied.

Swajaldhara TSC Use of Hand Pumps Use of Toilets

Asansol No Yes Partial Partial
Basmata No Yes Yes Yes
Jonka No Yes Partial Partial
Sikandra Under Village Yes Partial Partial
Consideration

Each of the villages visited is addressing problems related to water, sanitation and hygiene
differently and with varying degrees of success. Technology to access water, in all but
one of the villages included in the sample, was installed before Swajaldhara was
conceived. As such, all of these villages have experienced constraints associated with
seasonal water shortages. Only one of the villages in the study has achieved full sanitation
coverage under the TSC, but is still plagued by seasonal water shortages. Two villages
have implemented the TSC, but have yet to achieve full coverage, and one has
implemented the TSC with partial success and is in the process of implementing
Swajaldhara. The remainder of this report highlights the ways in which WES programmes
have contributed positively to people’s lives, the challenges faced in implementation
and behavioural change and the potential for replication of these programmes in other
rural villages.

17
Methodology

The aim of the study was to understand the ways in which sanitation and hygiene
programmes have affected rural, marginalised communities. Villages were chosen on
the basis of two criteria: 1) the team’s access to the community, and 2) the degree to
which the community had achieved full sanitation coverage3. Given the time constraints,
it was necessary to have a contact in the village in order to gain access to (and the trust
of) community members. Three NGOs working in Dumka, along with the TSC district
coordinator accompanied and assisted the team in the fieldwork. Initially, three villages
were chosen: Asansol, Basmata and Jonka. Asansol has received minimal government
and NGO intervention and was chosen as a baseline for comparison between Basmata
and Jonka, both of which were categorised as having attained full sanitation coverage. It
was soon discovered that while all households in Jonka had received WES facilities, the
community was a far from achieving full sanitation coverage. On the recommendation
of the host organisation, one more village, Sikandra, which had implemented the TSC
only three months prior, but was already demonstrating visible signs of behavioural
change was included.

It was initially proposed to contact between 20 and 100 per cent of village residents,
depending on the size of the village, using random stratified sampling techniques
(allowing for proportional representation of community members based on caste, age
and gender). However, given both the time constraints and the conditions of the visit,
the team was often unable to systematically administer the surveys and interviews. In
the smaller villages (Basmata and Sikandra), contact was made with nearly all the
residents present in the village on that day. In these villages, rather than systematic
random sampling, interviews were conducted with those most willing to talk to the
team. Due to the private nature of topics related to sanitation and hygiene (especially
toilet usage), many residents were reserved in their responses.4 Consequently, the team
members spoke at length primarily with those, who were willing to share information
with them.

The situation was slightly different in Asansol (a village of 49 households). As the

village is located near an airport, many of the residents were away for work as labourers

3
Our emphasis was initially on sanitation coverage, and villages were chosen accordingly. The degree to
which full water coverage had been attained proved to be a significant factor in the communities’ ability
to achieve full sanitation coverage and is discussed in greater detail below.
4
This was compounded by the fact that we were not known to the community and had little time to spend
in each village

18
at the airport. When the team returned in the evening, there was very little time to conduct
interviews, which were conducted with who ever was available. Thus, the team spent its
time in Asansol primarily in the school conversing with the children. In Jonka, the largest
of the villages, the sampling was more systematic. The team conducted a household
survey from a member of each of the different castes and tolas5 represented in the
community. Again, some people were more willing than others to participate in
interviews, which made the sampling techniques less ‘random’ than would have been
ideal.

FGDs were conducted with women, men and children in each village, as well as a joint
FGD with NGO representatives and village leaders (with the exception of Jonka, which
did not currently have a village leader). The household surveys and interviews were,
with few exceptions, conducted in groups as well (due to the high level of interest residents
expressed in the project, the team was accompanied by many members of the village
throughout the visit). As such, both men and women living in the household were often
present and it was possible to speak to them simultaneously. Children were interviewed
separately from adults, and often in groups as well. As women and children are UNICEF’s
target groups, these populations have received disproportionately more attention in
interviews and FGDs.

Using a combination of household surveys, interviews, and focus group discussions

(FGDs), the team learned not only about the residents’ water and sanitation conditions,
but the myriad of challenges and opportunities that they faced prior to and during the
acquisition of WES interventions. The household surveys and interviews were, with
few exceptions, conducted in groups as well (there was hardly a moment when the team
was not accompanied by a crowd of residents who were interested in what was being
done). As such, both men and women living in the household were often present and it
was possible to speak to them simultaneously. Children were interviewed separately
from adults, and often in groups as well. As women and children are UNICEF’s target
groups, these populations have received disproportionately more attention in interviews
and FGDs.

5
Tolas are geographical divisions in a village; their composition is related to extended families and caste
structures.

19
Case Studies

As noted above, the team was assisted by representatives from three NGOs working in
the area along with the District Coordinator of the TSC, for the duration of the visit to
Dumka. All three NGOs have incorporated water, sanitation and hygiene into their
overall rural development schemes and work alongside the TSC District Coordinator to
implement these programmes. The specific strategies employed by each vary, and are
described below in the context of the villages in which each is working. Contextual
information for each village is provided, but the focus is on the ways in which sanitation
and hygiene programmes have been experienced by residents, highlighting the associated
challenges and benefits.

It was evident from the observations and conversations in each of the four villages that
some programmes had been more successful than others in terms of: achievement of
full water and sanitation coverage; residents’ satisfaction and perceived changes in their
quality of life; and the sustainability of the facilities and behavioural changes associated
with the programmes.

If not always explicit, the importance of context-specific factors has informed both the
organisational choices and conclusions. While common characteristics of successful
programme implementation were evident in several of the villages, these cannot be
disconnected from the contexts in which they are embedded. As noted below, success
(and challenges) depended not on any single factor, but on the interactions of many
different factors within village-specific contexts. The following section provides an
impact-analysis of WES programmes, the most significant reasons for successful
programmatic implementation, key drivers of change and lessons for WES facilitators.

ASANSOL
Asansol is comprised of 49 households and approximately 300 people who belong to
the Paharia tribe. The village is geographically divided into four tolas or neighbourhoods
(Ramlaltola, Paharitola, Bagantola, and Beejtola). Although primarily agricultural,
Asansol is located only 3 km. away from the district capital which permits easy access
to services and serves as a source of employment for many of the village residents
(many of who work as wage labourers at a nearby airport). A small number of the
children from the village attend school in Dumka as well.In Asansol, leadership is
passed through a hereditary system, as is common in many ST communities. The
present village leader, Shri Shyam Pujahar, has been head of the community for 14

20
 years. During this time, the village has gained increased access to important services,
including the construction of a small dam and the implementation of other projects
that have improved access to clean water. Now there are two hand pumps and one
well available for the village. Asansol hosts two women’s SHGs that work on several
income-generating activities such as making paper bags and other handicrafts. Although
women’s SHGs have worked mainly on micro-credit schemes to help women in the
village save money and allocate their resources effectively, they have also played an
important role in disseminating information on sanitation and hygiene to women. They
educate residents about the importance of covering food, hand-washing, and the ways
in which diseases spread (particularly, as a result of open defecation). With assistance
from NGOs, women’s SHGs promote healthier behaviour, sanitation and hygiene
education in school and organise awareness-raising campaigns through street plays
and wall paintings. Asansol is also host to a boarding school for girls who drop out of
standard schooling. The boarding school, Balika Shibir, (operated by the NGOs) was
established in 1999 and provides education and accommodation for over 50 girls.
NGOs also participate in agricultural development, helping cultivators choose profitable
crops. They build awareness around environmental issues – the importance of fruit
trees, why plants are important to the village. Currently there are 23 hectares of barren
land which the villagers are planting with mulberry plants for silk production.

Quality of life

All the residents who were consistently using their toilets cited numerous benefits and
improvements in their quality of life as a result. Many residents cited the health benefits
of toilet usage and maintaining a sanitary and hygienic environment, noting visible
changes in their own and their children’s health:

We used to be sick more often before we had toilets because things weren’t as clean
and sanitary. It used to be filthy out there and then flies would sit on the food. Now we
cover the food all the time, so we aren’t sick as often.

While poverty was often cited among residents as being a constraint to their ability to
improve and maintain their toilets, many claimed that improvements in health were
accompanied by economic benefits. In a conversation with the village leader of Sikandra,
the interviewer asked if poverty has acted as a barrier to toilet usage. He responded:

Whether we eat or not, we still have to defecate. It doesn’t matter. We have to be

concerned with toilets. Before using toilets, we used to get sick often and had to spend
money on the doctor. But now we aren’t sick as often and we don’t spend as much on
health care.

21
 “Bhaat chal bhar dia. Pet dukha gia. Jaria chali gia. Chal
phooli gia”
“We used to go far from the house. If a woman was cooking
and if she had to defecate, her rice would be burnt by the
time she returned. It took a long time.”
- Bhawani Devi of Sikandra

While many of the benefits of WES programmes cited were related to health (such as
declines in the incidence of illness), the impacts of sanitation and hygiene improvement
were multifaceted and far-reaching, particularly for women. Many women claimed that
toilet usage has saved them time and made their lives easier. They no longer have to
walk far from their houses in order to defecate and it is “less embarrassing” than defecating
in the open, where there is little privacy. Due to the lack of privacy, women could only
defecate at specified times. This was not only inconvenient, but caused women physical
discomfort. During an interview, one woman explained the ways in which her life has
changed since acquiring a toilet:

If we felt like defecating during the day, we could not because we lacked privacy.
Whenever we used to go outside the house, we used to feel shy. Now we don’t need to
feel shy… We don’t need to plan when to defecate now either; we can go whenever we
need to. We could either go early in the morning or at night. And in the night, it was
frightening to go alone. There were insects and leeches that would bite us when we
went out. Now, we can go any time, we don’t need anyone to accompany us and we
aren’t bothered by insects…

In sum, sanitation and hygiene programmes have instigated a wide range of improvements
in the quality of life from physical and psychological to social and economic in nature.
Attention is directed next to the ways in which these programmes have been carried out,
the strategies used for addressing constraints and challenges, as well as the factors that
have encouraged successful WES implementation.

Limiting and enabling factors

The implementation of sanitation and hygiene programmes in each of the four villages
proved to be highly diverse with a wide range of constraints and limiting factors. NGOs
and community members confronted these challenges in a variety of ways. For example,
a commonly cited constraint in all but one village is that privacy is not ensured due to
the lack of ghera – a protective barrier surrounding the facility, usually made either of
brick, cement, mud, bamboo, or cement-dipped jute cloths. Other challenges, such as

22
seasonal water shortages, difficulties in improving and maintaining toilets, caste-based
conflicts and behavioural transformation were contributing factors to irregular toilet
use. Outlined below are the ways in which NGOs and community members have
addressed these issues. Because challenges associated with programme implementation
were prevalent in nearly all villages, this section begins with the ways in which
communities were affected by and responded to these limitations.

BASMATA
The smallest village in the sample, Basmata, is comprised of 14 households and just
over 100 residents, all of whom are Paharias. Agriculture has traditionally accounted
for the majority of the livelihoods; however, seasonal migration for urban employment
is prevalent. When asked during a women’s FGD to describe the most significant
challenges confronting the community, one woman replied: For the last couple of
years, our crops (rice and maize) have not been good. We haven’t had good rains,
which is why our crops have been poor. When our crops are not plentiful, we work as
labourers. Migratory labour provides not only a supplementary income for village
residents, but also allows families to save money. The main reasons why men go
outside the village for work is because all their meals are provided, they are remunerated
the same day and they are able to save all the money they earn. Women’s SHGs have
also played an important economic role in Basmata by saving money monthly as a
way to address potential problems in the community, such as failing crops, natural
disasters (i.e., floods), for matrimonial expenses or illness. Whenever a problem arises,
any member of the community can draw from the self-help group’s savings.The primary
school in the village serves children from Basmata as well as from neighbouring
villages. All children are provided with a mid-day meal and the school actively promotes
children’s immunisation programmes. The NGO in Basmata has worked in the village
since 1997 in several realms of rural development including agriculture, sericulture,
herbal medicine, well-drilling and the promotion of women’s SHGs. It operates a
Rural Sanitary Mart and Production Centre (RSMPC) that services 24 of the 27
Panchayats in the Jarmundi block of Dumka. In addition to the installation of toilets
(including construction of gheras), the NGO has launched an extensive awareness-
raising campaign and has successfully raised sanitation and hygiene awareness using
a diverse range of mediums, including public messages posted around the village,
street plays and village motivators.6 The organisation also provides training to women
and children in the maintenance and repair of water and sanitation facilities. The TSC
has only recently been implemented in Basmata. After only one year of receiving the
facilities, the village now has full sanitation coverage.

6
Motivators are recruited from rural villages by Adithi and employed to disseminate information about
sanitation and hygiene in an attempt to encourage other residents to implement the TSC in their villages.

23
Programme implementation: Generating demand

JONKA
Jonka is occupied by 161 households and 987 inhabitants. Most villagers work in
agriculture; rice, potatoes, dal, vegetables and wheat are their most important crops.
When there is no work in the field, men work as day labourers or rickshaw-pullers.
Villagers also make bidi (leaf-wrapped) cigarettes to generate income. Jonka was the
most socially and politically complex village visited. One of the most important features
of this community is its multi-caste composition; there are 11 different castes in the
village, and inter-caste and tola conflicts are not uncommon. Currently, there is no
consensus over a village leader, which makes implementation of sanitation and hygiene
programmes difficult. Of the nine hand pumps installed, three are currently being
used. Though all residents have access to water from the hand pumps, the distance
from most households prevents some villagers from using them regularly. A large
number of families use open wells as their primary source of drinking water. The
local NGO in Jonka is currently working to expand access to sanitary drinking water
as well as to improve pre-existing infrastructure. Installation of toilets during the
initial stages of the TSC was hindered by caste-divisions within society and, in part,
exacerbated these conflicts (described in detail below). The toilets came to be valued
more for the prestige brought upon the owners, rather than their intended benefits.
Attitudes towards sanitation and hygiene facilities and practices were constrained by
villagers’ general unwillingness to participate and claim ownership of the
programmes.Recognising that children are the link to sustained behavioural
transformations; a special emphasis has been placed on Jonka’s school hygiene facilities.
There is a middle school in the village that has separate toilets for girls and boys and
a special programme has been established by the local NGO in which students check
each other’s nails and general cleanliness. NGOs provide incentives for children who
demonstrate good hygiene conduct: new games are made to motivate the children to
practice healthier behaviours and prizes are awarded to the children with the best
hygiene practices.

As has been acknowledged for some time among academics and development
practitioners, community participation and ownership are crucial to programmatic success
and long-term behavioural change. To achieve and sustain proactive engagement among
community members, demand for the programmes must be generated before
implementation can occur. In Jonka, this proved to be challenging from the start.
According to the NGO working in the village, when the organisation first arrived, they
were met with considerable resistance to sanitation, health and hygiene on the part of
the villagers:

24
 When we came in and mentioned we wanted to install toilets, villagers would cover
their noses expressing their repulsion to the topic. They were unwilling to participate
in the construction of toilets and awareness-raising campaigns in their communities.
When some [villagers] began making toilets in their house, others used to say:
[sarcastically] ‘Look! They are defecating inside their house!’

Through extensive conversations and fieldwork, NGOs addressed residents’ resistance

to building toilets. This was a challenging process, particularly because residents found
toilets to be unnecessary. Villagers often claimed that their ancestors had always defecated
in the open and had never experienced any problems. In response, NGOs illustrated the
numerous ways in which villagers’ lives have changed from those of their ancestors:

Your forefathers lived a life in which they did not use chemicals for growing crops,
and also the population was less than today. Earlier people used to drink the water that
came from the rivers and ponds and they did not get sick [as a result]. But today, if you
drink water from the pond you will get sick. Your forefathers used to wear dhoti
(traditional male clothing); why have you all started wearing pants? Your forefathers
lived in a house that had a roof made of rice straw, but now you all build your houses
out of bricks? Many things have changed since your forefathers lived. If you use toilets,
you will enjoy better health and your life will be easier.

Once residents became more open to sanitation and hygiene education, the NGO began
to implement the TSC. This was challenging due to the fact that the TSC requires villagers
to contribute 20 per cent of the total costs on service installation. Misunderstanding the
rationale behind this requirement, villagers suspected the NGO of withholding money
granted by the government under the scheme; they had to be convinced that their
participation was a necessary component of the programme. To confront this challenge,
the NGO held a joint seminar with Government officials and Jonka residents to provide
community members an opportunity to air their questions and validate the information
received from the NGO. Once community members understood the structure and goals
of the TSC, subsequent steps could be taken towards implementation.

Apart from increasing awareness and generating programmatic support, implementation

of the TSC was also constrained in some villages by technical limitations. In order to
achieve full sanitation coverage, sanitation and hygiene programmes must be
implemented in conjunction with schemes that ensure consistent availability of and access
to water. While all villages are confronted with water shortages in the dry season, these
constraints were most marked in Sikandra. Despite the residents’ openness to the
programme and their willingness to use their toilets, inadequate access to water has
acted as a constraint to full sanitation coverage in the village. Resident’s experience

25
several months of drought (on an annual basis) during which time it is difficult for them
to use and maintain their toilets. At present, there are three hand pumps in the village, of
which only one is working. During the drought (or times in which hand pumps are
broken) villagers get their drinking water from wells.7 When these wells run dry, residents
are unable to use their toilets. Still, many have practiced water-saving techniques, such
as building repositories to save water during the rainy season that can be used for flushing
toilets during the large part of the dry season.

SIKANDRA
Sikandra is comprised of 34 households and 137 residents all of whom are Santhalis.
Agriculture is the primary economic activity among villagers, although, particularly
in the dry season, day labour is common. Residents also meet their subsistence needs
with money saved by women’s SHGs. These groups have played an important role as
micro-creditors providing community members with low-interest loans for various
activities. SHGs were initiated in 2003 with assistance from NGOs. By the beginning
of 2006, the groups expanded their services to include sanitation and hygiene
programmes and assisted in the formation of a Water and Sanitation Committee
(VWSC). This committee encouraged residents to manage and maintain their facilities.
Now there are three hand pumps in the village (only one of which is presently working)
and there are 8 wells but water is not available all year round. The VWSC has discussed
with local NGOs various possibilities to address these problems. They recognise the
health benefits associated with toilet use and are motivated to achieve full sanitation
coverage. Education and sanitation and hygiene are highly valued among community
members and they actively promote and practice sanitary and hygienic behaviours
such as cutting their nails, bathing regularly, covering their food and washing their
hands before eating and after defecating.

In addition, the NGO has begun advocating for the Swajaldhara programme. Sikandra
residents are investigating additional alternatives to address water shortages in summer
months, such as harvesting rainwater for sanitary use and establishing an irrigation system
that will transport water from a nearby perennial stream to the village.

Construction and maintenance of sanitation and hygiene facilities

Upon generating demand for the programmes, residents are expected to choose the kinds
of facilities they wish to install and participate in the construction and maintenance of
those facilities. This was challenging for many households. While every household had
a toilet, the majority of them (particularly in Jonka and Asansol) lacked gheras. During
a women’s FGD in Asansol, women claimed that many residents built gheras out of

7
The village leader told us that people do not get sick from well-water because it is stored in aluminium
vessels and carefully covered.

26
leaves because it is less costly. However, in a short time the leaves dry out and can be
seen through, rendering the ghera dysfunctional and thus inhibiting use of the toilet.
The Government and NGOs have responded to this problem by adding a provision to
the TSC for the construction of durable and long-lasting gheras upon toilet installation.
In addition, special programmes are in the process of being implemented to provide
households that have already received toilets with proper gheras.8

Moving forward and generating community ownership of sanitation and hygiene

facilities and programmes in Jonka has been difficult as well. When toilets were first
built, some residents constructed gheras out of bamboo and leaves. These were cost-
effective solutions to ensure privacy, but poorly suited to withstand the impacts of
climate and weather; even a small storm rendered the gheras ineffective. Once
damaged, villagers refused to repair their gheras, expecting the Government to lend
support in the construction of new and more weather-resistant ones. Running contrary
to community participation and ownership, Jonka residents perceive regular upkeep
of their toilets to be the responsibility of the Government and many have not taken the
initiative to repair and maintain their toilets themselves. Many of the toilets observed
appeared to have been out-of-use for some time and were serving functions entirely
different from those originally intended (for example, one resident’s toilet was used
for drying cow dung). However, as noted by the TSC District Coordinator, the most
significant problem in Jonka is not the construction of the gheras, but residents’ attitudes
towards their toilets:

[Residents’] houses are also damaged during the storm, but they repair their houses
themselves – they don’t wait for any governmental assistance. Because they see [their
house] as a necessity, they repair it. If they keep using the toilets for three to four
years, they will become accustomed to using them and then if they break, they will
repair the toilets themselves, because they will be perceived to be a necessity. When
using a toilet becomes a habit, they will maintain it themselves regularly.

NGOs in Jonka first attempted to address the ghera problem by conducting a ‘model
toilet’ scheme to demonstrate the variety of ways in which gheras could be constructed
and as an incentive for other villagers to build their own. Several households received
assistance to build gheras for their toilets. The wealthier of the households (with the
exception of one poor household) were chosen to participate in the scheme, as they were
the only ones who could partially fund and construct the toilets in the time allotted
(participants were provided the raw materials, but were given only 30 days to build the

8
This is a new scheme that has not yet been implemented. The Government and NGOs are still in the
process of determining how to allocate resources and the types of gheras that will be provided.

27
toilet). Consequently, pre-existing caste-based conflicts in Jonka were aggravated and
toilets came to be valued more for the prestige brought upon the owners rather than their
health benefits.

Although the model toilet scheme resulted in increased support from Jonka’s community
leaders, the NGO recognises that the allocation of gheras sparked confusion and
resentment among the villagers. The scheme has given the NGO “a bad name with the
villagers because they didn’t understand the reasons why [the NGO] gave model toilets
to some but not to all. [Village residents] used to think that [the NGO] gave toilets to
rich men, or that we gave toilets to those who where close to us”. After careful evaluation,
the organisation has decided to abandon the model toilet scheme. When implementing
the TSC in Sikandra, the NGO focused instead on working with village committees to
promote more active engagement among community members. This approach has been
particularly successful in Sikandra.

The NGO built upon pre-existing social structures, including women’s SHGs, to create
Village Water and Sanitation Committees (VWSCs). In partnership with these
committees, the NGO conducted sanitation and hygiene awareness campaigns through
wall paintings, street plays and child-focused community activities. This proved to be
successful on several levels. First, it reinforced the capacity of the committees to mobilise
collective action and promoted community decision-making regarding the direction of
WES in the villages. The NGO learned from their experiences with the model toilet
scheme in Jonka and made it clear from the start that the community was responsible for
the construction and maintenance of their toilets, including building their own gheras.
Second, working in partnership with the VWSC has opened a dialogue on how to solve
the village’s water constraints (to be discussed below). In addition to internalisation of
ownership among community members, the presence of corresponding infrastructure
increased the potential for the programme’s sustainability. The establishment of village
committees not only reinforces community ownership, but also serves as a forum for
dialogue and the resolution of internal disputes around WES issues. This is particularly
important in large villages.

Behavioural transformation
Installing toilets is the first (and arguably the easiest) step on the path to full sanitation
coverage; the real challenge is instigating behavioural transformation. While many village
residents attributed poor sanitation coverage to inadequate facilities and economic
constraints on their ability to improve their latrines, the team found that resistance to
behavioural change played a key role as well. The team was informed by the leader of
Asansol’s women’s self-help group that cultural beliefs and practices regarding health
and hygiene have been an impediment to the acceptance of information on sanitation

28
and hygiene and associated behavioural changes. The assumption among many villagers
that it is more sanitary to defecate a considerable distance from their home illuminates
the disjunction in the villagers’ understanding of health and sanitation; residents
understand that flies carry bacteria collected from excrement and, when in contact with
food or water, can result in the spread of disease. However, many still believed that this
process is caused by the proximity of excrement to their residences. Many did not
understand the principles behind containing excrement in a sanitary location as a means
of controlling the spread of disease.

Challenges to the Programme

1. Resistance to in-house toilets.
2. Water shortages.
3. Gheras (surrounding walls) to ensure privacy not included in toilet construction
scheme.
4. Maintenance of toilets seen as the government’s duty.
5. Differential funding for “model toilets’ creates resentment.

Some residents expressed outright disgust with the toilets in the village, as demonstrated
by one young girl’s proclamation that, “after going to toilets, we don’t feel like eating
and we feel like vomiting”. The NGO representative agreed that recognition of the
relationship between open defecation and health problems has not yet been internalised
by all community members and has proven to be a significant constraint on the realisation
of full sanitation coverage. Two representatives from the Public Health Department
corroborated these claims, stating:

The primary problems stem from the residents’ insistence on defecating in the open as
part of their daily routine – they are not accustomed to using toilets. People get up in
the morning, go to the main source of water in the village [river/pond], bathe, brush
their teeth and defecate before returning.

“When they realise the value of their lives, they will be

more careful and they will change their behaviour.”
- Purnima, leader of Asansol’s women’s self-group

Behavioural change in Asansol has been difficult, but women’s SHGs have been at the
forefront in their advocacy of sanitation and hygiene practices. They have played an
important role in disseminating information on sanitation and hygiene to women, teaching

29
them the importance of covering food, hand-washing, and the ways in which diseases
spread (particularly as a result of open defecation). The ten functional toilets in the
village belong to women in the SHGs and are used by all members of the groups.
Improvements on these toilets (including the construction of a ghera and regular
maintenance of the latrines) have been fully financed and undertaken by the women
themselves.

Enabling factors

Despite the difficulties that were faced during WES programme implementation,
community members found ways of responding that enabled them to overcome challenges
and engender sustainable change. This section examines the ways in which receptivity
to change, motivation, and children’s education have permitted behavioural
transformation. Although Basmata was the only village in the sample to have attained
full sanitation coverage, all four villages provided illustrations of enabling characteristics
that have contributed to changes within the village.

Motivation and receptivity to change

As was evident in the women’s self-help group in Asansol, motivation and receptivity to
new information and behavioural change is crucial to programmatic success. In this
regard, Sikandra and Basmata stand out. These villages have been receptive to WES
education and have made tremendous progress in initiating behavioural changes. The
processes of behavioural transformation have varied between the two villages, but high
levels of community motivation have been common to both.

Despite challenges associated with seasonal water shortages, residents of Sikandra were
highly motivated to find ways in which to use their toilets. Following an extensive
awareness-raising campaign and the establishment of a VWSC (described above), the
committee took on the role of disseminating information among community members
and generating demand for the programme. As a result, the TSC was met by residents
with enthusiasm. Villagers took the initiative to build gheras for the toilets themselves,
they were cognizant of the health benefits associated with toilet use and they were
motivated to achieve full sanitation coverage. According to one respondent:

[The VWSC] taught us about sanitation and hygiene. Then they informed us that excreta
contains bacteria; if it is scattered everywhere, bacteria will be spread by flies and can
potentially contaminate everyone in the village. That’s why we should use toilets – to
keep from spreading germs. If we follow the rules of health and hygiene, we will be
[healthy].

30
Receptivity to new information and behavioural change has played an important role in
the residents’ successful implementation of WES programmes in Basmata as well. The
women’s SHG has taken on an active role in engaging the community in sanitation and
hygiene projects. Established in 2000, this self-help group initially concentrated their
efforts on income-generating activities. Soon after, and with the assistance of local NGOs,
the group expanded their efforts to include raising hygiene and sanitation awareness in
the community. Within a short amount of time, their efforts came to fruition. Within
only one year of having acquired toilets, the entire community considers them to be a
necessity. Basmata residents are highly motivated to use their toilets and were eager to
cite the benefits, including improved overall health (and consequentially, savings on
health care), convenience, and time-saving. For some, even though the nearest hand
pump was more than a half kilometre away from their household and they had to queue
each time to obtain water, they incorporated morning and evening water collection into
their daily routine to ensure that they were able to use their toilets. The community’s
knowledge and regular practice of sanitation and hygiene has prompted local NGOs to
employ men from this village to work as motivators in nearby villages.

Social homogeneity and cohesion among village residents in Basmata and Sikandra
contributed substantially to the communities’ receptivity to behavioural change. This
factor cannot be overemphasised. In both villages, residents had pre-existing social
structures through which to address collective concerns. These organisations (i.e., SHGs
and village committees) enjoyed widespread community participation and served as a
useful tool for NGOs in their attempts to implement WES programmes. This level of
community engagement in each of the villages was aided by the fact that the communities
were small and relatively homogenous. Residents of Basmata were all from a single
tribe, and although two castes were represented in Sikandra’s community, they were not
in conflict. When considering larger and more socially complex villages like Jonka, one
must take into consideration the various factors that may encourage or impede successful
programme implementation, such as caste-based conflicts, the level of organisation and
participation in village committees and the status of political leadership.

Health and hygiene education

Recognising that children are the link to sustained behavioural transformations, special
emphasis has been placed on school sanitation and hygiene facilities and education. To
increase children’s knowledge of health-promoting behaviours, comprehensive School
Sanitation and Hygiene Programmes have been developed inclusive of:

• Well-constructed and maintained facilities;

• Separate toilets for girls;
• Regular and consistent use of the facilities by students, faculty and staff;

31
• Sanitation and Hygiene education in the school curriculum;
• Awareness-raising through aids – such as wall-paintings, posters and community
activities to teach children the health benefits associated with proper sanitation and
hygiene as well as the negative effects of poor sanitation and hygiene;
• Training for teachers and school staff.

In Jonka, significant progress has been made in children’s sanitation and hygiene
programmes. Separate toilets have been built for girls9 and boys and educational
programmes have been incorporated into the school curriculum. However, in the initial
stages of programme implementation, the NGO faced resistance from teachers. According
to the NGO representative:

We targeted the schools, but the school teachers did not allow us to work in the premises.
The teacher was saying we should have a written application for that, only then we
will allow you to work. The teacher was also right. A government officer came to the
school and we had a meeting in which the health education programme was established.

Once the programme was established in Jonka, three children’s committees were formed
to address issues of water, health and hygiene. They carry out tasks like checking each
other’s nails and general cleanliness. Through games and awards, children are provided
incentives for good hygiene. In addition, the NGO has promoted numerous community
activities to ensure long-term behavioural change. As part of an awareness-raising activity,
the NGO working in Jonka distributed bars of soap to all the children in attendance.
They were encouraged to wash their hands regularly and were rewarded for doing so.
Even a year after this activity took place, children in the village still carry a bar of soap
in their backpacks and wash their hands regularly.

Although behavioural change among adults in Asansol has been difficult to attain,
sanitation and hygiene education have been strongly promoted in the school. Children
practice sanitary and hygienic behaviours such as cutting their nails, bathing regularly,
covering their food and washing their hands before eating and after defecating. With
regard to children, one of the women’s self-help group leaders stated:

All the girls and young children go to school. Children should be clean and bathed
regularly. Children should be sent to school on time.

In terms of durability and accessibility, the sanitation and hygiene facilities located at
the school in Asansol are the best constructed in the village. The structure is made out
9
Separate toilets for girls have been found to contribute significantly to the retention of female students.
(UNICEF, 2004)

32
of cement and is comprised of two wash rooms and one latrine. All the students use
the facility regularly, as do some of the village residents. In addition, children receive
information about sanitation, health and hygiene in their classes and in turn relay
what they have learned to their parents and the residents of their respective communities.
One student in the village told us that each time she returns home she teaches her
parents about the importance of sanitation and hygiene. Although from a poor family,
the young girl has convinced them to construct a toilet of their own. The emphasis on
WES education for children is likely to instigate and ensure long-term behavioural
changes in the future.

33
Conclusions and Findings

It was evident from the observations and conversations in each of the four villages that
some programmes had been more successful than others. While Sikandra was well on
its way to successful programme implementation, Basmata was indeed the model village
in the sample. However, several features unique to this village – including a small number
of households, social homogeneity (in terms of tribal and caste-based identities), and
strong social cohesion – contributed substantially to the village’s success. Although
Jonka and Asansol have faced considerable challenges, they too have made progress
towards achieving full sanitation. The report concludes with the factors that have both
promoted and inhibited successful (and sustainable) implementation of water, sanitation
and hygiene programmes in the four villages studied. Crucial to this analysis is the
importance of understanding programmatic implementation in context. While the NGOs’
decisions indeed contributed to the outcomes of the programmes, the social, political
and historical contexts in which these organisations operated were equally, if not more,
influential on the degree to which sanitation and hygiene programmes were successful
in each of the four villages studied.

Key drivers of change

Several findings emerged from the villages that most successfully implemented sanitation
and hygiene programmes. The most important element of successful programme
implementation is generating community participation. The team found this to be largely
influenced by the degree to which the community is receptive to new information and
motivated to create behavioural changes. Additionally, the level of community
organisation already prevalent in the community is a contributing factor. Other
determinants include modes of addressing related constraints to programme
implementation (such as water shortages), communication links between the NGO and
community members regarding the nature of the programme and channels of
implementation, and levels of sustained programmatic support by Government and
facilitating NGOs. Perhaps most pressing, is investing in children. The need to establish
and support comprehensive SSHE programmes for village children is crucial to long-
term behavioural change.

34
Table 5: Contributing Factors to Achievement of Full Sanitation Coverage

Access to Water VWSC NGO SHG SSHE Motivation Awareness Use of

Sanitation Avail- Involve- Sanitation

facilities ability ment Facilities

Asansol +/– + +/– +/– + + –/+ – –/+

Basmata ++ + ++ ++ ++ – ++ ++ ++

Jonka +/– +/– +/– + – + – –/+ –

Sikandra + + – ++ ++ ++ – ++ ++ +

– Strongly lacking / completely absent

– / + Minimal community access / awareness / engagement; poor programmatic
implementation and maintenance
+ / – Adequate community access and programmatic implementation; inadequate
facilities / programmatic maintenance
+ Majority of the community with access / awareness / engagement; adequate
programmatic implementation and maintenance
++ 100% community access / participation; full programmatic implementation and
maintenance

Motivation and receptivity to behavioural change are prerequisites for community

participation and contribute substantially to programmatic success and sustainability.
Most importantly, the community must value the projects being implemented and consider
their WES facilities to be a necessary component of daily life. Villages such as Jonka
and Asansol have received WES facilities and have been exposed to sanitation and
hygiene education, but they have not yet achieved full sanitation coverage. In both of
these villages, toilets are not collectively valued for their health benefits and there is no
consensus among villagers regarding the necessity of sanitary defecation. Although some
understood the benefits of sanitation and hygiene practices, the majority of the residents
spoken to in Jonka valued their toilets more for the prestige they brought upon the
household than improvements in their health associated with sanitary and hygienic
behaviours. With the exception of the members in the women’s self-help group, Asansol
residents seemed to be unwilling to take the initiative to change their elimination habits
and continued to defecate in the open.

In contrast, Basmata and Sikandra have been receptive to WES education and the
corresponding behavioural changes. Although Sikandra has achieved partial sanitation
coverage, water availability, rather than collective motivation, has been the most
constraining factor. Basmata has had toilets for only one year, and the entire community
considers them to be a necessity. Although the nearest hand pump is up to 1/2 km from

35
residents’ houses and they must wait in a queue to obtain water, Basmata residents have
made water collection for toilet usage a priority, incorporating two trips to the hand
pump as part of their daily routine. Under these conditions, toilet use (and maintenance
of the facilities) will persist among future generations.

In all cases where behavioural change has occurred, it was accomplished through pre-
existing social structures such as women’s SHGs and community committees. These
enhanced the potential for concerted and efficient behavioural change by:

• Setting a standard for appropriate sanitation and hygiene practices within the
community;
• Facilitating the exchange of information and raising community awareness;
• Serving as a forum for addressing individual concerns and proposing solutions to
problems associated with WES facilities and maintenance;
• Orchestrating the distribution of resources among community members (particularly
in the construction phase of WES programmes);
• Collaborating with third parties (such as Government and NGOs) in monitoring and
evaluation of WES programmes and encouraging sustained investment through all
stages of programme implementation;
• Providing an environment in which community members can reflect on previous
programmes and address future challenges in programmatic implementation.

In Jonka, the absence of political leadership and a village committee made synchronised
and consensual collective action difficult to achieve. Residents were highly divided in
their attitudes towards WES issues and there appeared to be a lack of dialogue around
programme implementation. Basmata, on the contrary, has a history of collective
organisation around common objectives. Women’s SHGs and community committees
enjoy widespread support and participation from village residents. They have served as
a catalyst for change in the community on numerous levels from productive
transformations in agriculture and expansion of income-generating activities to
improvements in quality of life associated with water, sanitation and hygiene practices.
The high level of social cohesion evident in Basmata’s community organisations
engendered acceptance of WES programmes by village residents and allowed for quick
dissemination of information and behavioural changes. Likewise, in Asansol, the only
residents who were consistently using and maintaining sanitary facilities were members
of the women’s SHGs and their families. These groups successfully educated women
on the links between sanitation and hygiene practices and improved health and promoted
behavioural change among this sector of the community. Although a much smaller village,
Sikandra has also made use of its village committees to educate the community in WES
and determine how to best address their water and sanitation problems. These committees

36
generated demand for WES programmes and, because residents are now motivated to
achieve full sanitation, enjoy active participation among community members in
addressing WES problems. As water shortages are the most pervasive obstacle to full
sanitation in the village, the committee has served as a forum for discussing possible
solutions to the problem and ways in which to move forward on WES issues.

Chart 1: Water Sources to Househilds

180 0.1600

160 0.1400
140
0.1200
Households

Number of water
120
0.1000 Water Sources

sources
100
Ratio WS/
0.0800
80
Households
0.0600
60

0.0400
40

20 0.0200

0 0.0000
Jonka Basmata Sikandra Asansol

Indeed, concurrent implementation of water, sanitation and hygiene programmes

may play a significant role in whether or not the community can achieve full sanitation
coverage. While residents of Sikandra were highly motivated to use their newly-built
toilets, they were constrained from doing so in the dry season. During this time, residents
struggled to obtain enough water for consumption. Under these conditions the use of
toilets becomes a luxury rather than a necessity. Similar water constraints were evident
in all of the other villages, to different degrees. If the TSC is to be implemented with
success, villages plagued by annual periods of drought must first (or simultaneously)
address their water problems. Issues related to water accessibility must also be addressed.
The village that has been most receptive to hygiene and sanitation programmes, Basmata,
also has the greatest access to water sources.10 While water accessibility does not
determine programmatic success (e.g., while Asansol has better access to water, Sikandra,
due to additional factors such as community motivation and levels of social organisation,
has displayed greater collective interest in achieving full sanitation), it may indeed play
a role in residents’ attitudes towards achieving full sanitation coverage; if it takes more
time to obtain the water necessary to use their toilets, residents may be more inclined to
continue defecating in the open.

10
In the chart, Water Sources to Households, the bar graph corresponds with the left axis, while the ratio
of water sources to households corresponds with the right axis.

37
The degree to which village residents understood the aims and intended outcomes
of the intervention, including the clarification of roles and responsibilities among
residents and facilitators, proved to be important components of success. As was evident
in Jonka, confusion among village residents regarding the distribution of model toilets
intensified resistance to the programme itself. Toilets were valued among community
members not for their positive effects on health, but as symbols of status in the village.
In this context, the possession of a toilet aggravated pre-existing caste conflicts and
divisions within the community. The NGO learned from this experience and abandoned
the ‘model toilet scheme’ when implementing the TSC in Sikandra. Now equal treatment
is given to all residents to ensure that internal conflicts are neither created nor exacerbated
by the programme.

Investment by government representatives can have a positive impact on the degree

to which a programme achieves participation and ownership by community members.
In Basmata, the Governor of Jharkhand visited the village on two separate occasions
and provided the village with a reeling centre (equipped with reeling machines) in which
women could produce silk as an income-generating activity. As was recognised by the
architects of the TSC (especially with regard to the Nirmal Gram Purushkar award),
investment by government officials is highly valued in rural communities and encourages
proactive behaviour. Such investment cannot be overemphasised as a contributing factor
to Basmata’s successful implementation of water, sanitation and hygiene programmes,
particularly with regard to community mobilisation and participation at every stage of
programme implementation.

Perhaps the most effective assurance of long-term, sustainable behavioural change is

providing children health, hygiene and sanitation education. Jonka and Asansol have
faced numerous challenges in instigating behavioural change among adults. However,
they have focused their attention on SSHE in order to ensure that the young generation
understands the implications of sanitation and hygiene on quality of life and help them
embrace the corresponding behavioural changes. Moreover, the prevalence of sanitation
and hygiene facilities has implications that reach beyond health-related issues. As was
noted above, the presence of separate toilets for girls and boys in schools is a key
determinant of female retention rates. With continued investment in children’s sanitation
and hygiene education, it is likely that these children will enjoy a healthy and bright
future.

It should not be assumed that each of these factors, on its own, determined the degree to
which programme implementation was successful. As has been demonstrated, it was
often a combination of numerous factors, embedded in the specific social, political and
economic contexts of each village that contributed to successful or constrained project

38
implementation. Full WES coverage is undoubtedly an immense task. However, the
four communities in the study yield a number of insights that could be of use to
development practitioners. First, there is much to learn from the challenges and constraints
faced during programme implementation. While these may have initially hindered the
success of the project, these challenges have either been overcome or approached with
caution in future WES projects. Second, those factors that enabled programmatic success
were largely influenced by the degree to which communities were motivated (demand
for the intervention) and had pre-existing social and political structures through which
to generate community support and make decisions. As such, any WES programme
must take into consideration political and social dynamics within communities. If
participation and ownership are to be attained, WES interventions must be tailored to
address the specific challenges and needs of the target community.

39
References

Department of Drinking Water Supply Ministry of Rural Development, GOI (2004).

Guidelines on Central Rural Sanitation Programme / Total Sanitation Campaign.
www.ddws.nic.in.

Dumka District (2006). Official website. www.dumka.nic.in.

Ekka, B. (2005). “Family Planning and Reproductive Health Policy in India”, Jharkhand
Journal of Development and Management Studies: Special Focus on ‘Community
Health, Nutrition, Medical Care, and Education’ 3(1): 1173-1192.

Government of India (2001). Census of India, 2001.

Government of India (2006). Official website. www.india.gov.in.

Government of Jharkhand (2006). Official website. www.jharkhand.gov.in.

Oraon, P.C. ([1961] 2003). Land and People of Jharkhand. Ranchi: Jharkhand Tribal
Welfare Research Institute.

Planning & Development Department, Jharkhand (2006). Jharkhand: A Statistical

Profile-2005.

Prasad, A. (2001). Alleviating Hunger: Challenge for the New Millennium. Delhi: ISPCK.

UNICEF (2005). Mapping India’s Children: UNICEF in Action. Brighton, UK: Myriad
Editions Limited.

UNICEF (2004). Child’s Environment: Programme Plan of Operations 2003-2007. New

Delhi: UNICEF.

UNICEF (2002). Learning from Experience: Water and Environmental Sanitation in

India, New York: UNICEF.

40
Appendix

Impact Model of Sanitation Programmes in Jharkhand

Environment Objective
Health Problems Due to Open Improve Health and Hygiene in Tribal
Defecation and Poor Water Quality. Villages in Jharkhand.

Strategy
Create Awareness and Demand for Sanitary Practices.

Organization
GoI, GoJ, NGOs, VWSC, IO.

Inputs
Latrines, Pumps and Wells
Campaigning, Motivation, Organization,
Advocacy and Selection of Participants

Output
Installed Toilets:
Jonka 164 (100%)
Basmata 14 (100%)
Asansol 49 (100%)
Sikandra 33 (100%)

Impact
· Developing a sense of ownership among village residents
· Village residents manage and maintain facilities
· Time-saving
· Comfort and convenience
· Increased privacy

41
Background Note on the Internship Programme

UNICEF India’s Knowledge Community on Children in India (KCCI) initiative aims to

enhance knowledge management and sharing on policies and programmes related to
children in India. Conceived as part of the Knowledge Community on Children in India,
the objectives of the 2006 Summer Internship Programme were to give young graduate
students from across the world the opportunity to gain field level experience and exposure
to the challenges and issues facing development work in India today.

UNICEF India hosted over 100 interns from India, Germany, Mexico, Japan, Korea,
U.S., U.K., Australia, Netherlands, Switzerland, Finland, Chile, Jordan, Italy and France
to participate in the 2006 Summer Internship Programme. Interns were grouped into
teams of 4-5 and placed in 16 different research institutions across 13 states (Tamil
Nadu, Madhya Pradesh, Rajasthan, Bihar, Jharkhand, Karnataka, Orissa, Uttar Pradesh,
Gujarat, Andhra Pradesh, Maharashtra, West Bengal, Kerala) studying field level
interventions for children from 12 June-23 August 2006.

Under the supervision of partner research institutes, the interns conducted a combination
of desk research and fieldwork, the end result of which were 29 case studies of UNICEF-
assisted Government programmes and other interventions aimed at promoting the rights
of children and their development. Eight of these are supplemented by short films
capturing the reality of children and their families. The case studies cover key sectors
linked to children and development in India, and address important policy issues for
children in India. These include: primary education, child survival, incidence of
malnutrition, elimination of child labour, dimensions of social exclusion and water
and sanitation.

Another unique feature of this programme was the composition of the research teams
comprising interns with mutli-disciplinary academic skills and multi-cultural
backgrounds. Teams were encouraged to pool their skills and knowledge prior to the
fieldwork period and to devise a work plan that allowed each team member an equal
role in developing the case study. Group work and cooperation were key elements in the
production of outputs, and all this is evident in the interesting and mutli-faceted narratives
that these case studies are on development in India.

The 2006 Summer Internship Programme culminated in a final workshop at which all
teams of interns presented their case studies and films to discuss the broader issues
relating to improvements in service delivery, elimination of child labour, promoting
child rights and decentralisation and village planning. The KCCI internship case studies
series aims to disseminate this research to a wider audience and provide valuable
contributions to KCCI’s overall knowledge base.