PROMISING PATHWAYS

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4 PROMISING PATHWAYS Iovatios ad Best Practices i CLTS at Scale i Madagascar Towards a Ope Defecatio Free Coutry Kirsty Milward s Sisir Pradha s Katherie Pasteur Foreword by Kamal Kar

5 CLTS Foudatio Registered Office: R-109, The Residecy City Cetre, Salt Lake City Kolkata , Idia Admiistrative Office: CB 88, Salt Lake City Kolkata , Idia Website: CLTS Foudatio This book has bee published by CLTS Foudatio joitly with CLTS Foudatio Global ad Fods d Appui pour l Assaiissemet à (FAA) Madagascar. All rights reserved. No part of this publicatio may be reprited or reproduced or utilized i ay form or by ay electroic, mechaical, or other meas, ow kow or hereafter iveted, icludig photocopyig ad recordig, or i ay iformatio storage or retrieval system, without the writte permissio of the publishers. Cover Photo: Kamal Kar Prited ad boud i Idia by Hyam Eterprises, Kolkata

6 v The Global Saitatio Fud (GSF), a programme of the Water Supply ad Saitatio Collaborative Coucil (WSSCC), supports the Miistry of Water policies ad efforts to improve sustaiable access to basic saitatio ad practice good hygiee. The GSF focuses o promotio, social marketig ad awareess buildig, particularly for wome, girls ad the poor i rural ad iformal settlemets. I Madagascar, Medical Care Developmet Iteratioal (as the Executig Agecy) maages GSF implemetatio through grats to NGOs. O behalf of WSSCC, the Executig Agecy moitors ad reports o implemetatio ad impact. Australia, the Netherlads, Swede, Switzerlad, ad the Uited Kigdom have cotributed to the Global Saitatio Fud. CLTS Foudatio, based i Kolkata, Idia strives to create a world free from ope defecatio ad with zero cotamiatio, through improved hygiee practices. It works towards collective behaviour chage which ca produce a clea ad healthy eviromet for all ad empowered local commuities. Evetually this process has bearig o sustaiable improvemet i livig stadards ad digity for all, ad i upholdig the safety of wome. The CLTS Foudatio works through a iteratioal team of professioals, practitioers, researchers ad policy experts to build capacity ad ifluece policy for ehacig access to saitatio through CLTS. This publicatio was made possible through support provided by the Fods d Appui pour l Assaiissemet à Madagascar, a saitatio programme fuded by the Global Saitatio Fud. The opiios expressed herei are those of the authors ad do ot ecessarily reflect the views of the GSF or WSSCC.

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8 vii CONTENTS Authors Ackowledgemets Acroyms Foreword Executive Summary xii xii xiv xv xxv 1. Itroductio Why Madagascar? How ca the FAA Madagascar experieces be used? Research methodology Structure of the documet ad readig guide Establishig a eablig istitutioal eviromet Effective structures for programme implemetatio The Diorao WASH Evolvig role of the Programme Coordiatig Mechaism Stregths of the Executig Agecy Capacity buildig for sub-gratees A learig eviromet Dyamic strategies ad iovative models for achievig chage at scale The U approach: Systematic leveragig of istitutioal advatage for scale Istitutioal Triggerig Direct support from the sub-gratee i the scalig up process Expadig the base of implemetig actors Natural Leaders Commuity Cosultats Champios BCC experts, local techicias, masos Moitorig committees ad the follow up push (madoa) Collaboratios across a rage of actors to reach scale Collaboratio betwee sub-gratees ad Diorao WASH Collaboratio betwee sub-gratees ad other implemetig actors i saitatio 66

9 viii Promisig Pathways Collaboratios betwee SGs ad the regioal ad district admiistratio Collaboratio with schools, churches ad other local actors Leveragig traditioal structures ad cultural processes Active ivolvemet of traditioal leaders Uderstadig the authority structure the Ampajaka Workig to chage custom Usig sogs as a vehicle for spreadig the message Participatory techology developmet ad challegig the prototypes The FAA approach to techology improvemet ad the saitatio ladder Buildig o available techology optios Iovatios for techology adaptatio Breakig the iertia caused by subsidy Buildig a learig orgaisatio Mechaisms for systematic sharig of best practices Creatig model villages as local kowledge hubs Recogisig ad creatig space for exchage of techological kowhow Capturig ad commuicatig health outcomes Trackig kock-o effects beyod saitatio Use of media tools for wider outreach Workig Towards Sustaiability Recogitio of the beefits of the programme by the commuity Buildig o Commuity Cosultats, Natural ad Traditioal Leaders Capitalizig o istitutios ad their actors at local level Advocacy at local level Creatig robust istitutioal arragemets to esure sustaiability Workig through Diorao WASH Cotiued decetralisatio of Diorao WASH Establishig widespread kowledge ad commitmet to esure quality at scale Coclusio 129 Aex 135

10 ix SPOTLIGHTS Spotlight 1: Commuity Led Total Saitatio 8 Spotlight 2: Extedig the reach of the Diorao WASH 20 Spotlight 3: The chagig role of coaches 27 Spotlight 4: Picture of a local level Istitutioal Triggerig 44 Spotlight 5: Sub-gratee MIARINTSOA NGO s direct support iputs i the scalig up model 49 Spotlight 6: Success strategy i Vatovavy Fitoviay AINGA MADAGASCAR NGO 64 Spotlight 7: Actor coflicts ad the magic of the Diorao WASH: MAMIZO collaborates i Atsiaaa Regio 66 Spotlight 8: School saitatio liks i Itasy Regio 71 Spotlight 9: Key strategy: Triggerig the Tagalamea 74 Spotlight 10: Reivetig traditio: the Diorao WASH argues the case for latries 76 Spotlight 11: Challeges of scalig the saitatio ladder: a picture from Atsiaaa 85 Spotlight 12: Solvig techology problems: Desigig a light ad strog model i Itasy Regio 88 Spotlight 13: CLTS success where subsidy failed: Maakakora village, Ifaadiaa District 93 Spotlight 14: Wome, me ad childre catalogue the beefits of ODF i Vatomadry District 110 Spotlight 15: Soaambo: the woder fruit to mitigate huger durig food scarcity periods 111 Spotlight 16: From OD zoe to eatery 114

11 x Promisig Pathways LESSONS LEARNED Lessos Leared 1: Establishig a eablig istitutioal eviromet 19 Lessos Leared 2: The WASH Coalitio 21 Lessos Leared 3: A atioal decisio-makig body: the PCM 24 Lessos Leared 4: The role ad features of the Executig Agecy 26 Lessos Leared 5: Resposive capacity buildig 29 Lessos Leared 6: Usig a culture of shared learig to solve problems 31 Lessos Leared 7: Applyig a scalig-up strategy 41 Lessos Leared 8: Istitutioal Triggerig 48 Lessos Leared 9: Direct ad idirect itervetios ad support 50 Lessos Leared 10: Facilitatig large umbers of actors 62 Lessos Leared 11: Local ad regioal collaboratio 73 Lessos Leared 12: Egagig with the resources of culture 79 Lessos Leared 13: Realities of the saitatio ladder 86 Lessos Leared 14: Local approaches to the saitatio ladder 91 Lessos Leared 15: Workig with commuities which received free saitary hardware 94 Lessos Leared 16: Sharig ad learig 100 Lessos Leared 17: Model villages 101 Lessos Leared 18: Local iovatio for adaptatio 107 Lessos Leared 19: Moitorig health outcomes 109 Lessos Leared 20: Trackig kock-o effects 114 Lessos Leared 21: Maximizig commuicatio 117 Lessos Leared 22: Ehacig sustaiability 127

12 xi PROFILES Profile 1: Profile of Agela, a Natural Leader 52 Profile 2: Profile of a Commuity Cosultat: Etiee Radriariso, Vakiakaratra 54 Profile 3: Doatie: Leader of the co-operative of Commuity Cosultats i Aalajirofo 56 Profile 4: Picture of a Champio: Bejami Zafialy, Fokotay Chief, Salehy Commue, Atsiaaa Regio 57 Profile 5: Better collaboratio would beefit everyoe: Iterview with the Director, Water, Saitatio ad Hygiee, Atsiaaa Regio 68 Profile 6: A ew FamoPlat user: Fidy i Itasy Regio 90 Profile 7: Migrat farmer to settled farmer: the case of Remi 112 FIGURES Figure 1: Madagascar i relatio to the Africa cotiet, ad Madagascar s 22 Regios 4 Figure 2: Key structures of the GSF programme i Madagascar 16 Figure 3: Evolutio of the FAA programme for scalig up CLTS i Madagascar 18 Figure 4: Structure of the Diorao WASH i Vatovavy Fitoviay Regio 21 Figure 5: The dyamic role of the PCM 23 Figure 6: The decliig eed for coaches for achievig ODF status 28 Figure 7: Summary of phased chages i the coach system 29 Figure 8: The istitutioal scalig up process of sub-gratee MIARINTSOA NGO 37 Figure 9: Multi Factor collaboratio ad actio framework i Vakiakaratra Regio 42 Figure 10: ODF Villages, Natural Leaders ad Commuity Cosultats 51

13 xii Promisig Pathways Figure 11: Example of the Ampajaka hierarchy i Vatovavy Fitoviay Regio 76 Figure 12: Cases of diarrhoea i Ampefy Health Cetre, Itasy Regio 108 Figure 13: Cases of diarrhoea ad dysetry, Sahamatevia Commue, Atsiaaa Figure 14: Actors ivolved i various phases of CLTS facilitatio: a example from ASOS 123 Figure 15: Steps towards sustaiability evidet i the FAA programme126 TABLES Table 1: ANNEXES: Rakig of istitutioal actors i Ampasime Maatsatraa Commue List of key persos i FAA 137

14 xiii Authors This study has bee carried out ad writte by Kirsty Milward, Sisir Pradha ad Katherie Pasteur of CLTS Foudatio with guidace ad iputs from Kamal Kar. Writte iputs were also made by several key members of the FAA team ad sub-gratee represetatives i Madagascar durig a faceto-face meetig to fialise the fidigs of the study i February Ackowledgemets The authors sicerely ackowledge the valuable cotributios made by Dr Joséa Ratsirarso, Dr Rija Lalairia Faomeza, Dr Joelia Ratefijaahary, Dr Fao Lovatiaa Radriamaatsoa, Dr Jeremia Rakotozafy, Dr Oisoa Ridra Ralidera, Dr Aimé Radriamaalia ad all MCDI staff. Special thaks to Mrs Michèle Rasamiso, Chairperso of the PCM of FAA programme i Madagascar, to all PCM members, ad to the Miistries of Water, Health, Educatio, Decetralisatio, ad Eviromet for their valuable cotributios. We also thak Clara Rudholm, Matilda Jereck ad Mark Willis of GSF for their cosistet support, ad MCDI home office staff. Special thaks go to all respodets to this research at local levels who hosted our visits with such warmth ad edurace: thaks to sub-gratee staff at MIARINTSOA NGO, MAMIZO NGO, AINGA Madagascar, ASOS NGO, ADEMA NGO, FAMONJENA NGO, ad to all of those may commuity members who welcomed us ito their villages ad aswered our may questios. Lastly, we are grateful for all support ad iformatio give by Jea Herivelo Rakotodraiibe, Diorao-WASH Natioal Coordiator ad to the Regioal WASH coalitio teams i Vakiakaratra, Atsiaaa, Aalajirofo, Vatovavy Fitoviay ad Itasy Regios. Ad fially, we are deeply grateful for Jea Clémet Adriamaampisoa, traslator ad cultural advisor, without whom little of the followig would have bee uderstood. We apologise for ot beig able to metio here the ames of may others who cotributed directly or idirectly to the study but we thak them for all their efforts ad iputs.

15 xiv Promisig Pathways Acroyms AR BCC CC CHW CLTS CWCC CPM DWCC EA FAA GSF HAT IEC INGO MCDI MDG NGO NL OD ODF PCM SG WASH WSSCC Ariary Behaviour Chage Commuicatio Commuity Cosultat Commuity Health Worker Commuity Led Total Saitatio Commue WASH Coalitio Committee Coutry Programme Moitor District WASH Coalitio Committee Executig Agecy Fod d Appui pour l Assaiissemet Global Saitatio Fud High Authority of Trasitio Iformatio Educatio Commuicatio Iteratioal No-Govermet Orgaizatio Medical Care Developmet Iteratioal Milleium Developmet Goal No-Govermet Orgaisatio Natural Leader Ope Defecatio Ope Defecatio Free Programme Coordiatig Mechaism Sub-Gratee also kow i Madagascar as AMO (Agece de Mise e Oeuvre, or implemetig orgaisatios) Water, Saitatio ad Hygiee Water Supply ad Saitatio Collaborative Coucil

16 Foreword Kamal Kar It is a pleasure to put o record here that the work of scalig up CLTS by a group of committed istitutios ad idividuals uder the Fods d Appui pour l Assaiissemet (FAA) programme i Madagascar, ad the progress made over the last three ad a half years, is simply outstadig. This work eeds to be shared for the beefit of may coutries i Africa ad Asia. The publicatio of this documet, Promisig Pathways, which shares this recet experiece ad iovatio, is especially timely because there are ow less tha eightee moths before the MDG time limit is over, ad most coutries i Africa are off-track o targets for saitatio. I sicerely feel that some of the scalig-up strategies ad approaches used i the FAA programme i Madagascar, if backed by a strog political will, offer other coutries i Africa the possibility ot oly of achievig their MDG saitatio target, but also of movig closer to achievig ODF atios. I was persoally ivolved i the itroductio ad iitial scalig up of CLTS i more tha 30 coutries i Easter, Souther, Cetral ad Wester Africa, startig with the first pa-africa hads-o traiig workshop i Dar es Salaam, Tazaia followed by aother i Awasa, Ethiopia i The spread of CLTS all over Africa has bee fasciatig ad expoetial ad has overtake Asia both i terms of area coverage, quality ad iovatio. Madagascar is oe of the few coutries i Africa, which I visited more tha oce ad redered hads-o traiig, post-traiig follow-up, advocacy ad istitutioal hadholdig support. My first visit was i 2011 for a review of practice of CLTS o the groud, early itroductory traiig ad capacity buildig followed by advocacy support at differet levels for quality scalig up. While coutries like Zambia, Malawi, Ethiopia, Keya, Sierra Leoe, Mali ad Chad have bee able to make remarkable progress over the last seve years or so, I am simply overwhelmed to see the outcome of FAA s iitiative i Madagascar i just over three years. Whe I ask myself what the uique features of this programme have bee, ad what are the factors that have eabled it to move forward so steadily, two sets of factors stad out i my mid. Oe is the importace of istitutioal attitudial features. That is, how policy decisio-makers ad practitioers demostrate flexibility, chage ad adaptatio, ad how they

17 xvi Promisig Pathways draw upo commuity-led elemets to steer the programme ahead i their ow spotaeous ways. Secod, is the pheomeal maer i which these macro-level ad micro-level factors dyamically iteracted ad acted upo each other to cotribute to the exemplary success of the programme. While the commuity-level factors will be highlighted at a later stage, I will start with fleshig out the five key macro elemets of the programme which are: 1) Uique ad iovative GSF fudig mechaism, i which implemetatio by a umber of small ad large sub-gratees is facilitated by a i-coutry Executig Agecy (EA) recruited through a global biddig process. 2) Strog focus of the atioal level coordiatig body, the Programme Coordiatig Mechaism (PCM), a uique platform for all major stakeholders of saitatio i cojuctio with the Diorao WASH, the WASH coalitio i Madagascar. 3) Utmost sicerity with which actors i the programme received my traiig, capacity buildig ad advocacy iputs, iteralized them, ad brought them ito their practice. 4) High levels of flexibility displayed by may actors i adoptig the ew learig i the programme as experiece accumulated ad learig emerged. 5) Very high levels of commitmet of the 17 sub-gratees of the FAA programme workig i 14 regios, ad their success i attractig ad ivolvig local govermet leadership at fokotay, commue, district ad regioal levels. I relatio to the first poit, it must be added that globally, 11 coutries are implemetig GSF programmes usig at least four differet kids of executig agecies: govermet, INGO, cosultig compaies ad UN agecies (e.g. UNICEF, UN-Habitat). However, at the time of writig, evidece suggests that progress made by the FAA programme i Madagascar i terms of the umber of people livig i ODF eviromets has bee greater 1 tha i ay other GSF coutries, ad is the most advaced i the GSF portfolio i terms of stregtheig istitutioal likages, the developmet of Natural Leaders ad the promotio of local iovatio. It appears that the uique qualities of the fudig mechaism may be a ecessary coditio, but caot be a sufficiet coditio for achievig these levels of potetial i the programme. 1 Accordig to the Global Saitatio Fud Progress Report 2014 (upublished), the umber of people livig i ODF eviromets i the GSF coutries as of December 2013 is Ugada: 750,000 ad Madagascar: 840,000. I the majority of the GSF coutries, the umber varies betwee 206,000 ad 470,000.

18 Foreword xvii Therefore the role played by each of the ext four key macro-elemets may well be critical factors, although they may ot be complete aswers. These four features speak to a mixture of capacity, attitude ad approach ad to the eablig eviromet for CLTS. I feel certai that these features were istrumetal i achievig results, ad that if it is possible for these features to drive such sigificat achievemets i a coutry with so much diversity ad complexity, the it is possible for them to brig about results at scale i other coutries as well. For this reaso, I wat to reiterate that great thigs are possible i CLTS whe capacity buildig is truly backed by the right eablig eviromet ad supported by a flexible fudig mechaism that esures that the skills ad kowledge gaied are implemeted immediately. The flexibility of GSF s fiacig mechaism, icludig tools ad implemetatio guidelies, have greatly eabled the Mecaisme de Coordiatio du Programme (MCP) ad the Executig Agecy (EA) to implemet, cotiuously evaluate ad icorporate the learigs ito the programme so that it fits well with the Madagascar cotext. As suggested above, a iterestig feature of the programme has bee its promptess i icorporatig ew learig, ad its ability to costatly readjust the approach. For istace, the FAA programme started origially with six large sub-gratees, eleve small sub-gratees ad thirtee coaches i By the ed of 2013, this had chaged to a total of thirty sub-gratees, both large ad small, ad the discotiuatio of the coach system due to sub-gratee staff surpassig coaches i terms of kowledge ad skills. While ew sub-gratees were added ad the fudig amout was doubled for successful sub-gratees ow ruig extesio grats, some sub-gratees were also discotiued due to poor performace. This is clearly a approach that ecourages performace efficiecy with rewards ad pealties, ivolvig costat readjustmet. Proactive maagemet coupled with costat eeds assessmet, self-evaluatio of performace, capacity developmet ad techical backstoppig, has geerated a positive ad healthy competitio amog sub-gratees which has led to expoetial progress. This study, which sets out to uderstad the uique features of the FAA Madagascar programme, distil the learigs from it ad documet its iovatios, was iitiated i Jue 2013, whe a three-member CLTS Foudatio team carried out a extesive review of various cotours of the FAA programme ad a i-depth aalysis ivolvig a umber of actors from the grassroots to the atioal level. I was persoally ivolved i guidig the team ad providig iputs to ehace the rigorous documetatio process. This study will be a useful documet to support

19 xviii Promisig Pathways CLTS scale-up i Madagascar ad cotais may isights which ca be put ito practice i other GSF implemetig coutries. But beyod this, I believe it will also be a ispiratio to other Aglophoe, Fracophoe, Lusophoe ad Spaish speakig coutries rollig out CLTS across the world. As metioed earlier, the areas i which this documet eriches global kowledge o CLTS ad illumiates the future pathways of the approach are substatial. I particular, iovatio ad experiece has bee gaied i the areas of: a) Commuity-led spread of CLTS. b) Participatory techology developmet. c) CLTS as a etry poit for livelihoods improvemet ad poverty eradicatio. d) Creatio of platforms for effective istitutioal collaboratio ad coordiatio. While each of these factors are remarkable, I would like to highlight the emergece ad istitutioal egagemet of Natural Leaders (NLs) ad Commuity Cosultats (CCs); ad the participatory developmet of locallyappropriate techology as havig bee especially path-breakig. With respect to the commuity-led applicatio, iovatio ad especially spread of CLTS, I have always firmly believed that CLTS should have a i-built mechaism to evolve ito a commuity-led extesio (or scaligup) process. It is ofte misuderstood that this would egate the role of the govermet ad NGO frot-lie extesio staff ivolved i WASH. Further, there is a widespread miscoceptio that the CLTS approach does ot value the applicatio of scietific ad techical kowledge. I wat to emphasise that both these beliefs are far from the truth. First, govermet ad NGOs have a very importat role to play i CLTS as process facilitators ad catalytic agets i truly empowerig ad egagig the commuity so that NLs ad CCs ca spotaeously emerge from the hudreds ad thousads of ODF villages i differet districts, regios ad states; thus wideig the web, stregtheig the operatios ad forgig creative parterships that brig together i ew ways the local govermet ad social orgaizatios at the commuity level. Secodly, i relatio to the applicatio of professioal techical kowledge, I would like to emphasize, especially to my frieds ad colleagues, that egieerig skills ad experiece is of crucial importace, particularly whe the commuity s collective behaviour chage begis to occur, ad the demad for more durable ad efficiet toilets start to grow withi the commuity. The kid of iovatio i techology that sprigs from this process is pheomeal as people gai a appreciatio for the

20 Foreword xix importace of saitatio ad create saitatio solutios that are available locally ad at low cost. The implicatios for scale are obvious. The crux of CLTS lies i creatig a eablig eviromet i which the commuity is allowed to develop the leadership ad cofidece required to become selfreliat ad to be able to say with ier belief, We ca do it without outside help. I other words, the trick of truly empowerig the commuity lies i doig away with a top-dow prescriptive approach, right from the time of triggerig, ad istead, allowig the commuity collectively to aalyse their problems ad solve them. This requires a careful sequecig of social ad techical itervetios. I this approach lie the aswers to critical questios about ODF sustaiability as well as that of quality scalig-up. I other words, the CLTS approach paves the way for a paradigm shift from a outside agecy-led scalig-up process to oe that is coceived ad led by the commuity i every way, such that outside agecies oly play a supportive ad facilitative role i the trasformatio. To a great extet, such a process has bee witessed i Madagascar ad great examples of the fasciatig work accomplished by NLs ad CCs have bee documeted here. A secod very importat commuity-led iovatio that has emerged i Madagascar is that of participatory techology developmet. I have bee stressig this factor for may years ow, as I believe that it is a critical idicator as well as a outcome of commuity-based empowermet strategies withi CLTS. Whe such participatory techological iovatios emerge from withi a large-scale programme, the chaces of scalig-up are always higher, as compared to it beig developed withi a small-scale pilot study or research settig. I must metio here that the FAA programme i Madagascar provided us the ideal cavas o which we could start sketchig this success story. Give a cotext that was ot etirely marred by other itervetios, we were able to strategically itroduce CLTS ad cosciously itegrate elemets of participatory techology developmet ad commuityled scalig up i a systematic way, without missig out o ay essetial liks or strategies that were ecessary i producig the required outcomes. May ispirig examples of participatory techology developmet are documeted i this book. The cocept that CLTS ca be used as a powerful etry poit for livelihoods improvemet ad poverty eradicatio captures the widely uused ad utapped potetial of CLTS that focuses o outcomes beyod saitatio ad hygiee. This was aother area of excellece that shoe through i the FAA programme, ad the iovatios made i this aspect are highlighted i this publicatio. A importat lesso that emerges from

21 xx Promisig Pathways the FAA programme is that the potetial of CLTS to act as a catalytic lik to other developmet outcomes is possible oly whe the programme is well embedded withi the commuity ad is able to use the stregth of scores of NLs ad CCs. I Madagascar, for example, a remarkable example of ehacig livelihoods ad icomes is reflected i the iitiative by clove farmers to strategically sell their produce at a premium based o the fact that their cloves were produced i ODF villages. Ad last but ot the least, the emergece of a uique mechaism of istitutioal collaboratio ad coordiatio that emerged at the levels of fokotay, commues, districts ad regios i Madagascar has bee truly exemplary. The cetral idea that shapes this istitutioal model emerges from the eed to shift to coutig ODF fokotay, wards, commues ad parishes, etc. istead of oly ODF villages for a effective scalig-up process. This is importat so that a healthy istitutioal competitio esues betwee the local govermets of fokotay, commues, districts ad regios, which the iitiates ad motivates further triggerig ad follow-up actio. O the other had, whe the focus is o ODF villages aloe, oly traditioal leadership at the village level is ivolved ad the elected people s represetatives are missed. A systematic attempt was made i Madagascar to tap the potetial of istitutios by focusig o ad coverig all villages withi a fokotay, all fokotay withi a commue ad all commues withi a district. CCs ot oly played a very importat role i such admiistrative area-wide ODF coverage but later were also icorporated as importat members withi the local govermet structure. All these iovative features are captured i detail i this book. This effective model of istitutioal collaboratio ad coordiatio has also eabled a few sub-gratees to evolve as specialist istitutios i producig ODF areas. For example, ASOS, the sub-gratee i Aalajirofo, emerged as champios i developig NLs ad CCs. They have also developed excellet skills i istitutioal collaboratio ad coordiatio at the commue ad fokotay level. Similarly, sub-gratee CSGV i Ambilobe ad the regioal admiistratio of DIANA regio have developed skills i istitutioal triggerig. DIANA is the oly regio amogst the fourtee regios uder the FAA programme i Madagascar that have developed a clearly laid out milestoe for a ODF regio. I ve had first-had experiece of facilitatig the process of istitutioal triggerig with the seior officials of the regio i all the four districts icludig the sub-gratee CSGV i Ambilobe. Additioally, the sub-gratee FAMONJENA i Itasy has emerged as a uique istitutio i ivetig low-cost improved toilets usig locally available materials ad producig a excellet prototype. A ew dyamic

22 Foreword xxi approach of faster scalig-up of CLTS developed by Miaritsoa, a subgratee i Vakiakaratra regio, has prove to be very powerful i brigig both the commuity ad istitutioal actors together. This approach was successfully replicated by other sub- gratees. The FAA programme i Madagascar has bee GSF s very first coutry of itervetio i Africa, ad the opportuity to experiece ad lear from the systematically itroduced aspects of CLTS, such as those of commuityled scalig up, participatory techology developmet, creatio of etry poits for wider livelihood improvemets ad poverty eradicatio, as well as buildig of platforms for effective istitutioal collaboratio, have emerged for the first time. I am delighted to kow that GSF is committed to applyig the learigs ad kowledge geerated from the FAA programme i their ew programme itervetios, such as i Bei ad Nigeria. This book is a ladmark cotributio to the repository of global kowledge o CLTS ad I hope it will be traslated ito other major laguages for the beefit of CLTS practitioers globally. The kowledge from the FAA programme has also bee captured ad documeted i a series of four learig videos: (1) From OD to ODF, (2) Istitutioal Triggerig, (3) Saitatio Ladder ad (4) Growig Beefits; which I agai hope will be widely dissemiated for learig purposes. It has bee possible to carry out this work of distillig learig from field practices because of the deep iterest of the may people ivolved i the implemetatio of the FAA programme ad support from GSF ad WSSCC. The commitmet of several idividuals to deliverig their roles ad resposibilities to the maximum extet possible has made the FAA so special. At the ed of the day, it is more tha systems ad structures but the huma beigs ivolved i creatig ad sustaiig the programme that have made all the differece. The cotributio ad professioal support provided by Clara Rudholm, GSF Programme Officer based i Geeva has bee absolutely remarkable ad uique. The sicerity ad commitmet with which Clara has supported the build-up of the programme from its embryoic stage is of a rare kid. She has bee thoroughly supportive through all the stages, with a flexible ad ope mid, willig to lear from the ew experieces geerated ad to icorporate these learigs ito the fuctioig of the programme at all levels. Whe I was approached by Clara for help ad support o capacity buildig ad advocacy o CLTS durig the Global Forum o Saitatio ad Hygiee i Mumbai i October 2011, I was ot sure if it would be possible for me to travel to Madagascar to support this programme

23 xxii Promisig Pathways immediately. But i spite of commitmets to other coutries i Africa ad Asia, I foud myself arrivig i Ataaarivo, Madagascar a meltig pot of Africa ad Asia withi a couple of moths. Ad at this poit, I foud myself faced with what was surely a worryig CLTS situatio. There were gaps i the capacity ad uderstadig of CLTS amog EA staff; there were miscoceptios amog sub-gratees; ad the coaches who were primarily resposible for capacity buildig amog sub-gratees had received just oe traiig two years previously ad had o experiece of CLTS practice o the groud. Here I would like to metio the ames of three i-coutry architects of the FAA programme: Mrs. Michèle Rasamiso, Presidet of the CPM; Dr. Joséa Ratsirarso, Coutry Represetative of MCDI; ad Dr. Rija Faomeza Lalairia, FAA Programme Director whose commitmet ad professioalism was key i turig aroud the programme ad makig it a success after its iitial slow start. It should be metioed here that all the seior staff members of the EA i Madagascar are medical doctors by professio, ad i spite of beig from a health disciplie, the way i which they effectively maaged to coordiate with all the seior officers of the Miistry of Water who had professioal egieerig backgrouds, is truly commedable. Michèle, who is oe of the seior-most professors of Egieerig i the coutry, played a pivotal role i coordiatig ad bledig these cross-discipliary perspectives, easig the tesios arisig thereof, ad workig towards the larger beefits of the FAA programme. Joséa s great leadership backed by Rija s maagerial skills, perseverace ad commitmet eabled the sub-gratees to iovate as well as deliver tagible results withi a strict timeframe. I November 2011, whe I visited Madagascar for the first time there were less tha te ODF villages. As of May 2014, Madagascar has 9,059 ODF villages; 1,082 ODF fokotay ad 34 ODF commues. It is difficult to ascertai the exact umber of NLs ad CCs workig formally ad iformally towards a ODF atio, but I ca cofidetly say that there are several thousads of them. I have persoally see the quality of work doe by some of these self-motivated idividuals ad would like to make a special metio of Doatie i Aalajirofo regio, who is a CC ad is doig extraordiary work i this area. I am simply overwhelmed to see the deep uderstadig of CLTS that has bee gaied by people like him ad by key persos from some of the sub-gratees, their frotlie staff, govermet officials ad those from other formal ad iformal istitutios, ad the magificet chage i the quality of work doe by all these idividuals over the last three ad a half years.

24 Foreword xxiii The FAA programme i Madagascar presets itself as a woderful learig laboratory for CLTS programmes i other coutries. O my recommedatio, some of the traiers from the FAA programme were set to other Fracophoe coutries i Africa, for example, Bei, to trai ad build capacities of the sector practitioers there. Similarly, officials from the govermet ad UNICEF i coutries such as Togo, Bei ad Zambia, etc. visited the FAA programme i Madagascar. I strogly believe that the o-goig saitatio programmes i Madagascar should also take this opportuity to lear from the FAA programme ad brig about ecessary chages withi their ow CLTS programmig. A learig exchage iitiative ivolvig policy makers ad practitioers from various agecies ad differet coutries could thus work woders towards replicatig the success of the FAA programme i other CLTS programmes. The few cross-coutry learig programmes that have bee iitiated ivolvig key resource people are already begiig to show positive idicatios of a systematic CLTS itervetio. O my visit to Bei early this year, I was amazed to see the uderstadig ad isight of the CLTS approach gaied by Achille Kagi, the Chef du Service Promotio de l Assaiissemet de base et Appui Coseil aux Commues (Head of Basic Saitatio Promotio ad Support to Commues), who is i charge of saitatio i Cotoou i Bei. Achille Kagi had bee o a study visit to Madagascar with two other seior sector practitioers to lear about the istitutioal coordiatio mechaisms of the GSF supported CLTS programme implemetatio there. He took the kowledge gaied back to Bei to iitiate the process of istitutioalisatio of CLTS withi the Miistry of Health, ad to iclude it i the atioal strategy, elimiatig all sorts of subsidy approaches. Durig a recet atioal traiig workshop orgaised by him i Bei, he ivited practitioers from Madagascar to support him i the process ad made sure that other miistries ad some prefects from differet regios of the coutry were fully ivolved. These are the foudatio steps towards effective istitutioalisatio of CLTS. Bei is thus about to begi its CLTS jourey o a right footig, with the strog backig of GSF support ad a lot of good lessos from Madagascar. The FAA programme i Madagascar o its part has embarked o its secod phase of CLTS implemetatio, ridig high o its great success durig the first phase, which has rightly eared it the cofidece ad substatial additioal fudig support from GSF. The FAA programme is ow workig towards ehacig its istitutioal collaboratios by brigig may more istitutios ito its fold ad iitiatig a atio-wide ODF campaig that will cover all the regios of the coutry. This strategy will ivolve istitutios

25 xxiv Promisig Pathways at the lowest level of the local govermet, remaiig true to the CLTS spirit of puttig people at the cetre of all the activities. I will ed here with oe last poit. I take great pride i the success that the FAA programme has bee able to achieve, more so because it has ot bee a smooth-sailig jourey for all those who were ivolved. The programme was faced with all the challeges ad threats that could exist i a complex eviromet i ay coutry, i this case some of them beig Madagascar s regioal ad ethic diversity, the presece of a trasitio govermet, iadequate ifrastructure, the impact of ecoomic ad social crisis, difficult access to markets, etc. Ispite of all this, the fact that Madagascar made it, re-affirms my belief that chage might be difficult but it is ever impossible. As I have always said, CLTS is ot rocket-sciece; what it deserves to succeed is persoal, professioal ad istitutioal chage i attitudes. Our trust ad cofidece i the ability of the local commuity to chage is key to the success of CLTS. Whe this is accompaied by sicere political will ad backed by the right istitutioal support, othig ca stop true trasformatio from takig place. I hope that this book will trigger the emergece of a few more Madagascars i Africa ad evetually, i the ear future, a ODF Africa cotiet. What follows is a remarkable story of the features ad attributes that grew out of a upromisig positio ito the flourishig, excitig ad remarkably successful programme that we see today. I hope you ejoy readig it.

26 Executive Summary This documet is oe outcome of research ito the process ad practices of Commuity Led Total Saitatio (CLTS) as implemeted by the Global Saitatio Fud (GSF) programme i Madagascar kow as the Fods d Appui pour l Assaiissemet (FAA). This is oe of the first programmes strogly egagig with the challeges of scalig up CLTS, ad results are emergig as strikig: i three ad a half years, the FAA programme has achieved 7007 Ope Defecatio Free (ODF) commuities; 728 ODF fokotay (sub-commue level uits) ad 15 etire ODF commues. The research o which this documet draws aims to uderstad the factors behid FAA Madagascar s emergig success, teasig out the details of why ad how particular strategies are cotributig to the scale-up process. It is clear at the outset that this promisig process has ivolved creatig a eablig eviromet for CLTS implemetatio, capitalizig o emergig experiece, ad sometimes developig features ew to CLTS. Of particular ote, the FAA i Madagascar has begu to make the fudametal shift from aimig for ad coutig ot just ODF villages but ODF commues ad districts. This has ivolved settig a process i motio that does much more tha use a few orgaisatios or a govermet departmet to implemet a CLTS project: it sets out to create a atio-wide movemet i saitatio; oe that ackowledges the eed to address ad ispire everybody. This documet therefore offers sapshots of the Madagascar GSF experiece i CLTS to a wider audiece. Madagascar had all the usual atioal level challeges that geerally block or slow dow the pace of scalig up ad spread of CLTS. As i most coutries, part of the struggle has bee successfully to replace the age-old, subsidy-drive partial saitatio approach. How some of these challeges have bee addressed ad trasformed ito a apparetly sowballig strategy has bee thematically preseted here. The primary purpose is to provide evidece-based ispiratio, i the first istace to other coutries usig, or begiig to use, the GSF fudig mechaism to achieve saitatio goals, but also to other exterally fuded large saitatio programmes usig CLTS ad startig to scale up. I the spirit of faith i local level ability to solve problems, the documet aims to icrease the quatity ad quality of the idea bak for practitioers at all levels, for adaptatio ito local cotexts.

27 xxvi Promisig Pathways The istitutioal eviromet Elemets ad features of a positive istitutioal eviromet for CLTS i Madagascar take the form of structural features of the implemetig framework, ad attributes or cultural dimesios of the implemetig eviromet. Key structural compoets of the programme are: The Programme Coordiatig Mechaism (PCM), a support body established by the GSF to help desig, coordiate, oversee ad advise the coutry programme ad to maximise syergies betwee the GSF ad the atioal govermet. The Coutry Programme Moitor (CPM), a idepedetly appoited agecy which verifies ad reports o the work of the Executig Agecy. The Executig Agecy (EA), Medical Care Developmet Iteratioal(MCDI), which maages the fuded programme ad selects, supervises, ad supports sub-gratees (SGs). The sub-gratees, NGOs which directly implemet the programme i the FAA targeted areas, ad ow umber 17 i total. The dyamic relatioship with Diorao WASH, the WASH Coalitio i Madagascar. From the outset the Diorao WASH was the lead parter for the GSF i establishig the FAA i Madagascar ad it cotiues to play a importat role i coordiatio ad moitorig alogside the PCM. It has emerged as a key resource i scalig up, which has bee draw o for support at the regioal level. Key attributes ad cultural dimesios of the programme which have cotributed to good practice iclude: Flexibility ad a spirit of learig o the part of the EA. Experietial learig has played a importat role: there was a clear ackowledgmet at the programme desig stage that it was uclear what shape ad form this would take, ad it would therefore have to emerge. A commitmet to collaboratio across the implemetig structure, icludig developig a eviromet of sharig amogst the subgratees. Resposive capacity buildig, which has evolved i strategy i accordace with chagig circumstaces ad demad. Elemets of gradual support ad reward, such as movig from a small grat to a larger grat whe sub-gratees succeed, which has

28 Executive Summary xxvii promoted the replicatio of good practice ad esured the ability to elimiate poor performers. A culture of iovatio ad experimetatio which is based i cotiually seekig improvemet; a absece of complacecy; ad a firm focus o the overall visio which is to be made operatioal. Parterships at all levels (GSF-FAA; EA-SG; SG-village committees/actors) which use a model of clear objectives ad framework but cosiderable freedom/flexibility withi these regardig choice of strategies to achieve objectives. Scalig up Strategies for scalig up have ecessarily ivolved iovatio. Takig CLTS to scale has bee take o as a serious challege i Madagascar, ad there was early recogitio that the stadard liear progressio of makig villages ODF eeded to be tured ito a expoetial progressio i which the process would spread orgaically via icreasig umbers of ODF commuities ivolved. I the absece of a clear precedet, FAA has sought spaces for sharig successful or promisig strategies betwee differet subgratees with the result that strategies have cross fertilized ad begi to have commo themes. Strategies for scalig up all revolve aroud the cetral realisatio that oe orgaisatio caot do it aloe. Notable elemets of the mai model promoted for replicatio iclude the strategic selectio of locatios for direct itervetio through a cocerted selectio process ivolvig key idividuals at each admiistrative level. This takes place durig a preparatio period which begis to brig i ifluetial actors. This is followed by buildig a strog foudatio through direct village triggerig i strategic locatios ad brigig these to ODF. Next, local actors emergig from this foudatio process are facilitated to trigger ad follow up i surroudig locatios. Key to workig at scale has bee ivolvig large umbers of local actors who ca ifluece their etworks, iitially workig with these through a techique of Istitutioal Triggerig, i.e. gatherig actors together for a geeralised triggerig to garer support for a wider process. Triggerig istitutios to mobilise their ow efforts ad resources for implemetig CLTS is cetral to esurig that CLTS ca be achieved at scale ad to the shift from we (FAA) do it to let s all do it together. A powerful additio to triggerig tools for these exercises has bee the use of live testimoies from recetly ODF commuities.

29 xxviii Promisig Pathways I the process of ivolvig large umbers of actors, the FAA programme i Madagascar has also ivolved creatig CLTS actio roles at differet levels, ad empowerig local actors to step ito these roles, assistig i implemetatio of CLTS i their eighbourig commuities ad beyod. These roles iclude Natural Leaders, who have ot oly supported the ODF process i their ow villages, but also draw o this experiece to spread the word ad actio to eighbourig areas. Commuity Cosultats are selected from Natural Leaders who have gaied experiece locally ad put this to work more widely across the district. I oe case, a orgaisatio of Commuity Cosultats has also bee formed to facilitate this process, ad i others a few Commuity Cosultats have bee absorbed ito the subgratee orgaisatio more formally, as techical specialists such as Behaviour Chage Specialists. Champios are also familiar characters i CLTS. What is ew here is the active ature i which they are beig sought out, built up, ackowledged ad groomed ito the role by the catalyst sub-gratee actors. Priority has bee give to fidig the right level of reliable but hads off support to all these kids of actors from experieced practitioers as they progress. Buildig moitorig committees to do follow up work ad evetually to be ivolved i ODF verificatio processes has also bee a importat strategy to icrease coverage. Makig collaboratios really happe at all levels has also bee a cetral strategy, as these become the basis for ivolvig sufficiet umbers to scale up. Examples i Madagascar have icluded wi-wi collaboratios betwee sub-gratees ad Diorao WASH, parterships with other NGOs to idetify ad work to stregths, collaboratios betwee villages to support CLTS spread, ad collaboratios betwee sub-gratees for metorig ad learig purposes. A vital elemet of the success stories takig place i Madagascar has bee the ability of differet orgaisatios to leverage traditioal structures ad cultural resources ito the CLTS process. A commo isight across several sub-gratees has bee the recogitio that traditioal leaders hold authority that ca be tapped i a useful way, ad ideed that they ca be key gatekeepers to the success of a CLTS process. Traditioal leaders have i geeral bee brought o board through some versio of Istitutioal Triggerig, ad followig this, progress to ODF for the whole commuity has usually bee remarkably rapid. The mai criterio geeratig this speed was whether all of the relevat authority figures had bee brought o board. Esurig this has ivolved fully uderstadig how the traditioal leader hierarchy works i each differet cotext.

30 Executive Summary xxix Ivolvig traditioal leaders ad aligig the power of these structures with CLTS objectives has bee a way of embeddig saitatio more deeply ito social ad cultural life. A secod strategy with a particular focus o cultural life has bee the use of sogs ad sog groups to covey saitatio messages. Groups of childre have leared saitatio sogs; wome s groups perform saitatio sogs; traditioal sigers ad sigig groups are requested to compose sogs o saitatio; ad competitios are arraged betwee differet groups to keep their messages alive ad make their reach wider. Participatory techology developmet FAA has maaged to operatioalize a approach to techology developmet that is based i capturig the imagiatio of local commuities ad their ability to adapt. This approach is uusual i saitatio work, ad has the potetial to break importat ew groud regardig methods for promotig progress up the saitatio ladder. The spirit of CLTS has take cetre stage i ecouragig commuity egieers ad trasmittig local kowledge ito the desig of techologies. The FAA programme ad sub-gratees have bee costatly challegig themselves to idetify the best techological optios emergig ad to promote iovatios selectively, bearig i mid accessibility i the market, ad the ecological ad ecoomic ladscape. Some very promisig work i this regard is beig carried out, producig iovatios i locally appropriate desig ad maufacture for saitatio marketig. Developig improved latrie models at a reasoable price that ca be easily trasported, maitaied ad cleaed has bee a challege all over the world; some etrepreeurs here have addressed this ad succeeded i makig light, strog ad very low cost latrie models that ca also be washed easily. At the same time, there are challeges to the process of scalig the saitatio ladder. For most of the sub-gratees, some level of achievig improved latries forms a part of project objectives. However, all orgaisatios, i lie with CLTS priciples, have rightly bee careful to fully complete the behaviour chage compoet i.e. arrive at ODF before talk of saitatio marketig ad latrie improvemet is itroduced. Because of this, several have foud they have progressed less far with the latrie improvemet compoet tha they had scheduled. Early recogitio of some challeges ad the cotiued quest to overcome them has paved the way for some suitable alteratives. The EA is ot oly facilitatig the sub-

31 xxx Promisig Pathways gratees to idetify actors i the private sector who have the social ethos ad values to uderstad people s priorities, they have also strategically egaged with the private sector by icludig their represetatio i the PCM. These ascet iitiatives suggest that ivolvig the private sector i scalig the saitatio ladder is a key factor for success; ad that ew products adapted directly from local techology developed by commuity members have a good fit with local expectatios ad are cheaper tha more sophisticated desigs. There is also evidece that CLTS ca be a etry poit activity to move to wider areas of saitatio i the commuity, such as solid ad liquid waste maagemet. Buildig a learig orgaisatio FAA has put i place a umber of steps which cotribute to keepig the orgaisatio alive to learig from emergig experiece. Learigs eed to be idetified, captured ad brought ito the discourse of a shared learig process across the costituecies of the orgaisatio s work, while also remaiig dyamic ad chageable essetially ope to adaptatio o the basis of results ad evolutio of the programme process. Sharig best practices has bee ecouraged amog sub-gratees through carefully desiged workshops which give orgaisatios opportuities to reflect o their work ad idetify success areas. At the same time, they give less successful orgaisatios opportuity to lear from more successful oes, ad to build relatioships that ca lead to metorig. The Periodical Performace Assessmet is a further activity which promotes reflectio ad replicatio. Creatig model ODF villages has also bee a core learig tool. The U- shaped scalig up model, which idetifies strategic villages, uses this as a cetral feature, facilitatig learig from oe village s jourey to ODF to be used by aother. Oe criterio for selectig strategic villages is its potetial for beig used as a model. This criterio might relate to accessibility such as road access, or to how it is located i relatio to a group of other villages. Addig a immesely importat role for village testimoy to the Istitutioal Triggerig recipe is aother method for sharig learig. Withi a framework of agreed priciples ad objectives, the FAA program has ecouraged the emergece of local techological iovatios by allowig the freedom to SG sad commuities to take iovative steps. Several examples exist of where small adaptatios ad iovatios have

32 Executive Summary xxxi bee made to improve latrie desig ad make it fit for local coditios. Cosistet efforts have bee made to showcase these iovatios widely, both to cross-fertilise models ad desig, ad to ecourage further locally appropriate iovatio. Some positive outcomes are oly just begiig to be shared. Residets of ewly ODF villages suggest that results of the FAA programme peetrate deeper tha simple ODF status. They perceive a umber of advatages of adoptig ew behaviours o saitatio ad hygiee, most sigificatly better health. Some local level health data is becomig available which supports this perceptio ad suggests dramatic reductios i cases of diarrhoea followig the CLTS process as it works towards ODF status. Iformatio geerated i Focus Group sessios at village level provides further evidece that outcomes are clear to residets of ewly ODF villages. I rakig exercises, Better Health was overwhelmigly raked as oe of the most sigificat outcomes. I additio, a large umber of other outcomes ad kock-o effects were idetified ad discussed. Villagers associate ODF status with a rage of positive chages i life ad livelihoods at commuity level. While several villages are proud of their edeavour to make their village ad livig eviromet clea, they also see clear liks with ecoomic improvemet, food security, clea playig space for childre, social cohesio, icrease i school attedace, huma digity, ehaced self-esteem, ad better security for wome. Commuicatio is a importat factor of learig. FAA ad its subgratees have developed a umber of activities usig media to spread iformatio o saitatio more widely. These iclude both atioal level awareess raisig activities as well as local level iitiatives to promote discussio ad commuicatio alogside a CLTS process. Natioal ad local TV chaels have carried advertisemets o saitatio developed by the EA ad sub-gratees. Local radio has specifically bee used by subgratees to support the scalig up process with phoe-i discussio ad ews items. FAA has also developed a limited amout of carefully desiged visual material to reiforce triggerig experieces i CLTS sites. I geeral, it is clear that there is a role for all kids ad levels of commuicatio tools. It is importat to use several i order to reach out sufficietly widely to create a saitatio movemet. Here, the focus o local level stories as told by commuities has bee a strog factor i commuicatig CLTS messages widely.

33 xxxii Promisig Pathways Sustaiability Although it is early i the programme to have clear evidece of log-term ODF status, several process features suggest good prospects for sustaiability: The strog recogitio of health ad other beefits of the programme by the commuity is a positive factor for sustaiig behaviour chage. The sigificat ivolvemet of local goverace actors through the scalig up strategy helps to maistream the project i the larger local goverace framework. The FAA programme has established a orgaic lik with the istitutioal architecture of Diorao WASH; this orgaisatio is permaet i ature ad ot depedet o the FAA programme for cotiuity. FAA has also cotributed to developig Diorao WASH toward the lowest level ad, through it, helped to istitutioalise public evets like the celebratio of World Latrie Day ad World Had Washig Day. Ivolvig multiple actors ad istitutios at the local level promises to cotribute to sustaiability because ivested idividuals are likely to cotiue efforts ad help others to climb the saitatio ladder. Creatig local costituecies of iformed idividuals such as Natural Leaders ad Champios icreases the prospects of work beig cotiued eve after the phasig out of the project. With less tha two years util the coclusio of the MDGs, the experiece documeted here ca cotribute both to accelerated progress i these two years as well as to the post-mdg ladscape. This ladscape should iclude may more examples of coutries with a atio-wide ODF visio, ad the strategies idetified here offer potetial for geeratig ad allowig that visio to grow i other locatios. I Madagascar, the CLTS visio is beig successfully played out at scale. Evidece emergig from this experiece strogly suggests that i this broad-sweep scaled-up versio, like i the village-focused versio, CLTS actio which is strog i urturig priciples of local kowledge ad commuity empowermet has the power to stop ope defecatio, brig health beefits ad ispire social ad ecoomic developmet.

34 Chapter 1 Itroductio Photo: Kamal Kar

35 Previous page: Aveue of the Baobabs magificet ladscape of Madagascar i Meabe

36 Itroductio 1.1 Why Madagascar? Madagascar has made sigificat progress workig with Commuity Led Total Saitatio (CLTS) over the last two years at a level ad pace as yet far exceedig what has bee achieved i saitatio i most other coutries. Withi the programme of the Global Saitatio Fud (GSF) Madagascar, i three ad a half years, Madagascar has achieved 7,007 Ope Defecatio Free (ODF) commuities. The first coutry to start usig the GSF fudig mechaism to address saitatio i March 2010, Madagascar has pioeered GSF s objectives to scale up saitatio work ad its priciples of zero subsidy; put focus o the poor ad rural populatios; ad, i lie with CLTS (see Spotlight 1), give a strog focus o achievig behaviour chage rather tha o buildig latries. Achievig this umber of ODF commuities relatively rapidly has partly bee a outcome of evisioig scalig up i a serious ad systematic way. This has ivolved creatig a eablig eviromet for CLTS implemetatio, capitalizig o emergig experiece, ad sometimes developig features ew to CLTS. Oe aspect of brigig the visio of scaled up CLTS to life, for example, has ivolved begiig to make the practical move from coutig ODF villages util ow such a fudametal feature of CLTS i large scale programmes to coutig district ad subdistrict level ODF areas: i Madagascar s case, ODF fokotay ad commues. 1 Other ew features are beig geerated by the busiess of aimig for ad creatig a atio-wide movemet i saitatio; oe that sets out to touch the whole populatio; oe that ackowledges the eed to address ad ispire everybody. Movig from local level objectives for saitatio to the realisatio that a atio-wide movemet is ecessary is a big step. It is coected to two other types of realisatio: oe is based o the total part of the Commuity Led Total Saitatio visio. CLTS practitioers have log uderstood that the etire commuity eeds to be ODF to really achieve the health ad other beefits of saitatio eve oe case of ope defecatio ca jeopardise the 1 These are sub-district level admiistrative uits: a district has several commues; a commue geerally has about 6-7 fokotay; a fokotay has o average 5-6 commuities/villages.

37 4 Promisig Pathways health beefits for the whole commuity. 2 Thus a spirit of zero tolerace for ope defecatio (OD) has bee a stadard approach at commuity level, i the GSF programme i Madagascar as elsewhere. But give that commuities are ot, i fact, isolated groups but iteract with each other ad are frequetly situated very close to other commuities, it is ot a huge step to realise that oe commuity practicig ope defecatio ca jeopardise the health beefits of earby ODF commuities. Ad from there, it is easy to uderstad that ultimately ot just the commuity but the coutry eeds to achieve ODF status. Based o this particular visio of a ODF Madagascar, the GSF Programme kow as Fods d Appui pour l Assaiissemet (FAA) has developed this programme. The secod realisatio is that atio-wide ODF status simply caot be achieved by a few govermet officials or a hadful of o-govermet Figure 1: Madagascar i relatio to the Africa cotiet, ad Madagascar s 22 Regios Source: Baque des Doees Eau Assaiissemet Madagascar (BDEA), available at http: //

38 Itroductio 5 orgaisatios (NGOs) i partership with doors. Therefore the CLTS process ecessarily eeds to brig actors o board at all levels, actors who are empowered ad motivated to advocate for ad brig about chage i collective saitatio behaviour as a basic public orm of the atio as a whole. Madagascar has both these ideas as core elemets of its emergig ew visio for a ODF coutry, a visio drive by the FAA programme ad ow begiig to spread i some regios. Simply graspig ad the begiig to establish this visio has bee a sigificat driver, ad a triggerig tool i itself, i the remarkable successes of ODF villages (7007) achieved by the FAA programme as well as i processes ad mechaisms that have bee put i place, trialled, adapted ad adjusted to lead it to fruitio. It is because of these successes ad the apparet promise of the processes takig place that this documet sets out to offer sapshots of the Madagascar GSF experiece i CLTS to a wider audiece. Despite cosiderable effort, maily though classical approaches, most developig coutries i Asia, Africa ad Lati America have massive saitatio challeges. These coutries struggle with a situatio that costs millios of lives, mostly childre s; adds a huge healthcare ad family fiacial burde; ad ties well-beig stadards firmly dow to chroically low levels. At the same time, it slows dow ecoomic developmet maifested by a loss of GDP ofte ragig betwee four ad six per cet 3 ad burdes the coutry with a large umber of less productive ad weak huma resources caused by large scale stutig ad malutritio. These coutries eed to make a quatitative ad qualitative leap i saitatio ad hygiee progress, therefore lessos from approaches that have successfully addressed saitatio bottleecks elsewhere may be especially pertiet at this time. I 2010, the picture of saitatio i Madagascar was very similar to that i so may developig coutries: oly 15 per cet of the coutry s 21 millio people had access to improved saitatio. The remaiig 85 per cet were either practicig ope defecatio (37 per cet) or were usig uimproved toilets, which were ot fly proof ad therefore did ot break the faecal oral 2 The three mai criteria for achievig a ODF commuity are: 1) No more defecatio i the ope ad former OD areas have bee cleaed; 2) Every perso uses a flyproof latrie; 3) Had washig facilities are preset at every latrie ad these are used. 3 Water ad Saitatio Program (2011): Ecoomic impacts of iadequate saitatio i Idia

39 6 Promisig Pathways trasmissio route (48 per cet). 4 Just three years later, uder the FAA programme at least 840,000 people 5 have stopped ope defecatio. This meas they are usig fly-proof latries that is, the latries promote the breakig of the faecal-oral trasmissio by fulfillig three criteria: 1) The pit is covered; 2) There is o possibility for flies to get i ad out because the slab has o holes ad there are o gaps betwee the plaks; ad 3) I case of use of paper, the used paper is put i buckets or boxes which are safely covered so as to avoid ay cotact with flies. While the above figures are still some way off achievig the MDG target of 54 per cet improved saitatio by 2015, they evertheless costitute remarkable progress. I additio, they promise to be oly the first bricks o a foudatio costructed to achieve scale: they are just the first idicatios of a much wider impact that the strategies developed uder the programme are desiged to achieve, ad that its visio ecompasses. These results have bee achieved i the face of cosiderable difficulties: the cotext of socio-political crisis has led to icreasig levels of povertythe proportio of the populatio fallig uder the World Bak poverty lie rose at least 10 percetage poits from 2009 to 92 per cet i I additio, the crisis has caused icreasig challeges related to the operatioal ad istitutioal cotexts. The case of the FAA i Madagascar as preseted here strogly suggests that CLTS is a robust approach that ca be applied whatever the situatio is, ad further that it has every possibility of producig results i cotexts less operatioally challegig. Other istitutios therefore have much to lear from the various strategies that have bee applied i differet situatios across Madagascar ad across the saitatio spectrum. Madagascar had all the usual atioal level challeges that geerally block or slow dow the pace of scalig up ad spread of Commuity-Led Total Saitatio. As i most coutries, part of the struggle has bee successfully to replace the age-old subsidy-drive partial saitatio approach. Challeges of this jourey usually iclude lack 4 See JMP 2012, available at e.pdf 5 All figures citig progress i CLTS coverage are take from December 2013 moitorig reviews of FAA Madagascar. Obviously, the figures are cotiuously evolvig. 6 See World Bak, Jue 2013, Madagascar: Measurig the Impact of the Political Crisis, available at mada gascar-measurigthe-impact-of-the-political-crisis (accessed 12 February 2014).

40 Itroductio 7 of istitutioal coordiatio; the absece of a eablig eviromet; iappropriate govermet policy; a top-dow ad prescriptive mid-set; ad a huge baggage of old attitudes of staff at miistry, departmet ad frotlie levels used to implemetig prescriptive ad supply-drive saitatio programmes as well as lack of local ad istitutioal capacity. How some of these usual challeges have bee addressed ad sometimes overcome by the FAA programme has bee captured here. The research o which this documet draws set out i the first istace ot to dwell o the challeges ad problems. It did ot aim to improve or recommed but rather to uderstad where Madagascar s success is comig from. What is it based o? How has it come about? Are there particular features of the CLTS process here which have ot bee see before? For this reaso, this documet errs o the side of the positive. It tries to tease out the details of why ad how particular strategies have worked rather tha the details of what might be wrog with a strategy or how it could work better. It offers a wide variety of examples ad pictures of what has happeed i particular projects, commuities ad orgaisatios. 1.2 How ca the FAA Madagascar experieces be used? Evidece-based ispiratio It is ever easy to make geeralisatios from oe experiece i oe coutry or eve part of a coutry to aother i a place that might be very differet. It is usually impossible to pick up a strategy completely itact, drop it ito a differet cotext ad expect it to work. This is ot what is beig suggested here. Rather, the primary purpose is to provide evidecebased ispiratio. I the spirit of faith i local level ability to solve problems, this documet offers examples to draw o. Successful strategies for tacklig local issues are ofte based o combiig ideas ad iformatio from elsewhere with local uderstadig. This documet therefore aims to icrease the quatity ad quality of the idea bak for practitioers at all levels. It offers ideas about what has worked ad why it worked. These ideas, we hope, ca be used i a locally appropriate, flexible way, always ispired by CLTS-grouded itegrity. At the first istace, this publicatio is iteded for use by orgaisatios ad coutries usig the GSF fudig mechaism to achieve saitatio goals,

41 8 Promisig Pathways with the Milleium Developmet Goal (MDG) o saitatio as the global backdrop. These iclude the coutries i which GSF has established programmes: Cambodia, Idia ad Nepal i Asia, ad Ethiopia, Madagascar, Malawi, Nigeria, Seegal, Tazaia ad Ugada i Africa. I particular, however, it is hoped that this documet ca provide isights ad ideas relevat to the coutries ow begiig or i the early stages of o-thegroud implemetatio of GSF programmes: Burkia Faso, Togo, Bei, Keya, Bagladesh, Pakista ad evetually other future GSF coutries. Beyod this, the documet also aims to offer isights to other exterally fuded large saitatio programmes usig the CLTS approach but strugglig to scale up with quality ad achieve the desired outcomes, i Madagascar ad elsewhere. Ad i places where the objective to scale up CLTS is ot yet clearly articulated, we also hope it will ispire CLTS practitioers at all levels, workig with whatever fud or lack of it, to fie-tue work at the local level, strategize for large scale work, achieve atioal level co-ordiatio, ad, literally, to grow the visio.. Spotlight 1 Commuity Led Total Saitatio This documet assumes some kowledge of Commuity Led Total Saitatio (CLTS) ad uses some termiology, which is briefly outlied here for the beefit of ufamiliar readers. CLTS is a iovative approach for empowerig commuities to completely elimiate ope defecatio (OD) ad to begi the jourey towards a sustaied improvemet i public health. It focuses o igitig a chage i collective hygiee behaviour, which is achieved through a process of collective local actio stimulated by facilitators from withi or outside the commuity. CLTS ivolves o hardware subsidy ad does ot prescribe latrie models. CLTS uses participatory tools to trigger emotios of shame, disgust, fear ad self-respect through commuity aalysis, which covice the commuity to stop the practice of ope defecatio ad build ad maitai its ow toilets. These tools iclude commuity mappig of ope defecatio areas, aalysis of what happes to the shit over time icludig faecal oral trasmissio, trasect walk-through ope defecatio areas ad calculatio of medical expediture by the commuity. The style is provocative ad fu, ad is hads-off i leavig decisios ad actio to the commuity.

42 Itroductio 9 A commuity triggerig i Akotsaka village, Ataifotsy District Photo: WSSCC/Katherie Aderso A good CLTS process ivolves the whole commuity icludig the margialized ad the disabled. This latrie was built for easy access for a paraplegic commuity member. Photo: WSSCC/Katherie Aderso Follow up after the iitial triggerig is essetial to esurig the commuity stay motivated ad become ODF promptly. Natural Leaders ted to emerge durig the triggerig ad follow up process ad ca be supported to take a leadig role i esurig their commuity becomes ODF. Oce their ow commuity is ODF, these Natural Leaders ca be empowered to facilitate CLTS i eighbourig commuities, ad are the kow as Commuity Cosultats. Workig with Commuity Cosultats esures that the spread of CLTS is expoetial rather tha liear.

43 10 Promisig Pathways For further iformatio o CLTS please see the website: cltsfoudatio.org or refer to the followig documets: Hadbook o Commuity-Led Total Saitatio Kamal Kar with Robert Chambers, Pla Facilitatig Hads-O Workshops for CLTS: A Traier s Traiig Guide Kamal Kar, WSSCC Research methodology The research o which this documet is based was carried out by CLTS Foudatio, a Idia-based global orgaisatio led by Dr Kamal Kar, fouder ad pioeer of the CLTS approach. Kamal Kar also provided guidace to the research team throughout the process. The research was carried out i close co-ordiatio with MCDI (Medical Care Developmet Iteratioal), the Executig Agecy (EA) of the Madagascar FAA programme; other key etities of FAA such as the PCM, which icludes the major miistries like Water, Health, Eviromet, Educatio, Decetralisatio, ad INGOs; ad with sub-gratees. 7 It was fuded by the Global Saitatio Fud, a programme of the Water Supply ad Saitatio Collaborative Coucil (WSSCC). The research process icluded reviewig backgroud material ad documetatio of the CLTS process i Madagascar, ad three weeks of fieldwork, which took i five differet regios i which FAA is implemetig CLTS. Tools used icluded semi-structured iterviews, focus group discussios, participat observatio ad participatory most sigificat chage exercises, workshops ad stakeholder cosultatio at differet levels. I order to attempt to ucover features of the process that have led to sigificat results, research questios were focused i four areas: What strategies have bee used to implemet CLTS at scale? What iovatios are evidet? What has bee the role of the istitutioal eviromet? What mechaisms were used to esure quality of CLTS traiig, replicatio of efficiet traiers ad facilitators, ad other dimesios of sustaiability? 7 I this documet, the term sub-gratee (SG) is used to refer to the implemetig orgaisatios. I FAA Madagascar, these are also referred to as AMOs (Agece de Mise e Oeuvre, or implemetig orgaisatios).

44 Itroductio 11 The research did ot attempt to assess or evaluate impact at this stage. O the other had, it did seek at fieldwork sites to cofirm evidece of results at outcome ad impact levels as reported by SGs ad MCDI, as the EA. This was ecessary to establish credibility for the coclusios of the research, as preseted here, which idetify ad describe pathways showig promise for geeratig similar results elsewhere. Maily, however, the research was qualitative ad focused o uderstadig the methods used to achieve good levels of results, ad why particular strategies ad decisios had bee take i each of the five fieldwork locatios. These were: Vakiakaratra Regio where sub-gratee MIARINTSOA NGO is implemetig a extesio grat. Atsiaaa Regio where sub-gratee MAMIZONGO is implemetig a small grat. Vatovavy Fitoviay Regio where sub-gratee AINGA MADAGASCAR NGO is implemetig a large grat. Aalajirofo Regio where sub-gratee ASOS NGO is implemetig a large grat. Itasy Regio where sub-gratees ADEMA NGO ad FAMONJENA NGO are implemetig small grats. Limitatios of the Research. The research was ecessarily framed by time costraits. Time available for research i the field was far from eough to observe or uderstad all the strategies ad methods beig implemeted by all 17 sub-gratee orgaisatios. The result is that the iformatio ad aalysis preseted here are sapshots of a much wider ad more varied picture. They are sapshots of situatios brought forward by FAA actors as examples of iterestig work that they felt warrated attetio ad descriptio. The researchers, believig that FAA actors have a good uderstadig of the activity at the SG ad commuity levels, did ot attempt to ifluece this selectio of visit sites. Therefore the fidigs of the research are biased towards those examples ad themes that had already bee recogised withi FAA as illustratig potetial promisig practice. A secod limitatio cocered laguage. Although part of the research team had some limited ability i Frech, the team had o ability i Malagasy which is the laguage of operatio particularly at commuity ad SG levels.

45 12 Promisig Pathways The team worked through a very competet traslator from Malagasy ad Frech ito Eglish, ad is cofidet that this act of commuicatio wet well beyod the call of duty. Nevertheless, as i ay multiligual situatio, there remais a risk of missed details ad utraslated iformal iteractios. 1.4 Structure of the documet ad readig guide This research ucovered may iterestig features of CLTS implemetatio i differet areas of the coutry. It also sought to uderstad the roles of the Executig Agecy (EA), the PCM ad the may other actors ivolved i the saitatio ladscape. The kids ad levels of iformatio geerated were therefore very varied. For this reaso, this publicatio orgaises the iformatio preseted as follows. The ext sectio, Sectio 2, discusses eablig features of the istitutioal eviromet for CLTS. Sectio 3 presets the mai overall model the framework that has bee used to put the scaled-up visio ito practice ad the describes some of the otable features that have evolved to support this process. Sectio 4 discusses progress with participatory techology developmet. Sectio 5 presets some aspects of buildig a learig orgaisatio which cotribute to keepig the programme evolvig ad spreadig i a dyamic ad experiece-based way. Sectio 6 draws out some issues aroud sustaiability, otig that several strategies ad features, which are formig part of the scalig up process, are also ehacig prospects for depth ad sustaiability of ew behaviours i hygiee ad saitatio. The text is iterspersed with a umber of Spotlight boxes with blue backgrouds ad Profiles with beige backgrouds. Spotlights offer a i-depth look ito particular cocepts, issues ad/or situatios, ad ited to sharpe isights ad add detail ad texture to readers uderstadig of the cotext. Profiles aim to give evidece-based iformatio about the importat roles i CLTS: who might become a Champio? What motivates a Commuity Cosultat? What might a idividual farmer gai from the commuity becomig ODF? Each mai sub-sectio is followed by a umber of Lessos Leared with light gree backgrouds. These ited to summarize the major learig poits to take forward ito ew iitiatives implemetig CLTS as scale.

46 Chapter 2 Establishig a eablig istitutioal eviromet Photo: Kamal Kar

47 Previous page: Local govermet officials iteractig with a ODF commuity i Amboakazo village, Itasy.

48 Establishig a eablig istitutioal eviromet A key factor cotributig to successful progress i CLTS coverage i targeted regios i Madagascar has bee the eablig istitutioal eviromet. Elemets of this eablig istitutioal eviromet iclude: The structures for programme implemetatio, as described below; the ivolvemet ad willigess of local authorities at regioal, district ad commue levels. The atioal WASH coalitio kow i Madagascar as the Diorao WASH. The dyamism of the Programme Coordiatig Mechaism. The stregths of the Executig Agecy. The regular capacity buildig, advocacy ad strategic support by Kamal Kar. The coachig system ad cotiuous efforts to develop i-house capacities of the sub-gratees, Natural Leaders ad Commuity Cosultats. Approaches to learig withi the programme. Elemets of gradual support ad reward (such as movig from a small grat to a larger grat whe sub-gratees succeed) ad of grat termiatio o poor performace. Support of the Miistry of Water to the FAA programme. Respose from govermet istitutios has bee positive i spite of the difficult political situatio experieced i the coutry sice March A iterim govermet (a de facto Govermet) is still i place at the time of writig this documet. 2.1 Effective structures for programme implemetatio The Global Saitatio Fud (GSF) desiged a umber of key structures for programme implemetatio ad oversight. As Madagascar was oe of the first coutries to implemet GSF it has bee somethig of a test bed for these structures ad has prove them to be effective.

49 16 Promisig Pathways Figure 2: Key structures of the GSF programme i Madagascar Global Saitatio Fud Coutry Programme Moitor Executig Agecy Programme Coordiatig Mechaism Large Sub-gratee Small Sub-gratee Extesio Sub-gratee The structures, illustrated above, are as follows: The Programme Coordiatig Mechaism (PCM) is made up of members of govermet, atioal ad iteratioal NGOs, iteratioal agecies, civil society orgaizatios, represetative from the Diorao WASH ad the private sector. Its role is to help desig, oriet, oversee ad advise the FAA programme ad to maximise syergies betwee the GSF, the atioal govermet ad other stakeholders. The Coutry Programme Moitor (CPM) is a idepedetly appoited agecy which verifies ad reports o the work of the Executig Agecy. The Executig Agecy (EA) receives the grat from the GSF ad maages the fuded programme. The EA i tur selects, supervises, ad supports sub-gratees (SGs). Sub-gratees (SGs) are NGOs which directly implemet the programme i the FAA programme targeted areas. They are of three types large, small ad extesio gratees. As i most coutries, i Madagascar the Executig Agecy is a ogovermetal orgaisatio appoited through a iteratioal competitive biddig process, though i some coutries bilateral agecies have bee

50 Establishig a eablig istitutioal eviromet 17 appoited as Executive Agecy, e.g. UNICEF i Togo, ad i Ugada the govermet is the EA. Implemetatio by NGOs has bee very successful i Madagascar, despite some challeges i selectio of appropriate subgratees ad their heterogeeity i terms of capacity ad scope. Govermet, however, has played a key role through the PCM i supportig, facilitatig ad esurig good practice. The govermet has a key leadership role, ad acts as facilitator to the whole programme implemetatio process. I total there are curretly 17 sub-gratees facilitatig CLTS o the groud uder the FAA programme: eight receivig large grats, seve receivig extesio grats ad two still ruig their iitial small grats. 8 I most cases, sub-gratees are idividual NGOs, but i a few cases the cotract is give to a cosortium of NGOs. This scope ad diversity of implemetig orgaisatios, icludig both large ad small, as well as both atioal ad iteratioal NGOs, has aided iovatio withi the programme as each orgaisatio has bee give the space to develop its ow strategy for achievig the objectives set withi its cotract with the EA, withi the overall framework of CLTS priciples. Not puttig all the eggs i oe basket (i.e. ot givig all the fuds to oe sigle orgaisatio) has meat that whe sub-gratees have ot performed well, the egative impact has bee limited. The selectio of diverse SGs has also ecouraged diversity i competecy ad iovatio i programme implemetatio.where SGs have performed well, the EA has esured that those examples are shared widely so that all the sub-gratees beefit ad improve. I the case of the small grats, which work at a commue or district level, good performace has bee rewarded with a grat extesio to cover further commues or districts withi the same regio. This has promoted the replicatio of good practice ad esured the ability to elimiate poor performers. Of eleve small grats at the begiig, seve got extesio grats; two are still ruig; ad two were dropped. Oe of ie iitial large grats was also dropped. Over three years of implemetatio, the programme structure has bee stregtheed, with additioal layers of formal ad iformal actors ad 8 The categorisatio of grats is as follows: 1) Large Grats are betwee 300K to 400K USD; cover the whole regio; ad ru for 3 4 years 2) Small Grats are betwee 21K to 45K USD; cover 1-3 commues; ad ru for 1 2 years 3) Extesio Grats are for 150K USD; are grated to Small Gratees who have show good performace; should cover at least 50 per cet of the regio; ad last three years.

51 18 Promisig Pathways agecies. This has created a higher order of implemetatio efficiecy ad effectiveess for achievig scale. Coscious efforts have bee made to allow the emergece of a comprehesive ad fuctioal implemetatio structure from experietial learig. There was a clear ackowledgmet at the programme desig stage that it was uclear what shape ad form this would take, ad it would therefore have to emerge. Figure 3: Evolutio of the FAA programme for scalig up CLTS i Madagascar FAA 2011 Large sub-gratees Small sub-gratee Coaches Targetig ODF villages ODF villages We (FAA) do it all. FAA 2012 Commuity Cosultats & Natural Leaders No-performig large SG dropped Targetig ODF fokotay Critical review of coachig system 1039 ODF villages 101 ODF fokotay NLs/CCs Let s all do it together. FAA 2013 Capitalizigo experiece of CCs ad NLs at large scale More specialized coachig system emergig from sub-gratees themselves Istitutioal Triggerig ad creatig Champio mayors, fokotay chiefs, traditioal leaders, govermet officers 2 small SGs dropped ad 4 small SGs exteded 7007 ODF villages 728 ODF fokotay 15 ODF commues Regio roadmap

52 Establishig a eablig istitutioal eviromet 19. Lessos Leared 1 Establishig a eablig istitutioal eviromet Creatig islads of excellece is ot eough: developig a atiowide cosesus agaist OD is the objective. Takig the step from We do it all to Let s all do it together is essetial, ad ivolves istitutioal chages. The willigess of the programme to icorporate learig from experiece ad chage (i.e. becomig a Learig Orgaisatio) is essetial to improve efficiecy ad performace. A firm strategy that maistreams the iitiatives i the local goverace structure is essetial for sustaiable ad lastig chage. This should establish commuicatio ad egagemet betwee implemetig agecies ad the govermet. 2.2 The Diorao WASH Workig together with the Diorao WASH the Natioal WASH coalitio i Madagascar - has bee a sigificat factor i cotributig to the smooth establishmet ad ruig of the FAA programme. From the outset, the Diorao WASH was the lead parter with the GSF i establishig the FAA i Madagascar ad it cotiues to play a importat role i coordiatio ad moitorig alogside the PCM. Established i 2002, it has aroud 200 members represetig the key actors i the water ad saitatio sector icludig govermet, NGOs, iteratioal agecies, civil society ad the private sector. The WSSCC was istrumetal i establishig the Diorao WASH ad had bee i discussios sice 2002 aroud developig a programme of work o saitatio ad hygiee. Strog relatioships were therefore already i place for the smooth ad effective developmet of the FAA programme. Sice 2003, the Diorao WASH has established regioal committees, agai represetig key govermet departmets, civil society ad private sector agecies workig o water ad saitatio issues. These committees have also bee egaged to participate i FAA processes, e.g. i the selectio of sub-gratees ad i the verificatio ODF fokotay ad commues. Although the itetio has bee to establish district ad commue level Diorao WASH Committees i all regios, they oly exist i a few.

53 20 Promisig Pathways. Spotlight 2 Extedig the reach of the Diorao WASH I the Vatovavy Fitoviay Regio, the regioal sub-gratee, AINGA MADAGASCAR, has worked directly through the Diorao WASH to aid implemetatio of the programme. The regioal Diorao WASH committee played a lead role i the submissio of the expressio of iterest for regioal selectio, ad i idetifyig the most appropriate sub-gratee to submit a proposal o behalf of the regio. Therefore whe the FAA programme was cofirmed for the regio, the Diorao WASH suggested that AINGA MADAGASCAR establish district ad commue level committees ad implemet the project through them. Therefore, i parallel with a first phase of commuity triggerig, betwee December 2012 ad February 2013 AINGA MADAGASCAR established district level DioraoWASH Committees (DWCCs) i all six districts ad commue level Diorao WASH Committees (CWCCs) i the 87 commues of the regio. CWCC members iclude the commue mayor, traditioal authorities, cofessioal authorities, chiefs of fokotay, commuity health voluteers, the head of schools for the commue ad WASH stakeholders. The role of the CWCC is to provide follow up ad moitorig i triggered commuities, ad the role of the DWCC is to provide oversight ad support, as well as carryig out verificatio of ODF commuities.

54 Establishig a eablig istitutioal eviromet 21 Figure 4: Structure of the Diorao WASH i Vatovavy Fitoviay Regio Regioal WASH Coalitio Committee Members: Miistries of Health, Populatio, Water, Tourism, Eviromet, ad Educatio; NGOs such as Red Cross, AINGA MADAGASCAR, ASOS; head of churches; head of scouts; media Role: Techical assistace o plaig ad saitatio developmet District WASH Coalitio Committee Members: District represetatives Miistries of Health, Populatio, Water ad Educatio Role: Techical assistace o plaig ad saitatio developmet, support ad advice to Commue WASH Coalitio Committee; verificatio of ODF commuities; feedback to Regioal WASH Coalitio Committee Preset i 6 districts Commue WASH Coalitio Committee Members: Commue mayor, traditioal authorities, cofessioal authorities, chief of fokotay, commuity health voluteers ad chief of schools for the commue Role: Techical assistace o plaig ad saitatio developmet, provide follow up i triggered commuities util they become ODF; post ODF moitorig to esure sustaied status; feedback to District WASH Coalitio Committee Preset i 87 commues Commuity. Lessos Leared 2 The WASH Coalitio The WASH coalitio, where it exists - or ay such atioal level co-ordiatig body for water/saitatio - is a key resource i scalig up, which ca be draw o for support at regioal, district ad lower levels. Stregtheig ad ivigoratig these structures at all levels may be a importat compoet of a scalig-up strategy. Where roles of members of the body are ot specified, these should be clearly defied. Clear roles ad tasks at district ad lower levels ca greatly ehace local level istitutioal participatio ad egagemet.

55 22 Promisig Pathways Egagig with such a multi-sectorial body from the begiig esures greater buy-i of all actors, thereby cotributig to a eablig eviromet for CLTS implemetatio at scale. The atioal level body ca play a specific role i developig lower level bodies, ad this structure ca facilitate kowledge flows, both dowwards ad upwards, ad esure greater iteragecy coordiatio. The differet levels must be systematically coected. 2.3 Evolvig role of the Programme Coordiatig Mechaism As metioed above, the Programme Coordiatig Mechaism is a support body established by the GSF to help desig, coordiate, oversee ad advise the coutry programme ad to maximise syergies betwee the GSF ad the atioal govermet. Its 14 members iclude represetatives of the Miistries of Water, Health, Eviromet, Decetralisatio ad Educatio; iteratioal ad atioal NGOs (SAF/FJKM ad WaterAid); the private sector (Famojea Cosultig Developmet); iteratioal agecies (UNICEF ad USAID); ad a represetative from the Diorao WASH (the Natioal Coordiator). Despite the challege of the operatioal cotext i Madagascar due to the political crisis, the PCM has made importat ad evolvig cotributios to the desig ad implemetatio of the FAA programme, ad cotiues to esure a supportive istitutioal eviromet for the ogoig work. It played a key role i settig up the FAA programme ad participatig i the selectio of the EA ad the Coutry Programme Moitor. Before the start of FAA, may of the members of the PCM were heavily ivolved i the Diorao WASH, ad therefore were playig key roles i iitial discussios with WSSCC aroud the developmet of a saitatio programme i Madagascar. The PCM was formally established by October 2008 with the goal of brigig together govermet ad o-govermet actors to pla ad coordiate the work to be fuded by the WSSCC. As this was the first coutry where GSF was to be implemeted, the PCM was essetially a thik tak workig together with the WSSCC to help desig ad refie the programme cocept.

56 Establishig a eablig istitutioal eviromet 23 Figure 5: The dyamic role of the PCM Stage I: Pre-Iceptio Roles 4 Desig 4 Work to build fuctioal likages ad workig relatios betwee all actors 4 Selectio of potetial EA Stage II: Iceptio Roles 4 Cotributio i selectio of EAs 4 Cotiue buildig the iter-agecy relatioship 4 Ifluecig policy ad advocacy withi FAA Stage III: Early Implemetatio Roles 4 Advisory ad decisiomakig body 4 Assistig EA to lauch FAA programme 4 Participate i evaluatio ad selectio of SGs 4Policy ad advocacy i water ad saitatio sector Stage IV: Mid- Implemetatio Roles 4 Strategic follow up 4 Cotiued advocacy 4 Re-defiig roles of all members of PCM 4 Evaluatio of the performace of SGs 4Plaig reward ad pealty Oce the executig agecy was idetified, the primary resposibility for implemetatio shifted to them, ad the PCM became a advisory ad decisio-makig body, assistig, for example, i the selectio of the sub-gratees. It also helped resolve the issues arisig from poor performace of sub-gratees. The termiatio of the cotact with two sub-gratees sice the begiig of the programme could have had udesirable repercussios for the EA, but the full backig of the PCM gave legitimacy to the decisio. The PCM also helped the EA i reorietig some levels of grats i accordace with sub-gratee performace. Those who performed well have bee rewarded with larger grats. Although the relatioship betwee the PCM ad the EA has bee successful, it has ot bee without its challeges. The PCM foud it had o authority to direct the EA, ot havig ay cotractual relatioship with them. This meat that issues have had to be resolved through discussios ad egotiatio, which have required a high time commitmet o both sides. More recetly the role of the PCM has shifted agai from providig a high level of support withi the programme, towards stroger

57 24 Promisig Pathways ifluecig ad advocacy across the water ad saitatio sector o behalf of the programme. As members of the PCM are draw from across several miistries (Water, Health, Eviromet, Educatio ad Decetralisatio) as well as NGOs, iteratioal agecies, civil society ad the private sector, they are well placed to brig the major saitatio actors closer to the FAA, to improve their kowledge ad uderstadig of CLTS implemetatio ad to cotribute towards achievig a ODF Madagascar.. Lessos Leared 3 A atioal decisio-makig body: the PCM A idepedet advisory body with represetatio from major saitatio actors icludig the govermet is a key asset to a harmoised scalig up process. Timely ad strategic shifts i the roles of PCM sigificatly cotribute to improvig the efficiecy of programme implemetatio. Coscious efforts are eeded to improve the level of awareess, capacity ad role of each member represetig differet istitutios/orgaisatios o the philosophy ad priciples of CLTS, such as that of commuity empowermet. A idepedet body is i a good positio to assess the comparative stregths ad weakesses of differet actors from a eutral perspective. Efforts may be eeded to ehace the accoutability of each member ad egage them i establishig strog fuctioal likages for improvig the efficiecy of the programme. More is required from members tha simply attedig meetigs ad occasioally travellig to programme areas. 2.4 Stregths of the Executig Agecy The executig agecy (EA) for the FAA programme, Medical Care Developmet Iteratioal (MCDI), has played a critical role i esurig a positive ad ecouragig eviromet for effective implemetatio by sub-gratees. There are several factors relatig to their style of work ad

58 Establishig a eablig istitutioal eviromet 25 strategy that ca be highlighted to illustrate good practice. It is otable that as Madagascar was oe of the first coutries implemetig GSF, there was o blueprit to follow, ad the EA was ecouraged to experimet ad seek local solutios to the problems ecoutered rather tha beig offered exteral solutios. However, the EA appears to have take full advatage of the opportuity to iovate ad lear i the process of FAA implemetatio i Madagascar, i collaboratio with the sub-gratees. I this joit learig process, the EA has give cosiderable flexibility to the sub-gratees to implemet their objectives usig their ow strategies ad to adapt them based o their ow learig, followig GSF ad CLTS priciples. Therefore, implemetatio has bee a process of co-learig alogside the executig agecy. As oe member of MCDI said: We did t always kow what we were doig, so we just had to try. We leared alogside the sub-gratees. The EA developed a effective capacity buildig process usig local coaches, described i the ext sectio. It also employed the expertise of Dr Kamal Kar of the CLTS Foudatio, the origiator of CLTS, to support the programme by givig his iputs at regular itervals. Dr Kamal Kar has made three separate visits to Madagascar over the last three years the first i November to support ad guide the FAA process. O each of these occasios he visited regios ad had meetigs at atioal level with FAA staff, sub-gratee represetatives, the PCM ad other stakeholders. Dr Kar s early observatios icluded poor practice of CLTS, weak scalig-up strategies, very poor performace by three sub-gratees, problems with the coachig system, ad weak ivolvemet of importat istitutioal actors. The EA has cosistetly acted o Dr Kar s recommedatios to make radical improvemets, icludig edig the cotract with oe sub-gratee that could ot improve its performace, makig sigificat chages to the coachig system (see Sectio 2.6), ad puttig much more emphasis o ecouragig sub-gratees to explore scalig up strategies (see Sectio 3). It is otable that durig his latter visits, the EA has used Kamal Kar s time strategically to tur aroud slow progress i certai regios ad to ifluece actors at the atioal level. Much of the success of the EA ca also be attributed to its strog ad collaborative relatioships with the Diorao WASH ad with the PCM, esurig atioal level istitutioal support for their work from withi govermet as well as from atioal ad iteratioal orgaisatios.

59 26 Promisig Pathways. Lessos Leared 4 The role ad features of the Executig Agecy Flexibility, a spirit of experimetatio ad learig, ad a willigess to collaborate are importat attributes of the EA. Clear articulatio of roles amog all the team members regardig coordiatio, CLTS capacity buildig, commuicatio, kowledge maagemet, moitorig, etc. esures greater complemetarity of actio ad thereby improves the delivery of outputs o groud. The EA should be coscious that their role is to get the programme implemeted by the sub-gratees. This is oly possible through cotiuously supportig ad ehacig the quality of SGs through capacity buildig, improvig efficiecy ad moitorig of performace o a outcome basis. Implemetig i this structure also ivolves trust i the abilities of local orgaisatios ad people. Top-dow directives followig a blueprit are uhelpful. 2.5 Capacity buildig for sub-gratees A umber of coaches (14) were take o by the programme at its outset to support the sub-gratees with capacity buildig ad advice, particularly i CLTS, but also coverig other aspects of implemetatio. This coachig system has bee broadly successful, oly, however, as a result of some adaptatios to the iitial strategy based o observatios ad learig by exteral experts ad the executig agecy. The EA had developed a detailed capacity buildig pla for the SGs based o the learig from programme implemetatio ad recommedatios made by Dr Kar. I other words, the EA was gradually shiftig from implemetig a blueprit model of programme implemetatio to a more flexible capacity buildig pla.

60 Establishig a eablig istitutioal eviromet 27. Spotlight 3 The chagig role of coaches Most of the coaches had bee traied i CLTS i 2008 by a traier from CREPA, Burkia Faso who had bee ivited by UNICEF Madagascar. Early o i the programme, the coaches were more kowledgeable tha the sub-gratee staff, havig received at least some traiig i CLTS ad other aspects of programme operatio, ad their role was successful. However, as the time passed it became clear that the sub-gratees kowledge was surpassig that of the coaches. After the 2008 traiig the coaches had had little opportuity to practice what they leart ad, as a result, most of them failed to uderstad the commuity level dyamic of CLTS particularly the phases of post-triggerig follow-up ad post ODF activities. They emphasised CLTS triggerig tools, ad triggerig was cosidered as the fial product of the process. A further problem was that most of the coaches were based at Ataaarivo, oly visitig the regios periodically, ad offerig assistace that was supply drive (what they kew) rather tha demad drive (what sub-gratees eeded to kow). Oly those coaches who were based i the regios, ad were closely liked to projects, were cotiuig to add ay value. Meawhile, hudreds of villages were triggered, which produced hardly ay ODF villages. By mid-2012 it became clear that the role of the coaches eeded to be reviewed. The first step towards improvig the role of the coaches was to make them purely demad drive, i other words they provided assistace (ad were paid) oly whe it was requested. Secodly, the experiece of ot oly the existig coaches but also other sub-gratee techical staff was assessed to idetify a ew cadre of thematic coaches with expertise i specific areas based o practical experiece, ad who were happy to share that experiece with others. Now, istead of fixed term support which was prevalet i the iitial days, ad focused maily o teachig CLTS triggerig techiques, the egagemet of a coach is more dyamic, eed-based ad outcome focused. There has bee a shift, for example, from coutig traiigs coducted ad villages triggered to coutig ODF villages ad Natural

61 28 Promisig Pathways Leaders developed. Whe the executig agecy sees a gap i performace they discuss the eed for coachig support with the relevat sub-gratee, ad idetify a appropriate coach. Furthermore, the techical staff of a sub-gratee i oe regio ca be selected to assist aother sub-gratee i the same or a differet regio to provide specific thematic iputs. This has had the added advatage that the visitig thematic coach ca also lear from other sub-gratees ad regios durig their capacity buildig visits. This style of coachig has prove highly successful. Jocely Rakotoiria is the Techical Officer of ASOS, Aalajirofo Regio, who graduated to the role of coach based o his performace as a traier ad facilitator. Accordig to him: The coachig is effective if the cliet orgaisatio realises the eed for it, ad if, at the same time, the coach ca demostrate hads-o ability ad tagible results. The coach must have already mastered the skill of traiig of traiers ad uderstad the local cotext ad realities. I other words, the coach must be able to meet the eeds of the sub-gratee who hires his or her service. Figure 6: The decliig eed for coaches for achievig ODF status 8,000 7,000 Evolutio of ODF villages vs. umber of coaches ,000 7, , , , , ,000 2, , , April 10- Sept 10 Oct 10- March 11 April 11- Sept 11 Oct 11- March 12 April 12- Sept 12 Oct 12- March 13 April 13- Sept 13 Oct 13- Dec 13 0

62 Establishig a eablig istitutioal eviromet 29 Figure 7: Summary of phased chages i the coach system 2011 Appoitmet of geeric coaches with some kowledge ad traiig o CLTS. Supply drive approach with fixed term cotract. Most coaches from Ataaarivo with limited exposure to local cotext Gradual reductio i umber of days support from 10 days to 4 days. Icompatibility with the local cotext ad SG leadership. Skill ad capabilities are seriously challeged for a few coaches. Sub-gratees fail to appreciate the support o may occasios as it was ot demad drive Thematic/specialized coaches idetified. Demad drive approach based o gap aalysis. Appoitmet based o demostrative skills ad hads o kowledge. Emphasis o traied ad bright facilitators of sub-gratees who have demostrated exemplary results i their locatios. Greater emphasis o cotiuous field based support with familiarity of local cotext.. Lessos Leared 5 Resposive capacity buildig A effective strategy for high-quality capacity buildig based o demad by the implemetig agecy is essetial, but the ability to adjust a falterig strategy is equally importat. Basic coachig is eeded i the early stages of the programme but permaet techical assistace by outsiders to sub-gratees should be avoided.

63 30 Promisig Pathways Rather, the evolvig experiece of sub-gratees should be draw o cotiuously to fie tue the programme. As soo as capacity of the sub-gratees has bee created, specialized coaches should be idetified from amog good performig sub-gratees to metor other sub-gratees. Coachig iputs are more effective whe based o demad from sub-gratees rather tha i a supply drive mode. Sice CLTS is a outcome focused approach, the performace appraisal of ay CLTS traier must be based o the emergece of ODF villages as a result of traiig ad other related activities. 2.6 A learig eviromet O oe had, developig a eviromet of learig ad sharig amogst the sub-gratees, as well as iterally i the EA, has bee a importat feature helpig the programme evolve ad improve. The culture of colearig: the EA co-learig with the sub-gratees; the coaches (i more successful cases) co-learig alogside implemetatio experiece - has aided iovatio ad adaptatio withi the programme. At the same time, a istitutioal learig eviromet has bee built betwee the EA, PCM ad sub-gratees; ad betwee the Miistry of Water ad the FAA Programme, which has led to a strog owership of the programme. But how has this culture bee achieved? I part it has bee a matter of circumstace. Madagascar beig oe of the first coutries to implemet the GSF, the spirit of learig by doig was high. There was ot much to follow or past experieces to be guided by. Iovatio ad experimetatio was therefore to some extet a matter of course; this programme itself was quite origial i its style, ad the use of CLTS was i its ifacy at that time i Madagascar. It has also bee a matter of attitude: a ability to keep learig implies cotiually seekig improvemet; a absece of complacecy; ad a firm focus o the overall visio which is to be made operatioal. It ivolves recogisig problems ad mistakes, ad fidig ways to correct them. It ivolves puttig the objectives of the programme at the forefrot, over ad above istitutioal pride ad/or iter-istitutioal competitio, so that usuccessful compoets, rather tha beig covered up or protected, are cofroted ad chaged.

64 Establishig a eablig istitutioal eviromet 31 The executig agecy has show several circumstaces i which it has bee able to take stock of problem areas ad chage them: i the discotiuatio of a usuccessful grat; i the evolutio of the coach system; ad i chages i the way the grat rouds have bee put ito effect. Icreasigly, the EA has also take cocrete steps to esure that there is systematic learig ad sharig betwee sub-gratees ad regios ad that eighbourig villages lear from each other durig the CLTS process. These are discussed further i Chapter 5.. Lessos Leared 6 Usig a culture of shared learig to solve problems It is importat to fully address ad chage problem areas i order to keep movig forward. A clear system for idetifyig ad sharig learig ad likig this directly with plaig is a asset.

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66 Chapter 3 Photo: Kamal Kar Dyamic strategies ad iovative models for achievig chage at scale

67 Previous page: CLTS Triggerig sessio i progress i a village i Boey.

68 Dyamic strategies ad iovative models for achievig chage at scale Workig with CLTS at scale was a objective of the FAA i Madagascar from the outset. But at the begiig there was o clear cocept of how this would be achieved. I fact, there was little i the way of precedet to follow, as the most commo model of CLTS had bee a liear progressio of a sigle or a few agecies triggerig ad facilitatig the ODF process from oe village to aother. Takig CLTS to scale has bee take o as a serious challege i Madagascar by FAA ad there was recogitio that this liear progressio eeded to be tured ito a expoetial progressio i which the process would spread orgaically via icreasig umbers of ODF commuities ivolved. But exactly how this might come about was uclear. For this reaso, at first several differet strategies evolved i differet sub-gratee orgaisatios i parallel, with differet degrees of success. SGs were give full freedom by the EA to develop their strategies as they foud appropriate locally, withi the framework of some fixed CLTS priciples: There must be o household hardware subsidy. The focus must be o behaviour chage to completely stop ope defecatio. This freedom meat that SGs were able to draw o their previous experiece i work i other sectors where they foud it relevat. Oe small SG, MIARINTSOA NGO i Vakiakaratra Regio, for example, drew o methods developed i previous goverace work to develop a visio of workig at all levels with multiple actors to create a movemet, ot just a project. I the course of implemetatio, four mai models of scalig up emerged ad achieved some success. CLTS scalig up through religious etworks: Salfa, the SG from Haute Matsiatra regio achieved rapid spread by triggerig the pastors of churches ad subsequetly by triggerig the differet groups associated with churches, such as the scouts. Members of the differet churches the take CLTS actio to the village level. Commuity Health Workers (CHWs) as agets of CLTS

69 36 Promisig Pathways implemetatio at scale: FASA, a SG of Alaotra Magoro egieered the approach aroud the CHWs. Each fokotay has two CHWs. These health workers are give orietatio ad subsequetly used for triggerig of their respective villages ad fokotay. Mobilisig Natural Leaders ad Commuity Cosultats as facilitators: Natural Leaders emerge from the CLTS facilitatio process at the village level. Sub-gratees have created space for these Natural Leaders to get better experiece, exposure, capacity ad the trigger their eighbours. May of them are promotig themselves as Commuity Cosultats triggerig may villages i the regio. The U approach: this uses all of the above actors i a systematic leveragig of istitutioal advatage to achieve scale. As it became evidet that some SGs were producig results more successfully tha others, FAA icreasigly sought spaces for sharig successful or promisig strategies betwee differet sub-gratees (SGs) with the result that strategies have cross fertilized ad begi to have commo themes. Gradually, the method developed by MIARINTSOA NGO has bee cosolidated ad promoted by FAA as a model for other SGs to replicate, with regioal adaptatios as appropriate. At the same time, other strategies which were producig results have also retaied their basic structure. Strategies for scalig up all revolve aroud the cetral realisatio that oe orgaisatio caot do it aloe. Here, differet types of respose to this realisatio have bee orgaised thematically as follows: Selectig promisig sites: strategic selectio of locatios for direct itervetio. Ivolvig local actors who ca ifluece their etworks: Istitutioal Triggerig. Makig productive collaboratios really happe. Empowerig local actors for implemetatio. Deepeig the reach: workig with traditio ad cultural processes. 3.1 The U approach : Systematic leveragig of istitutioal advatage for scale The sub-gratee MIARINTSOA, workig i Vakiakaratra Regio, cosidered the step betwee aimig for ODF villages ad aimig for ODF

70 Dyamic strategies ad iovative models for achievig chage at scale 37 fokotay, commues, ad districts ad decided that a bold ad direct strategy was eeded. The visio was of creatig a ODF district, ad it was this visio that drove the emergece of the strategy. If the goal was to create a ODF district, the it was at this level that the scalig up work must begi. But how could oe orgaisatio operate effectively i all villages across the whole district, ad later across other districts too? Clearly, it could ot. The solutio was twofold: 1: to devise a carefully plaed framework for direct CLTS actio by the SG i selected strategic social ad admiistrative uits such as villages, fokotay ad commues which would lead to idirect CLTS actio by ew actors i others. 2: to develop ad carry out various kids of Istitutioal Triggerig i order to support this process ad build the eablig eviromet i which idirect CLTS actio might be successful. The process which formed the backboe of this strategy is depicted i Figure 8 below. Figure 8: The istitutioal scalig up process of sub-gratee MIARINTSOA NGO PHASE 3 : Scalig up to the Admiistrative Levels PHASE 1 : PREPARATION ü Advocacy ü Istitutioal Triggerig ü Plaig ad strategic orgaisig l l l l Regio Strategic District Strategic Commue Strategic Fokotay l l l l Regio District Commue Fokotay Scalig up to o - strategic Districts through ODF Commues Scalig up through o - strategic ODF Commues Scalig up through strategic ODF Commues Scalig up through strategic ODF Fokotay ü Area triggerig workshop ad developmet of Pla of Actio for leadig towards a ODF area ü Reiforcemet of actor capacity ü Implemetatio of Plas of Actio ü Follow-up ü Strategies to maitai achievemets PHASE 2 : Puttig i place a strog base for scalig up (ODF strategic villages ) ü Triggerig ü Actio Plas ü Follow up push l l l l Source: Approche De Mise A Echelle Ascedate Das Le Cadre De L élimiatio De La Défécatio A L air Libre, MIARINTSOA NGO, March 2013

71 38 Promisig Pathways Phase 1: Preparatio Preparatio for spreadig the ODF process across a wide area ivolves a importat process of selectig locatios for direct itervetio. Durig this selectio process, a major advocacy strategy is also rolled out to brig key actors o board. The mai techique for advocacy is a Istitutioal Triggerig process, described later i Sectio 3.2. To arrive at selectio of the strategic villages at which direct actio would take place i order to create the Strog Foudatio of Phase 2, however, a key decisio was decidig to work from the district dowwards. Startig at the district level, the, through advocacy work, Istitutioal Triggerig ad strategic plaig, strategic commues are idetified i which direct CLTS triggerig will be coducted i some villages, fokotay ad commues to form the strog base. Withi these selected commues, a umber of key idividuals from public, private ad local etities are ivited to help select strategic sublocatios for direct actio at the ext level dow: commue level actors are ivolved i idetifyig strategic fokotay; fokotay level actors are ivolved i selectig strategic villages. Durig this selectio process, these key actors are themselves triggered. This selectio process takes place had i had with advocacy o saitatio at all levels from the district to the fokotay. The mai objective is to ivolve local etities as much as possible ad egage them i actio to eradicate OD. Resposes to this advocacy are oe aspect of the criteria for selectio of strategic locatios i.e. whether there are key idividuals there who are ethusiastic about behaviour chage-based ad outcome focused saitatio work. Other criteria iclude the presece of a river or road which coects commuities; previous NGO experiece i the village/fokotay /commue; locatio of the Commuity Health Worker; strategic positioig with access by may, etc. Approximately two or three villages from a selected strategic fokotay of five or six villages are expected to be selected for direct triggerig. Phase 2: Buildig the strog base Havig worked dow to select strategic villages, MIARINTSOA NGO begis to put i place the strog base from which scalig up will take place. This ivolves direct triggerig i these villages by sub-gratee actors traied i CLTS via the coachig process rolled out by the EA. Actio plas are made durig the triggerig, ad the SG follows up the process alog with Natural Leaders idetified from with the commuity util all of the selected villages are ODF.

72 Dyamic strategies ad iovative models for achievig chage at scale 39 Where the overall populatio of a whole fokotay is small, the SG also coducts mass triggerig, for all the villages at oce. The whole populatio of the fokotay s villages must be preset at this triggerig if the follow up work is to lead successfully to ODF. As the work progresses ad ODF commuities start to emerge, it is also possible to ivite represetatives from eighbourig ODF villages to a mass triggerig to help the sub-gratee to trigger the commuity at this higher level of admiistrative uit. Phase 3: Scalig up Oce a umber of strategic villages have bee brought to ODF by direct triggerig, it is time to begi the scalig up process i which the ostrategic villages will be brought to ODF by the actors emergig from the Phase 2 process. There are a umber of compoets to this which are used as steps as the particular cotext requires. ä Compoet 1: Idirect triggerig of o-strategic villages This uses the followig steps: A Istitutioal Triggerig workshop is orgaised at strategic fokotay level. Represetatives from the ow ODF strategic villages are ivited, alog with participats from o-strategic villages. The o-strategic villages are triggered by Natural Leaders from the ODF strategic villages usig classic CLTS tools as well as testimoy by participats from the ODF villages (see Spotlight 4 below). Workig teams are built: a team is composed of oe or two represetatives from strategic villages, ad oe or two represetatives from o-strategic villages. Each team will the trigger o-strategic villages i the fokotay which have ot yet bee addressed. The teams will follow them up, ad accompay them util they reach the ODF status. Workig teams are assisted by Natural Leaders ad assiged to a Commuity Cosultat. 9 9 A Commuity Cosultat is a actor who has gaied experiece of the CLTS process at local level, usually his/her ow village ad eighbourig villages, ad is subsequetly ivited to draw o this experiece to facilitate CLTS more widely uder formal cotract with a NGO or other agecy. See Sectio

73 40 Promisig Pathways ä Compoet 2: Idirect triggerig i o-strategic fokotay Oce some strategic fokotay have achieved ODF i.e. all strategic ad o-strategic villages i the fokotay have become ODF through these approaches - it is time to cover the o-strategic fokotay. To do this, MIARINTSOA NGO orgaizes a workshop at commue level. Participats are actors/stakeholders from the strategic, ow ODF, fokotay ad from the o-strategic OD fokotay i the commue. The objective is to begi to brig the whole commue to ODF. There are four steps: Istitutioal Triggerig of actors/stakeholders from the o-strategic fokotay. Through testimoy, participats from strategic fokotay are used as a triggerig tool. The developmet of commo objectives ad a joit work pla i order to clea the commue of the practice of OD. Settig up a workig team for each o-strategic fokotay cosistig of a mix of participats from strategic ODF ad o-strategic fokotay. This team will be resposible for triggerig, followig up ad accompayig the o-strategic fokotay. At the same time, workig teams are set up by the fokotay workig team withi each village where idirect triggerig will take place, to moitor ad carry forward the process ad to commuicate with the fokotay level team. O a mothly basis, a implemetatio review is orgaized. ä Compoet 3: Spreadig to o-strategic commues Commuity Cosultats alog with some key actors from commues which have become ODF are brought to eighbourig o-odf commues for Istitutioal Triggerig ivolvig ifluetial actors from all the fokotay of the ew commue. Teams are formed to work at fokotay level, ad the at village level to begi the village triggerig process i this commue. A joit commue work pla also emerges from this triggerig process. The crosscuttig elemet of these compoets is usig the key Diorao WASH messages coied as a campaig, WASH Everywhere, i.e. icludig schools, churches, market places ad other local istitutios i the process of motivatig ifluetial actors. The selectio of compoets depeds o a umber of issues: Locatio ca be a defiig factor. Importat features of locatio iclude

74 Dyamic strategies ad iovative models for achievig chage at scale 41 whether a ODF village is ear to a o-odf village i a o-strategic eighbourig fokotay or whether a river coects a strategic fokotay with a o-strategic oe. The stage i the emergig process ad therefore the admiistrative level at which triggerig is required. Oe or two guidig priciples have emerged out of the experiece of implemetig this strategy, ad these have bee used to steer the spread of the strategy amogst further sub-gratees: First, it is uderstood as a sustaiability priciple that i each village oe key actor is eeded to take resposibility for every four or five households. Secod, it is clear from experiece that the strategy is more successful if moitorig the process towards ODF ad the the maiteace of ODF status is carried out by commuity members rather tha outsiders. Third, buildig a workig team, or Committee, out of these local level actors puts them i a collective which ca be more ifluetial tha Natural Leaders workig as idividuals. The role of the SG i this process chages quite rapidly from a direct aget of triggerig to oe of facilitator of a large umber of other actors carryig out triggerig, follow up, verificatio ad activities to maitai ODF. Like for the EA, evetually the role of the SG is oe of eabler of the implemetatio of others, rather tha direct implemetatio.. Lessos Leared 7 Applyig a scalig up strategy Oe sub-gratee caot trigger village by village i a scaled up versio of CLTS, so strategic sites - startig at district level ad workig dow - must be chose for direct itervetio that will maximise the potetial for spread by the may actors ivolved i the process. There ca be more tha oe compoet i the scalig up toolkit: the appropriate compoet ca the be fie-tued ad applied accordig to the specific locatio ad its stregths. But whatever strategy or formula is used, it must always be withi the framework of CLTS basic priciples.

75 42 Promisig Pathways 3.2 Istitutioal Triggerig Istitutioal Triggerig is the process of mobilisig istitutioal support for CLTS prior to commuity triggerig. It ivolves evokig similar emotios of shame, disgust ad self-respect which motivate key players to take actio withi their scope of ifluece, whether that be regio, district, commue, fokotay or village. Triggerig istitutios to mobilise their ow efforts ad resources for implemetig CLTS is key to esurig that CLTS ca be achieved at scale. Istitutioal Triggerig is a cetral tool i the shift from we (FAA) do it all to let s all do it together. As described above, the sub-gratee MIARINTSOA NGO developed a strategy for Istitutioal Triggerig at differet levels of the admiistrative structure usig a rage of differet advocacy activities. Figure 9 elaborates o the U-Shaped Curve scalig up strategy to specify activities coducted at each level of the U-shaped process, ragig from iformal meetigs, visits, persoal iteractios, formal meetigs of key actors ad Istitutioal Triggerig sessios i which groups of people are brought o board i CLTS. Triggerig sessio i progress Photo: Kamal Kar Figure 9: Multi-actor collaboratio ad actio framework i Vakiakaratra Regio ** The list of actors metioed i this diagram is idicative ad varies with locatio ad cotext.

76 Dyamic strategies ad iovative models for achievig chage at scale 43 levels FAA iput/ actio Outputs Actors Actors respose actio/strategy Outputs Regio Idividual visit/ persuasio iformatio sharig through mothly meetig Triggered regioal actors Resolutio for ODF strategic district Dowward commuicatio through govermet order Govermet: Chief of Regio & represetative of district Regioal director of developmet Director of water Regioal committee of Wash Director of Natioal Educatio Regioal director of Health Regioal director of populatio Civil Society Federatio of churches ad other religious groups, traditioal leaders Wash programmes ad projects Workshop ODF regio District Idividual/visit persuasio; iformatio at district meetig; Orgaisig field visits; coductig quarterly meetig Collectig feedback; Recommedatio ad follow up Triggered district actors; Writte commitmet of all actors; Selectio of strategic commue; Formatio of moitorig committee; ODF district Actio pla Govermet: Chief of district Vice chief of district Chief of CICSO Chief of Health/Ispectio District committee of WASH Represetatio frome commue Civil Society Federatio of churches ad other religious groups, traditioal leaders WASH NGO Local radio statio Commue (strategic) Idividual/visit persuasio; iformatio at Commue meetig; Orgaisig field visits; coductig regular meetig; Collectig feedback; Recommedatio ad follow up Triggered Commue actors; Writte commitmet of all actors; Selectio of strategic fokotay; Formatio of moitorig committee; Commue Actio pla Govermet: Mayor Executive officers Chief of Educatio Chief of local Hospital All chief of fokotay Civil Society Pastors/Priests Local orgaisatios Traditioal leaders Commuity cosultats Secod workshop with ODF strategic fokotay + o ODF fokotay; Group selectio based o earby fokotay; Advace ifo o reward; CC provides iformatio/traiig/ supervisio; Follow up Emergece of atural leaders; Formatio of actio team ad moitorig team; Triggerig ad follow up by the team from the ODF to o ODF fokotay with support of CC FOKONTANY (strategic) Commuicatig to chief of fokotay; Coduct collective meetig; Esurig represetatives from commue/district or moitorig committee members; Istitutioal triggerig by CC; Traiig to actors Triggered fokotay actors; Writte commitmet of all actors; Selectio of strategic village Formatio of facilitatio group moitorig committee fokotay Actio pla Govermet: Chief of Vice chief of fokotay School teachers Commuity health workers Security persoel Civil Society Pastors/Priests Local orgaisatios Traditioal leaders Commuity cosultats Cultural groups Secod workshop with Represetative ODF ad NON ODF fokotay Represetative from ODF village trigger o ODF with CC Writte commitmet betwee ODF ad o ODF village Actio pla ad timelie Traiig for voluteers by CC ad NGO Reward for success Ruig competitio The team formed with atural leaders of No-ODF ad ODF commuities take up the resposibility for the o-odf fokotay Moitorig resposibility by the atural leaders Recogitio of good work ad strategic ivolvemet of folk groups for spreadig Wash messages Village (strategic) Pre triggerig visit Triggerig of istitutio, adults ad childre Commuity actio pla Follow up ad declaratio of ODF Triggered Village level actors Emergece of Natural Leaders Village actio pla ODF village Message from Church Security me Health worker School teacher Pastor & religious leader Village elders Traditioal leader Village orgaisatio leader Villagers Childre Oce ODF, improvig i saitatio ladder; Usig collective actio for other activities for example cultivatio of ex-od areas; Triggerig eighbourig ostrategic village; Rewards for the triggerig team Neighbours triggered; Natural leaders are cofidet; Greater iter village cooperatio; Neighbourig village is ODF; Sustaied iterest of commuiry members

77 44 Promisig Pathways Istitutioal Triggerig takes place at several levels i this U-approach, ad durig both Phase 1 (Preparatio) ad Phase 2 (Scalig Up). Triggerig takes place at regioal or district level i meetigs with represetatives from various departmets; church leaders; other actors i saitatio, etc.; dow to commue ad fokotay level where key commuity members the fokotay chief; school teachers; commuity health workers; village security agets; traditioal leaders, etc. are ivited to a workshop. These exercises are the uts ad bolts i the process of geeratig CLTS actors for implemetatio at scale. They produce ot oly the Big Champios those visible actors who work o a broad geographical scale to promote CLTS but also the Small Champios who brig passio ad commitmet to the process ito the spaces of their daily lives: homesteads, eighbours, schools, etc. They produce people who are coviced ad are prepared to carry that covictio to others.. Spotlight 4 Picture of a local level Istitutioal Triggerig The Settig It is early ad chilly as people begi to gather i the school yard. Some people kow each other well ad some are stragers. Nobody seems to kow exactly what the meetig is about, but two fokotay chiefs have come; the commue Mayor is due to arrive; ad some people from a NGO are also here. They have brought some foreig visitors with them. They all go ito the schoolroom ad itroduce themselves. There are church leaders, teachers, studets, village security agets ad some geeral citizes here who just heard about the meetig ad came alog out of curiosity; there are people from about ie differet villages, formig two distict groups. Four of the villages are i a eighbourig commue, upriver from here. These visitors stad to oe side. The Triggerig The sub-gratee places a huge sheet of paper o the floor with some strategic markigs: this is the river; that is the road that rus betwee the villages. The facilitator is a Commuity Cosultat who has accompaied the ODF process of several villages ow, icludig his ow. Represetatives of the sub-gratee are also here, however, icludig its dyamic project maager. Participats from the fokotay villages i this commue are requested to mark the locatio of their villages with coloured sheets of paper, ad the, i village groups they agree o some

78 Dyamic strategies ad iovative models for achievig chage at scale 45 basic data about their village: how may households; populatio; umber of schools, churches, orgaisatios, wells ad latries. All the villages have a few latries, but ot may. The facilitator carefully leads the focus to health ad hygiee as suggested by the data. Are there eough latries so that everybody uses them? he asks. There is some hesitatio, eve deial of OD, but the a elderly woma boldly steps forward to mark OD areas aroud her village o the map, ad quickly others follow for each of the five villages. Spotaeously, oe participat starts represetig adult shit with bigger piles of sad tha the childre s. The facilitator picks this up ad does a quatificatio exercise: how much shit is there every day? Ad where does it go? I this way, the river is brought ito discussio, ad how the shit is i the water. Ad oce the talk is about drikig shit, it is a small step to thik about flies, ad about eatig shit too. This is a fast-paced triggerig. There is a lot to do, ad the facilitators wat to be fiished by luch time so that participats do ot feel too much of their time has bee take. But there are some hesitatios. There is agreemet that the participats represet people with resposibilities i their villages, ad that they should be leadig the saitatio drive. They should be the oes sesitizig others, but of course they eed to lead by example. How log will it take for them to build their ow latries? Some say a few days; some say three weeks. Oe participat worries that We ca sesitize, but people do ot always follow. So the facilitator takes everyoe outside. There are school toilets here; they defiitely smell bad as everyoe approaches. Do the studets ad teachers always use these smelly latries? the facilitator asks. They all go to look aroud the back ad fid the OD area. The facilitator pokes at oe pile of shit with a stick, the uses the water ad hair triggerig tool. By ow everyoe is truly disgusted. Oe village leader suddely thaks the facilitator for opeig their eyes to this reality. The group is triggered. Everybody agrees that they are the leadig citizes i their villages ad that they must do somethig about OD. Back iside, a poster showig the various ways that flies ca trasfer shit oto food is used: directly oto cooked food; oto fruit at the market which is the bought ad eate by may... The poit is that it oly takes oe perso doig OD to cause harm to may people. Everybody eeds to be o board for ODF to gai the health beefit. But the poster also oce more draws attetio to the flies. These eed to be i people s awareess because of what will happe ext.

79 46 Promisig Pathways IEC Material developed by FAA: A perso who defecates i the ope is like a sorcerer castig spells The Testimoies After a deadlie has bee agreed for everyoe preset to build their ow latries by, the group of visitig villagers is asked to step forward. They place their village markers o the same map, ad preset the same data as the first group. The obvious differece is that i each of this group s villages there are far more latries - virtually the same umber of latries as households. It would be easy for this group to take the moral high groud at this poit, but that is ot what they do. Istead they emphasise commo groud. They talk about how what coditios were like before the CLTS process i their villages, ad what they have gaied from it: there is less illess; they do ot have to look out where they put their feet; they ca sit comfortable i the shade of their fruit trees. They also poit to the river o the map ad ote that they have stopped shittig i the water that their eighbours here drik later. A Fly Ca Travel Six Kilometres... But there is a problem, they say. Although our village is ODF, we

80 Dyamic strategies ad iovative models for achievig chage at scale 47 are still eatig shit. Because a fly ca travel six kilometres, ad that meas they ca brig your shit to our village. The visitig group ackowledge that they eed to work o this together ad offer assistace to the ew group. The Actio Pla Immediately, the facilitator starts the process of buildig teams cosistig of a mixture of people from the ODF villages ad from the ew villages. People are ivited to choose a village which is ear to them or where they kow people. The aim is to make oe team for each of the five ew villages. The visitig villagers seem quite surprised at this developmet ad are hesitat about beig o teams i villages they do ot kow. But the facilitator emphasises the eed for collaboratio ad mutual help. Evetually each participat writes their ow ame ito a team as a mark of commitmet ad a list is placed ext to each village. The facilitator pushes for a Actio Pla: How log? Whe? There is a lot of mometum i this period. Fially, however, the sessio closes without completely fializig the Pla. Istead, participats are called for a two hour traiig four days later. A few people wat the traiig a few days later, but the sese of urgecy outweighs them. They are also told about a twice weekly radio programme about this process. They will be iterviewed i the programme ad they will be able to hear each other talk about the process. Fially, a Moitorig Committee is created out of a umber of people preset the fokotay chief; the health worker, school teachers, several of the village security agets, ad two members of the ODF villages. By midday, a covicig foudatio has bee built which should take five villages to ODF. This Spotlight describes a relatively local level Istitutioal Triggerig, ad team buildig to iteract directly with teams at village level. Similar triggerigs take place at commue ad district level. Natioal level triggerig has also o occasio take place i Madagascar, ivolvig stakeholders from across the sector. Defiig features of a Istitutioal Triggerig iclude that ifluetial people who work at the same level as the triggerig are preset. It is importat to iclude a hads-o compoet such as observig a latrie ad discussig either good or bad features. The triggerig must also iclude

81 48 Promisig Pathways settig up a actio pla ad deadlies for work at that level. Most importatly, i cotrast to straightforward advocacy work, Istitutioal Triggerig explicitly uses CLTS triggerig tools to create shock, disgust ad a sese of urgecy to act. Like village triggerig, it aims to hit hard with ucomfortable facts about ope defectio. MIARINTSOA NGO, sice they started usig Istitutioal Triggerig rather tha direct village triggerig i 2012, have coducted 131 Istitutioal Triggerigs across four districts. O average these ivolve actors, thus approximately 4500 actors have become ivolved via this techique through the work of oe SG. Some other SGs have also begu usig Istitutioal Triggerig i their ow scalig up work, ad MIARINTSOA NGO has take a role of odemad coach for this, i lie with the evolvig demad-drive specialist coachig strategy described i Sectio 2.5. The spread of Istitutioal Triggerig across other SGs is also a example of how the EA works as a architecture for facilitatig the spread of good practices ad iformatio throughout the programme. Oe sharig workshop was held specifically o this theme.. Lessos Leared 8 Istitutioal Triggerig Istitutioal Triggerig is a key tool i the scalig up toolbox because it ca brig i large umbers of actors who ca spread behaviour chage i their areas of ifluece. Istitutioal Triggerig ca take place at may differet istitutioal levels ad should ivolve key ifluetial players at that level. To be effective, the implemetig agecy should have a clear uderstadig of the larger goverace architecture, actors ad social cofiguratio of the regio. Istitutioal Triggerig must produce the roadmap ad without which implemetatio at scale is a distat dream. Testimoy from ihabitats of eighbourig areas which are already ODF is a very powerful additio to the triggerig. Idetifyig ad emphasisig the factor of coectedess of differet commuities is importat for spreadig the CLTS process. This could be about locatio up or dowstream of a river; it could be about the prevailig wid; it could be just about proximity. A fly ca travel six kilometres is a powerful matra for commuicatig this.

82 Dyamic strategies ad iovative models for achievig chage at scale Direct support from the sub-gratee i the scalig up process As the role of the SG has chaged from direct actio to facilitatio, a strategy has also developed which amouts to a ivetory of what is ivolved i successful facilitatio of the large umbers of other actors brought o board (See Sectio 3.4). Although the scalig up process rightly relies o hadig over the stick for other actors to implemet triggerig ad follow up i their surroudig areas, the sub-gratee MIARINTSOA NGO cotiues to provide as much direct support i the process as possible. Differet kids of support are offered i differet circumstaces.. Spotlight 5 Sub-gratee MIARINTSOA NGO s direct support iputs i the scalig up model 1. Presece at idirect village triggerig where possible After the Istitutioal Triggerig workshop, led by a Commuity Cosultat ad supported by MIARINTSOA NGO, there is also traiig for those who will trigger i the targeted fokotay or villages. Durig this traiig, the teams practice triggerig tools ad are give some resources, such as the IEC material developed by the EA. There is also always a hads-o compoet to this traiig: participats are asked to describe a fly-proof latrie, ad are take to observe a dirty latrie ad to talk about what eeds to chage. They practice makig it fly proof the locatio of the traiig is always arraged so some o fly-proof latries are available earby. Next, the Actio Pla developed durig the Istitutioal Triggerig (see Sectio 3.2) is made eve more precise. I this way the NGO kows the dates set for triggerig i each village ad is able to schedule for NGO presece alogside the triggerig. 2. Presece ad support for NLs triggerig for the first time There is always good support for Natural Leaders i their early triggerig.

83 50 Promisig Pathways 3. Occasioal itervetio i triggerig The NGO members might itervee i a triggerig at which they are preset if it is about to fail. It may also itervee ad trigger directly i a village which emerges as difficult. 4. Small icetives for the triggerig team There is a small reward for the idirect triggerig team whe the whole fokotay is declared ODF. This motivates the team to cotiue work util specific outcomes are achieved. The importat skill, acquired through practice ad experiece, has bee gaiig the right balace betwee ivolvig a large umber of actors ad etrustig them with the role of carryig out CLTS i a wider area, ad offerig the right amout of support at key momets ad i challegig situatios. Actors at village level have bee empowered with a visio ad a approach, ad offered the opportuity to take resposibility for creatig chage with those basic igrediets. The trust ivested by the SG i the ability of local people to lead the process is essetial. At the same time, the role of the SG i guidace ad quality cotrol of the process remais very importat.. Lessos Leared 9 Direct ad idirect itervetios ad support Reliable but hads-off support to ew Commuity Cosultats ad Natural Leaders from experieced practitioers is ecessary durig the scalig-up process. Fidig the right balace betwee givig support ad allowig experimetatio ad freedom is a importat step. A model i which a framework of priciples ad specific objectives are agreed but methods for achievig these are ot specified has bee successful at several differet levels of partership. 3.4 Expadig the base of implemetig actors A sigle orgaisatio or body of actors caot hope to achieve atio-wide ODF aloe. I this sectio we look at how CLTS actio roles have bee

84 Dyamic strategies ad iovative models for achievig chage at scale 51 actively created at differet levels, ad how local actors have bee empowered to step ito these roles, assistig i implemetatio of CLTS i their eighbourig commuities ad beyod. Usig commuity members to assist i the immediate follow up process after triggerig is critical to esurig that actio is sustaied. Early o i the FAA process, sub-gratees assumed that they themselves were resposible for all aspects of triggerig ad follow up i commuities, as they had bee traied ad felt they had the kowledge. As a result, follow-up was lackig ad triggerig was slow simply due to the lack of sub-gratee capacity. However, oce they were alerted to the importace of ivolvig local actors to assist them i the implemetatio process, progress could cotiue at a much greater speed, ad as Figure 10 shows, the umbers of local actors ivolved has icreased expoetially, i lie with the umbers of ODF villages. Figure 10: ODF Villages, Natural Leaders ad Commuity Cosultats Evolutio of ODF villages vs. Number of Natural Leaders ad Commuity Cosultats 9,000 8,000 7,000 6,000 7,241 8,538 7,007 5,000 4,000 3,000 2,000 1, April 10- Sept 10 0 Oct 10- March 11 0 April 11- Sept 11 1, Oct 11- March 12 2,001 April 12- Sept 12 1, , ,769 Oct 12- March 13 1,116 April 13- Sept 13 5,328 Oct 13- Dec 13 1,235 Number of ODF villages Number of Natural Leaders Number of Commuity Cosultats Several of the roles ito which local actors are placed are familiar to CLTS practitioers everywhere, but have take o ew dimesios i the scalig up process. Others roles are as yet less familiar, ad are evolvig as experiece with puttig scale-up plas ito actio icreases Natural Leaders Natural Leaders have log bee characters i the CLTS cast. These idividuals ted to be ethusiastic citizes withi their commuities, though they may

85 52 Promisig Pathways ot have bee active i ay official role i the past. They ted to aturally emerge durig the CLTS triggerig or follow-up process, ad with some urturig, support ad ecouragemet, they ca be empowered to take o a leadership role to trasform their ow commuity to become ODF. Natural leaders help i motivatig their fellow commuity members, i moitorig as households become ODF, ad i esurig that behaviour chage is sustaied. Sub-gratee staff simply idetify these Natural Leaders durig the triggerig, collect their cotact details, ad ca the liaise with them i the weeks followig util the commuity becomes ODF. All sub-gratees of FAA ow systematically work with Natural Leaders ad furthermore, ecourage them to take the ext step towards facilitatig CLTS i eighbourig commuities. This latter is the evolutio evidet i Madagascar: the success of the programme has much to do with the effective ivolvemet of a curret total of 8538 Natural Leaders who have cosistetly emerged out of triggerig processes i their ow villages. This meas that the umber of Natural Leaders is greater tha the curret total umber of ODF villages. Give that Natural Leaders work i more tha their ow village, this meas that several Natural Leaders are i pricipal available to each village. Ideed, the programme has made coscious efforts to systematically use Natural Leaders ot oly i supportig the ODF process i their ow villages, but the drawig o this experiece to spread the word ad actio to eighbourig areas. They are actively ecouraged to stay ivolved as CLTS spreads i their immediate eighbourig areas. Whe they have gaied experiece through beig associated with achievig ODF i several villages i their area, they may be called o to work as Commuity Cosultats further afield.. Profile 1 Profile of Agela, a Natural Leader Agela has bee a Natural Leader sice She was called upo to take the role by the mayor ad was give traiig. The she wet out ad coducted triggerig i commuities ad gives follow up ad support util they are ODF. That usually takes two more visits. Followig the traiig, she triggered her ow village first ad the 11 further villages. She attributes her success partly to the fact that she is well kow as a siger, so whe she speaks people liste to her. She

86 Dyamic strategies ad iovative models for achievig chage at scale 53 believes a good Natural Leader is someoe who has the cofidece to speak up, ad who is dyamic. Agela ejoys workig with people, ad movig to differet villages ad this helps i her professioal work too, as she also becomes well kow for her sigig. She says that after triggerig, most people accept the eed to chage, ad the few who resist usually follow whe they see others start to chage. At this stage, she may take resistat people to a fruit tree where they ca see how the flies o the rotte fruit o the groud also fly up to the fruit o the trees. She also talks about a fly havig six legs ad that it ca fly six km per day so it reaches a lot of places. The glass of water tool, she says, also has a huge impact. She meets with staff from the sub-gratee every three moths to assess progress. ASOS also visits after triggerig, ad this is a opportuity to discuss ay issues that they might have. Oce the commuity is ODF they stop the regular work there, but visit oe moth later to ecourage them to cotiue their behaviour Commuity Cosultats The FAA programme i Madagascar has ow 1184 idetified Commuity Cosultats draw from amog the most motivated Natural Leaders, ad they are fast becomig stadard cast members across the coutry. These are ow available to cotribute to scalig up the outcomes of the programme i other commues, districts ad regios. Beig draw from Natural Leaders, they have already gaied experiece i actively supportig the achievemet of ODF status i their ow ad several eighbourig commuities. They also ted to have a certai charisma, ad some mobility. I some cases Natural Leaders spotaeously decide to start triggerig i eighbourig commuities, without ay support or ecouragemet. However, all sub-gratees ow systematically empower promisig Natural Leaders to help spread CLTS further, ad whe they have gaied sufficiet experiece, to become Commuity Cosultats. Through this, they ca exted their ifluece across eighbourig commues as part of the scalig up strategy. Some sub-gratees have goe a step further to facilitate the orgaisatio of Commuity Cosultats ito a cooperative ad to offer them fiacial

87 54 Promisig Pathways icetives for achievig targets of a certai umber of ODF villages. I Aalajirofo Regio, the sub-gratee ASOS has supported Commuity Cosultats to orgaise at the commue level, ad has give them traiig ad ecouragemet to work i a systematic way. The Commuity Cosultats the work i teams of three or four to trigger commuities across the commue. They are able to achieve a ODF fokotay withi a couple of weeks, ad oce this is achieved ASOS gives a small fiacial reward to the group. I MIARINTSOA NGO i Vakiakaratra Regio, oe or two Commuity Cosultats have also bee absorbed i the orgaisatio more formally, as techical specialists, such as Behaviour Chage Specialists, but more commoly Commuity Cosultats work to carry experiece developed i oe commue usually their home commue to a differet, ofte eighbourig or earby, commue.. Profile 2 Profile of a Commuity Cosultat: Etiee Radriariso, Vakiakaratra Sometimes you trigger someoe whe you re just talkig to them i the street. Etiee Radriariso lives i Ambodifarihy ad is married with five childre. He is 48 years old. His twi sos, age 22, are both married ad have their ow lad. The ext so, age 19, is also a Commuity Cosultat i a differet district. His other childre are aged 14 ad 11. I 2010, sub-gratee MIARINTSOA NGO came to his village to trigger ad he was therefore amogst those beig triggered. His family already had a latrie, but he helped the Commuity Health Workers to sesitize the other villagers. This was a successful process ad ow the village is ODF. After ODF, the MIARINTSOA team asked him if he would be willig to help other villages become ODF. They explaied that sice a fly ca travel six km, if there are o-odf villages withi six km of his village, it is his problem too. So he worked i these villages util about six more were ODF. The FAA team visited these villages for the first time, but did t suggest aythig the. The they came a secod time ad saw the villages were still ODF.

88 Dyamic strategies ad iovative models for achievig chage at scale 55 After that, MIARINTSOA cotacted him persoally ad gave him traiig. The they offered him a cotract to work i aother commue, i the same way he had worked i his ow village. Now he s the Commuity Cosultat i charge of Ambodiriaa Commue. He triggers the commuity at village level the same as he did before - always lookig for Natural Leaders i this early process, so as to collaborate with them. Sometimes the Natural Leaders do t emerge straight away, so he does follow up ad a lot of activities ad actios util they really emerge. Most of the time, Etiee says, it is the chief of the fokotay who first emerges as a Natural Leader. Etiee Radriariso describes the other tasks that are ivolved as well: talkig to the Mayor, talkig to church leaders, to the pricipals of schools. He also does triggerig at the istitutioal level, the these key people trigger their ow church/school for it to impact i their ow place as well. This is importat as a balaced situatio is eeded i which people are usig latries i these istitutios as well as at home. I these processes, Etiee also provides hygiee iformatio. For triggerig at the village level, he uses mappig first, the the glass of water tool. If people are still ot triggered at this stage he takes the Walk of Disgust. It has ever happeed to him yet, but if they are still ot triggered the last tool is to say that he will leave them to it. He is certai that if he ever did have to use this tool, someoe would stop him from leavig. He says his mai motivatio is that he was really coviced by this process so he wats to covice other people too. He is also quite busy with other work, but says it is just a questio of time maagemet. He gives two hours a day to do this commuity work, ad rest of the time he works to take care of his family. Apart from agriculture, he also helps his wife i machie stitchig clothes. He has ½ a hectare of lad ad grows maily cassava ad maize. The family also helps with this work, ad sometimes he hires people i to help. The work is seasoal, so whe it is less busy i the fields, he has more time for commuity work. For the future, Etiee Radriariso sees life is a costat learig process. He always wats to improve ad go higher. I this job, he iteds to evetually become a district supervisor. The reaso I ejoy the work so much is oly because I am really coviced about it, he says. Sometimes you trigger someoe whe you re just talkig to them i the street!

89 56 Promisig Pathways. Profile 3 Doatie: Leader of the co-operative of Commuity Cosultats i Aalajirofo Doatie is a farmer, married with three childre. He is well kow because he has triggered a lot of villages sice he started i he triggered his ow village ad also aroud 29 others. He was ivolved with other orgaisatios ad programmes before this oe for example, he used to work o atural disasters. I that programme, he feels, there were a lot of meetigs but these did t impact o people s lives. CLTS is differet because it really touches people s lives ad big behaviour chages have occurred with real impacts. He had used sesitisatio approaches before but whe he leared about the triggerig tools he foud that they really shocked people ito takig actio. He says that a adaptatio he has made to the stadard CLTS practice was i goig house to house. People are too busy ad do t have time to meet. He fids the house to house method more successful. He has a booklet outliig the steps ad the tools for CLTS, but he does it his ow way ad also uses his ow ideas to trigger people. For example, to church goers he says that God had give us a clea world, clea water, etc. Churches use water for baptism which is a pure process so it should ot be made impure by usig dirty water. To others, he also talks about the fight for idepedece i 1947 whe people fought ad shed their blood for a better ad cleaer life. They washed the eviromet i their blood so we should ot make it dirty agai. O 28 Feb 2013, a group formed a Natural Leader ad Commuity Cosultat orgaisatio, which Doatie leads. There are 12 members (three wome ad ie me). They have orgaised themselves ito three teams to work i three differet areas coverig six fokotay. So far they have triggered 30 commuities. Lookig to the future, he hopes that soo the commue will be 100% ODF. Maybe the they will move to other commues if ASOS ca provide some support. If he is to go further afield to do triggerig, his livelihood will have to come from this work. He also hopes that he might have the chace to visit other regios. It would be very iterestig to lear from the experieces of people like him elsewhere.

90 Dyamic strategies ad iovative models for achievig chage at scale Champios Champios are also familiar characters i CLTS. What is ew here, however, is the active ature i which they are beig sought out, built up, ackowledged ad groomed ito the role by the catalyst sub-gratee actors. I Vatomadry District of Atsiaaa Regio, for example, sub-gratee MAMIZO has carefully urtured strategic champios who have sufficiet motivatio ad ifluece to take CLTS further, give it credece, ad are a big asset i the pursuit of sustaiability. Champios iclude idividuals workig at several differet levels. Their cetral role is i creatig a eablig eviromet to speed up the attaimet of programme objectives at the level at which they work. Their ivolvemet is also a cotributio to the sustaiability of programme outcomes because they are permaet ad usually sigificatly ifluetial members of their commuities. A commo strategy ad oe liked to the scalig up strategy of idetifyig strategic locatios has bee to urture the support of commue Mayors ad other idividuals i the district admiistratio. The mayor of Sahamatevia Commue i Vatomadry District, for example, was proud that his commue was oe of two selected, ad had bee a ifluetial actor i esurig success of the process. But Champios are also extremely effective at lower levels too. MAMIZO foud, for example, that Champios at fokotay level were able to exert wide ifluece, ofte beyod their ow fokotay.. Profile 4 Picture of a Champio: Bejami Zafialy, Fokotay Chief, Salehy Commue, Atsiaaa Regio Bejami Zafialy is the chief of Salehy Fokotay of Salehy Commue of Vatomadry District. He is a CLTS champio. Besides esurig a eablig eviromet for CLTS work i his fokotay, he has also played the role of Natural Leader ad, of late, as Commuity Cosultat. He ot oly took strog iitiative i his ow village ad fokotay, but also has bee quite istrumetal i motivatig aother 20 villages i the etire commue.

91 58 Promisig Pathways Bejami got iterested i the work whe MAMIZO came to him ad explaied their purpose. As he elaborates, I am the chief of the fokotay. Aythig that is goig to happe i the fokotay, I am the first perso to kow ad act upo it. From MAMIZO s explaatio, I became coviced that it is high time to stop ope defecatio. He started his work from his Bejami Zafialy, Champio i Salehy Commue. Photo: Sisir Pradha ow village ad whe people were sesitized through hads o CLTS exercises, they became coviced ad immediately prepared themselves to stop OD. He was very ecouraged by this respose ad so cotiued pursuig the issue i other villages of his fokotay. I these he also met success. Gradually he took active iterest i the surroudig fokotay, alog with other Natural Leaders which emerged durig the process of makig his ow fokotay ODF. Respodig to the questio of why he became a Champio, rather tha ay of his frieds ad colleagues, he said, The issue is very close to my heart. I wat to see my people healthy ad disease-free. At the same time, I started my work immediately after I received iput from the sub-gratee, which allowed me to sustai my iterest i the area of work I like. He is very happy to see the positive chages happeig aroud him. I his village, they have chaged the old OD area ito a restaurat site. Oe family is ow earig their livelihood out of this busiess. This oly became possible because the commuity took resposibility for stoppig OD. He aspires to cotiue his work ad cotribute to a ODF Madagascar at a higher level as Commuity Cosultat. He is iterested i helpig people develop mechaisms to improve their toilets. Sice people are poor ad have low purchasig power, he will ecourage commuity members to pool resources ad build revolvig fuds to fiace improved saitatio.

92 Dyamic strategies ad iovative models for achievig chage at scale BCC experts, local techicias, masos It has bee recogized that a successful scaled-up saitatio movemet will eed to ivolve a broad rage of differet actors fulfillig tasks i villages, market places ad orgaisatios. I keepig with this, some orgaisatios have bee traiig ad creatig several other kids of implemetig actors: MIARINTSOA NGO i Vakiakaratra Regio has absorbed some former Natural Leaders showig particular promise ito the orgaisatio as specialists i Techical Support ad Behaviour Chage Commuicatio (BCC). BCC experts have also bee traied by ADEMA, i Itasy Regio. MIARINTSOA NGO has traied four local busiesses i the productio of sa plat slabs. FAMONJENA i Itasy Regio has traied selected youg people to istall a iovative desig of sa plat i existig latrie spaces. Some orgaisatios have traied masos to build latries where there is demad. ADEMA s BCC experts, for example, are assiged roles focused o educatio, mobilizatio, spreadig the three key messages of WASH 10 ad i usig the local radio broadcasts. They are ivolved i the desig ad developmet of visual ad audio-visual tools that will be used to ehace the triggerig, to reiforce the idea of commuities ow capacity to solve their saitatio issues; to maitai the ODF status, ad for their educatio. A BCC expert must therefore have the capacity to idetify efficiet commuicatio tools ad at which step they should be used. For CLTS, the use of audio-visual ad visual material should begi after the triggerig i order ot to bias the triggerig process. A umber of commuity egieers emerge from the ODF process i their ow villages. SGs select from amog these idividuals with particular aptitude ad recommed them for traiig to carry techical capacity more widely across the commue. At preset 75 seior local techicias / Master Traiers have bee traied i five types of low cost improved latrie techologies as well as i the process ad implemetatio of saitatio marketig. These master traiigs are carried out i partership with the 10 The three key messages of Diorao WASH are: 1) had washig with soap or ash; 2) have ad properly use a improved latrie (fly proof ad usig a sa plat slab); 3) use safe drikig water.

93 60 Promisig Pathways NGO Sait Gabriel, ad traiees are expected to trai juior egieers at the local level. These techicias the play a sigificat role i the scalig up process by offerig services i latrie improvemet via local techologies i ODF villages (see Sectio 4). They offer paid services related to improved saitatio, advice, productio, sale, istallatio ad after sales services Moitorig committees ad the follow up push (madoa) At the begiig of the FAA programme i Madagascar, follow up was weak, triggerig was ofte i itself cosidered a outcome rather tha the ODF villages it is iteded to produce, ad the ratio of triggered villages to ODF villages was low. I some cases, the time take betwee triggerig ad ODF was excessive. Recogisig this as a problem area, the EA set up activities to draw the attetio of sub-gratees to the follow up process, ad evetually prepared a follow up protocol or guidelies. These guidelies were, however, loose eough so that sub-gratees were able to operatioalize follow up i the way that best suited their area ad project strategy. The guidelies iclude suggestios for follow up preparatio, approach ad sequecig. They highlight, for example, that settig the right time for follow up meetigs is importat if the maximum umber of village residets are to be preset. For the approach, emphasis is give to recogisig ad applaudig the achievemets already made, as well as to dyamic reiforcig of the ODF goal. The guidelies also specify a clear objective: to achieve ODF more quickly ad idetify tasks of moitorig immediately after triggerig (the ext day); follow up over the ext few weeks, ad primary ODF verificatio.

94 Dyamic strategies ad iovative models for achievig chage at scale 61 IEC material developed by FAA: the three criteria for ODF A village where there is o shit outside ad everybody uses a latrie. The latries must be clea, covered ad fly proof. Next to all latries there is a hadwashig device. However, cofroted oce more with the limited capacity of sub-gratees to follow up adequately whe CLTS was operatig at scale, differet SGs developed their ow solutios. These are variatios o the theme of settig up moitorig committees with membership from across the wider commuity. I some cases, moitorig committees were set up to follow up after triggerig, provide advice ad support, ad assess ODF status. Usually these ivolve large umbers of people, ad a umber of levels of moitorig. MIARINTSOA NGO has created moitorig committees at each admiistrative level. At the district level, these iclude represetatives from the Departmets of Water, Eviromet, Educatio etc. as well as represetatives from the district level Diorao WASH if there is oe, ad from the federatio of churches ad other religious groups; NGOs workig o WASH such as SAF/FJKM ad WaterAid, ad members of the local radio statio.

95 62 Promisig Pathways At the commue level, the committee would iclude the commue Mayor; some executive officers; the chief of educatio; chief of the local hospital; pastors; represetatives of local orgaisatios ad Commuity Cosultats. At the fokotay level, moitorig committees cosist of the chief of fokotay; the vice chief; school teachers; Commuity Health Workers; security persoel; pastors; represetatives of local orgaisatios, Commuity Cosultats ad represetatives of cultural groups. At the village level, moitorig committees iclude security me; a health worker, a school teacher, a pastor, village elders, village orgaisatio leaders etc. Similarly AINGA MADAGASCAR built Diorao WASH orgaisatios at district level ad i 87 commues. Like i MIARINTSOA NGO s committees, at district level these iclude represetatives from the Miistries of Health ad Educatio. At the commue level, they iclude the chief of the Health Cetre; a represetative from schools admiistratio, ad teachers, etc. As the triggerig process spreads, all of these committees will be ivolved i follow up. AINGA MADAGASCAR expects that i the course of brigig 800 villages to ODF, 330 actors will be ivolved. I some cases, as oted earlier, the results of icreased attetio to follow up ad a clear strategy to put it ito place have bee dramatic. AINGA MADAGASCAR, for example, had oly 16 ODF villages five moths after the start of triggerig, but i the three moths after allocatig follow up duties to the commue ad district level Diorao WASH Committees, a further 425 villages became ODF. Ideed, by December 2013, AINGA MADAGASCAR had produced 934 ODF villages although they had triggered oly 639. This was possible due to the excellet work doe by the other actors icludig follow up committees, Natural Leaders ad Commuity Cosultats.. Lessos Leared 10 Facilitatig large umbers of actors Skills ad experiece gaied through oe s ow village achievig ODF status should be tapped to spread CLTS to wider areas. Failig to idetify ad develop the right Natural Leaders ad Commuity Cosultats squaders this opportuity. Clear mechaisms for progressig effective idividuals to work more widely should be proactively developed. Career plaig for

96 Dyamic strategies ad iovative models for achievig chage at scale 63 Natural Leaders ad Commuity Cosultats to take o higher order roles i the CLTS process is costructive to keep up their motivatio. Similarly, developig icetive structures like attributig a clear idetity ad defiig rewards helps to ehace their performace. Champios ca be made as well as foud. They are rich resources at may differet levels key idividuals i strategic positios ca have wide effect. Idetifyig these idividuals ad actively buildig them as Champios ca be a effective strategy. Follow-up work is essetial, ad is aother reaso why sub-gratees caot do it all themselves. People brought ito the follow-up process ca come from all parts of the commuity, but eed to fully uderstad the spirit of CLTS. Guidelies ad/or clear terms of referece are helpful for specifyig their role. 3.5 Collaboratios across a rage of actors to reach scale Collaboratio is a cetral peg i Madagascar s visio of a ODF coutry. To be effective as a method for growig the movemet, collaboratio has to go beyod payig lip service to protocol ad etiquette aroud basic commuicatio betwee the bigger ad more powerful actors. Rather, collaboratio eeds to take the form of a sicere search for the most appropriate roles for each player i each settig. To arrive at roles which support rather tha udermie the actios of other actors, full commuicatio of itet ad approach from each actor is essetial, as is a certai level of trust which ca arise out of a recogised shared visio. There have bee several examples of collaboratio drivig CLTS actio at differet levels: As see, sub-gratees have used collaboratio across key idividuals i eighbourig groups of villages to spread CLTS from oe area to aother. Collaboratios betwee sub-gratees have eabled the metorig of oe by aother i key processes. For example, MIARINTSOA NGO at 15 moths ito their scalig up process has offered support ad guidace to GREEN ad the Sofia Makadio Project as they are startig to expad CLTS o a large scale. This is oe form i which a kid of specialised coachig system is evolvig. As a result, the umber of ODF villages i

97 64 Promisig Pathways GREEN targeted area has bee tripled i oly three moths. Collaboratios betwee the private sector ad a sub-gratee, such as ASOS NGO traiig private traders i makig sa plat Collaboratio betwee sub-gratees ad Diorao WASH I a strikig example of a wi-wi collaboratio which has produced excellet results for both orgaisatios ivolved, AINGA MADAGASCAR i Vatovavy Fitoviay Regio co-ordiated with the Regioal WASH coalitio right from project proposal developmet stage. I effect, they wrote the buildig of the district ad commue level WASH coalitio orgaisatios ito their project, partially fulfillig a log-held objective of the atioal level Diorao WASH to establish orgaisatios at these levels i regios.. Spotlight 6 Success strategy i Vatovavy Fitoviay AINGA MADAGASCAR NGO I Vatovavy Fitoviay Regio, the FAA programme is implemeted by AINGA MADAGASCAR. They started implemetatio i October 2012 ad already by July 2013 they had achieved 425 ODF villages out of 441 that were triggered i November ad December What are the reasos behid this very rapid achievemet of results? A key aspect appears to be their strategy of workig through the structure of Diorao WASH. I Vatovavy Fitoviay Regio, the Regioal Diorao WASH was established i It is made up of represetatives of the Miistries of Health, Populatio, Eviromet, Water, Tourism ad Educatio; represetatives of NGOs such as the Red Cross, AINGA MADAGASCAR, ASOS ad others; the head of churches, the head of the scouts ad represetatives of the media. Whe it was established, it was iteded that the Regioal Diorao WASH would establish further committees at district ad commue levels. However members reported that they had iitially bee uable to establish these due to a lack of fuds. Therefore whe the FAA

98 Dyamic strategies ad iovative models for achievig chage at scale 65 programme was allocated for the regio, part of the project implemetatio icluded AINGA MADAGASCAR establishig these committees ad implemetig the project partially through these ew bodies, potetially creatig a mutually beeficial arragemet betwee the Diorao WASH ad the sub-gratee. The represetative of AINGA MADAGASCAR reported that they had a lot of previous experiece i istitutio buildig ad were happy to take this approach. I the early stages of the project, therefore, AINGA MADAGASCAR established six District WASH Coalitio Committees (DWCCs) ad 87 Commue WASH Coalitio Committees (CWCCs). Iitially, the triggerig of 441 commuities by AINGA MADAGASCAR Techical Assistats was provig fairly slow i achievig ODF outcomes. Durig a atioal level sharig workshop orgaised by FAA i March 2013, it was suggested that AINGA MADAGASCAR use the CWCCs ad DWCCs more actively i the process of follow up after triggerig. Oce this strategy was implemeted, the results radically improved: by March 2013 oly 16 villages were ODF, but betwee March ad ed Jue 425 further villages became ODF. Members of the Commue WASH Coalitio Committees divide the villages i the commue betwee them, ad pay regular visits to ecourage behaviour chage. They give some techical support where eeded, ad they mobilise people without pressurig them. O average they make two or three visits before the commuity becomes ODF. They do t get ay paymet for their cotributios but whe they atted district level Diorao WASH meetigs they get paid a per diem ad trasport. The DWCC members udertakig a moitorig visit are always accompaied by a CWCC member from that area. Sometimes this role ca iclude facilitatig discussio to arrive at techical solutios. Oe moitorig group, for example, reported that i the village they had just visited, o-oe was defecatig outside, but there were too may flies aroud to be able to declare ODF. So they had spet the visit discussig the flies ad helpig the commuity idetify ways to reduce their presece, icludig through geeral waste maagemet strategies. The DWCC has quarterly meetigs to review progress ad to address problems ad challeges. There is a represetative of CWCC i the DWCC ad there is regular iformal commuicatio outside of meetigs. The DWCC has a budget to brig people to meetigs ad to travel to commuities for verificatio.

99 66 Promisig Pathways Collaboratio betwee sub-gratees ad other implemetig actors i saitatio I a differet example of collaboratio, MAMIZO, a sub-gratee workig with a small FAA grat i Atsiaaa Regio, experieced some tesios with other NGOs ad agecies ruig projects i the same areas, ad the Diorao WASH was istrumetal i helpig them to resolve this issue. MAMIZO was ew to CLTS: they had their first traiig i CLTS three moths before the start of their first grat, ad o previous experiece. They aimed to trigger 100 villages over the 16 moth grat period. Half way through the project, they also joied a traiig ru by Kamal Kar, ad o his advice started to itegrate Natural Leaders ad Commuity Cosultats/Champios more strogly ito the project strategy. As a result, at the ed of 16 moths, results exceeded objectives. I the course of this, however, they foud that other orgaisatios work i saitatio was ot always supportive of their implemetatio of CLTS ad sometimes threateed to prevet their work from properly igitig. They foud the regioal level Diorao WASH was a space i which these coflicts could be resolved ad complemetary ad mutually supportive roles established.. Spotlight 7 Actor coflicts ad the magic of the Diorao WASH: MAMIZO collaborates i Atsiaaa Regio MAMIZO experieced may challeges i egotiatig the differet approaches ad styles of work o both water ad saitatio that were preset i the areas where they were startig to work with CLTS. USAID, UNICEF ad WaterAid all had projects i the area, maily workig through implemetig NGOs or govermet agecies. Although by the time MAMIZO started work other orgaisatios were also usig CLTS, there were still differeces i methodology. MAMIZO foud the regioal level Diorao WASH immesely helpful i solvig may of these territorial problems. The coalitio has brought actors together both formally i meetigs ad iformally i outigs. At oe level, this commuicatio simply meas that the actors kow much more about what each other are doig. Beyod this, the iformatio exchage meas that actors with objectives or populatios i commo have a opportuity to fid out about each other s stregths ad weakesses, which ca result i better strategies.

100 Dyamic strategies ad iovative models for achievig chage at scale 67 I oe example, commuicatio through the Diorao WASH meat it was possible to overcome difficulties MAMIZO was havig with aother NGO, Sait Gabriel. Through the coalitio, they worked out a arragemet such that both orgaizatios were workig to their stregths, with MAMIZO doig behaviour chage work ad Sait Gabriel developig the saitatio marketig mechaisms. I aother example, MAMIZO was fidig that their way of workig with CLTS coflicted to some extet with that already established i Mahaoro District, where USAID was fiishig up a project. MAMIZO had bee workig with oe village i that district which was orgaizig a ODF celebratio, so o the basis of cotact with USAID through the Coalitio, they ivited the USAID actors to the celebratio. After that, they had a meetig i which it was agreed that as the USAID woud up their work, they would had over the sites to MAMIZO to esure sustaiability ad to cotiue the process i villages which had ot become ODF. All levels of iformatio, good ad bad, were exchaged i order to optimize this strategy. Whe it is ecessary to ehace coordiatio ad syergy to get a harmoized approach, Diorao WASH has a fudametal role i coflict resolutio. This is also true at the atioal level of Diorao WASH, where harmoizatio of approaches to saitatio is ot complete. I particular, the Decree o Saitatio regulatig the activity of the Directorate of Saitatio states that CLTS is a priority approach but others are also possible. This is a poit of disagreemet betwee the Directorate ad the FAA, which Diorao WASH attempts to egotiate Collaboratios betwee SGs ad the regioal ad district admiistratio At the atioal level, relatively active collaboratio betwee the EA ad govermet departmets has bee established via the close ivolvemet of the Programme Coordiatig Mechaism (PCM). At regioal level, also, there are examples of good collaboratio, although ot ecessarily through the formal goverace process. Sub-gratee MIARINTSOA NGO, workig i Vakiakaratra Regio, for example, had coducted a exteded advocacy process at differet levels of the admiistrative structure. It had also built Moitorig Committees at each level: district, commue ad fokotay. Both district ad commue level committees icluded represetatives from

101 68 Promisig Pathways govermet departmets such as the Departmets of Eviromet ad Educatio although these represetatives saw their ivolvemet i the committees as persoally motivated ad volutary rather tha madated as part of their role i the Departmet. Istitutioal Triggerig (See Spotlight 4) is a importat tool for iitiatig ad maximisig collaboratio at regio, district ad commue level ad for creatig the follow-up committees at all levels which brig a umber of differet actors together. From the Vakiakaratra example (MIARINTSOA NGO), this triggerig strategy has bee rolled out to other regios such as Diaa, Sofia, Boey etc. Scope for deeper collaboratios may be limited i Madagascar i some areas at this time by the uresolved political crisis. I oe case at regioal level, this was cited as a major blockage to the govermet s ability to act i co-ordiatio with NGOs, but also as a excuse for other agecies to bypass govermet departmets, despite the fact that these are the pillars of sustaiability of the project outcomes:. Profile 5 Better collaboratio would beefit everyoe: Iterview with the Director, Water, Saitatio ad Hygiee, Atsiaaa Regio Mme Marie Pierrette Ramihaja Voitsoa has bee the director of water, saitatio ad hygiee for two regios icludig Atsiaaa sice 2009 but sice 2012 whe the regios were separated, she became resposible oly for Atsiaaa Regio. She is very ethusiastic about CLTS. Mme Ramihaja Voitsoa explaied that although saitatio iitiatives i the regio are ot ew, there was earlier ot much commuicatio amog the actors or emphasis o behaviour chage. Oly whe FAA came ito the picture did the may meetigs begi to be coducted ad a eviromet of workig together was built. Atsiaaa Regioal Director of Water, Mme Marie Pierrette Ramihaja Voitsoa. Photo: Sisir Pradha

102 Dyamic strategies ad iovative models for achievig chage at scale 69 Before adoptig the CLTS approach, may actors icludig the Govermet of Madagascar costructed toilets o behalf of the commuity, but this approach failed to serve the purpose. I the case of commuity toilets, whe these became dirty o oe was iterested i maagig them ad they were abadoed. Household toilets geerally met the same fate. But with CLTS, the results are tagible. Citig her experieces from ivolvemet i the ODF certificatio process, she said that she was amazed to see how clea the villages are, that there is o smell, that people are takig resposibility without ay coercio from outside ad they have built latries themselves without ay outside support. She believes that this approach is more sustaiable ad should be implemeted everywhere. The director expressed uhappiess about various actors who are still followig the subsidy approach, ad sometimes by-passig the local govermet i order to do so. For example, oe NGO came to discuss a subsidy-based project with her before implemetatio. She emphasised that a behaviour chage approach is ecessary, but the NGO simply did ot come back to her ad wet ahead with implemetatio. Although FAA has iitiated a collaboratio, tryig to brig together all stakeholders icludig her office, the director oted a few challeges impedig greater ivolvemet of her office i the process: Because of the political crisis, may doors do ot recogise the govermet ad hece some are either accoutable or seek govermet support. But whe there is a problem, i may cases the icidet is referred back to her office for solutios. Sice the director s office is ot ivolved i the implemetatio process, at times it is very difficult to solve problems that arise later. Regioal ad district level WASH coalitios exists but they do ot have resources to perform properly. They have a actio pla, but it is seldom followed for lack of fuds. There are may parters who are iterested i workig i accessible areas but few are iterested i reachig the commues farthest from

103 70 Promisig Pathways the district headquarters. So the govermet is left with resposibility for these areas, but lacks the fiacial resources to perform this role fully. The FAA programme is fuctioig well, showig results o the groud, ad has started collaboratio. But there could be eve greater collaboratio if it is iteded that the director s office will take up the approach ad the resources gaied oce the project is phased out. The govermet structure is the sustaiable structure. Hece the people workig withi this structure should be ivolved i the capacity developmet ad experiece sharig process. Oly beig ivolved i the ODF certificatio is ot eough. She cocluded by sayig that the process of collaboratio iitiated by FAA is good ad she is optimistic that it will get stroger ad have better results if the Regioal Director, Diorao WASH ad all other actors come together ad work coheretly Collaboratio with schools, churches ad other local actors The process of scalig up CLTS has also ivolved other kids of collaboratios, because the process makes appeals to all kids of commuity members, ad ofte specifically to idividuals resposible for ifluetial orgaisatios. There have bee istaces, for example, i which iteractios with teachers ad church leaders i istitutioal or commuity triggerig processes have caused those istitutios to seek saitatio improvemets at their ow school or church. This was doe usually through their ow iitiatives, or alteratively by seekig support from the church structure ad/or the Diorao WASH. I oe example, CLTS triggerig acted as a catalyst to reigite a saitatio i schools project which had earlier failed to stop ope defecatio.

104 Dyamic strategies ad iovative models for achievig chage at scale 71. Spotlight 8 School saitatio liks i Itasy Regio Before the sub-gratee FAMONJENA NGO worked with the FAA project, they facilitated a schools saitatio project which built school toilet blocks i all the schools i Ampefy Commue, i Itasy Regio, with fudig from a Frech NGO. This was i The teacher, Radriamaholitiaa Simoette, i Soaviadriaa Fokotay primary school, said, however, that before the village became ODF the childre did t use the toilet as they were ot used to the cubicles ad were afraid to use them. They cotiued to go to the bush. However, oce the village was triggered i 2012 the childre started to use the toilet at school alogside their household or shared latries at home. The teacher reported that the differece i the school sice the fokotay became ODF has bee huge. Before, up to 50 per cet of the 95 childre i the school were abset at ay oe time due to sickess, but ow the attedace rate is ear to 100 per cet. The childre are more motivated to study ad their performace has improved. She reported that she is much more satisfied i her job as the childre are attedig school, they are clea, ad she also has a toilet that she ca use. She oted that the whole village is cleaer. The childre sag sogs about usig the toilet, had washig with soap, ad had washig before eatig. Of the studets i the school, five do ot live withi the commue but come from o-odf villages. Those childre have spread the ODF message to their families ad all have a latrie i their household, though their villages are still ot 100 per cet ODF. Those villages will be triggered uder the ext phase of FAA s support to FAMONJENA NGO. As might be expected give the scalig up process ad the eed for multiple actors, for most projects, a umber of differet kids of collaboratios operate together to brig about ODF. I Ampasime Maatsatraa Commue of Feerive Est District of Aalajirofo, Natural Leaders were asked to idetify all the istitutioal actors which had bee ivolved i the ODF process. The commue was almost fully ODF (oly the fokotay ecompassig the local tow was still OD). The Natural Leaders idetified 15 differet actors ad the agreed o a rakig of these actors accordig to their cotributio to the ODF process.

105 72 Promisig Pathways Table 1: Rakig of istitutioal actors i Ampasime Maatsatraa Commue Actor Score Reaso out of 10 Natural Leaders / 10 They do the hardest job because Commuity Cosultats they go to villages. Deputy Mayor 10 Visits differet villages, helps NLs ad CCs ad gives traiig ad support. ASOS the sub-gratee 10 Nothig would have happeed without them. Mayor 9 He provides techical support. Fokotay chief 9 He provides techical support ad stregth. CCDW (Commue WASH 9 Works hard i collaboratio with Coalitio Committee) CCs ad NLs. Tagalamea 7 They have power i the commuity. (Traditioal Leaders) Miistry of Water 7 The MoW provides some sesitizatio. Commue police/ 7 They supervise the rules about OD. After security agets a first warig they fie a household without a latrie Ariary. Miistry of Home Affairs 6 MoHA helps by sesitizig people i meetigs. Lad Agecy (BIF) 5 Whe they go to measure lad plots, if they see OD they iform people. Churches 5 They sesitize people i meetigs. Local techicias 5 These work with NLs ad CCs. Jouralists 5 They report o ODF progress ad evets o local radio. UNICEF 1 Works o school saitatio.

106 Dyamic strategies ad iovative models for achievig chage at scale 73. Lessos Leared 11 Local ad regioal collaboratio Collaboratios betwee differet kids of actors should be urtured as a priority at all admiistrative levels. Collaboratios are the basis for ivolvig sufficiet umbers of actors to scale up. Wi-wi situatios i which other orgaisatios are supported to eable CLTS to flourish ca beefit everybody. These ca also greatly improve sustaiability. Idetifyig actors ca reveal cotributios from uexpected sources, such as from lad agecy officials, who ca also the be fully egaged i the process. It is importat to recogise that differet actors have differet roles i various stages of CLTS implemetatio from pre-triggerig to post-odf follow up. Some, like Natural Leaders ad Commuity Cosultats are very effective i pre-triggerig ad follow up; other agecies like BIF (the lad survey departmet) could be very effective i post ODF moitorig actio. 3.6 Leveragig traditioal structures ad cultural processes A vital elemet of the success stories takig place i Madagascar has bee the ability of differet orgaisatios to draw traditioal ad cultural features ito the CLTS process. This has played out i differet ways across the varied ad complex social ladscape of this large islad, but a commo feature has bee the absolute ecessary to work through traditioal structures Active ivolvemet of traditioal leaders A commo strategy, see i differet maifestatios i differet regios, was to pay particular attetio to brigig traditioal leaders o board with CLTS. The differet social groups across the coutry of Bara, Sakalava, Atemoro, Betsimisaraka, etc. have leadership structures amed variously Ampajaka, Apajaka ad Tagalamea, but strategies to brig them ito the CLTS process have emerged cosistetly ad are similar. Ofte this is achieved through some versio of Istitutioal Triggerig. This strategy

107 74 Promisig Pathways was usually ot preset i the iitial stages of the FAA programme i differet regios, but was put ito place because of slow progress ad a gradual recogitio that traditioal leaders hold authority that ca be tapped i a useful way. Istitutioal Triggerig to iclude these actors might take place directly i meetigs with groups of traditioal leaders, or via itroductios ad persuasio by the Mayor or other Champio; or traditioal leaders might be ivited to a wider Istitutioal Triggerig. Advocacy strategies have also icluded courtesy calls, callig a traditioal leader s coferece; ad holdig mothly meetigs at the commue level with them.. Spotlight 9 Key strategy: Triggerig the Tagalamea I Atsiaaa Regio, MAMIZO foud that addressig the traditioal leaders kow i this area as Tagalamea - has bee a absolutely ecessary step i their CLTS process ad traditioal leaders also reported that the project just did t work before MAMIZO called them together for a workshop. MAMIZO s iitial experiece was that customs, oversee explicitly or implicitly by Tagalamea, were a sigificat blockage i CLTS. People struggled with a taboo or perceptio that it was disgustig to keep shit i oe place as the latrie system requires. They also foud it difficult to chage from a system based o defecatig outside the village to oe based o brigig the shit ito the villages, ad ofte closer to home. Triggered Tagalamea with the Champio Mayor (cetre) i Atsiaaa Regio Photo: Kirsty Milward MAMIZO also recogised that, especially i situatios related to culture or appropriate behaviour, traditioal leaders have a lot of authority whe they speak. Their strategy was first to ivite Tagalamea from their workig villages to joi a WASH committee, ad the have a separate meetig with all of them. Effectively, this was a triggerig with adaptatios desiged to address the particular cocers of these leaders. The symbolic importace of clea water for rituals was emphasised ad draw o whe facilitators asked if the Tagalamea were sure the water was free of shit. Facilitators drew attetio to the

108 Dyamic strategies ad iovative models for achievig chage at scale 75 fact that there is ofte shit, or eve a whole OD area, very close to every village s sacred place, so they asked, How is this sacred? At this meetig, Tagalamea agreed that if they were to take this forward, it was first ecessary to build their ow latries, ad the esure that each household i their direct families also had latries. Several the set deadlies of 15 days for every household to have a latrie ad a fie of 5000 AR for ot buildig a latrie. For some of the smaller villages, the period from the Tagalamea meetig to village ODF was oly two weeks; for the bigger villages the process took up to six weeks. The Tagalamea are very pleased they were cosulted i this process, that they are recogised as key actors, ad are proud of the results. They also thik that they should be recogised as resposible authorities more ofte Uderstadig the authority structure the Ampajaka Addig depth to the realizatio that traditioal leaders are key gatekeepers to the success of a CLTS process, AINGA MADAGASCAR i Vatovavy Fitoviay Regio discovered that oce the local traditioal leaders here kow as the Ampajaka, or literally kigs - were o board, progress to ODF for the whole commuity could be remarkably rapid. The mai criterio geeratig this speed was whether all of the relevat authority figures had bee brought o board. Esurig this ivolved fully uderstadig how the Ampajaka hierarchy worked. I this case, the Ampajaka is the Kig of the big house ad represets a village or sometimes a group of villages. Workig as his mouthpiece ad implemeters, below him there are chiefs of the big house Chiefs of Traobe. Each of these chiefs has authority over three or four households of his direct family (see Figure 11). The key, AINGA MADAGASCAR explaied, is makig sure each of the Traobe Chiefs is triggered as well as the Ampajaka. This is because the Ampajaka by traditio does ot make decisios i isolatio from the people he is resposible for. For him, the mouthpieces of the situatio of his people are the Chiefs of Traobe. Therefore, addressig the Ampajaka directly will ot yield a decisio rather it is the Chiefs of Traobe who have to covey advice to him. Oce that is doe, very little else is eeded as the Traobe Chief has the authority to esure each of the households i his group will build a latrie fast. The Traobe Chiefs ot oly ivolve

109 76 Promisig Pathways themselves i triggerig, motivate their cla group but also esure the follow up process i their locatios. I fact, the Diorao WASH moitorig committee ow claim that the ODF process is much easier i villages with a Ampajaka structure. I some cases, Ampajaka/Tagalamea represetatives are ivited to be members of the Commue WASH Coalitio Committee. Figure 11: Schematic example of the Ampajaka hierarchy i Vatovavy Fitoviay Regio Ampajaka Chief of Traobe Household Chief of Traobe Household Chief of Traobe Household Household Household Household Household Household Household Workig to chage custom The Diorao WASH members i Vatovavy Fitoviay have, however, foud that it is ot just a case of buyig ito traditioal structures i order to alig their authority with CLTS objectives. Rather, they have foud that there are i fact spaces for egotiatio withi traditios however fixed ad uchageable these are preseted as beig.. Spotlight 10 Reivetig traditio: the Diorao WASH argues the case for latries Some of AINGA s workig areas i Vatovavy Fitoviay Regio, are said to be very traditioal ad hard to chage. Some groups i this area have claimed ope defecatio as a custom or traditio. People i Maazare

110 Dyamic strategies ad iovative models for achievig chage at scale 77 District, for example, said that defecatig o the beach is their customary practice. The implicatio, of course, is that OD is a importat feature of cultural idetity, therefore ialieable especially by outsiders or stragers. But members of the regioal Diorao WASH the regioal co-ordiator; a represetative of the Miistry of Water; ad a represetative of the Miistry of Eviromet, argue covicigly that together AINGA MADAGASCAR ad the Diorao WASH ca make a ew traditio of latrie use amogst these groups. The formula they use, says Ada Herijaka of the MoW, is = 3 : that is the value added of this sub-gratee-diorao WASH collaboratio. The regioal co-ordiator, who comes from this regio, poits out that owhere is it cast i social laws or practices that defecatig o the beach is a uchageable custom, rather it is just a bad habit. Ad habits, like traditios, ca be chaged with the right strategies. The team is fully aware that this ca oly be achieved by workig carefully with the guardias ad spokesme of traditio: i this case, the Ampajaka, or traditioal leaders. If the Ampajaka istitutes a Decree or local law forbiddig OD ad ecouragig latrie use, ad uses latries himself, the this chage will become the ext custom, because custom is i the hads of Ampajaka behaviour. If CLTS leaves the Ampajaka out of the behaviour chage process, the custom will ot chage either Usig sogs as a vehicle for spreadig the message Ivolvig traditioal leaders ad usig these structures to stregthe CLTS has bee a way of embeddig saitatio more deeply ito social ad cultural life. A secod strategy with a particular focus o cultural life has bee the use of sogs ad sog groups to covey saitatio messages. There are a umber of ways i which this has bee doe: Groups of childre either through school or simply i the commuity have leared saitatio sogs, icludig actios/dace depictig OD behaviour. These sogs ca be performed at eighbourhood evets ad also as part of eighbourig village triggerig or follow up processes. Saitatio sogs by childre are also ivolved i Clea Schools competitive processes orgaised by Diorao WASH, ad at other evets at the commue ad fokotay levels such as durig ODF celebratio evets.

111 78 Promisig Pathways Wome s groups perform saitatio sogs, teach the sogs to childre, ad spread them i similar ways through local performace opportuities ad i eighbourig CLTS activities. Both wome s ad childre s sog groups have also bee featured o local radio. Traditioal sigers ad sigig groups, who have a local etertaimet role, are requested to compose sogs o saitatio. These ca the be icluded i their regular repertoire ad/or also taught to childre s ad wome s groups. Competitios are arraged betwee differet groups ad for performace of saitatio sogs, as well as amog traditioal sigers for the best ew compositio. I oe case i Vakiakaratra, childre s performaces of saitatio sogs were oe elemet of a wider clea village competitio aroud which a evet ivolvig several villages was orgaised. Ofte, these take place at fokotay or at commue level. These evets ca also be used as triggerig activities, ad ca iclude demostratios of triggerig tools. Sogs are recogised by the SGs which ecourage their use for saitatio messages as a importat way of displayig feeligs. Ofte people spotaeously create sogs after triggerig, ad the use these sogs to trigger other people. Creatig sogs is a commo reactio to may major evets so their use here taps ito behaviours which are familiar. The sogs ad daces / gestures that go with them are also very uifyig, ad help to build collectivism. I additio, they are a learig tool: repeated sigig is a remider to siger ad listeer of the message. Other kids of performace, such as drama ad poetry writig / readig, have also bee used but are less commo. I three districts of Vakiakaratra Regio there are Childre i Vakiakaratra Regio sigig a saitatio sog. at preset 161 sigig groups Photo: Oisoa Ridra Ralidera

112 Dyamic strategies ad iovative models for achievig chage at scale 79 some of these are childre s groups ad some wome s groups. There are 925 ODF villages, so sog groups have bee used/formed i approximately oe i every six ODF villages i the area of MIARINTSOA NGO s operatio. Implemetig CLTS at scale therefore eeds to seek ways of usig the resources of culture to sychroise with objectives of elimiatig ope defecatio.istitutioal Triggerig must always take o board the actual structures of ifluece, ad iclude traditioal leadership at locatios where this exists alogside ewer power structures, i particular the decetralised admiistratio. Sice power structures are cofigured differetly from area to area i Madagascar, as i may coutries, it is oce agai importat to retai sufficiet flexibility with methods ad approach at SG level so that these differet cotexts ca be successfully addressed ad all of the right actors ispired. It is also importat specifically to aalyse which structures are strogest i a particular locatio ad work maily with those structures. At atioal level i Madagascar, for example, there is a structure of traditio leaders but these actors are ot very powerful at this level. But local level traditioal leaders are very powerful. I operatioal terms this meas that at the atioal level iformig the leaders about the project is sufficiet; while at the local level much more is required. Similarly, the resources of culture ca vary from place to place: those activities that brig people together i a spotaeous ad celebratory way should be sought out as spaces i which to urture the geeratio of behaviour chage.. Lessos Leared 12 Egagig with the resources of culture It is essetial to work with the power structure of traditioal leaders where it exists ad to trigger the leaders. However, it is importat that this happes alogside triggerig at the village level. Rather tha usig traditioal leader power to eforce behaviour chage, the objective is to alig leadership with the motivatio for behaviour chage created i the commuity. It is importat to fully uderstad how the power structure works. Focusig strategically o key idividuals withi it ca also lead to very fast-movig CLTS processes.

113 80 Promisig Pathways Traditios of ope defecatio are rarely a true impedimet, because traditios are ofte chaged ad re-iveted. CLTS aims to ecourage commuities to ivet a traditio of fly-proof latrie use. Workig with the existig cultural resources such as traditioal sog groups, groups of childre ad wome sigers, poem writers ca help to chage the traditios. Saitatio sogs are effective ad powerful message carriers, ad they ca help brig a commuity together to act collectively. Through this ad the remider effect of performig ad hearig sogs, they ca help to create ad sustai ODF status. It is importat to create space ad istitutioal platforms like competitios for performig the sogs as this keeps them i circulatio ad helps to dissemiate the message to a large umber of people.

114 Chapter 4 Participatory techology developmet ad challegig the prototypes Photo: Kamal Kar

115 Previous page: Upgradig pit latries i Itasy.

116 Participatory techology developmet ad challegig the prototypes Participatory techology developmet ad movig up the saitatio ladder has bee a grey area amog the CLTS fraterity across the world. There is a strog tesio betwee those who advocate the itroductio of techological prototypes with a wide rage of icetives, ofte justifyig a case for upfrot household subsidy, ad those who believe that diverse techological optios must evolve by capturig the imagiatio of local commuities ad their ability to adapt. This approach to techology developmet is uusual i saitatio work, ad has the potetial to break importat ew groud regardig methods for promotig progress up the saitatio ladder. This sectio is orgaised ito the followig sub-sectios: The FAA approach to techology improvemet ad the saitatio ladder. Buildig upo available techology optios. Iovatios for techology adaptatio. 4.1 The FAA approach to techology improvemet ad the saitatio ladder Madagascar paits a special cavas of local techology developmet i saitatio by appreciatig the diversity of resposes, cotext specificities, local iovatios, idigeous kowledge ad gradual adaptatio by differet groups of the local commuity. The spirit of CLTS has take cetre stage i ecouragig commuity egieers ad trasmittig local kowledge ito the desig of techologies. I fact, it is the commuity imagiatio that is reflected i the process of techology adaptatio rather tha the more usual picture i saitatio programmes i which outside techology maipulates commuity choice. The FAA programme ad sub-gratees have bee costatly challegig themselves to idetify the best techological optios ad promote iovatios selectively, bearig i mid accessibility i the market, ad the ecological ad ecoomic ladscape. For example, i Atsiaaa, commuities have come up with raised toilets with a strog superstructure that ca withstad cycloes, a commo feature of the regio. I additio, the SG is seizig the advatage of Sait Gabriel, a NGO which has bee offerig low cost

117 84 Promisig Pathways saitary hardware choices. Recogisig the strog specialised skill base of Sait Gabriel i offerig both techology ad techical assistace for capacity buildig of local masos, FAA cotracted them to support other SGs as a part of the saitatio ladder strategy. I Aalajirofo, a wide basket of choice of techological optios is tested with traied masos, who are liked up with hardware suppliers. Further, to reduce costs procurig materials i bulk, the masos form groups ad operate i a cluster of households. These examples are ot isolated aecdotes rather FAA has tried to expad these methods through effective commuicatio across SGs ad by icorporatig them as systematic elemets i the techical assistace ad traiig provided by the EA ad its traiig agets. The key thikig i the FAA programme has bee to allow the commuity to iform the techology developmet process that complemets their ability to maage ad afford to the techological optios. This strategy accommodates the low purchasig power of the commuity while still addressig the mai issue of breakig faecal-oral cotamiatio. This approach is effectively challegig the domiat paradigm of saitatio techology. This domiat paradigm teds to iclude high levels of axiety about the sigificace of improved techology, which ultimately acts as a serious impedimet to basic saitatio for all because it is uaffordable for may. For this reaso, it is ofte a stated reaso for reitroducig subsidy after a basic CLTS process i the ame eablig the saitatio ladder. I operatioalizig this approach ad perspective o saitatio techology ad marketig, FAA Madagascar has its share of challeges as well as positive outcomes. The followig sub-sectio throws some light o cotextual issues with which the sub-gratees are cofroted, as well as highlightig successful programmatic attempts to promote techological iovatios with the potetial to make a differece at scale. 4.2 Buildig o available techology optios For most of the sub-gratees i Madagascar, some level of addressig saitatio marketig ad techology upgradig forms a part of project objectives. However, all orgaisatios, i lie with CLTS priciples, have rightly bee careful to fully complete the behaviour chage compoet i.e. arrive at ODF before talk of saitatio marketig ad latrie improvemet is itroduced.

118 Establishig a eablig istitutioal eviromet 85 Because of this, several have foud they have progressed less far with the latrie improvemet compoet tha they had scheduled most projects were i mid-implemetatio at the time of research. But where some actio had bee take to lay the groudwork for saitatio marketig ad movig up the saitatio ladder, a umber of other challeges were also evidet, most clearly the cost of trasport, the ability to pay by poor commuities ad the challege of the shift required i structural desig to accommodate the kid of improved latries that are most commoly available. Sub-gratee MIARINTSOA NGO, for example, iteded to take advatage of existig possibilities by keepig saitatio marketig i the hads of the private sector. They had publicised the opportuity at commue ad district level, emphasisig that it was likely that 10,000 or more households would build latries over the ext three years. They ivited local traders ad etrepreeurs to a traiig to lear how to produce sa plat slabs, ad four eterprises took the traiig. Of these, three are ow workig o productio but busiess has ot yet take off. 97 sa plats have bee sold at a price of 12,000 AR (US$ 6) across early 1000 ODF commuities. I Atsiaaa Regio, MAMIZO had developed a multi-activity strategy for iformatio dissemiatio about improved techologies, ad was carefully trackig sa plat buyers, but they had similarly ot yet experieced the large scale improvemets they were hopig for.. Spotlight 11 Challeges of scalig the saitatio ladder: a picture from Atsiaaa I Atsiaaa Regio, a atioal NGO Sait Gabriel, was already workig o saitatio i some areas ad had started a outfit Saitech - makig sa plats i three grades. Whe the sub-gratee MAMIZO bega doig CLTS i some of the same areas this caused cosiderable tesio because the behaviour chage was icomplete ad Sait Gabriel was thus puttig the cart before the horse. MAMIZO used the Diorao WASH mechaism to address this coflict, ad the result was a agreemet that MAMIZO would do the soft work of behaviour chage, ad Sait Gabriel would do the hardware productio ad distributio. MAMIZO has carried out several activities publicisig ad geeratig awareess about the sa plat techology. It has bee discussed o radio programmes at harvest time whe cash is available. It has bee advertised with a mobile va broadcast uit. They have show video demostratios of the techology i ODF villages. Nevertheless, they are somewhat

119 86 Promisig Pathways surprised that across the 14,161 ODF idividuals, oly 200 sa plats ad 51 ceramic latries have bee sold so far. Of these, oly 80 latries have as yet bee istalled. MAMIZO keeps detailed data of the purchase of Saitech products, ad household profile data of purchasers. Five local techicias were traied i istallatio. The project chief, Christia Fellack, puts this slow progress dow to lack of cash or poverty. The three grades are: Simple sa plat 20,000 Ariary (US$ 10) Sa plat with sipho / U bed 25,000 Ariary (US$ 12.50) Ceramic plate 30,000 Ariary (US$ 15) He believes that may of the sold uits have ot yet bee istalled because istallatio also requires cash ad it is possible that owers are waitig till the ext cash seaso (geerally two per year) to take the ext step. Because of this situatio, publicisig the sa plat has bee put o hold for the time beig: MAMIZO would prefer to see the curretly sold uits istalled before they take the ext step. As Spotlight 11 suggests, scalig the saitatio ladder faces a umber of challeges. Nevertheless, FAA has bee makig a systematic attempt to optimise opportuities withi these limitatios. By improvisig the modalities of techology access, orgaisatios like ASOS i Aalajirofo, as described briefly below, have facilitated more tha 34,140 persos to use 3,538 improved latries out of a total 153,408 people livig i a ODF eviromet.. Lessos Leared 13 Realities of the saitatio ladder The process ad pace of demad-drive progress up the saitatio ladder may vary from place to place depedig o may factors. This should be factored ito timescales i a realistic fashio. Ambitios to make it faster should ot jeopardize the CLTS priciple that sustaied ad collective behaviour chage must come first. Affordability ad easy access to saitatio hardware appear to be cetral challeges for improvig latries. Therefore facilitatig the developmet of low cost models usig local techology i partership with the ODF commuity is essetial.

120 Establishig a eablig istitutioal eviromet 87 Besides tappig existig opportuities for techology adaptatio, early recogitio of challeges ad the cotiued quest to overcome them has paved the way for some suitable alteratives. The EA is ot oly facilitatig the sub-gratees to idetify actors i the private sector who have the social ethos ad values to uderstad people s priorities, they have also strategically egaged with the private sector by icludig their represetatio i the PCM. This, however, is just the first step of the solutio. The ext step is to facilitate mass productio. At the time of this research, the EA with the PCM is startig to grasp ad coceptualise strategies to address this. I oe strategy, FAA has created space for oe private sector etrepreeur to work had i had with NGOs over a log period of time to iteralise the priciples of CLTS. The followig sub-sectio outlies the outcome of this i greater detail. Nevertheless, it is clear that grapplig with issues of participatory techology developmet is pushig the EA to deal with the challege of mass productio ad scale. 4.3 Iovatios for techology adaptio Alogside the as yet ufulfilled potetial i some regios, some very promisig work is beig carried out i others, producig iovatios i locally appropriate desig ad maufacture for saitatio marketig. Key iovatios i Itasy Regio have bee led by Tovo Ratefy ad his private sector orgaisatio, Famojea Cosultig Developmet (FCD). Developig improved latrie models that ca be easily maitaied ad cleaed whilst maitaiig a reasoable price has bee a challege all over the world. Most optios offered so far have bee sa plats, rig ad slab, or a slab with a lid cover all made from cemet or reiforced cemet cocrete (RCC). The problem with these models are as follows: They are heavy hece difficult to carry from the productio/sales cetre to the poit of use. They are easily broke or damaged durig trasport. There is a high trasport cost. They require a stroger sub-structure to carry the weight of the heavy sa plat. They require a lot of effort ad moey to reistall to a ew pit oce the old pit is full.

121 88 Promisig Pathways. Spotlight 12 Solvig techology problems: Desigig a light ad strog model i Itasy Regio The iovatio of Tovo ad his orgaisatio has successfully addressed all the above problems ad costraits. The model is made of a light ad strog compoud material that makes it very easy to trasport, istall ad reistall to ew locatios oce a first pit is filled up. Tovo is a egieer by traiig. Sice 1997 he has bee lookig ito saitatio. Whe he got ivolved i the FAA programme he visited a lot of ODF villages but was shocked at the state of the latries, ad recogised that there is strog cofusio aroud the otio of a improved toilet promoted by the Joit Moitorig Programme of the UN. Tovo could see that it was difficult to scale up the use of cocrete sa plats as they are heavy ad expesive. So he tried costructig a slab usig waterproof pre-fabricated plates made of sad, silica, saw dust ad glue. A local techicia came up with the idea of the higed lid as people forget to put the lid back. The idea of the elastic sprig meas that people do ot have to bed ad touch the lid it will close with a tap of the foot. FamoPlat with higed cover as developed by Famojea Cosultig Developmet. Photo: Katherie Pasteur A fly-proof lid is cut out very cleverly from the hard board ad fixed with a hige at the wider ed of the hole. There is a elastic sprig attached to the lid cover which opes up the lid with a sigle touch. The lid cover rests o a ridge cut carefully from the platform which makes it very close fittig ad totally fly proof. The user also puts ash iside the pit icludig dow the walls of the pit after every use, leavig o huma excreta exposed to air. This is essetial to esure o movemet of flies from withi the pit to outside. As a result of a completely fly-proof lid ad the use of ash, maggots caot grow ad the pits are free from foul odour. The model developed here has esured that the direct pit latries are completely fly proof.

122 Establishig a eablig istitutioal eviromet 89 Accordig to the ODF commuities, the other advatages of this model are as follows: They are affordable (17,000 Ariary or US$ 8.5). They are easy to brig from the market/productio cetre to the village. They ca be easily cleaed ad maitaied. Istallatio of this model o the existig pit latrie with ay kid of structural platform is very easy, rapid ad cheap. Istallatio of such a FamoPlat o a existig latrie was demostrated by a youg ma of the village who was traied by a maso set by the FAA programme. The whole operatio was complete withi 30 miutes i frot of may visitors ad the commuity. The process of istallatio was as follows: 1) Measuremet was take of the existig platform o the area of the ew model by usig chalk. 2) A bucket of sad was spread uiformly o that area leavig the hole of the pit i the cetre. 3) The FamoPlat, paited gree, was the placed oto the sad. 4) After esurig that the FamoPlat sits horizotally a mud plasterig is doe aroud the four edges of the platform ad it is left to dry out. 5) After a couple of days, oce the mud has dried out, the ower of the toilet is free to use it ad eve make a clea cemet plasterig o the rest of the floor area for easy sweepig ad cleaig. So far Famojea Cosultig Developmet (FCD), the private sector orgaisatio, has istalled about 250 FamoPlat out of the total umber of about 1000 targeted households i Itasy regio. This has bee doe by creatig a market chai usig the fokotay leadership over a six moth period. The FamoPlat is sold with a clever had washig facility (FamoSoapTap ) costitutig a small shelf with two 1.5 litre water bottles. Oe bottle is filled with soapy water ad the other with plai water, ad each has a small hole ear the bottom. Whe the lid is opeed, pressure is released ad the water flows. The user washes first with soapy water the rises with plai clea water. FamoPlat ad FamoSoapTap are sold as a o-separable kit.

123 90 Promisig Pathways Experimetal urie collectio kit. Photo: Katherie Pasteur FCD has also developed urie collectio kits either itegrated ito the FamoPlat or as a separate stadig urial for me oly. It has also started experimetig with compostig huma waste ad sellig the soil. FCD hopes that as people see there is a value i their shit, they will start to use it themselves. Thaks to the FAA programme Tovo s eyes have bee opeed to uderstad the challeges of techology optios ad to seek to meet a demad. He markets the techology by ivolvig the fokotay chiefs ad other local istitutios. They market the techology to the commuity o behalf of Tovo s associatio. The productio, istallatio ad maiteace services chai is assured by FCD, while promotio ad distributio are supported by the FAA programme. Though this iitiative is still i its early phase ad commuity uptake is relatively low as yet, key cosideratios have bee take ito accout while developig the techology: it is easy to trasport, easy to fit without alterig the sub-structure of the pit latrie, easy to clea, low cost ad durable. For these reasos, it holds much promise as a importat cotributio to achievig scale.. Profile 6 A ew FamoPlat user: Fidy i Itasy Regio Fidy istalled his ew FamoPlat just three days ago. Sice he built his latrie aroud oe year ago, the cover over the pit had bee made from wood with a mud coverig ad a piece of wood to cover the hole. He

124 Establishig a eablig istitutioal eviromet 91 heard about the FamoPlat from the fokotay chief ad decided to ivest i oe. These FamoPlat are better because they are totally fly proof, whereas with his old cover, flies could get i ad out through small gaps. He has also oticed there is less smell ow. He paid 4,000 Ariary up frot for the FamoPlat ad he will pay 2,000 Ariary per moth util he has paid a total of 17,000 Ariary (US$ 8.5). The FamoPlat was brought to the village ad a maso has traied up a local perso to istall it, who did ot charge for istallatio i this case. Fidy outside his FamoPlat toilet Photo: Katherie Pasteur The FamoPlat came with a bottle holder for had washig. This holds two bottles oe for soapy water ad oe for clea water. Fidy also showed a bucket that they use for goig to the toilet i the ight. He says that whe it is cold ad dark the wome ad childre do ot like to go out to the toilet so they use the bucket ad lid, ad the empty it i the morig. The superstructure of Fidy s toilet is made of wood, clay ad thatch with some ti sheet for the door. It cost him aroud 30,000 Ariary to build oe year ago. He plas to improve the walls of his latrie to make them smooth.. Lessos Leared 14 Local approaches to the saitatio ladder Local iovatios for improvig simple pit latries may happe siletly, but they must be idetified, observed, uderstood ad ecouraged. Lightess for ease of trasport, stregth ad very low cost of saitatio hardware are attributes which may be importat everywhere.

125 92 Promisig Pathways Likig the private sector appropriately i scalig the saitatio ladder is a key factor for success. Saitatio hardware developed by adoptig local iovatios ad techology from ODF commuities geerally has a good fit with local expectatios ad is more affordable tha more sophisticated prototypes prescribed by outsiders. Commuity arragemets ad orgaizatios ca therefore alleviate the barriers of fiace ad access to durable ad sustaiable saitatio products ad services. 4.4 Breakig the iertia caused by subsidy Workig with CLTS i areas where the subsidy approach is also operatig or has bee operatig util recetly is widely recogised as a challege, with the subsidy actig a impedimet to successfully achievig ODF. Subsidy drive projects ad approaches are evidet i seve out of the 14 FAA operatioal regios, ad these may represet a cosiderable obstacle for effective roll out at scale. The FAA is addressig this challege at various levels. They work through the PCM ad the Diorao WASH to ifluece policy as well as actors at the atioal level. At regioal level, the SGs are tryig to address this issue through the regioal Diorao WASH i various ways. Meawhile, at the village level, there are some promisig examples i evidece which demostrate the possibility of breakig the iertia caused by subsidy. Oe of such examples is fromvatovavy Fitoviay Regio. Here AINGA MADAGASCAR s project has bee able to tur the previous subsidy-based work to its advatage, usig the sa plats distributed durig that process to make a few quality latries while a large umber of simple latries were also beig built. How did this happe? Facilitators ad villages say that durig triggerig, villages really came to uderstad the eed for ODF. But facilitators also emphasised that the process was about usig whatever resources the village has to stop OD. Sice the sa plats were there, they could obviously be used to support the process. The focus was off the techology itself, ad o the questio of how existig resources could be used to solve a problem that everybody ow wated to address.

126 Establishig a eablig istitutioal eviromet 93. Spotlight 13 CLTS success where subsidy failed: Maakakora village, Ifaadiaa District Maakakora is a village which had previous experiece of saitatio projects. A local orgaisatio workig i villages aroud the Raomafaa Natioal Park had worked o hygiee. PAMOLEA, a project implemeted by a NGO cosortium, had ru a subsidy-based project i the village: PAMOLEA provided the substructure ad the superstructure was the resposibility of the commuity. This project had eded i Jauary 2013, ad AINGA MADAGASCAR had begu workig o saitatio from November Prior to that, AINGA had worked o a goverace programme i the village. PAMOLEA provided seve sa plats to the village clearly iadequate for a big village - but there was little behaviour chage ad the village was a log way from ODF. But four moths after AINGA MADAGASCAR s CLTS triggerig, the village declared ODF status ad eight moths later some other developmets were also evidet. The village ow has ad uses the seve latries built with the previously uused sa plats ad so that it was really possible to be ODF they built 36 simple latries built with motivatio from CLTS ad o subsidy at all. The sa plat latrie ad the simple latrie i the same village. Photo: Kirsty Milward But this village had goe eve further tha latries: there were also compostig pits for waste maagemet, ad oe household had a simple bamboo bathroom.

127 94 Promisig Pathways Compostig pits ad a simple bathroom i Maakakora Village. Photo: Kirsty Milward Takig advatage of hardware distributed i the course of subsidy drive approaches may be oe possible pathway towards the spread of improved latries. Through this ad other methods, by the ed of December 2013, the FAA programme had facilitated about 19,027 improved latries, icludig both idividual ad shared latries. About 189,417 persos out of 840,780 persos livig i ODF villages are curretly usig such toilets.. Lessos Leared 15 Workig with commuities which received free saitary hardware A good quality triggerig of CLTS ofte turs the egative aspects of earlier top-dow subsidised saitatio itervetios ito a advatage. Ofte the uused hardware supplied free/subsidised to commuities is brought back to use immediately after triggerig, whe the commuity realises the meaig of collective behaviour chage ad total saitatio. CLTS should be the etry poit activity to move to wider areas of saitatio i the commuity, such as solid ad liquid waste maagemet, icludig the hadlig of aimal ad other waste.

128 Chapter 5 Photo: Kamal Kar Buildig a learig orgaisatio

129 Previous page: Usig video documetatio to capture the learig process Aalajirofo.

130 Buildig a learig orgaisatio To be relevat ad effective over time ad space, ay orgaisatio ad approach must be alive to the learig arisig from experiece. Promisig practices eed to be idetified, captured ad brought ito the discourse of a shared learig process across the costituecies of the orgaisatio s work icludig commuities, implemetig actors ad policy makers. But i ay o-goig process, this ew kowledge must also remai dyamic, chageable essetially ope to adaptatio o the basis of experiece, results, ad evolutio of the programme process. Importat features of a successful process are therefore likely to be threefold: A culture that is ope to experimetatio, so that iovatio ca happe ad improvemets ca be made. Iterative mechaisms for documetig, sharig, discussig, egotiatig, alterig, ad re-broadcastig reviewed kowledge. Mechaisms for spreadig kowledge such as use of the media, sharig workshops, ad documetatio. The followig sub sectios outlie various cotours of FAA s edeavour towards istitutioalizig learig ad usig learig to achieve scale: Mechaisms for systematic sharig of best practices. Creatig model villages as local kowledge hubs. Recogisig ad creatig space for exchage of techological kowhow. Capturig ad commuicatig health outcomes. Trackig kock-o effects beyod saitatio. Use of media tools for greater outreach. 5.1 Mechaisms for systematic sharig of best practices While specific mechaisms for sharig learig were put ito place relatively recetly i the FAA programme, there have bee a umber of activities across differet projects which have supported a culture of experimetatio, learig ad the sharig ad dissemiatig ew kowledge.

131 98 Promisig Pathways The FAA program icludes the capture ad sharig of best practices ad lessos leared amog its itermediate results. Therefore, the programme has already begu the process of developig a kowledge maagemet strategy. This has icluded: Orgaisig exchage visits ad exchage workshops with the itetio of promotig good practices i both scalig-up approaches ad strategies ad i local techologies. Documetig good practices usig media ready to be shared, such as DVDs, ewsletters, flyers, etc. Capacity buildig i emergig good practices by sharig locally developed kow-how with SG actors i coachig roles. Participatig i all sharig opportuities such as the Diorao WASH Geeral Assembly, thematic workshops, etc. Promotig ad participatig i atioal harmoizatio process activities. These have eabled the adoptio of some priciples at atioal level as guidelies for the sector, such as the ODF criteria promoted by the FAA. Sharig workshops As evidece icreased that several iterestig methods ad approaches were developig i sub-gratee projects, a opportuity was made to reflect o ad share these practices. The FAA egieered a structural space ito programme admiistratio ad roll out i the form of learig evets. These provide opportuity for aalysis of the pros ad cos of ay ew practice through systematic cosultatios. Through this they also allow wider debate withi the policy makig structure of FAA, i a process of buildig cosesus ad reflectig the learig ito implemetatio strategies. To cite oe such example, i March 2013, sub-gratees were ivited to a six-day workshop i Vakiakaratra i order to lear from each other ad offer their ow examples of actio. The workshop bega with a evaluatio process through which the SG s performace i relatio to objectives was preseted ad reflected upo, ad through which SG good performers became apparet. These were asked to preset good practice, which was also discussed ad i some cases participats were traied i the practice. Participats were take to practice triggerig ad to do live follow-up themselves. At the ed of the workshop, two additioal days

132 Buildig a learig orgaisatio 99 were ecessary to perform a plaig ad budgetig exercise for all subgratees. They were requested to idetify ad pla at least oe key best practice that would be most appropriate for acceleratig their progressio towards objectives i the ext aual work pla. While participats made suggestios for improvig this kid of workshop, it was clear that: The process of sharig good practices helped the sub-gratees to improve the orietatio of their activities for the comig year ad choose approaches suitable to their cotexts ad situatios. The discussios ad costructive criticism durig the sharig sessios geerated iterestig food for thought which is useful i fie-tuig ad improvig the good practices. The sharig process ca help motivate both good ad bad performig sub-gratees ad ca be a mechaism for providig support for those whose work is progressig more slowly. For these reasos it should be carried out at least oce a year. The workshop also improved uderstadig of what costitutes a good practice: there was agreemet that a good practice must be evidece-based before it is shared with others, so experiece with usig the practice has to be substatial. Periodical Performace Assessmet (PPA) The Periodical Performace Assessmet (PPA) of sub-gratees has also bee a effective tool for reflectio ad replicatio. This is part of the programme review process ad is essetial i selectig SGs for extesio grats. It is orgaized at least oce a year ad the results are shared durig the programme review ad sharig workshop. It aims to assess the performace levels of SGs based o (i) their ow objectives, (ii) the programme s objectives, i.e. to assess the level of cotributio of each SG i achievig overall programme objectives, ad (iii) the volume, speed ad quality of achievemets i lie with the work pla ad budget for the evaluatio period. The PPA is coducted i a objective way ad allows each SG to be categorized accordig to a traffic light system. I the case of weak performace, measures ca be idetified to improve future work. The PPA is therefore a crucial decisio-makig tool to orietate efforts ad grats towards the achievemet of objectives.

133 100 Promisig Pathways. Lessos Leared 16 Sharig ad learig Opportuities to brig implemetig orgaisatios together to share experiece ad successful strategies are fruitful i at least two ways: Û They give orgaisatios opportuities to reflect o their work ad idetify success areas. Û They give less successful orgaisatios opportuity to lear from more successful oes, ad to build relatioships that ca lead to metorig. The istitutioalisatio ad scalig up of positive experieces by adjustig implemetatio plas promotes a Actio Learig Cycle which ca multiply good practice as a iformed choice. Sharig ad learig are used to address weak capacity i subgratees ad other actors ad must be icluded i a capacity buildig strategy, i.e. capacity buildig, should be a clear compoet of learig. The orgaizatio of the PPA amog gratees creates a spirit of competitio, stimulates a spirit of results-based performace ad speeds up the achievemet of results. 5.2 Creatig model villages as local kowledge hubs Combied with the mobilizatio of Natural Leaders ad Commuity Cosultats, the establishmet of model villages is a key strategy adopted by the FAA programme to implemet scalig up. Several projects have made very good use of model villages ideed the scalig up model which idetifies strategic villages is very much based o the idea of eighbourig villages learig from oe village s jourey to ODF. Amog criteria for selectig a strategic village are its potetial for beig used as a model this might relate to accessibility such as road access, or may relate to how it is located i relatio to a group of other villages, ad the dyamism of the commuity. ASOS i Aalajirofo, for example, particularly cosiders villages located at road juctios because of the potetial for may passers-by to observe the ew ODF status.

134 Buildig a learig orgaisatio 101 I Vakiakaratra, MIARINTSOA s mechaism for brigig ODF ad o-odf eighbours together ad addig village testimoy to the Istitutioal Triggerig recipe is a extesio of the model village cocept. Here, rather tha takig outsiders or actors from ew workig areas to observe the model village, actors from the model village are requested to travel to other areas to talk about the chages i their villages ad their experiece of brigig these about. I every sub-gratee locatio, there are a umber of model ODF villages idetified ad urtured to creatig a cascadig impact i their ow regio. I various ways, they ca fuctio as village-level CLTS schools where other commuities ca visit ad lear from them.. Lessos Leared 17 Model villages The selectio criteria for model villages must be focused o the potetial of these villages to iduce positive effects o surroudig villages. They should be carefully chose. The itroductio of model villages could be cosidered as a way to accelerate scalig up through the learig available at each site. 5.3 Recogisig ad creatig space for exchage of techological kowhow A importat CLTS priciple is that local people will fid solutios to their agreed problems if give the credece to do so, ad that there should be o prescriptio of latrie models at village level so that people are free to desig the latries that they ca maage to build. At the same time, each village is ot expected to reivet the wheel. Where good local models exist, which ca be made at o cost or very low cost usig freely available local materials, these should ot be withheld from villages ewly takig o CLTS. I Madagascar withi the FAA program, a productive balace seems to have bee struck betwee maitaiig a culture of respect for local kowledge ad the ability to come up with solutios at the same time as providig simple, clear ad miimalist guidelies o latrie buildig. As metioed, guidelies usually give advice o: l distace from water source l depth of pit l existece of had washig facility l fly-proof criteria

135 102 Promisig Pathways Withi this framework, the FAA program has ecouraged the emergece of local techological iovatios by allowig the freedom to SG sad commuities to take iovative steps. Several examples exist where small adaptatios ad iovatios have bee made to improve latrie desig ad make it fit for local coditios. I Ampasiimaigory village, Aalajirofo Regio, raised bamboo structures were built i some coastal areas. Photo : WSSCC/KatherieAderso Differet desigs have bee made to deal with high groudwater ad vulerability to floodig. I Vakiakaratra Regio (CARITAS Project), there were mud structures with raised latries i low-lyig: the door ad floor level is about 70 cm from groud level. Photo : Kirsty Milward

136 Buildig a learig orgaisatio 103 A rage of iovatios have bee made to aid fly proofig, like this woode cover with hadle, with a ash box alogside ad a shovel made from a plastic bottle.the umber of flyproof latries established i the programme reached 31,507 by the ed of December Photo: WSSCC / KatherieAderso I Atsiaaa Regio (MAMIZO Project), there were latries with a stroger superstructure to withstad cycloic wid. This was built after the March 2012 cycloe which flatteed several of the ewly built simple latries. Photo: WSSCC/Katherie Aderso

137 104 Promisig Pathways Various devices have bee made for had washig, icludig this Tipi Tap. Photo: WSSCC/ Katherie Aderso A bigger tap-operated model. Photo: FAA A foot-operated Tipi Tap. Photo: FAA

138 Buildig a learig orgaisatio 105 I Ambohimaaa village, Itasy regio (ADEMA NGO Project), bamboo pipes were beig used as vets. Because of the earthe wall of the pits there is actually o eed for a vet pipe for release of the methae gas which might accumulate i the pit. However, these vet pipes were duly covered with mosquito et at the ope ed, makig them fly proof. O the corers, pieces of ti are iserted ito the walls to prevet rats from climbig up ad damagig the superstructure. Photo: WSSCC/Katherie Aderso Here, a stoe slab has bee used to make cleaig easier. Photo: FAA

139 106 Promisig Pathways I some cases, households have made commodes, or sittig latries, rather tha the stadard squat latrie. Photo: FAA The programme gives value to local techology ad local materials such as those used i the costructio of traditioal local houses. Here, father ad daughter use a mixture of cow dug ad clay for the wall ad the slab. Photo: Latries Amboasary - Statio

140 Buildig a learig orgaisatio 107. Lessos Leared 18 Local iovatio for adaptatio Local level iovatios ad adaptatios to local coditios happe all the time. It is importat to showcase these iovatios widely, both to cross-fertilise models ad desig, ad to ecourage further locally appropriate iovatio. Local iovatios ca over come the problems of affordability for households ad promote the empowermet of commuities ad households through self-costructio of latries. Techological iovatios ca lead to sustaiability of saitatio facilities if commuities are sufficietly orieted towards iovatio for problem solvig icludig durability. 5.4 Capturig ad commuicatig health outcomes Those sub-gratees who received FAA grats i the first roud of fudig ad subsequetly were recipiets of extesio grats have ow bee implemetig for up to 30 moths. Some very strog results have emerged i terms of ODF villages (7,007), ODF fokotay (728) ad commues (15). However, residets of ewly ODF villages suggest that results of the FAA programme peetrate deeper tha simple ODF status. They perceive a umber of diverse advatages of adoptig ew behaviours o saitatio ad hygiee, most sigificatly better health. Some local level health data is becomig available which supports this perceptio ad suggests dramatic health results from the CLTS process as it works to ODF status. Data from the Primary Health Cetre i Mahazoarivo, Ampefy Commue, Itasy Regio i the workig area of SG FAMONJENA NGO, cofirms a cosistet drop i the icidece of diarrhoea betwee 2012 ad 2013 (see Figure 12), durig which time CLTS was carried out.

141 108 Promisig Pathways Figure 12: Cases of diarrhoea i Ampefy Health Cetre, Itasy Regio Jauary February March April May Jue July August September October November Year 2012 Year 2013 Similarly, data from oe commue Health Cetre i MAMIZO s workig area shows a dramatic drop i cases of diarrhoea ad dysetery betwee 2012 ad the first five moths of The CLTS process took place i late 2012 ad early Figure 13: Cases of diarrhoea ad dysetery, Sahamatevia Commue, Atsiaaa Cases of illess Iformatio geerated i Focus Group sessios at village level coducted as part of this research provides further evidece that outcomes are clear to residets of ewly ODF villages. I Ambodiaviavy village i Vatomadry District ad Atsorokahitra village i Ambatolampy District, for example, all five groups Natural Leaders; two wome s groups; childre; ad me listed health improvemets amog the mai outcomes of the project. I the rakig exercise that followed, Better Health was overwhelmigly raked as the most sigificat outcome. Similarly, a Focus Group with villagers from four villages i Mahasoabe commue i Vatovavy Fitoviay Regio also raked Less Diseases as amog the top three most sigificat outcomes. They elaborated that diarrhoea has strogly ad clearly decreased i the village which was ODF already at the ed of the last raiy seaso, whe diarrhoea is usually at its worst. The whole household has felt this

142 Buildig a learig orgaisatio 109 beefit, as icideces have decreased amog everyoe. This has resulted i cosiderably reduced health expediture estimated at aroud 10,000-20,000 AR before ODF to about AR a year ow. Sice ODF was i fact declared less tha a year ago, these testimoies should be treated as aecdotal, but the perceptio that CLTS has had visible health beefits is clear.. Lessos Leared 19 Moitorig health outcomes There may be highly sigificat health outcomes resultig from ODF status which ca be traced usig data from local health facilities ad commuity discussio. More methodical ad widespread moitorig of these health beefits would be immesely useful to future advocacy processes. The moitorig of health impacts could be easier if saitatio data (e.g. iformatio o ODF status) was itegrated ito the routie health data collectio at primary health cetre level. 5.5 Trackig kock-o effects beyod saitatio As a result of better saitatio, i additio to better health, a large umber of other outcomes ad kock-o effects were idetified ad discussed i focus groups. Villagers associate ODF status with a rage of positive chages i life ad livelihoods at commuity level. While several villages are proud of their edeavour to make their village ad livig eviromet clea, they also saw clear liks with ecoomic improvemet, food security, clea playig space for childre, social cohesio, icrease i school attedace, huma digity, ehaced self-esteem ad better security for wome. Brigig these impacts to light ad commuicatig them to eighbourig villages which are ot yet ODF has begu to take place i Madagascar through the scalig up strategies, but further focus will also be ecessary here to esure that these effects are widely kow. Steps are curretly beig take i the FAA programme to esure that the M&E system will systematically capture impacts, icludig these o-saitatio kock-o effects, i order to use them for Istitutioal Triggerig, advocacy ad to facilitate the scalig-up process.

143 110 Promisig Pathways. Spotlight 14 Wome, me ad childre catalogue the beefits of ODF i Vatomadry District The wome s group i Ambodiaviavy village of Sahamatevia Commue of Vatomadry District, durig a focus group discussio, expressed a lot of self-satisfactio as they proudly revealed that their eighbours are evious of them ow. They are clea; there is reduced prevalece of diarrhoea. The childre of the village were cheerful ad are happy that they do t have to worry about steppig o shit while ruig aroud the village. They ca play everywhere ad they ca freely collect ad eat the falle fruit without the fear of faecal cotamiatio. The me s group revealed aother dimesio: they are ow more productive as they themselves are less ill ad they also sped less time attedig to sickess i their families. They also claim to fetch more reveue from their horticulture produce ow, as may buyers prefer to buy lychee ad orages from ODF villages which they kow are ot cotamiated with shit. Accordig to oe farmer, Earlier about 10 to 20 buyers used to come to our village to buy lychees ad orages. This year, about 60 buyers came, ad they offered about 5000 Ariary per basket of orages ad 8000 Ariary per basket of lychee, which is about 90% more tha the previous year s price. Aside from raisig the value of produce, i may coastal villages becomig ODF has served a more basic fuctio: food security. May villages have foud that becomig ODF sigificatly improved food security because of the extra fruit that ca be harvested from former ope defecatio sites.

144 Buildig a learig orgaisatio 111. Spotlight 15 Soaambo: the woder fruit to mitigate huger durig food scarcity periods Soaambo is the woder tree that fruits twice a year. The fruitig seasos are February ad September which exactly coicide with the food scarcity periods for coastal people i Madagascar. This fruit cotributes sigificatly to wardig off starvatio from local commuities. It is utritious; people already kow various ways to cook it; ad ow the Natioal Office of Nutritio has come up iformatio o how to cook it so that it maitais its utritious quality. The fruit is sweet ad susceptible to fallig with the slightest wid. It is relatively heavy, varyig from 800g to 4kg a piece. A challege whe collectig the fruit is that the tree s braches are extremely fragile, so it caot be climbed for harvestig. Before the CLTS itervetio i Aalajirofo Regio, people used to defecate uder these trees. Ofte durig triggerig evets it is foud that the mai OD area is aroud the Soaambo trees, because these large groves of broad leaf trees do ot allow much A Natural Leader showig the clea Soaambo fruit, Aalajirofo Regio. Photo: WSSCC/Katherie Aderso udergrowth, so it is clear for OD. However, the humid coastal climate ad low sulight peetratio also makes the area ideal for isect growth ad reproductio. With faeces aroud ad a high cocetratio of isects,

145 112 Promisig Pathways the area was very uhygieic ad a prime site for faecal-oral cotamiatio via the Soaambo fruit to people. Accordig to Fracie, a Natural Leader, before last year people were always hesitat to eat the widfall fruit as they kew very well where it had falle. This made the huger situatio worse. Fracie also poited out that durig triggerig they always make the defecatio area trasect to the Soaambo area so that people realise the loss due to OD. May people the see the clear lik betwee food security ad ope defecatio ad make the decisio to costruct toilets for themselves. Sice September 2012 ad durig 2013, a huge icrease i collectio ad sale of Soaambo has bee oticed i most of the ODF villages. Oe family said they used to collect oly oe ad a half bags of Soaambo ad leave the falle fruits o groud. The harvest was also quite cumbersome as they used to pluck the fruit with a log pole ad had to be very careful that it did ot fall o the groud. This year the family has collected eight bags of Soaambo fruit. Aother old traditioal leader revealed a equally iterestig fact. Oly two members of his family live i the village. This year after meetig his ow food eeds ad givig a good quatity of fruit to the other family members livig i the city, he maaged to ear about 80,000 Ariary -about US$40 - from the sale of the fruit. The collective effort of commuities to stop OD has brought ew opportuities to address the problem of food scarcity periods. Soaambo, which was ofte a wasted fruit, has become the woder fruit which ca solve the food crisis ad to some extet meet cash eeds for may poor families of Aalajirofo Regio. I additio to better food security for all, for some idividuals ODF behaviour has give the ew possibility of earig a icome withi the village because of the lad that is freed up by stoppig OD.. Profile 7 Migrat farmer to settled farmer: the case of Remi Remi is a youg farmer of Ambodiaviavy village. His lad is situated ear a stream that flows i the orth of the village. Before last year Remi was a daily labourer, but today he is a residet farmer of the village. Although he had a good piece of lad, he could ot cultivate as it was

146 Buildig a learig orgaisatio 113 commoly used as the ope defecatio groud for the village. Accordig to Remi, Earlier I used to hate to come to this place as it was very smelly ad full of shit everywhere. Though I had some orage trees, I could ot harvest them properly as it was impossible to sped much time o the plot. Now that the etire village is Ope Defecatio Free, I am able to cultivate my lad. Remi is ow very ethusiastic about his farm. He has plated cassava ad pieapple as itercroppig with the orage trees. He has also ivested Remi, a labourer tured farmer. Photo: Sisir Pradha i fecig his lad ad hopes to get a very good harvest this year. Sice this is the first year, it is ot yet possible to arrive at the ecoomic beefit of this chage, but the stadig crop gives a strog impressio of a good retur. New cultivatio o previously OD lad. Photo: Kirsty Milward This is ot a loe story. These kock-o effects appear to be quite commo i most regios. Oe village of Ambatolampy District, for example, also tells the same story of oe ladless villager makig a ew livelihood by cultivatig a piece of lad which was previously a uproductive ope defecatio site. I aother strikig story from Sahamatevia Commue, Atsiaaa, two families are ow earig icome from a restaurat they built o a former ope defecatio area.

147 114 Promisig Pathways. Spotlight 16 From OD zoe to eatery Mrs Joizia Gargote of Salehy Commue, Vatomadry District has opeed a restaurat i a place which earlier used to be the OD area. Her family employs a waitress ad the busiess has a turover of A restaurat built o a former OD groud. Photo: MAMIZO, Vatomadry about 40,000 Ariary about US$ 20 per day. Sice most of the cliets of her restaurat are bus passegers, she ow wats to build pay public toilets to cater to about 100 passegers as her ext veture. She iteds to charge 100 Ariary from each perso usig the toilet. She thiks this will solve two issues cotributig to her family icome ad helpig to cotrol ope defecatio by outsiders. The villagers of four villages of Mahasoabe Commue i Vatovavy Fitoviay Regio attributed the story of ODF to the blessigs of God ad the virtue of their traditioal leaders, the Ampajaka. Accordig to the me ad wome, a umber of good thigs have happeed sice they became a clea village. Now they are harvestig clea coffee beas with ease; childre have better kowledge of saitatio; there is stroger collective actio with regular commuity meetigs. Youg wome also poited out that there is less opportuity for boys ad me to spy o or threate them i a sexual way ow that they do ot defecate i the ope: this, they said, is about digity as well as safety. The ODF story is ot very old i may of these locatios: i most it was six moths or less. Yet the treds pait a clear case of strog likages of ODF with the overall social ad ecoomic developmet of the commuity.. Lessos Leared 20 Trackig kock-o effects There is ofte a wide rage of beefits upo achievig ODF status that are associated with better livelihoods, food security/utritio ad other social ad idividual beefits. These are clearly evidet to commuities.

148 Buildig a learig orgaisatio 115 More methodical moitorig ad documetatio of these beefits could greatly cotribute to spreadig the process further ad thus movig towards a ODF coutry. The experiece of collective actio through CLTS ot oly brigs differet sectios of the commuity together but also gives them leverage to use this for other collective iitiatives. 5.6 Use of media tools for wider outreach Dissemiatig iformatio widely ad regularly is a importat elemet of the scaled up Madagascar-wide visio: if CLTS is to ivolve thousads of actors across the coutry ad ispire them to take roles fulfillig a rage of tasks, the various kids of media are available to reach these actors. FAA ad its sub-gratees have developed a umber of activities usig media to spread iformatio o saitatio more widely. These iclude both atioal level awareess raisig activities as well as local level iitiatives to promote discussio ad commuicatio alogside a CLTS process. Two types of strategy documets have bee developed withi the framework of the commuicatios strategy. These are istitutioal commuicatios for the programme s visibility ad advocacy, ad programmatic commuicatios which promote positive behaviour chage i.e. Iformatio Educatio Commuicatio/ Behaviour Chage Commuicatio (IEC/BCC) materials. Materials produced by the programme have also bee adopted by other parters. I additio, media campaigs have bee coducted ad media supports ad tools produced. At least 14 local media statios work closely with gratees fuded by the FAA. Natioal TV has carried a short advertisemet o saitatio developed by the EA ad depictig a shockig scee of child death due to diarrhoea. This was carried o TVM (Télévisio Malagasy), the oly atioal govermet based chael. Resposes have ot bee systematically assessed as yet, but aecdotal reports suggest it was certaily shockig ad i some cases sufficiet to trigger people i villages where OD is rampat. Local TV has also bee accessed by some sub-gratees for their ow, locally adapted, advertisemets. Local TV has also carried ews items o CLTS related evets, such as ODF celebratios, visits to the area focusig o saitatio, ad some district level activities ad meetigs. These have icluded testimoy from Champios ad iterviews with villagers ad visitors.

149 116 Promisig Pathways Local Radio has specifically bee used by sub-gratees to support the scalig-up process. However, care has bee take to retai the surprise effect of the CLTS tools durig triggerig. The EA advises sub-gratees to phase-i media activities carefully because a media campaig that begis too early may udermie the success of the triggerig sessio. Thus sub-gratees are ecouraged to start the media campaig at the momet of fokotay or eve commue triggerig. A media campaig could cosist of a phoe-i radio programme o saitatio, with discussio ad testimoy from local people, or a classic advertisemet, or a educatio media sessio. Other commuicatio tools FAA has developed a limited amout of carefully desiged visual material to reiforce triggerig experieces i CLTS sites. These iclude lamiated posters depictig how a sigle case of OD ca, via flies, withhold from everybody the health beefits of behaviour chage by the majority. A secod poster depicts positive chaged behaviour: each house havig a latrie; had washig facilities; latrie covers, etc. These are used i ODF villages as remider stimulus. IEC Material developed by FAA: There are may taboos, but eatig shit or makig someoe else eat shit is the worst.

150 Buildig a learig orgaisatio 117 Oe of the key stregths of the types of commuicatio used here has bee the focus o coveyig the stories of local ODF commuities by their Natural Leaders ad by commuities themselves, with strog local flavours. May types of atioal ad local commuicatio media have bee used i sharig the messages ad learigs of CLTS i order to reach out sufficietly widely to create a saitatio movemet.. Lessos Leared 21 Maximizig commuicatio The focus o local level stories as told by commuities has bee a strog factor i commuicatig CLTS messages widely. The combiatio of appropriate electroic ad prit media has bee importat i dissemiatig iformatio i poorer areas. There is a role for all kids ad levels of commuicatio tools. It is importat to use several i order to reach out sufficietly widely to create a saitatio movemet. The issue of timig is importat i usig the mass media for commuicatig locally emergig messages. Care should be take to calibrate media slots so that they do ot udermie the elemet of surprise of triggerig tools.

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152 Chapter 6 Photo: Kamal Kar Workig Towards Sustaiability

153 Previous page: Natural Leaders of Apasimbe Maatsatraa commue i Aalajirofo.

154 Workig Towards Sustaiability Programme implemetatio is relatively ew i most of the regios, varyig from six moths to two years. It is therefore premature to expect cocrete evidece of sustaiability i terms of log ruig ODF commuities. However, the programme has demostrated soud process features that suggest elemets of sustaiability, uderstood here i terms of the quality of outcomes ad as people-drive rather tha data-drive. The cetral feature of the sustaiability pathway i this case is the behaviour chage of large umbers of actors. A compoet of this cocers buildig sesitive istitutios to sustai such behaviour chage processes. Some of the early idicatios of sustaiability, grouped ito a few broad categories, are as follows: Recogitio of beefits by the commuity. Bestowig trust o commuity extesio by buildig o Commuity Cosultats, Natural ad Traditioal Leaders. Capitalisig o istitutios ad their actors at the local level. Advocacy at local level. Creatig robust istitutioal arragemets to esure sustaiability. Workig through Diorao WASH at the regioal ad atioal level. Cotiued decetralisatio of Diorao WASH. Esurig ad sustaiig quality at scale. 6.1 Recogitio of the beefits of the programme by the commuity There are several idicatios that commuities are strogly coviced of the positive impact of stoppig ope defecatio. A project leader i ASOS, for example, observed that whe people have toilets they feel hoour ad self-respect, ad that oce this behaviour chage is complete, slip back to OD is ulikely. This opiio is let credece by Focus Group discussios i which self-respect ad the respect / evy of outsiders ad eighbours emerge clearly alogside other outcomes of ODF status. Evidece that maitaiig ODF ad the beefits that accompay it as a priority is also

155 122 Promisig Pathways suggested by the fact that commuities i Atsiaaa, a area vulerable to cycloes, without promptig from MAMIZO, quickly rebuilt latries damaged by the cycloe of February Buildig o Commuity Cosultats, Natural ad Traditioal Leaders The FAA programme emphasises creatig local costituecies of iformed idividuals, maily Natural Leaders ad Commuity Cosultats, ad providig them with opportuities to sharpe their skills ad stregthe local collective actio. Sub-gratees have also succeeded i developig Champios, may of whom are placed i strategic positios i society. Embeddig the work withi the traditioal social ad cultural leadership of the Tagalamea / Ampajaka also stregthes those costituecies. Schematic evidece suggests that may Champios are sufficietly motivated that their work will be cotiued eve after the phasig out of the project. There is also strog evidece of Commuity Cosultats ad Natural Leaders takig proactive steps to trigger eighbourig commuities ad expectig work to cotiue uder their ow iitiative where possible, such as through the Natural Leader orgaizatio i Aalajirofo Regio. 6.3 Capitalizig o istitutios ad their actors at local level As a scalig-up strategy, the SGs are utilizig available istitutios ad istitutioal actors at every level ad multiplyig the actio through them. Istitutioal actors i this case are uderstood to iclude actors affiliated to formal ad iformal istitutios as well as to commuity groups, ad this uderstadig maximises ivolvemet i differet spaces. This leaves behid a group of motivated people to cotiue efforts ad help others to climb the saitatio ladder. The shift i approach from coutig ODF villages to coutig ODF districts/ commues / fokotay through Istitutioal Triggerig cotributes greatly to buildig a eablig eviromet for quick actio. But importatly, the greater ivolvemet of local goverace actors through this feature of implemetatio helps to maistream the project i the larger local goverace framework ad thereby cotributes to greater sustaiability. Local goverace

156 Workig Towards Sustaiability 123 Figure 14: Actors ivolved i various phases of CLTS facilitatio: a example from ASOS Phase 1 Iductio Phase 2 Scalig Up *Emergece of Natural Leaders, ODF fokotay, sub-gratees, Miistry of Water *Commuity Cosultats, Natural Leaders from ODF villages, ivolvemet of istitutios like Diorao WASH, Departmet of Educatio, Health, sub-gratees, mayor/ deputy mayor, media groups Phase 3 Sustaiig *BIF (departmet of lad measuremet), Police Commuale, Diorao WASH, Commuity Cosultats ad istitutioal actors actors ca be very effectively mobilized whe they see the scale ad coverage of their respective admiistrative uits. The strategy of fosterig team work right from village to regioal level ot oly helps i achievig ODF at scale, but also cotributes to this eablig eviromet. 6.4 Advocacy at local level Most sub-gratees are workig proactively to put CLTS o the ageda i the commue ad regioal plaig processes so that some fiacial ad huma resource support ca be esured irrespective of project support. For example, Ampasime Maatsatraa Commue provides some food ad travel expeses to Commuity Cosultats ad Natural Leaders who are tryig to trigger other villages. Similarly, MIARINTSOA NGO has successfully lobbied for a small budgetary provisio at the commue level to support CLTS activities o the groud. Sub-gratees have also bee tryig various ways to develop iteral fudig mechaisms to fiace improvemets up the saitatio ladder. I Atsiaaa Regio, for example, there has bee a iitiative to create a revolvig fud by poolig resources amog differet families to fiace latrie improvemets. Though this iitiative is at its ascet stage, it shows promise for sustaiability.

157 124 Promisig Pathways 6.5 Creatig robust istitutioal arragemets to esure sustaiability The resiliet desig of the FAA programme i Madagascar with the PCM at the cetre ad ivolvig all saitatio actors from various istitutios icludig the govermet is a i-built mechaism to articulate the wider visio of ODF Madagascar ad esure positive istitutioal iterplay. The orgaic lik ad overlap of the Diorao WASH with the PCM provides good opportuity for a large buy i of actors at various levels of the admiistrative structure. The PCM together with the Diorao WASH exerted ifluece to create a Departmet of Saitatio withi the Miistry of Water. This is a big step forward. Mr Niry Lato Rakotodrasoa, a member of PCM, was chose by the Miistry of Water to become the first Director of Saitatio ad Hygiee i Madagascar. With the formatio of the directorate, all saitatio ad hygiee programmes of the coutry came uder this portfolio. The allocatio of fuds to saitatio ad hygiee was also icreased from its previous level whe saitatio was a simple divisio withi the Miistry of Water. The emergece of the ew directorate ot oly sigified the importace to saitatio sector, but has also facilitated the implemetatio of the FAA programme i the regios ad districts. The istitutioal spaces created through the programme, alog with the strog atioal madate, has the potetial to work towards the budgetary framework to esure sustaiability. Fiacial support to the idea that is importat to maitai ODF status ad work towards a higher order of saitatio outputs will be importat. The ivestmet i huma resources at various levels ad the developmet of a appropriate istitutioal framework are factors that ca esure the effective use of fiacial iputs to sustai the strog mometum geerated at the commuity level. 6.6 Workig through Diorao WASH The FAA programme has established a orgaic lik with the istitutioal architecture of DioraoWASH. This has provided differet kids of opportuities i differet areas: i Atsiaaa Regio, the Diorao WASH has bee able to create parterships betwee differet stakeholders for example, betwee MAMIZO ad Sait Gabriel; i AINGA MADAGASCAR s project, commue ad district level WASH Coalitio orgaisatios provide follow up ad moitorig, ad play a role i the ODF certificatio process. The Diorao WASH icludes represetatio by may stakeholders i the

158 Workig Towards Sustaiability 125 WASH sector, ad is permaet i ature, ot ecessarily depedet o the FAA programme for cotiuity. Thus its ivolvemet i follow-up actio will cotiue beyod the project. 6.7 Cotiued decetralisatio of Diorao WASH. I some regios such as Aalajirofo ad Atsiaaa, there has bee cosiderable effort by FAA to istitutioalise public evets like the celebratio of World Latrie Day, World Had Washig Day, etc. MAMIZO, for example, i collaboratio with the Diorao WASH ad the Director of Water, is celebratig these evets, providig a greater platform of iformatio dissemiatio ad reachig out to a wider commuity. These evets are ot oly a effective tool for show-casig the work of ODF commuities ad ispirig others, but also the collaboratio to orgaise them helps stregthe relatioships betwee differet stakeholders. The WASH Everywhere approach, which is the sigature work of the Diorao WASH, has also bee take up by SGs i the regios workig i post-odf cotexts. Several SGs i particular are workig with schools, health cetres, churches ad other local istitutios to promote WASH Everywhere as these istitutios are key locatios for cotiued replicatio of saitatio learigs, ad therefore are key tools for sustaiability. 6.8 Establishig widespread kowledge ad commitmet to esure quality at scale The diverse rage of actors with appropriate capacity ad kowledge operatig at differet levels right from atioal to commuity levels i Madagascar esures a high possibility of the maiteace of quality. These are actors who are observig the situatio at local levels, ad, more importatly, are ivolved ofte with a persoal stake i the cotiued reiforcemet of ODF priciples. Such capacity at groud level, built with the mechaisms of scale described i Sectio 3, promises to make the process self-sustaiig. It is these people, ot a data-drive checkig exercise, who promise to ehace sustaiability. At the same time, the moitorig ad evaluatio data collectio framework put i place by the FAA programme complemets this people-led quality adherece mechaism while also eablig the broader perspective o progress ad status at the regioal ad atioal levels.

159 126 Promisig Pathways Figure 15: Steps towards sustaiability evidet i the FAA programme Strog team work at differet levels with multiple actors Motivated CCs, NLs ad traditioal leaders Maistreamig i larger goverace framework Champios at strategic positios like Mayors & Deputy Mayors, Govermet officers Evidece of strog commuity resiliece Ivolvemet of Diorao WASH ad istitutioalisatio of evets Commuity level mechaisms like revolvig fud to fiace actio to move up the saitatio ladder This diversity of strategies ad processes potetially feedig sustaiability suggest good prospects. It is clear that there is a high level of syergy betwee various actors as well as teacity ad covictio at the commuity level to help take the process ahead. The crucial shift i thikig towards coutig ODF regios couteracts ay project mode i approach, rather settig programmatic thikig o track ad brigig i a strog orietatio towards log term process ad systems.

160 Workig Towards Sustaiability 127. Lessos Leared 22 Ehacig sustaiability Sustaiability higes upo sustaied saitatio ad hygiee behaviour chage through proper commuity extesio backed with mechaisms to reiforce commuity actio for a exteded period. Sustaiability caot be achieved uless most major actors of saitatio, icludig the cocered miistries of the govermet, are ivolved. The formulatio of a atioal saitatio strategy ad the developmet of structures withi the cocered govermet miistries ca esure a eablig eviromet for CLTS through local empowermet ad promises to cotribute sigificatly towards sustaiability. Mechaisms supportig istitutioal collaboratio ca support sustaiability. The creatio of Directorate of Saitatio withi the Miistry of Water; the establishmet a strog ad very effective PCM; ad budget allocatio i a govermet plaig process are good examples. Ivolvig ifluetial local actors such as local govermet ad the Diorao WASH at the regioal ad district level ad below, (commue ad fokotay levels) ad icludig key idividuals are promisig steps towards sustaiability after the ed of the project/programme.

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162 Chapter 7 Photo: Kamal Kar Coclusio

163 Previous page: Sakalaba Kig declarig the first ODF village i Tsarao Amboy commue, Boey.

164 Coclusio The FAA programme i Madagascar cotiues to geerate ODF villages, fokotay, commues ad rural areas of districts ad promises to create may more. But sice there are still aroud two years left of this five-year programme, it is ot possible to draw defiitive coclusios about specific levels of impact. What is possible is to ackowledge that a remarkably effective process is takig place i the programme, ad to offer some of the emergig lessos to a wider audiece beyod Madagascar. These experieces ca offer ew hope, ad the basis o which to improve strategies, as may off-track coutries move towards their Milleium Developmet Goals o saitatio. There are ow less tha two years remaiig for the MDGs, ad few coutries are o track with saitatio targets. But, as Madagascar s FAA programme shows, a lot ca be doe i the remaiig two years. With the right strategies ad the right outlook, ad with a selectio of tools to choose from, may coutries may be able to get back o track. Besides the MDGs, however, it is importat also to ackowledge the post-mdg ladscape o the horizo. Now is the time to begi to cotribute to the discussio of what will happe i saitatio after Ad much surely will happe, give the poor performace i geeral i saitatio alogside moutig evidece of the urgecy to address it. Icluded i this post-mdg ladscape should be may more examples of coutries with a atio-wide ODF visio alog the lies of that emergig i Madagascar. Natio-wide ODF status is i fact essetial if the full beefits of better health, stroger livelihoods, ad icreased productivity are to be felt for all. So the Madagascar experiece documeted here offers some learig for geeratig ad allowig that visio to grow: Implemetatio of CLTS at scale requires a effective structure ad mechaisms for cosistet commuicatio ad egagemet across stakeholders ad govermet at all levels. Harmoizatio of efforts ad a coheret policy eviromet to support the CLTS approach will yield faster results i saitatio coverage ad beefits. It is essetial to take the step from We do it all to Let s all do it

165 132 Promisig Pathways together. Widespread ODF status will ot be achieved with the ivolvemet of a few NGOs or govermet departmets aloe: it requires a saitatio movemet that will brig i thousads of actors. The Let s all do it together approach meas brigig a rage of actors o board at all levels but especially at the grassroots level. It is essetial to be strategic about where to target direct actio by the iitial teams. Flexibility, adaptability ad a spirit of learig are key attributes of ivolvig all actors i the process. A partership model cosistig of a agreed ad clear framework ad objectives alogside freedom to develop ad adapt strategy to achieve these objectives shows great promise at all levels of implemetatio. Ivolvig all actors also meas takig every opportuity to urture, exted ad draw o the developig skills ad experiece of local people with CLTS ad achievig ODF: mechaisms must be foud for makig Natural Leaders ito Commuity Cosultats ad have these work as widely as possible. Champios at all levels atioal to local should be actively created as well as appropriately ackowledged ad recogised for their key roles. It is importat ot to be itimidated by traditio but to carefully ad respectfully work with traditioal leadership structures as well as other cultural pheomea. The power of local leaders ca be a immese asset to CLTS if it is aliged with ODF objectives. The model followed here for progress up the saitatio ladder is uique ad has great potetial. Local commuities are developig may iovative ad alterative ways of improvig their latries. This is vital from the stadpoit of esurig that very poor people evetually access better latries. Saitatio marketig iitiatives ofte attempt to address cost issues by workig at low cost, but usually do ot cosider the importace of startig with the existig techology ad buildig o that. Here, actors workig o saitatio ladder issues have take pre-existig techologies of existig latrie models as a startig poit to make improvemets ad adaptatios that have good local fit. This approach has potetial for much more widespread maageability as well as affordability. Methodical moitorig of health impacts of ODF status, as well as the kock o effects of achievig ODF o livelihoods, food security ad

166 Coclusio 133 social outlook, will be a great asset to future advocacy campaigs i earby or far off locatios. As is evidet from this documetatio ad aalysis of the FAA Madagascar experiece, the CLTS story here offers a very rich variety of lessos. Nevertheless, it is clear that the programme i Madagascar also faces certai challeges. These iclude that there has ot yet bee replicatio of this particular istitutioal framework for implemetatio either iside or outside Madagascar, so there is ot yet firm evidece that the mechaisms described here ca be trasferred elsewhere. GSF more widely clearly has a opportuity here, to fid ways of puttig mechaisms i place elsewhere that draw strogly o the jourey pioeered i Madagascar. The strategy embedded i the secod roud of FAA fudig icludes coverage of all the 22 regios of Madagascar. This is a great asset, as it icreases the reach of the commo platform urtured at may differet sites of iter-istitutioal collaboratio. Nevertheless, there are still challeges facig the oward process of harmoizatio of iitiatives i saitatio. Despite the emergig success of the mode of operatio represeted by FAA, there are still gaps i aligig with it closely. These gaps must be filled if the process is to reach its full potetial. I additio, after the completio of the FAA iitiative, after however may years, there is as yet o guaratee that the govermet, particularly frot lie staff, will have gaied the capacity to maage or deliver cotiued mometum for the process either at atioal or at local levels. The mai challege lies i the fact that, as is clear from may of the issues discussed i this documet, CLTS is a cotiuous, iterative process of developig iovatio ad buildig o progress as it emerges. Uless the govermet mode of operatio ca build i a appreciatio of the ature of this cotiuous learig ad improvig process, the gais made here may remai vulerable. But despite these challeges, the fial message must be oe of great optimism. I Madagascar, the CLTS visio is beig successfully played out at scale. Evidece emergig from this experiece strogly suggests that i this broad-sweep scaled-up versio, like i the village-focused versio, CLTS actio which is strog i urturig priciples of local kowledge ad commuity empowermet has the power to stop ope defecatio, brig health beefits ad ispire social ad ecoomic developmet.

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168 Aex Photo: Kamal Kar

169 Previous page: Sustaied behaviour chage prompts appropriate techology adoptio Rarofiaritra Fokotay.

170 Aex LIST of FAA Key Persos Etities MCP CP AE Names -RASAMISON Michèle (Presidet du MCP) -RAKOTONDRAINIBE Jea Herivelo ( Natioal Coordiator of Diorao WASH Coalitio) -RAKOTONDRASOA Niry Lato (Director of Saitatio Miistry of Water) -RASOLOFONIAINA Stephe (Miistry of Educatio) -TATA Veace (Miistry of Health) -RAKOTOARISON Norohasia (Miistry of Health) -RANDRIAKALOMALALA Fajà Oliva (Miistry of Eviromet) -MAHAZOASY Roger Mevazara (Miistry of Decetralizatio) -RASOLOFOMANANA Lovy (Iteratioal NGO: WaterAid) -RANDRIANARISOA Ridjairaiy (Iteratioal NGO: WaterAid) -RALAIARIVONY Jacky (Doors: USAID) -RAZAFIMAHATRATRA Rova (Doors: UNICEF) -SYLVIA Gaya (Doors: UNICEF) -RATEFY Tovo (Private Sector: FCD Famojea) -RAVELOSON Arsèe (Civil Society: Taratra) -RANAIVOSON David (Local NGO: SAF FJKM) -RAMIANDRISOA Hugo, Program Maager -RAMANOARAY Naridra, Program Maager -RATSIRARSON Joséa (Coutry Represetative) -FANOMEZA Rija Lalairia (Program Maager) -RAKOTOZAFY Jerry (M&E Specialist) -RALIDERA Oisoa Ridra (BCC IEC Specialist) -RANDRIAMANALINA Aimé (Kowledge Maagemet Uit) -RANDRIAMANATSOA Fao Lovatiaa (Capacity Buildig Uit)

171 138 Promisig Pathways Etities AE SGs Names -RATEFINJANAHARY Joelia (CLTS Coordiator) -RAZAFIMAHEFA Mialy (Admiistratio ad Fiace Uit) -RAMANANJOHARY Soloavaloa (Grat Maager) -ALIJIMY Fabie (Grat Maager) -Holiiaia RAKOTONDRALAMBO (Project Maager, SAF FJKM Aalamaga Regio) -Narisoa (Project Maager, MSIS Atsimo Adrefaa Regio) -RABENJA Grégoire (Project Maager, GREEN Boey Regio) -ANDRIANAMBININA Théodule (Project Maager, Ny Taitsika, Amoro I Maia Regio) -TONGAZARA Désiré (Project Maager, CSGV Diaa Regio) -RAKOTOARISON Yves (Project Maager, CASH Sofia Regio) -RAKOTONIRINA Jocely (Techical Advisor, ASOS Aalajirofo Regio) -RAZAIVAOVOLOLONIAINA Helioro Diamodra (Executive Director, AINGA MADAGASCAR, Vatovavy Fitoviay Regio) -EUGENE DE Ligorie (Project Maager, MIARINTSOA Vakiakaratra Regio) -RAKOTONDRANAIVO Charles (Project Maager, CARITAS Vakiakaratra Regio) -RABEHARIVONY Seta (Project Maager, FASA Alaotra Magoro Regio) -FELACK Christia (Project Maager, MAMIZO Atsiaaa Regio) -RATEFY ANDRIANTAHIANA Tovoherisoa (Project Maager, FAMONJENA Itasy Regio) -RAVELONJATO Léo (Project Maager, ADEMA, Itasy Regio) -RABETOKOTANY Rivosoa (Project Maager, AIM Meabe Regio) -NAMEARISON Robert (Project Maager, CODE, Meabe Regio) -RAINIMANALA Blaise (Project Maager, SALFA, Haute Matsiatra Regio)

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