2000 CHN: End-of-Cycle Evaluation Report of the Environmental Sanitation and Hygiene Education Projects
Author: Luong, T. V.; Wang, J.; Chen, Y.; Bao, X.
The Water Supply and Environmental Sanitation Porgramme (WES) is based on a two-pronged strategy: one at national and providincal levels to contribute to policies and strategy development and to the acheivement of NPA goals; and one at the sub-provincal levels to demonstrate the benefits of integrating safe water supply, improved sanitation and hygeiene education package. The WES programme area were selected in 14 counties of 6 provinces. In 1999, three new porject rpovinces were selected for this initiative to accelerate sanitation coverage.
Purpose / Objective
The primary objective is to evaluate the quality, effectiveness and sustainability of the programme as well as its contributions to the achievement of NPA sanitation goal. The outcomes would be used as guidance for the implementation of the next programme cycle, 2001-2005.
The Evaluation is based on a desk review of relevant reports/documents and field assessment. Desk review includes the review and analysis of end-cycle project reports of the project counties and provinces, policy papers, programme documents and related studies and research reports submitted by the project provinces and counties.
The sanitation team visited selected project counties in 4 provinces Xinjiang, Gansu, Anhui and Liaoning. Project sites, schools, health centres, and households were visited. Interview/Meeting/Discussion were held at project sites and at the head offices of the county and province with community members, concerned officers and government leaders/functionaries at all levels.
Key Findings and Conclusions
The evaluation team found that the project objective and target have been achieved during the project period. Most project counties have achieved more than 40% coverage of the NPA sanitation goal through UNICEF inputs as seed to
generate the catalytic effect. During the five years project period, through governments' own initiative, support and financial investment as well as people contribution had created a momentum on acceleration of sanitation coverage in
the eight project provinces, resulting in a total of 26.64 million sanitary latrines built and used. In addition, the project provinces have built 248,318 sanitary latrines in schools, health centres and public areas to benefit the students and local inhabitants with government inputs. The Chinese government is expecting to achieve 40% national sanitation coverage by 2000.
The steady progress of the projects was attributed to a large extent to the following factors:
· Strong political commitments on the achievement of the NPA sanitation goal at all levels
· The establishment of WES project implementation committee and office at province, county, township and village levels with assigned officers/personnel responsible for project management, implementation and monitoring
· Availability of financial allocation from governments of all levels and contribution from the communities
· Intensive social mobilisation to motivate leaders to take action and to encourage people at grassroots for behaviour change.
Over the past five years, the project had built up the capacity of the government functionaries and project personnel on both technical and social mobilisation aspects in the project provinces on project management and implementation through training and study visits. Thus, the project provinces/counties have formulated a strong project implementation team at each level to carry out the tasks.
China has proved the capability of improved rural environmental sanitation and hygiene on her own initiation, capacity and determination. The external support from UNICEF has been considered as catalyst to stimulate the chain effect in acceleration of coverage.
Although most project provinces have not evaluated the quality of training and the capability of the resource trainers, the performance of trained government functionaries at all levels are found satisfactory, in general, based on the steady progress and the positive behaviour change of the people and the demand created on sanitary latrine during project period.
Through the acceleration of sanitation coverage, intensive social mobilisation and hygiene education in the project provinces and in the nation as a whole, the project has achieved positive impacts on:
· Behaviour change of the rural people to be clean - clean hands, clean clothes, clean children and clean house compounds are observed in many rural households/villages.
· Demand to build and use sanitary latrine and clean environment - Peoples attitude on sanitary latrine has changed from "you have to change" to "I want to change". Flies and maggots are largely reduced in the house compounds and in the community. No longer heard of young children falling into the traditional pit latrine ever since sanitary latrines were built in villages.
· Health benefits - Filth-born diseases incidence was reduced to some extent in project areas. Families reported spending less on medical expenses.
· Economic gain - The use of higher fertiliser value of well-digested sludge from the sanitary latrine to the vegetable garden/farmland had produced higher yield of farm products. Thus, family income would increase through the saving of money for chemical fertiliser and selling more farm products. Farmers now consider that building a sanitary latrine at home is as if having a "family fertiliser factory." Private sector participation in the promotion of environmental sanitation is gradually being involved. Large numbers of self-employed, skilled masons have been trained to build sanitary latrines for families in rural areas, thus speeding up meeting people' demand. Several factories have developed and produced some innovative latrine devices for its easy use and simple maintenance. Some factories produce sanitary latrine parts such as ceramic pan and urns using local available materials and new technique to improve the quality, thus shortening construction time and reducing the construction cost. The "foot operating-water saving high-pressure water flushing device" produced by a factory in Liaoning is found practical and hygienic. Such device is welcomed by users and is being promoted.
Gender issue is quite balanced in the project implementation. In fact, female involvement in decision-making, planning and social mobilisation at all levels is quite unique. Many females are county governors, directors of PHCCO who are directly responsible to make decisions on programme implementation. More than one third of the resource trainers and trained personnel, including from the grassroots, on project implementation, are females.
China promotes various types of sanitary latrines in the rural areas to suit the vast geographic areas, various climatic conditions and the people' culture and belief. The types of these sanitary latrines are double urn, three-compartment, YIP and biogas. The design criteria of these latrines meet the Chinese Government' standard. The cost of one such sanitary latrine ranges from RMB 300 for double urn latrine to RMB 3000 for biogas type. The government adopts a subsidy scheme for sanitary latrine construction considering the weak local economic capacity as all project areas are selected from national and provincial poverty counties. In general, people' contribution is more than 50% of the latrine cost. Although many project areas have come up with meaningful ways of reducing the cost of sanitary latrine, the major concern is the project sustainability and its scale up in the long term, if such subsidy scheme is to continue.
Many project provinces already reported that the limitation of government funds is the major constraint for slow progress. There is a need to gradually reduce the government subsidy for latrine construction and to generate financial resources from the community if sanitation coverage is to accelerate in China.
Several improvements on sanitary latrines have been developed to simplify the installation and for easy use and maintenance by users. The team found the following technical weaknesses in some of the sanitary latrines built in some provinces that need urgent action to be taken to rectify the defects especially in the provinces where many latrines built were having such weaknesses:
- Pig waste/manure is discharged into the sanitary latrine where pigs are raised for augmenting the family income or for family consumption.
- Some three-compartment septic tanks have only two compartments and a hole on the two compartment walls is fixed instead of an incline overflow pipe.
- Oversized three-compartment septic tanks.
Such technical weaknesses would affect the degree of safety on sludge digestion, thus polluting the environment and minimising the health benefit when the sludge is used as fertilizer in the field. If technical support were not given in time, there would be wastage of huge financial investment from the government and the people. Besides, the projects would be de-credited and the trust of the people would be lost.
The government of the project provinces has adopted a surveillance system to monitor the progress against target set at each level. The system has an in-built quality inspection component adopting "build one - inspect one -accept one". Such approach is effective provided that the inspectors at the field level are well conversant with all technical aspects of all types of sanitary latrines built in the area. It seems that the quality issue is focussing on masonry workmanship rather than on the correctness of sanitary latrine design criteria especially the underground compartment, where the weakness was found.
Programme Approaches for Sustainability:
- The scope of the programme needs to expand beyond safe water, sanitation/hygiene to include safe disposal of garbage and household wastewater, food hygiene, healthy schools, healthy households and clean environment for healthy children, and linkage of clean environment to tourism industry to stimulate local economic growth
- Keep up the Momentum for Acceleration of Sanitation Improvement -- Continue to support some of the on-going 11 project provinces in the next project cycle, 2001-2005, in addition to the newly selected project provinces. Built the modalities of support need to be modified depending on the needs.
Long-term Capacity Building :
- Institutionalise the Training Need -- Establishment of the National and Provincial Training Centre/Network at appropriate institutes for long-term, cost-effective and sustained capacity building on both technical and social mobilisation aspects as suggested by some provinces and recommended by the Mid-term review.
- Strengthen Technologies Options to Assure Environmental Safety -Establishment of a Sanitary Technology Advisory Committee/Team at central, provincial, city and county levels to provide technical support to the field in solving various sanitary technical problems encountered.
- Build-in the Subjects of Rural Environmental Sanitation and Health Education into the Curricula of "Continuous Medical Education " -- All government functionaries and professional personnel who are engaging in the field of public health works should learn and be fully conversant of such knowledge and skills, thus enabling the acceleration of progress and quality improvement of environment.
School Sanitation for Clean Environment and Behaviour Change:
School sanitation activities should be implemented in all schools in project provinces. Provide safe water supply and sanitary latrines in all schools and ensure its proper usage and maintenance.
Areas for Further Research:
- Continue the study on re-infection of the de-wormed school children in Yongjing county, Gansu province to evaluate the health effect of built and use sanitary latrine, improved hygiene and cleanliness of the environment.
- Long-term systematic collection of gastro-intestinal disease data on mortality and mobility in selected project areas and control areas to study the trend of such disease reduction in relating to the use of sanitary latrine and behaviour change.
- Study on the reduction of schistosomiasis infection in a fishing village (Hekou village, Qingyang county, Anhui province) where all families in the entire village have built and use sanitary latrine and safe water supply is also available.
-Study on the different types of latrine promoted in semi-urban and small town areas and its relation to local economic growth. The study is to assess the suitability of latrine types based on people' need and change of life style as economic growth, and whether a need to provide certain appropriate services that could solve the problems on safe handling and disposal of the collected sludge.
- Study to provide technical advice on the innovative devices for sanitary latrines developed by the private sector for its effectiveness, durability and weakness that need to improve.
- Study to improve the design capacity of a sanitary latrine underground compartment (double urn and three-compartment types) to incorporate the mix treatment of animals' (pigs/chickens) waste and human excreta for warm and cold climatic conditions where families raise pigs/chickens for income generation.
- Study on worm eggs survival rate in the sludge compartment of urine separate latrine and dry latrines in various climatic conditions (warm to extremely cold) of wide geographic locations in China (from south, central and far north province) to ensure that the environment and farmlands are not polluted.
Full report in PDF
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