1. Creating a new Social Norm Community Approaches to Total Sanitation (CATS)

2. Evolution of Community Approaches What have we learned? In the past 40 years the WASH sector has been involved in 21 different “software” approaches Confusion over the difference between the provision of information, advocacy, behaviour change, social change and changing social norms. Limited formative research on “insights” Converting “insights” to action Focusing on collective action and Public reasoning Sequencing of activities

3. Why Sanitation? Professional PerspectiveUsers Perspective Improves Health Enhances Social Development Dignity and privacy for women and girls Generates economic benefits Protects the Environment Privacy Social Status (modern) Health Economic

4. Old ApproachesNew Approaches Building Toilets Individual/family Health Message Focused Top – Down & Externally Driven Didactic Technologies predetermined Subsidized Don’t mention the S*** word Changing Social Norms Social/Community Economic, Social, Health, disgust, Community led –Internal, demand driven Participatory – natural & traditional leaders Local technologies, community capacity Rewards – PRIDE – celebration Talk SHIT – faeces, Poo, Kaka, toilets, latrines

5. Adopter Categorization Innovators Early Adopters Early --Majority– Late Late MajorityLaggards Reach a Critical Mass of Adopters

6. Community Approaches to Total Sanitation Background: UNICEF supports Community Approaches to Total Sanitation (CATS) with the goal of eliminating open defecation in communities around the world. CATS is an umbrella term developed by UNICEF Sanitation practitioners in 2008 to encompass a wide range of community-based sanitation programming. The CATS ‘Essential Elements’ are the common foundation for UNICEF sanitation programming globally. These principles provide a framework for action and a set of shared values which can be easily adapted for programming in diverse contexts.

7. CATS: The Essential Elements At their core, CATS rely on community mobilization and behavior change to improve sanitation and integrate hygiene practices. They are demand-driven and community- led, and emphasize the sustainable use of safe, affordable, user-friendly sanitation facilities. The Essential Elements are based on lessons learned from decades of sanitation programming, and are a framework for action providing a common foundation for work in the sector reflective of UNICEF’s Global WASH Strategy.

8. Network Theory Define Target Audience Community engagement Triggering Public Declaration Community M&E IncentivesDiffusion CATS & Social norm theory

9. How is CATS implemented? The example of CLTS

10. Pre-triggering Selecting a community and building a rapport before triggering takes place (Network Theory & Defining Target Audience)

11. Network s Define Target Audience Community engagement Triggering Public Declaration Community M&E IncentivesDiffusion Social norm theory

12. 1.Select a community Start in the least challenging communities Once they are ODF, move on to the more challenging ones Quality is always more important that quantity Select communities close to each other 2. Build a rapport Build a rapport with leaders and the entire community. Everyone needs to trust the facilitator before triggering can begin Important that the facilitator does not disclose why they are visiting the community. They are just there to look at the “health situation” of the community.

13. 3. Get to know and understand the community Formal and informal structures Community groups Demographics Inclusion and exclusions!!! 4. Map the various networks Family and Clan groups (inside and outside the village Religious ties Savings clubs, etc

14. Triggering Using a variety of demonstrations to encourage a community to face the hard reality of open defecation and the impact it is having on their village (Community Engagement, Triggering, Public Declaration)

15. Network s Define Target Audience Community engagement Triggering Public Declaration Community M&E IncentivesDiffusion Social norm theory

16. Tool 1: The Transect Walk The community takes a tour of the village to view areas of open defecation. This creates a sense of collective embarrassment forcing the community to acknowledge their sanitation situation. No individual shame is involved in this process.

17. Tool 2: Open Defecation Mapping Community members help draw a map of their village including all major structures, water points and areas of open defecation A representative from each household should draw their own house

18. Tool 3: Food and Feces The facilitator places the a sample of feces (discretely collected during the Transect Walk) on the floor next to a piece of food (e.g. bowl of rice or banana). Flies will most likely move between the feces and food. When asked, people will refuse to eat the food. The facilitator asks the community “why?” and the link is then made between open defecation and eating feces.

19. Tool 4: Water and Feces The facilitator places the a sample of feces inside a bottle containing drinking water). When asked, people will refuse to drink the water. The facilitator asks the community “why?” and the link is then made between open defecation and eating feces.

20. Tool 5: Shit and Shake The facilitator gathers the community for a meeting. They use a leaf or hand to wipe away their shit after defecating (using charcoal or clay). The community is asked “what is left on my fingers? The facilitator then shakes hands with other members of the community including the chief. Food is offered to those people who have shaken hands with each other. This sparks the understanding that shaking a neighbour’s hand and not washing may lead to you eating their shit.

21. Natural Leaders After the triggering, the facilitator will ask the community what they will do about their sanitation situation. Natural Leaders are highly motivated community members who volunteer to help improve sanitation situation in their community. They help motivate households to build their latrines and help oversee construction Natural Leaders often go on to trigger other communities in the surrounding area and are therefore critical in the scale-up of CLTS

22. Community Action Plan The Natural Leaders encourage the community to draw up their own plan of action Includes a realistic time frame for completion (no more than 3 months) Displayed in a central/public location Each household is checked off following the completion of their latrine

23. Post-triggering Latrine construction, monitoring and follow-up, ODF verification, declaration and celebration (Monitoring and Evaluation, Incentives, Diffusion)

24. Network s Define Target Audience Community engagement Triggering Public Declaration Community M&E IncentivesDiffusion Social norm theory

25. Latrine Construction

26. ODF Certification The indicators for ODF verification vary between countries. However, most generally require all households to have and be using their own latrines and Open Defecation must be eradicated. Examples of additional indicators include: Mali: HWWS facilities and latrine covers India: safe disposal of child feces and institutional latrines (schools and hospitals) must also be present

27. ODF Certification

28. ODF Declaration and Celebration Once all latrines have been completed and the community meets the required ODF standards, it can be declared Open Defecation Free. Verification must be carried out by independent monitors (e.g. District Council, other NGOs etc). The community then celebrates their new ODF status

29. Where is CATS being implemented? CATS is currently being implemented in 54 countries

30. Number of people with access to household latrines as a result of UNICEF-supported CATS interventions More than 25 million people now have live in ODF communities as a direct result of UNICEF-support, indirectly, 92 million people have benefitted

31. CLTS in Mali – first results In the first 3 months after triggering  latrine coverage increased from average of 30% to 100% in the first triggered communities

32. In Zambia a sample of communities was selected for a more detailed study into the quality of toilets constructed. Which revealed that 99% of toilets were in use, 90% had superstructures (although only 45% had roofs), 90% had lids for the squatting holes and 85% were covered at the time of the visit, and 88% had a smooth and clean squatting. It was also found that 76% of toilets had hand-washing facilities (a significant improvement on the initial pilot), 84% of which had water, and that 51% of households were using soap and 34% using ash for hand-washing. CATS - If we have a new Norm?

33. Network Theory Define Target Audience Community engagement Triggering Public Declaration Community M&E IncentivesDiffusion Social norm theory

34. How CLTS works: From theory to practice Define target audience: Communicate around socio- ethnically relevant issues: CLTS based around the universal emotions of shame and disgust (not health based). Community Engagement: CLTS works directly with community members. A CLTS facilitator is “there to learn”. It is not a prescriptive strategy; there are no latrine plans given. Triggering: The CLTS tools facilitate a dialogue around sanitation that ultimately arrives at a situation where the community members themselves decide to change their situation. The tools are designed to arrive at this moment

35. How CLTS works: From theory to practice Public Declaration: A public declaration is made by community members to stop open defecation. This is the moment when the new social norm is created Community Action Plan and Monitoring: The community develops their own plan on how to improve their sanitation situation and sets time limits. Community members are able to see who has complied and who hasn’t. This creates a community “by-law” that is self-enforced. Incentives: CLTS creates both internal and external incentives to achieving ODF status. Positive internal incentive: pride in the community. Negative internal incentives include shame and disgust in the act of open defecation. External incentives include the ODF certification process and the celebration for achieving the ODF status.

36. How CLTS works: From theory to practice Diffusion: Through the celebration process, traditional and political leaders are engaged from neighboring communities and districts. As CLTS is scaled up, there is also national diffusion through national level celebrations and awards. Network Theory: During the triggering, “natural leaders” are identified through their participation in the process. These leaders are then implicated closely in the process to ensure community compliance and offer support as needed. They are often also implicated in triggering in nearby villages.

38. Beyond CATS What are we learning about CATS? What do we still need to do better? What about Sanitation Marketing? Does CATS fit with UNICEF’s equity Agenda?

39. www.communityledtotalsanitation.org http://intranet.unicef.org/PD/WASH.nsf