The push for universal access in the SDGs brings with it an urgency to better consider how all groups are reached. And whilst some might hold the view that the ‘trickle down’ effect of economic development will ensure all groups are eventually reached, experience demonstrates that this may not be the case. Equally, at the opposite extreme, the increased emphasis on reaching everyone fast, means there is a temptation to jump to ‘quick fixes’ like implementing strong enforcement measures or directly providing toilets, and in doing so by-passing the important step of genuine behaviour change or understanding specific individual needs (particularly, for instance, in the case of people living with a disability).
It is this topic that brought together a group of practitioners from SNV along with key government and academic counterparts in Lampung, Sumatra, Indonesia for a learning event in May 2017. The event built from an intensive Rural Sanitation D-groups e-discussion on the topic, namely: “Universal access and use of sanitation and hygiene services: reaching the last mile”. One wonders about why we are talking about ‘miles’ in the age of the metric system, however it turned out to be a very useful term for describing the group of people who are ‘last’ to have access to a toilet.
This ‘last mile’ can indeed include groups that might find it difficult to own a toilet - including factors such as poverty, female-headed households, challenging geographical environments and people living with a disability. However, the last mile group was recognised to also include the better-off - those who might be able to afford, but for cultural or other reasons, resist and do not invest. And indeed amongst those people whose voiced reason as to why they do not have a toilet is affordability, it is often observed that a household can afford a low-cost latrine, but would prefer to wait (sometimes indefinitely!) until they can afford a much better latrine.
The learning event surfaced many arguments and rationales for a variety of approaches to addressing the last mile, not least of which was the need to firstly identify, and secondly better understand, that last mile. It was agreed that we need to scratch beneath the surface of ‘affordability’ as the key reason for lack of access, and obtain a more detailed understanding of motivations, constraints and genuine needs.
Bhutan shared a strong example where this group was identified, validated by local government, and then formative research was conducted to understand their needs and barriers, solutions were developed (primarily to address barriers in access to labour), embedded in national policies and strategies, and implemented.
Key amongst SNV’s approach is a focus on local leadership and collective mobilisation at community level as the primary means to facilitate access to sanitation for all. This contrasts other approaches in the sector which assume financial barriers as most significant, and respond with financial or hardware related mechanisms. This is not to say, however, that finance is not part of the picture, since clearly it often will be - costs for durable toilets in remote rural areas can escalate, and also may cost more in areas that flood. However, what is clear in SNV’s experience and approach, is the importance of development partners keeping the ‘big picture’ in mind, and avoiding setting up overly costly, administratively complex mechanisms prone to corruption, and instead looking to mobilise finance and support as close to the ground as possible (hence within communities, where that is possible, or from local budgets at the lowest level). This means that such support can be provided within a wider context that supports effective government roles, and avoids by-passing important behaviour change processes that ensure intrinsic motivations to have a toilet are triggered.
Besides this thinking, the learning event also recognised that multiple other software approaches and strategies can be used to reach the last mile. These included careful use of incentives and sanctions (and monitoring for their side-effects!). Examples were shown of locally decided ways to prompt action through enforcement and shaming, with the discussion centred around the potential ill-effects of overuse of such approaches since they build on extrinsic rather than intrinsic motivations.
Tailored demand creation and behaviour change communication were also recognised as important ways to reach different groups, matched with affordable and inclusive technologies that meet their needs. These two strategies are particularly important when we consider intra-household differences and needs - just because a household has a toilet does not mean that all household members can access it easily and that it meets their needs - this could be the case both in terms of women’s menstrual hygiene needs, and also for persons living with a disability or indeed elderly or very young household members. Lastly, inclusive business models within the supply chain can also be facilitated, either directly or with involvement from local government.
A closing thought is that although broad efforts to trigger the majority of people in a community make sense to be the core focus in the early stages of trying to achieve sanitation coverage, there is also a case to ‘look ahead’ and take precautions to strengthen the voice of marginalised groups or people right from the outset in all rural sanitation approaches. We can make predictions about who is likely to end up in a last mile group and take actions aiming to reduce the proportion of vulnerable people who make up the last mile, and from a human rights perspective, this should indeed be one of our starting points.
Blog written by Professor Juliet Willetts, Research Director at the Institute for Sustainable Futures of the University of Technology Sydney.