Open defecation drops in Upper West Region
Ghana has a target to end open defecation by 2020. This target is captured in Ghana’s 2014 presentation at the 2014 High Level Meeting held in New York by members of the Sanitation and Water for All (SWA) global partnership.
Ghana also has a vision of sanitation and water for all by 2025 and the global Sustainable Development Goals (SDGs) also have sanitation for all by 2030 and both have eradication of open defecation implied.
The reduction of open defecation has been generally slow in the country. In 2006, 20 per cent of households in Ghana practised open defecation. This dropped to 18 per cent in 2011 and 16.9 per cent in 2014.
But the Upper West Region has a different story. From 78.7 per cent in 2006, it dropped to 71.2 per cent in 2011 and then a massive drop to 49.2 per cent in 2014, making Upper West the fastest region in reducing open defecation rates over the past 10 years.
Community-led Total Sanitation (CLTS) approach
Environmental health authorities in the region attribute this commendable achievement to the introduction of the Community-led Total Sanitation (CLTS) approach to basic sanitation promotion.
The region was among the first to pilot CLTS in a couple of districts between 2007 and 2010. From 2012 to date, the region has managed to scale up the approach to all the 11 districts.
“With the exception of CLTS, we don’t have any other programme that targets eradication of open defecation,” says Inusah Agambire, a Senior Environmental Health Assistant at the Upper West Regional Coordinating Council.
According to Inusah, even though there were occasional mass media discussions and public sensitisation, as well as prosecution of sanitation offenders, CLTS remained the main approach to which the region could attribute the success, a view the Regional Environmental Health Officer, Henry Bagah, also attested to.
CLTS targets behaviour change from open defecation as a norm to the use of latrines or toilets as the new norm. To achieve this, field facilitators interact with communities and make them aware of the dangers associated with open defecation.
This awareness generally triggers a community’s decision to stop open defecation immediately. They then start to take collective actions, including construction of household latrines to ensure that no one practises open defecation in the community. They usually do not wait for any external agency or government to come and provide them with latrines.
Showpiece districts
Districts that are fast making the Upper West Region a showpiece include Nandom, Wa West, Wa East, Nadowli-Kaleo and Lambussie. Nandom, for instance, has the greatest potential of being the first to declare district-wide open defecation-free status in the region, if not the entire country given its work rate in recent months.
With 88 communities in the whole district, 68 has been officially verified as open defecation-free as of June this year. Sissala East, Sissala West and Jirapa districts so far have the highest number of communities still practising open defecation in the region.
Mr Mohammed Tawfeeq Aliu, an Assistant Director at the Nadowli-Kaleo District, who has keenly followed and supported the CLTS approach, attributes the success of the CLTS programme to the dedication of the Environmental Health staff and support by management of the district.
He says his personal experience with the CLTS staff in community work on a few occasions indicates that they have great facilitation skills that trigger communities into action with ease.
“The whole programme has been successful because we have UNICEF, the World Bank/IDA, SNV, CARE, PLAN, WaterAid among others behind us,” says Inusah.
He says though financially government support may be low, more than 90 per cent of the field staff are paid by government in addition to the provision of motorbikes for field visits.
Inusah also saluted the people in the Upper West Region for being very responsive to change through CLTS.
“We appreciate the progress but we are still not happy that we are the third highest region practising open defecation in the country. There is still a lot of work to be done and we still need support from government and partners,” says Henry Bagah, Regional Environmental Health Officer.
Open defecation costs Ghana about U$79 million every year. It affects tourism, thereby reducing the chances of earning more foreign exchange. It is also the cause of many preventable diseases, such as cholera and typhoid.
It is the main cause of diarrhoea, which kills nearly 4,000 children under five every year in Ghana. It also causes stunting and impedes intellectual development in children. Cholera alone claimed 248 lives and affected more than 29,000 people in Ghana in 2014.
The writer is a Communication Consultant for UNICEF and the Environmental Health and Sanitation Directorate of the Ministry of Local Government and Rural Development. E-mail: addaibrenya@gmail.com