1. Emerging Markets Consulting GSF CRSHIP II Baseline and Feasibility Study October 6, 2015

2. EMC 1.Clearly identify target beneficiaries, potential partners, and sub- grantees to reduce duplication of efforts 2.Obtain WASH baseline context in target areas, including: –Determine the externalities affecting the WASH sector in target areas (e.g. physical conditions affecting latrine uptake in villages, presence of subsidy projects, etc.) –Determine presence and types of vulnerable Households –Catalogue types of latrine technologies in use –Determine the level of vulnerability, the ability of households to pay for improved access to sanitation facilities and improved sanitation –HH and community environment (garbage issues, water management, pets, fowls, and livestock management) –Determine the knowledge, attitude, practice, satisfaction with sanitation and household hygiene matters 2 Project Objectives The study’s objectives were twofold:

3. EMC 20 target districts we selected in 5 provinces –Districts selected were those with highest proportion of ID Poor and lower sanitation coverage –Stratified random sampling for HH survey DORD officials were interviewed in each of the 20 districts Field data collection was carried out May 18-29, 2015 3 Methodology The data collection process consisted of a quantitative HH survey and a range of stakeholder interviews.

4. EMC 4 On average, educational attainment was low and illiteracy rate was high, possibly due oversampling ID Poor HHs. Household Profile The absolute majority of heads of HH had no education of only primary education 83.9% of sampled HHs reported at least one vulnerable member 57.8% of sampled HHs had at least one illiterate member

5. EMC 5 Household Profile ID Poor StatusAverage Income (2014) NoneKHR 9,507,282 (USD 2,377) ID Poor 1KHR 6,098,912 (USD 1,535) ID Poor 2KHR 5,669,913 (USD 1,417) Average annual household income was 7,7 million KHR ($1,928) The distribution concentrated below the median value of 4,3 million KHR ($1,077.5) Several types of vulnerabilities were reported in the sample with the following frequency (more than one answer possible):

6. EMC ProvinceDistrictFlooded areaRocky areaForested areaDifficulty level Prey Veng Peam Chor80%0% 2 Sithor Kandal64%0% 2 Kanhchrieh0%50%0%1 Ba Phnum33%11%0%2 Me Sang0%13%0%1 Kamchay Meas 0% 1 Kampong Trabaek 0% 1 Svay Antor0% 1 Kampot Kampong Trach 25% 0%2 Chhuk0%29%43%2 6 Nearly all 20 target districts had geographically problematic conditions (DoRD/PDRD data). District Profiles

7. EMC ProvinceDistrictFlooded areaRocky areaForested areaDifficulty level Kampong Chhnang Chol Kiri100%20%80%3 Baribour82%9%18%3 Tuek Phos0%13% 2 Kampong Tralach 50%10%20%3 Kratie Sambour80%70% 3 Snuol0%40%0%1 Kampong Thom Sandan67%44% 3 Kampong Svay44%0% 1 Prasat Balang0% 43%1 Santuk30% 20%2 7 Nearly all 20 target districts had geographically problematic conditions. District Profiles

8. EMC Average latrine cost was consistent across the 5 provinces (PDRD information) Most respondents had access to sanitation businesses in the area –Only 41 respondents reported lacking access 8 Sanitation costs are consistent across target provinces. District Profiles Latrine typeAverage Cost Dry pit / unimproved latrineUp to USD 25 Improved latrine (substructure)USD 50 – 60 Whole structure with wallsUSD 350

9. EMC Improved sanitation facilities Flush/pour flush toilet connected to sewage Flush/pour flush toilet connected to septic tank or pit Covered pit latrine with a slab Unimproved sanitation facilities Flush/pour flush to elsewhere Open pit latrine without slab Latrine over water Ash latrine 9 Baseline Indicators: Sanitation This baseline collected information on the following types of latrines in the sample:

10. EMC 10 The majority of respondents did not own a latrine; of those who did, most had an improved latrine. Baseline Indicators: Sanitation 97.9% of latrines in the sample were functioning 92.9% of latrine owners use it regularly 84.3% of HHs shared their latrine facilities 24.2% share with other village residents (not relatives)

11. EMC Reasons to own a latrine:Problems with owning a latrine: 11 Baseline Indicators: Sanitation

12. EMC 12 The majority of reported latrines in the sample was improved latrines. Baseline Indicators: Sanitation District-level improved sanitation facilities as a percentage of latrine-owning HHs

13. EMC Baseline Indicators: Sanitation 13 Overall, households in Prey Veng were morel likely to have improved sanitation facilities:

14. EMC 14 Improved latrine prevalence in districts with regular floods: Baseline Indicators: Sanitation Chol Kiri district, located around Tonle Sap River, had the highest incidence of collapsed latrines due to flooding (50%).

15. EMC 15 There was a direct negative relationship observed between improved latrine ownership and difficulty level of physical conditions: Baseline Indicators: Sanitation

16. EMC 16 Respondents named several times when open defecation was considered acceptable: Baseline Indicators: Sanitation

17. EMC 64% of respondents were “somewhat capable” to build a latrine 22.2% “not at all capable” to build a latrine “Not enough money” was the main reason for not owning a latrine at 78% –“Not enough information” was the second most common answer at 7% 17 The main barrier for latrine adoption is financial. Baseline Indicators: Sanitation

18. EMC 18 Sources of drinking water by season: Baseline Indicators: Drinking Water

19. EMC 72.2% of HHs treat their water at least occasionally –55.1% always treat their water Boiling was the most common treatment method (44.2%) –Water filters were second (36.2%) No large differences between ID Poor and non-ID Poor HHs 19 Baseline Indicators: Drinking Water

20. EMC Baseline Indicators: Hand Washing 73.6% used laundry powder for hand washing 56% used bar or liquid soap 7.6% used only water 20 About half of respondents had used the right cleaning products for hand washing.

21. EMC 21 Sources of water for washing hands: “Bowls” refer to special bowls with water nearby for hand washing and other purposes, although respondents did not consider them to be proper HWS. Baseline Indicators: Hand Washing

22. EMC 22 Every HH reported washing hands in some way at least once a day: Baseline Indicators: Hand Washing

23. EMC Washing hands after defecating is important Washing hands before preparing food is important 23 Baseline Indicators: Hand Washing There was a knowledge-behavior gap observed in hand washing.

24. EMC Baseline Indicators: Solid Waste Management 24 Reported methods of solid waste disposal:

25. EMC 25 Female respondents were asked about most common ways of used feminine products disposal: Baseline Indicators: Solid Waste Management

26. EMC Correlation between ID Poor status and latrine ownership (% of sampled HHs) ID PoorNo latrine ImprovedUnimproved None25.4%24.%0.7% ID Poor 1 19.2%6.3%0.3% ID Poor 2 17.2%6.2%0.2% Correlation between head of HH education and improved latrine ownership Head of HH education% of HHs with improved latrines No education27.6% Primary44.4% Middle school56.3% High school58.1% 26 Bivariate Analysis Conclusions Latrine ownership was positively correlated with income, ID Poor status, and education.

27. EMC Respondents from HHs without latrines tended to report more problems than the ones that actually owned latrines 27 Bivariate Analysis Conclusions

28. EMC Education level of the HH head had the most direct relationship with treating drinking water No significant relationship between HH head gender and HH income Overall, 38.1% of all households in our sample owned a latrine, of which 92.9% were used regularly by all HH members and 97.9% of those latrines were functioning –The data show that in practice, if households can afford a latrine, they will maintain it and use 105 respondents reported not understanding the importance of drinking water; among them: –76.0% did not own a latrine –88.6% considered open defecation acceptable in some circumstances Men, respondents with less education, and respondents from poorer HHs were more likely to not use any kind of soap for hand washing 28 Bivariate Analysis Conclusions

29. EMC ADDITIONAL SLIDES 29

30. EMC 30 Data source: NCDD 2013; maps made by EMC. Latrine Ownership by Province

31. EMC 31 Data source: NCDD 2013; maps made by EMC. Improved Latrine Ownership by Province

32. EMC All latrinesImproved latrines 32 Latrine Ownership by District in Prey Veng Data source: NCDD 2013; maps made by EMC.

33. EMC All latrinesImproved latrines 33 Latrine Ownership by District in Kampong Chhnang Data source: NCDD 2013; maps made by EMC.

34. EMC All latrinesImproved latrines 34 Latrine Ownership by District in Kampong Thom Data source: NCDD 2013; maps made by EMC.

35. EMC All latrinesImproved latrines 35 Latrine Ownership by District in Kampot Data source: NCDD 2013; maps made by EMC.

36. EMC All latrinesImproved latrines 36 Latrine Ownership by District in Kratie