Combined Outcome of Three Reviews of CLTSH in Ethiopia Authors of Presentation: Jane Bevan, Rural WASH Manager, UNICEF Ethiopia and Zufan Abera Damtew, Director Health Extension and Primary Health service Directorate, Federal Ministry of Health, Ethiopia Country: Ethiopia Copyright Colin Purrington (http://colinpurrington.com/tips/academic/posterdesign). Ethiopia Country Context Study 1 Elements of success Ethiopia has the highest OD reduction rate globally Scale up CLTSH promotion through the strong HEW network OneWASH SWAP in Ethiopia for greater coordination and partnership National Sanitation Marketing Strategy flagship programme of MoH Ambitious National targets UNICEF Review: Qualitative and Quantitative rural survey in 8 Regions (Tigray, Amhara, SNNP, Oromia, Benishangul, Gambella, Afar, Somali) 24 Woredas (Districts), 3,168 Households Findings: OD Continues to reduce (32%) Coverage is highly variable between regions Most toilets are unimproved (89%) Handwashing is limited (19%) Total Population: 98,942,000   Urban Population: 19,266,000 (19%) Urban Population growth: 4.8% Population Density: 99 per km2 Gini Co-efficient: 32 GNI per capita (USD): 590 Income classification: Low income Population below international poverty line of US$1.90 per day: 29.6% Stunting: 38% Under-5 Mortality: 64 Life expectancy at birth: 64.5 Hazards: Chronic drought situation Sources: World Bank Databank, UNICEF Data Map Challenges Regional Breakdown of Sanitation Coverage CLTSH Survey 2016 Health Sector Transformation Plan, 2015-20. Sanitation goal: 82% access to improved latrines and 82% ODF Kebeles SDG Targets: Universal ‘safely managed’ sanitation coverage by 2030 Challenges: humanitarian crises – chronic drought, AWD outbreak – divert partners and resources from development activities Sanitation in Ethiopia SDG Baseline 2017 Joint Findings and Implications The reviews found 93% of new coverage is unimproved Sanitation Marketing needed to diversify products available – local DIY solutions preferable Focus on behaviour change for handwashing Regional sanitation planning needed for realistic goals Pastoralist regions need additional support linked with humanitarian response Baby WASH – new component to address nutrition impact – focus on child faeces disposal, infant hygiene, safe play areas Study 2 GSF Review: Qualitative and Quantitative rural survey in the better performing 4 Regions (Tigray, Amhara, SNNP, Oromia) 22 Woredas, 2,100 Households Findings: Latrine utilization is half that of access (45%) Only 7% of toilets are improved Handwashing is limited (25%) Next steps Ongoing regional sanitation planning Continue marketing support and promotion for range of products including plastic Satopan Integrate Baby WASH into all programmes Support national monitoring for Improved/safely managed Integration of urban sanitation Study 3 CRAP Review: Qualitative CLTS Rapid Appraisal Protocol led by Kamal Kar (April 2016) Findings: Major regional disparities Limited post-ODF follow up Need regional road maps for ODF * No safely managed estimates available