Community-Led Sanitation Program Results in Decrease in Diarrheal Disease

Community-Led Sanitation Program Results in Decrease in Diarrheal Disease

SWSS team and NGO members visited a local shop for information, education, and communication materials in Baghalak village of Nahrin district, Baghlan province. {Photo credit: Bashir Ahmad, CLTS Supervisor/SWSS.}Photo credit: Bashir Ahmad, CLTS Supervisor/SWSS.

Afghanistan has yet another village which has successfully become an Open Defecation Free (ODF) zone. Baghalak is a village in Nahrin district with 630 inhabitants dispersed among 90 households --- each with unused latrines in poor condition. For this reason, Baghalak was selected by the USAID-funded project, Sustainable Water Supply and Sanitation (SWSS) and the Organization for Health Promotion & Management to partake in community-led total sanitation (CLTS) training.

Prior to CLTS’ involvement in the village of Baghalak, the traditional latrines also lacked hand washing facilities, which is crucial to proper sanitation. In addition, significant amounts of human waste could be seen on farms, gardens, and sidewalks. As is a common problem in communities without CLTS instruction, latrines tend to go unused due to the lack of communal education regarding their importance. While the hygienic and sanitation status of the community were in severe need of improvement, there also existed a strong desire within the community to reduce their high incidences of infectious illnesses, particularly diarrheal diseases.

Improved latrine with hand washing facility in Baghalak village of the Nahrin district, Baghlan province, Afghanistan. (Photo credit: Bashir Ahmad, CLTS Supervisor/SWSS) Shortly after CLTS facilitators and supervisors were invited to assess the situation, they began to work with the community to recognize the importance of living in an ODF zone. After several follow-up visits all 90 traditional latrines that had previously gone unused were improved and hand washing facilities were added.

To ensure the sustainability of the program, 15 women from a Family Health Action Group, an organization that promotes continued behavior change and provides social support, were selected to monitor the 90 households. On February 20, 2011, Baghalak was officially certified as ODF from an external verification team.

During the ODF certification process, the village was lauded for the positive shift that it had achieved.

Haji Said Agha, head of CDC, talks about his satisfaction with CLTS in the Baghalak village. (Photo credit: Bashir Ahmad CLTS Supervisor/SWSS) Haji Said Agha, head of the district’s Community Development Council, expressed his amazement.

“Many NGOs have been working in the Nahrin district delivering different kind of services and programs like distributing food, constructing culverts and paved roads; but nothing as important and fundamentally needed as CLTS [has been done before]... This project is the basis of well being and health of our community.”

He also added that the incidence of diarrhea in his village of Baghalak, and within his family, has significantly decreased.

Certification ceremony in Baghalak village, Afghanistan. (Photo credit: Bashir Ahmad, CLTS Supervisor/SWSS)Research conducted by the monitoring teams showed a 50 percent decrease in the number of outpatient visits in the Nahrin district. Dr Sahed Iqbal Hashimi, the clinic head, noted to the monitoring team that the number of diarrheal disease visitors in Nahrin district dropped by 60% after implementation of the CLTS project.

Dr. Abdul Qawi Qadiri is Baghlan Provincial WASH Coordinator.

The USAID-funded Sustainable Water Supply and Sanitation Project, Afghanistan (SWSS) project increases access to potable water and sanitation services in Afghan communities and decreases the prevalence of water borne diseases through household hygiene interventions. Led by the Association for Rural Development, in partnership with Management Sciences for Health, SWSS has led nearly 400 communities in Afghanistan to become Open Defecation Free. The MSH components of the project have succeeded under the astute leadership of Dr. Abdul Hatifie, the team leader for Sustainable Health Outcomes, and Dr. Logarwal, the BCC Material and Media Specialist. Together they have led the successful implementation of innovative approaches in all aspects of the SWSS project. 

To learn more about SWSS’s accomplishments, please see the cover article in USAID's Global Waters magazine.