|Sanitation Promotion (SIDA - SDC - WSSCC - WHO, 1998, 292 p.)|
|Promotion through innovation|
1 Research Associate, Water, Engineering and Development Centre, Loughborough University, UK.
National Programme for Low-cost Sanitation (PNSBC)
The programme is a widely acknowledged success in Mozambique. It has established a series of well-functioning production units in every province in the country that provide poor, peri-urban communities with access to affordable and durable low-cost improved latrines. The sanitation technology used is based on a simple, but effective, unreinforced domed concrete slab with a tight-fitting lid to reduce odour and insect nuisance. A flexible mix of construction options has been developed to cater to varying physical and socioeconomic conditions. The programme runs in parallel with a strong social development effort, based on employing sanitation animators, to promote the latrine programme and reinforce hygiene behaviour and education messages. Efforts to help alleviate poverty are being made through creation of employment opportunities in latrine production units. Future plans are to decentralize programme activities to municipal city councils.
Programme objectives were to:
- identify and develop a suitable technology and method for large-scale implementation of improved sanitation in peri-urban areas; and
- contribute to improved living conditions and alleviate poverty by reducing the morbidity and mortality resulting from unhygienic living conditions; and creating local employment opportunities and management capacities, focusing on the needs of vulnerable groups, through establishment of latrine production and sales units.
Mozambique is one of the world's least developed nations, with general development having worsened over the last three decades. Human development indices and measures of economic wealth and prosperity fell markedly during the 1980s. Sixteen years of civil war, drought, and related economic and social factors have left between 60 and 90 per cent of Mozambicans living in serious poverty. Estimates of those living in absolute poverty range between 50 and 60 per cent.
After Mozambique's independence from Portugal in 1975, the Government identified sanitation as a critical factor in improving national health. In 1976, the Ministry of Health launched an intensive national self-help latrine construction programme that comprised the construction of thousands of latrines over a short period. However, insufficient technical guidance in latrine design and construction, a shortage of building materials and the lack of awareness of environmental conditions meant that many of these latrines became structurally unsafe, unusable, and a health hazard to users. The consequences of technical weaknesses and negative impacts on health were most severely felt in densely-populated peri-urban environments, where the majority of the nation's urban population settled. In response, a research project was commissioned in 1979 to identify and develop a suitable technology and methodology for large-scale implementation of improved sanitation in peri-urban areas. Project results led to creation of the PNSBC in 1985, implemented through the National Institute of Physical Planning.
The pilot project identified and tested a technology based on the concept of a simple, unreinforced domed concrete slab that is placed over a lined or unlined pit. Slabs are built to a standard 1.5 m in diameter and a thickness of 40 mm, rising 100 mm from ground level at the centre, to give the characteristic flat dome. Its shape reduces the need for expensive steel reinforcement, since the weight of the load is distributed to the peripheral zone and kept within the range of what the non-reinforced concrete can support. A small inward slope of 100 mm width around the squat hole is incorporated to direct any waste into the pit. Footrests placed on either side of the squat hole guide the user to the correct position for defecation. A tight-fitting lid is placed in the squat hole when the latrine is not in use, as an effective seal to prevent odour from escaping or insects from entering the pit. The lid can be attached to the latrine superstructure by a wire or cord to prevent deposition in the pit. The exterior surface of the slab is compacted and smoothed to facilitate cleaning. It bears the initials of the mason who constructed it and the quantities of cement, sand, and aggregate used, as a means of quality control.
Figure 1a. Unreinforced domed slab
Figure 1b. Unreinforced domed slab
Construction techniques are fairly simple, and have been aimed at using the least possible amount of cement, normally three-quarters of a 50 kg bag. A flexible mix of construction options have been developed, and differ, depending on varying physical and socioeconomic conditions. Complete latrines, with lining blocks for pits, predominate in areas of high-water tables or difficult soil conditions, whereas in most other areas, slabs placed over unlined pits are the norm. A characteristic superstructure, without roof, made of local materials (reed and palm leaves), surrounds the latrine, as a privacy screen for users.
The activities of the PNSBC are based on:
- the construction, promotion, and use of improved latrines in peri-urban settlements;
- sanitary education through the activities of animators, health officials, and theatre groups to maximize latrine use and the benefits of construction;
- coordination of sanitation interventions with water supply; and
- development of local capacity to construct latrines.
The programme operates in 15 cities nationwide, with 35 production units centred in peripheral settlements, employing 271 workers. Each production unit employs a number of workers drawn from the local community. Twenty per cent of all workers are women.
The PNSBC is funded by three major sources: donors, the central government and user communities. Donor funding supports technical assistance, equipment, production costs (purchase of cement), and some operation and maintenance costs. Government funding has focused on a direct subsidy for part of the production costs, in addition to some support for staffing and running costs. Communities pay a proportion of production costs, through direct sales of latrines, construction of the superstructure to surround the latrine, and transport of the slab from production unit to household plot. Communities pay about 4 per cent (US$ 1) of the total production cost of a simple slab, and US$ 7 for a complete latrine (with concrete lining blocks for the pit). Donor agency and government contributions to production costs are 83 per cent and 13 per cent respectively.
The PNSBC works in poor communities in peri-urban settlements. The programme's target population falls under three categories:
- most vulnerable families, existing in conditions of absolute poverty (as defined by health and income indicators, such as elderly over 60 without income, or family income per capita below MT 13 000, US$ 1.3). Families classified as vulnerable will get their slab free of charge and where necessary have their pit lined.
- families functioning at minimum survival income levels (minimum income was defined in 1996 as US$ 20 per person per month); and
- families surviving on an income of 2 or 3 minimum incomes. Households dig their own pits and decide the location of the latrine.
PNSBC promoted sanitation in the following ways:
· The social development programme was consolidated to emphasise hygiene education activities (through inputs from Ministry of Health staff). Greater appreciation of the importance of sanitation was achieved through the appointment of a series of 'animators', who helped to assess the individual needs of those without sanitation, to monitor and evaluate the performance of the programme in the community and to reinforce hygiene behaviour practices.
· Selection of appropriate communication channels was critical in reaching target audiences and reinforcing core messages. Messages built on ideas and concepts which are already present in the community (for example, the fear that children would fall into latrines was addressed through poster campaigns highlighting the benefits of the keyhole shaped squat hole).
· A mixture of promotional techniques and methods were used. These included use of indigenous media (such as employing dance/drama troupes to visit a district) in conjunction with more traditional communication channels (lectures, activities at church and voluntary level, poster campaigns, and radio/television broadcasts). One innovative promotional idea was the distribution of T-shirts, caps and other promotional clothing to publicise the programme. Given the high demand that exists for affordable clothing in Mozambique, this method was an effective way of communicating the programmes' central message (through slogans on the front and back of the T-shirt).
· Production units were a source of information and promotion within the heart of the community. Mobile production units were used to reach small-medium sized towns. Production units acted as catalyst for generating demand.
· Despite economic and political difficulties, from 1979 to May 1996, 170 496 improved latrines were sold and installed, benefiting more than 1 022 916 persons. Production sales capacity is between 25 000-35 000 latrines per year.
· The programme proved to be successful despite the fact that institutionally no one really wanted to house the PNSBC.
· A social development programme was consolidated to emphasize hygiene education activities, appreciation of sociocultural influences on the latrine programme through training of sanitation animators, and support to various community outreach activities, such as theatre and radio campaigns.
· Poverty alleviation was enhanced by creating employment through the establishment of local production units.
· Most of the population continues to live in extreme poverty and the economic situation is worsening. At the end of the civil war, over five million refugees returned to peri-urban settlements throughout the nation. Low-income groups cannot afford to purchase improved latrines.
· The State's excessive political/administrative centralization weakens decision-making capacity, affecting programme management.
· Sector coordination at national and local levels is inadequate. This is particularly true regarding national departments dealing with water, sanitation, and the urban sectors.
· The programme is very dependent on external donor funding.
· Different levels of purchasing power exist within the peri-urban communities. The programme needs access to this information so that pricing structures for latrines may be targeted more appropriately, in line with the different economic capacities of the populations.
· Monetary incentives and other social benefits can be used as a means for recruiting and retaining qualified staff within the programme.
· It was found that introducing productivity bonuses for production units did not work adequately because there was no direct relationship between what is effectively produced and what is sold. A scheme of food for work has proven successful as a motivating factor for workers, bringing direct benefits to them and their families.
· It was found that target communities frequently did not have the means to construct latrines (i.e. dig pits) or erect superstructures, hence latrine slabs were being purchased but not used.
· The Mozambican example proved successful because of its combination of rigid standardisation of low cost slabs and complete freedom for the families to build the superstructure as they want. Excluding subsidies from the superstructures resulted in considerable community contribution.
· Decentralizing activities and responsibilities for basic infrastructure services to municipal councils will continue. More attention must be paid to creating management capacity within these units.
· A mechanism that enables subsidies to be provided to the private sector for acquiring tools and production equipment to produce and market improved latrines will be developed.
· Mobile production units to cover areas that are currently isolated or distant from existing production centres will be introduced.
· The programme will be expanded into rural areas, introducing pilot projects into an additional province each year.
Key institution and responsible persons
Carlos Noa Laisse, Acting National Coordinator
Vincente Macamo, Civil Engineer/Coordinator BSS
Programa Nacional de Saneamento a Baixo Custo (PNSBC)
Avenida Acordos de Lusaka 2115
Telephone: +258 1 465850
Fax: +258 1 465407
© Mr Darren Saywell, Research Associate, Water, Engineering and Development Centre, Loughborough University, UK, 1997, edited by WHO with permission of Darren Saywell, 1997.
Prepared in association with SARAR TransformaciC.