Impact evaluation of an innovative approach to improve sanitation practices in rural Mali

A CEDLAS-PEP-UNICEF project was granted support by the Bill & Melinda Gates Foundation to evaluate the impact of a new approach to improve sanitation practices, through the case study of a project being implemented in Mali. This impact evaluation was conducted following the experimental approach fostered through the PEP-PIERI group.

CLTS : a new approach to improve sanitation practices

Since 1990, sanitation is considered a priority sector for improving health and welfare of the rural population. In order to reduce the incidence of diseases related to poor sanitation, development programs have, for some time now, incorporated the need to raise awareness on the benefits of toilet usage. But progress in the achievement of the MDGs’ sanitation target has been slow; in 2006, 36% of rural population in Africa – over 200 million people – still practiced open defecation.

A recent approach focuses on behavioural change as a key ingredient for successful adoption of better sanitation practices in rural Africa. Referred to as Community-Led Total Sanitation (CLTS), this approach aims to promote behavioural change at individual-level by empowering local communities whose members aspire to live in a cleaner environment and, thus,  are motivated to take collective action in order to produce 'open defecation-free' villages. Such interventions may even have additional benefits on women's well-being, since it has been documented that women practicing open defecation often visit the sites at night time, being more vulnerable to harassment and assault. 

However, while CLTS and related programs have already been implemented in more than thirty countries, no quality impact evaluation were being conducted to assess the actual effect of these interventions on the desired outcomes.


Sanitation in Mali

Joining efforts to producing evidence on the impact of CLTS 

In 2010, UNICEF and the government of Mali joined efforts to implement CLTS in rural areas of the country - where 28% of the population did not have access to any type of latrines and still practiced “open defecation”. UNICEF simultaneoudly contacted PEP to conduct an external evaluation of the intervention, in order to assess its effective impact on the improvement of health outcomes, but also to determine what is driving collective action in order to increase sanitation coverage.

The Bill & Melinda Gates Foundation granted the necessary funds to support the initiative. The evaluation was conducted as a research collaboration of the Center for Distributive, Labor and Social Studies (CEDLAS) of Argentina (Universidad Nacional de La Plata), UNICEF and PEP. The project, involving methods of experimental research as fostered by the PEP PIERI program, was led by PEP Research Director Maria Laura Alzua and PEP resource person Habiba Djebbari

New evidence arising from this evaluation allowed UNICEF, government and donor agencies to learn about cost effective solutions to reduce open defecation. The results also shed light on several outcomes that can be positively affected by improved sanitation: health, time use, community empowerment, safety of women and behavioral change leading to adoption. By providing simple and clear evidence on the effectiveness of an innovative sanitation program, this evaluation is helping guide decisions of the donor community, international organizations and developing country authorities, in order to reach the MDGs’ sanitation target and thus improve the lives of millions living in poverty.


An opportunity for building local research capacity 

As in all PEP-led initiatives, local researchers were called on to take active part in the research work, and thus offered training to acquire the necessary knowledge and expertise to do so. An intensive training workshop was provided to over 20 participants in Bamako (Mali) October 15-18, 2011. GIZ Mali and IDRC's Think Tank Initiative had agreed to provide funds in order to extend the training opportunity to other researchers in the region.

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