lesson plan 6 implementation case [read · pdf fileintroduction • international ngo based...

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Clear Cambodia

HWTS Option: Biosand Filters

Target Population: 5 provinces, Cambodia

Impact: Implemented 67,161 filters as of the end of October 2010; another 5000 filters sold to NGOs and local government

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Introduction

• Local faith-based NGO

• Mission to transform water quality, sanitation and health in target communities by making appropriate technology and education accessible to all

• Samaritan’s Purse has fully funded all of Clear’s work, and in addition, actively provide programmatic support

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Current Details

• Current project start date: January 2010

• Target: Install 15,600 biosand filters

• Working in 5 provinces:• Kampong Thom

• Prey Veng

• Svay Rieng

• Kampong Chhnang

• Pursat

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Creating Demand

• Conduct promotion meetings in target villages

– Schools and general community groups

– Meet twice (promotion and health education)

• Use variety of tools and communication methods• Posters, leaflets, booklets, videos, presentations

• Train Community Health Promoters • Volunteers selected by village leaders• Trained by Hagar and apprentice with their staff• May be contracted later for monitoring or follow up

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• Successes

– 150,000 filter requests

• Challenges

– Meeting the demand is beyond programme capacity

• Lessons Learnt

– Collaboration with local leadership and community meetings are crucial entry points

– People request a filter when they understand, accept and value the technology, and know why they get sick from contaminated water

Creating Demand

150,000 Requests for Filters

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Supplying Products and Services

• Employs Cambodian staff to manufacture and distribute

• Uses travelling teams that transport moulds and tools to temporary work sites

• Spends several weeks in the village until demand has been satisfied

• Most construction materials are found locally

– Filtration sand is centralized to ensure quality control

• Households contribute labour under staff supervision

– Mixing concrete, washing sand

– Transport filter to their home

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• Full cost of filter and safe storage container = US$60– Includes transport, labour, education and follow up visits

• Sell at full cost to other NGOs and government groups

• Subsidize filters for the poor

1.Contribute US$4 to partially pay for the cost of the filter

2.Contribute labour (e.g. mixing concrete and washing sand)

3.Transport the filter to their house

4.Attend the BSF promotion meeting, the health and hygiene promotion meeting, and follow-up visits

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• Lessons Learnt

– Important to ensure quality of filtration sand

– Need to have households invest at some level to accept and value the filters

– Households sign a contract committing to proper use and maintenance


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Monitoring and Improvement

• Follow up visit schedule to monitor subsidized filters:

– 1st visit - 1 month after installation

– 2nd visit - 3 months

– 3rd visit - 6 months

– 4th visit – 12 months

• Currently done by paid Community Health Promoters

• Information used to consider what should be implemented next

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• Challenges

– Monitoring filters purchased at full cost

– Cannot monitor individual households located far from the project area

• Lessons Learnt

– When an individual household wants to purchase a filter, should cluster with at least 5 households in the same area

– Makes it more cost effective for Clear to do follow up visits


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Programme Financing

• Samaritan’s Purse has fully funded all of Clear’s work, and in addition, actively provide programmatic support

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RDI Cambodia

HWTS Option: Ceramic Pot Filters

Target Population: Cambodia

Impact: Implemented 60,000 filters

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Introduction

• International NGO based in USA

• Implemented projects to provide safe water to rural villages

• Since 2003, manufacturing and distributing Ceramic Water Purifiers

• Started on small scale to develop manufacturing techniques

• Scaled up and in 2007 distributed 24,000 filters

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Creating Demand• Creates own education materials

– Instruction brochure, posters, flip charts and video

• Developed key messages to ensure correct use and maintenance

• Engage village Group Leaders to increase support

– Given 1 free filter to use themselves and 10 filters to sell

• Targets schools

– 2 free filters for classroom and 1 free filter for teacher’s home

– Teachers are responsible for maintaining classroom filters

– Use a letter of agreement

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• Lessons Learnt

– User education is one of the most important aspects of implementation

– Filters more likely to be used by households that already have some knowledge of water, sanitation, and hygiene

– Very important for uptake to have the support of the local leaders (e.g. village Group Leaders, teachers)

Creating Demand

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• 1 year to develop product requirements, manufacturing process, and maintenance instructions

• RDI manages factory themselves

– Employ local skilled staff

• Distribution

– Direct to individual users from factory

– Direct to NGOs and government agencies

– Mobile marketing and education teams

– 26 retailers and 1 distributor (full cost recovery plus profit)

• Cost to produce 1 ceramic filter = US$7

• Retail cost to users = US$8, US$2.50 for filter element

• Sells 23,000 filters/year at full cost

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Ceramic Pot Filter Construction

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• Challenges

– Other NGOs and government purchasing filters from RDI who distribute them free or subsidized

– Could negatively impact the overall commercial market that RDI has created

• Lessons Learnt

– Need to have households invest at some level to continue using their filters

– Supplying support services to households is essential for the on-going and proper use of filters


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• Monitor manufacturing to ensure product quality

• Track filters sold

• Manufacturing and education methods continually reviewed and improved

• Largest water quality tester in the country

• External evaluations by Water and Sanitation Programme -Cambodia

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Programme Financing

• Costs are recovered through individuals and donors

• Costs are partially recovered through filter sales to users, NGOs and government agencies

• Encourages international volunteers

Eawag & International Relief and Development

HWTS Option: Solar Disinfection (SODIS)

Target Population: Lao PDR

•3 pilot districts in 3 provinces

•1,200 households

•30 schools

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Introduction

• Eawag: Provides technical assistance and support to IRD

• IRD: International NGO based in USA

• Phase 1: 20 communities in Khammouane province

• Phase 2: Started May 2010, 3 pilot districts in 3 provinces

• Collaboration with National Centre for Environmental Health and Water Supply (Namsaat)

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Creating Demand• Raise awareness with households

and schools

• Namsaat trains their health staff who then train volunteer community promoters

• Variety of education tools and methods– Demonstration units

– Banners, posters, stickers

– Role plays

• Community promoters do follow up visits with households and schools

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• Lessons Learnt

– Pilot project was effective: 44% people used SODIS

– Not all people use SODIS regularly or exclusively

– Overall demand may be higher, limited bottles in some remote village

Creating Demand

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Challenges:

•Limited availability of plastic bottles in remote villages

•Entrepreneurs not interested in bottle supply systems

– No profit and users not willing to pay

Lessons Learnt:

•Initial free distribution of bottles created expectations for regular bottle supply

•Not sustainable for long-term use of SODIS

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• Monitoring done during household visits by community promoters and IRD staff:

– Number of SODIS users

– Number of bottles used

– Reasons for using / not using SODIS

• Surveys also conducted on water sources, treatment methods, hygiene behaviour, and diarrhoea incidence

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Programme Financing

• Promotion and education activities funded by Swiss foundation

• Nam Saat contributes staff time for training and follow up

• Household contributes time or money to collect bottles

• Private sector involvement unlikely since no opportunity to earn profit

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Population Services International (PSI)

HWTS Option: WaterGuard Chlorine

Target Population: Myanmar

• Children under the age of five

• Caregivers

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Introduction

• Largest social marketing NGO

• 1995 - Started working in Myanmar

• 2001 - Introduced household water treatment

• WaterGuard chlorine solution, safe water storage and hand washing

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Social Marketing

• Uses marketing theories and techniques to influence behaviour in order to achieve a social goal

– Similar to commercial marketing, except that the goal is not to maximize profits or sales

• Tries to understand who people are and what motivates them

• Then manufactures, distributes and promotes products and services to meet their needs and motivations 31

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Creating Demand

• Targets young children and caregivers

• Work at household, small group and village levels

• Use mass media and health education

• Interpersonal Communicators (IPC)

– Paid staff

– Communication sessions

– Edutainment with mobile video units

• Sun Primary Health Providers (SPH)

– Community health promoters

– Selected from community

– Conduct household visits

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• Lessons Learnt

– Media exposure of the target population is low

– Peer-to-peer recommendations and word-of-mouth have proved more effective in creating demand

Creating Demand

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• Locally manufactured and packaged by outsourced supplier

• PSI distributes throughout the country using non-traditional and traditional outlets

• Different prices depending on where it is sold– 70% subsidized when sold by IPC or SPH in rural areas

– Full cost through retail outlets in urban and peri-urban areas

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• Challenges

– Distributors reluctant to stock large quantities because of limited shelf life

– Breaking bottles during delivery

• Lessons Learnt

– Subsidies increase consumer demand

– Need to balance subsidized prices with retailers’ need to earn a profit

– Free distribution by other organizations reduces the willingness to pay


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• Quality control during manufacturing

• Follow up visits to households

• Follow up visits to retail outlets to monitor availability and expiry dates

• Research to better understand target group

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• Challenges

– Some confusion about the correct dosage and mixing instructions

– Some users also fail to read the instructions on the product


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Programme Financing

• International donor funding subsidizes:– Manufacturing

– Distribution

– Retailing

– Promotion and education

• Government provides lower rates for WaterGuard television commercials

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PATHSafe Water Project

HWTS Option: Chlorine (Aquatabs)

Target Population: Low income households and those with children under the age of 5 in Mekong Delta, Vietnam

Impact: 2,000 households since 2008

Introduction

• International non-profit organization

• Creates sustainable, culturally relevant solutions, enabling communities worldwide to break longstanding cycles of poor health

• Mission is to improve health by:

1. Advancing technologies

2. Strengthening systems

3. Encouraging healthy behaviors

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Introduction

• Objectives of Safe Water Project are to:

– Explore the effectiveness of commercial strategies to provide household water treatment and safe storage (HWTS) in Vietnam

– Use market-based approaches to complement efforts by the government, NGOs and socially minded commercial enterprises

Current Pilot Details

• Start date: October 2010

• Project size: 4,200 households

• Completed activities: 2 trainings on WASH and interpersonal communications, 21 social marketing events in 21 communes

• Target: Poor households and those with children < 5 years

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Creating DemandSocial Marketing

Events

Household Visits

Frequency Once in each commune Monthly

Marketing Materials Leaflets, posters, samples of Aquatabs,

and free storage containers to half of the

communes

Leaflets, flipbooks

Who leads? Health station workers Health station workers

Demonstrations Yes Sometimes

Creating Demand: Successes

• 63 Health Station Workers (HSC) completed 2 day training on WASH and sales techniques

• 63 HSC are able to promote HWTS at communes

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Creating Demand: Challenges

• Complaints that the old Aquatabs in prior pilot have a distinct taste and smell

• People are concerned about long-term side effects

• HSC may be too busy to conduct monthly household visits

Creating Demand:

Lessons Learnt• Comprehensive intervention necessary

(buy in from all parties)

• Need to build capacity of HSC

• Participation of private sector and applying business principles are vital

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Supplying Products & Services

• Medentech manufactures Aquatabs in Ireland

• HSC instruct consumers on correct use during social marketing events and households visits

• Cost to consumer: 1,000 VND per tablet

• Consumers pay full cost of product

• Not all households have appropriate storage containers


• Distribution

Medentech

Zuellig Pharma

DMC

Communes

Households

Manufacturer

Regional Distributor

Inventory Warehouse

Sales Staff

Consumers

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Successes:

• New distribution channel: Aquatabs is now available at the commune level

• HSC can communicate WASH messages and instruct households on appropriate use of HWTS


Challenges:

•Low demand / product unknown

•Constrained by project budget

•Costs may not be feasible for commercial scalability

•Not locally produced

•Global crises can usurp supply of Aquatabs; redirected to other countries

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Lessons Learnt:

•Provide sales tools to aid HSC early in their work (e.g. flipbooks, games)

•Ensure enough HWTS product is available prior to pilot launch



• Product quality ensured because of blister packaging

• PATH team will accompany HSC during monthly household visits

• HSC required to submit sales reports

• Abt Associates will conduct endline survey near the end of pilot

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Building Human Capacity• Different roles:

– HSC

– DMC representative

– Reporting Consultant

• 2-day training: WASH and sales

– Pre- and post-training tests

– Interactive discussions and games

Programme Financing

• Major donor: The Gates Foundation

• Private sector partner (Zuellig Pharma) absorbs distribution and some marketing costs

• Cost recovery unknown at this time

• Major costs include:

– Creating demand

– Marketing

– Distribution

– Reporting requirements

lesson plan 6 implementation case [read · pdf fileintroduction • international ngo based...

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