Sanitation and Hygiene Specialist
Sustainable WASH for All
Until the 1980s, the status of sanitation in Nepal was very alarming. The declaration of the international decade of water supply and sanitation for the period 1981-1990 by the United Nations was instrumental for Nepal to think and start up sanitation activities. In 1980, only 2% of households had toilets whereas it increased to 6% in the 1990s. In 1994, the Nepal government formulated National Sanitation Policy and Guidelines for the Planning and Implementation which was the first sanitation policy in the country. This policy recognized sanitation as a basic right of the people and focused on both software and hardware aspects of sanitation and hygiene. In 1998, the Nepal government Introduced the National Water Supply Sector Policy which laid more focus on the principles of decentralization, empowerment of Water Users and Sanitation Committees (WUSCs) and sanitation as an integral component of water supply projects.
As evident by the data, there was a big gap between the access to water supply and sanitation by 2000. The access to basic water supply in Nepal was 36% in 1990 and increased to 82% in 2000 whereas access to toilets increased to 26% in 2000 from the 6% in 1990.
In 1997, the government formulated a comprehensive 20 year Water and Sanitation Strategies by setting a target of achieving 100% sanitation coverage in the country by 2017 AD, committing to realize the sanitation related targets in line with the Millennium Development Goals (MDGs). The government made its commitment to ensure the access of basic water supply and sanitation services to all households by the end of 2017 through the integrated National Rural Water Supply and Sanitation (RWSS) Policy and Strategy 2004 (HMG, 2004). This was the first policy document that mandated to allocate a 20% budget of the water supply for the sanitation sector activities. The provisioning of the 20% budget for the sanitation sector activities was a big milestone for Nepal and different community approaches emerged to address the alarming sanitation situation throughout the country. The School Sanitation and Hygiene Education Program and National Sanitation Week (NSW) Campaign have been promoted in Nepal since 2000. Similarly, the Community-Led Total Sanitation (CLTS) approach and School-Led Total Sanitation (SLTS) program were introduced in 2003 and 2005 respectively.
As per national data, the access to sanitation increased to 43% by 2010, however, the trend of progress was not enough to realize the target of attaining universal access to sanitation by the year 2017 as committed to by the government of Nepal. By 2010, there were many development partners focusing in the WASH sectors and implementing different projects. As there were different agencies with diverse program modalities, there was a strong need to have sector coordination and harmonization. Realizing all these concerns, the Government of Nepal launched the comprehensive National Sanitation and Hygiene Master Plan in 2011, with the commitment of 6 key ministries having direct downward institutional mechanisms and development interventions and the National Planning Commission as well. The master plan served as the comprehensive sectoral document, to unify stakeholders’ efforts, fulfill resource gaps in the sector, harmonize working procedures and run sustainable ODF and post-ODF (total sanitation) campaigns through the leadership and ownership of local body and multi-stakeholders’ collaboration. The Master Plan also set a target to declare Nepal ODF by 2017.
The 7.6 magnitude earthquake that shook Nepal in 2015 brought the sanitation campaign to a halt for sometime, as it caused the death of 8,790 people and injured nearly 22,300 people. Nearly 500,000 private houses including government buildings were completely damaged and nearly 260,000 private houses including government buildings were partially damaged. The earthquake also caused big damage to the WASH sector and WASH facilities. Nearly 220,000 toilets were completely damaged. With 31 districts affected by the earthquake, the national movement for the sanitation promotion gave way for a shift in priority at the household level, from toilets to the construction of shelter and houses.
After courageously coping with the difficult post-earthquake situation, Nepal aimed to get back on track through reviving and intensifying the sanitation movement. Having declared all districts as ODF, Nepal declared the country ODF on the 30th of September 2019. Karnali province, though it lags behind of all provinces in terms of human development index (HDI) and multidimensional poverty index (MPI), acted as the pioneer for the ODF movement. All the Karnali districts were declared ODF by June, 2018 almost one and half year before the country was declared as ODF.
The 15th plan of the government of Nepal (FY 2076/77-2080/81- 2020/21-2024/25 AD) has the goal to ensure access to basic toilets for 99% of households. Further, the government recommitts to continue and increase the focus on Total Sanitation. In line with the SDG 6, Nepal’s goal is to attain 95% household access to improved toilets, while ensuring that ODF status is maintained in all communities.
For sanitation, the global coverage has increased from 47% in 2015 to 54% in 2020 but at current rates of progress the world will only reach 67% coverage by 2030, leaving 2.8 billion people without safely managed services. Achieving universal access to safely managed services by 2030 will require a 4x increase in current rates of progress (15x in least developed countries and 9x in fragile contexts). for sanitation.
As Nepal has committed to ensure access to improved toilets for 95% of the households by 2030, it seems difficult to realize the target, as it has been observed that the rate of the slippage has been an increasing trend across different geographies. The SUSWA baseline, which was conducted by surveying a representative number of households in 42 municipalities in the Karnali province in September, 2022 revealed that 8% households don’t have toilets whereas 17% of households are using temporary toilets. The percentage of households using shared toilets stands at 2%. This means that approximately 27% households in SUSWA working area in Karnali need either to construct or improve their toilets in order to have improved sanitation. The data reveals that sanitation related interventions are required in more than every fourth household, either for new construction or for the improvement of the toilets. If hygiene is considered, intensive interventions will be required for every second household. It is assumed that there is a significant number of toilets throughout the provinces which merely fall under safely managed sanitation services though they are observed or reported as improved toilets.
As state restructuring and enactment of the legal instruments for the local governments have been in progress and the second tenure of the elected representatives has been started, the palikas from the Karnali province are envisioned to take a proactive role to be the pioneer for the promotion of sanitation and to ensure safely managed toilets as envisaged by the national plan and the SDG as well.
The deadly diarrheal and cholera outbreak that occurred in Rukum, Jajarkot, Dailekh and other districts in the Western Part of the Country in 2009 have remained an unforgettable and painful story in the country, that no one wants to see repeated. Fortunately, due to the realization and leadership on sanitation, the construction and the improvement of toilets on the part of the communities and the back up support from the sector agencies, the situation has luckily significantly progressed since then. The integration of promotional activities on education, health, nutrition and vaccination with water, sanitation and hygiene has significantly decreased the number of deaths of children under the age of 5 due to water and sanitation borne disease.
Despite this, globally 297,000 children under five (800 per day), and about 1000 children under five a year in Nepal die from diarrhoeal diseases due to poor sanitation, poor hygiene, or unsafe drinking water. These deaths are preventable.
Almost half of the schools in the world do not have handwashing facilities with soap and water available to students. Clean and safe toilets help keep more girls in school and increase attendance rates. Far too many girls miss out on education just because of the lack of a clean and safe toilet. (WHO/UNICEF 2020). Over half of the global population or 4.2 billion people lack safe sanitation. (WHO/UNICEF 2019). For every $1 invested in basic sanitation, the return is $2.5. And in the case of basic sanitation in rural areas, every $1 returns on average more than $5 in saved medical costs and increased productivity. (Hutton et al. 2015). A clean and safe toilet ensures health, dignity and well-being — yet 40% of the world’s population does not have access to toilets.
It is pragmatic to have a set of activities that have been designed based on the learnings and the ones that fits with the local socio-cultural aspects. There seems to be an intensive need to create a package forpost(ODF) triggering in order to mobilize communities and stakeholders on the benefits and areas for improvement, market based sanitation supply chain, which ensures viable and tested inclusive technological options, as well as the important enabling policies and enforcement packages. The interventions will require improved financial mechanisms and improved supervision and monitoring mechanisms to track the progress.
There are many promising WASH projects in Karnali and together the capacity of the local governments will be enhanced for improved ownership and leadership for the sanitation. The only aspect required from the development agencies will be to have the improved coordination, collaboration and concerted efforts to realize the results at scaler reaching the unreached and the vulnerable in the provinces that are lagging behind of development indices.