Blog

Dramatic rise in sanitation uptake in Zambia

L Markle
Akros Research
 Correspondence: Laurie Markle (LMarkle@akros.com)
Download PDF

Citation style for this article: Markle L. Dramatic rise in sanitation uptake in Zambia. Health Press Zambia Bull. 2017;1(4), [Inclusive page numbers]

Access to water and sanitation and uptake of good hygiene practices can reduce the risk of getting diarrhea by an estimated 30%. Since diarrhea is the world’s second leading cause of death and the leading cause of malnutrition and stunting in children under five [1-3], finding ways to reduce the diarrheal burden is essential to the health and wellbeing of Zambians.
Community-Led Total Sanitation (CLTS) is used in developing contexts around the world to improve sanitation in rural communities. Under the CLTS model, communities take stock of their own defecation practices and collectively make a decision to end open defecation by building and using household latrines. Under the CLTS model, communities work together to build low-cost latrines using locally sourced materials and are responsible for maintaining these latrines.
The CLTS model can be powerful in terms of driving behavior change. However, the data collection systems typically used to monitor whether communities are building and maintaining latrines are slow and error prone; the resulting information is insufficient to measure progress. The lack of timely and reliable data makes it nearly impossible to follow-up with communities that are lagging behind and/or champion communities that have embraced the use of latrines. In Zambia, Akros has supported the former Ministry of Local Government and Housing (MLGH) and UNICEF to resolve this data issue.
In 2014 the MLGH introduced a Mobile to Web (M2W) platform to collect and aggregate the CLTS data. Using simple technology, volunteer community champions submit latrine construction data using a mobile phone on a monthly basis. These data are creating the ability for government, chiefs and communities to see their progress towards better sanitation practices. The platform has expanded to include water access monitoring so that government officials can take monthly stock of community-level water access and know when pump minders are needed in the field.

Chief Singani of Zambia’s Choma district shows the tablet he uses to keep tabs on his chiefdom’s sanitation progress. The leadership of chiefs and chieftainesses in Zambia equipped with real-time data has helped drive the country’s sanitation agenda
One key component of the CLTS M2W model is the Chief’s Visualizer Tool. Chiefs are provided tablets equipped with a widget or mobile application that delivers sanitation reports of the Chief’s land. Since the chiefs are the key agents of behavior change in rural Zambia, being equipped with real-time data on the performance of the villages within their chiefdom allows them to make judicious use of limited fuel and monitoring resources to place pressure on villages that may be underperforming [4]. This goes hand-in-hand with one of the main CLTS principals of communal resolve to improve the health of yourself and your neighbor.
In Zambia, the introduction of CLTS M2W saw 1.5 million new users of sanitation in the first 18 months of implementation and has helped to declare three districts as open defecation free. This level of sanitation uptake is such a short period of time is unprecedented [5].
Akros has continued to work with the MLGH (now called the Ministry of Water Development, Sanitation and Environment Protection) to support roll-out of the system in Zambia.  The system currently receives data from over 1,900 community champions across 67 districts. Although the CLTS platform is the largest of its kind in Zambia, Akros has also supported the design and implementation of information systems for health, education and agriculture in Zambia. For more information about Akros in Zambia, please visit www.akros.com.
References

  1. Bhutta ZA, Ahmed T, Black RE, Cousens S, Dewey K, Giugliani E, et al. What works? Interventions for maternal and child undernutrition and survival. Lancet. 2008;371(9610):417–40.
  2. Fewtrell L, Kaufmann RB, Kay D, Enanoria W, Haller L, Colford JM Jr. Water, sanitation, and hygiene interventions to reduce diarrhoea in less developed countries: a systematic review and meta-analysis. Lancet Infect Dis. 2005;5(10:42–52.
  3. Black RE, Cousens S, Johnson HL, Lawn JE, Rudan I, Bassani DG, et al. Global, regional, and national causes of child mortality in 2008: a systematic analysis. Lancet. 2010;375(9730) :1969-87.
  4. Zimba R, Ngulube V, Lukama C, Manangi A, Tiwari A, Osbert N, et al. Chiengi district, Zambia open defecation free after 1 year of community-led total sanitation. Am J Trop Med Hyg. 2016;95(4):925-7.
  5. Markle L, Maganani A, Katooka O, Tiwari A, Osbert N, Larsen D, Winters B. A mobile platform enables unprecedented sanitation uptake in Zambia. PLoS Negl Trop Dis. 2017; 11(1): e0005131. https://doi.org/10.1371/journal.pntd.0005131.