Why the health of sanitation workers needs to be our society’s concern?

“In a world without sanitation workers, business and daily life would come to a halt”.

It may seem too extreme to state but is nevertheless true. Without sanitation workers, the functioning of our ecosystem will halt as supply chains of products and services are adversely affected.

Samhita believes that it is essential to ensure preventive health care for our sanitation workers to not only ensure the smooth functioning of our society but also enable them to live a life of dignity. Our WASH platform and, more recently, our IPA platform aims to put money where our mouth is.

To know more about our approach, read this article written by Priya Naik, Ragini Menon and Tushar Carhavlo for CNBC-TV18.

Creating the Hygiene Culture: Impact of Dettol School Hygiene Program

COVID-19, the most severe public health crisis of our times, amplified our need for hygiene & sanitation. Governments, policy makers, health workers and civil society swiftly ramped up hygiene infrastructure and education in their drive for a disease-free world.

Following this trend Samhita & Collective Good Foundation partnered with Reckitt Benckiser to launched the Dettol School Hygiene Education Programme in the State of Andhra Pradesh in 2015 and extended the programme to Telangana by 2016 and to Tamil Nadu by 2018.

The programme builds knowledge, attitudes, practice and behaviour around hygiene in children by engaging children as collaborators, letting them drive the change. It builds their leadership and critical-thinking skills and enables them to solve hygiene problems in creative, sustainable ways, like solving the problem of access by setting up soap banks, ensuring hygiene through Child Parliaments and more.

In a boost to the programme, the curriculum was translated into several local languages, easing the path to adoption and engagement across South India. In another first, Collective Good Foundation introduced digital learning through government education portals. Andhra Pradesh was the first state to upload digital video episodes on their DISHA portals. These videos are accessible to all schools and teachers at the touch of a button and now reach 2.5 million students across 42,000 schools.

Click below to read the full report on how the Dettol School Hygiene Education Programme is developing a culture of hygiene in India’s children.

Our Private Healthcare System’s COVID-19 response can make or break India’s future

India has a mixed healthcare system, with majority of healthcare services being provided by the private sector. This accentuates the importance of private health care enterprises to partake in providing smaller and district level health providers with the support to continue functioning during economic upheaval.

Public health and economic experts stressed the importance of organising and fortifying the private healthcare system’s response to the COVID-19 crisis. They unanimously believed that investing in streamlining and strengthening the public healthcare system today can prepare the country for the long haul.

Check the key insights from our webinar ‘Strengthening the public health system is in our enlightened self interest’ and Samhita’s take on it.

Are healthcare facilities accessible to India’s tribals?

“India no longer has the luxury of continuing to wait and watch as millions of its tribal peoples suffer and die from preventable causes.”

There is a much higher incidence of maternal and under-five mortality, stuntedness, tuberculosis, and cardiovascular diseases among India’s 104 million tribals compared with the larger population.

Piramal Swasthya and The Bridgespan Group map out the reasons for the lack of reduction of health challenges in tribal areas based on their field studies.

They outline factors such as barriers in access to healthcare and information, insufficient number of public health facilities, and lack of data.

They stress that for scalable and population-wide impact to be achieved, especially to meet India’s national aspirations of Sustainable Development goals of health and well being- a focused and collaborative approach between all stakeholders of society is the only way forward.

The key to COVID-19 prevention in slums

Slums across India have been disproportionately affected by the COVID-19 crisis. 42% of Mumbai’s population lives in slums and therefore they require carefully planned measures to ensure that preventative and primary care remain accessible.

The Bridgespan Group and WHO emphasise that community participation is the key to implement any COVID-19 preventive interventions in the slums.

This is as a model of care, designed while incorporating community participation is more likely to be accepted and effective in the long-term. To elaborate on the practicality of their recommendation, they describe activities where communities have been engaged and relay how this principle helped the programs in Mumbai slums.

Kimberly Clark | Making lives better through purpose driven brands

The global effort to achieve sanitation and water for all by 2030 is extending beyond the household to include institutional settings such as separate washrooms in schools and workspaces. 

About 94% of women are employed in the informal sectors, according to the National Women’s Commission. Such informal sectors lack basic sanitation facilities including toilets. Public toilets, even if available, are often unsanitary and poorly maintained. Without access to toilets, women and girls develop coping strategies like drinking less water that in turn increases the risk for women’s health problems and their well-being, especially in times of menstruation. The extent of the problem is large in the school ecosystem across India

With the mission to create better workplaces that are healthier, safer and more productive, KCP in partnership with Samhita, designed two projects- 

  • Provide improved sanitation infrastructure in rural schools in Maharashtra and nudge children to adopt better sanitation habits
  • Provide increased access to better sanitation facilities for women working in informal markets

How did we impact 2000+ women and children’s lives

Project 1- The project aimed at solving two key challenges-

  • Poor usage of toilets by children in schools, and
  • Absence of hand washing facilities at critical junctures

We collaborated with the Swachh Maharashtra Grand Challenge, a first-of-its-kind open innovation platform, in partnership with the government, corporate & social sector to address the key challenges in the sanitation ecosystem; by identifying and piloting innovative programme models across sanitation value chain. We identified 4 major components under this setup-

How to address the school sanitation ecosystem

Project 1 – The project aimed at solving two key challenges –

  • Poor usage of toilets by children in schools, and
  • Absence of hand washing facilities at critical junctures

We received 50+ innovative solutions from across the country. A thorough review of the applications led us to select the most innovative and sustainable programs that would help build an impactful ecosystem in school sanitation. KCP and Samhita together set the journey from selection to knowledge dissemination for the selected programs:

  • Providing grants to selected pilot programmes
  • Coaching & mentoring
  • Project monitoring & evaluation, and
  • Knowledge dissemination.

The project impacted 2000+ children of Chandrapur, Maharashtra.

How to help women access sanitation in informal markets

The second project aimed at addressing the need for safe sanitation facilities for women working in informal markets. We shortlisted GARV TOILETS and CORO as implementation partners. The project provides sanitation facilities with following features:

To provide holistic, effective and sustainable sanitation impact, four components were designed:

  • Localised Behaviour Change Communication
  • Menstrual Hygiene Management
  • Operations & Maintenance
  • Waste Management

To support the end-to-end implementation of the project, Samhita leveraged their in-house expertise through the following stages- providing operational plans, developing standard operating procedures, monitoring and evaluation progress and outcomes and providing capacity building support for the implementation partners.

The project impacted 2000+ women in Kurla, Mumbai, Maharashtra.

Geographies

Project 1: Chandrapur Maharashtra

Project 2: Kurla, Mumbai, Maharashtra

Impact Numbers

4000+ Lives Touched

VIACOM18 | How to impact through the media lens

In a time where majority stakeholders were concentrating on building infrastructure to achieve the mission of Swachh Bharat Abhiyan, Viacom18 utilized the weapon they knew best – storytelling to create lasting impact in a society that has long been captured by the screen.

The Viacom18 story

With the launch of Swachh Bharat Mission, availability and access to toilets had improved tremendously. But social and behavioural change communication were far from implementation questioning the long-term adoption of infrastructure usage. Lack of sanitation has many rippling effects. 

The economic deprivation increases manifold when healthcare expenses and the cost of lost potential due to sickness arising from inadequate sanitation is added.

With the belief that sustained change in behaviour is at the helm of creating long term impact, Viacom18 worked with Samhita to design an intervention that aimed to address the issue of Open Defecation in Mumbai’s slums and inadequate sanitation in schools.

How did we impact 8,000+ lives

Samhita designed and implemented a community sanitation program with a focus on strong behaviour change in addition to providing basic infrastructure. Our theory of change centered around changing behavior, beliefs, and myths around toilets as a key to ensuring sustained open defecation free status in all communities and schools. The idea was to design visual messaging at key locations in slum areas, followed with awareness campaigns that brought together a social message with Viacom’s unique panache for storytelling.

Our vision of multiplying the impact by evolving the approach from infrastructure to behavioral change was distributed in 3 stages.

Geography

Impact

WASH Platform | Wash Grand Challenge (2019)

The WASH Platform builds synergistic collaboration between multiple stakeholders from the Private Sector, Development Sector and the Government, to identify, implement and replicate high impact projects across the sanitation value chain, starting from the state of Maharashtra.

The platform is a joint initiative between Samhita Social Ventures and India Sanitation Coalition in partnership with The Government of Maharashtra, The Bill and Melinda Gates Foundation with UNICEF and CEPT University as knowledge partners.

Implementing sanitation Programme at RB

1. What CSR programs do you currently focus on in sanitation and the Swachh Bharat mission? How does this align with Reckitt Benckiser’s broader sustainability approach?

We have a broad responsibility towards Banega Swachh India (BSI). [RB’s ambitious program to address the sanitation and hygiene crisis in India] We work under 4 pillars. The first pillar is behaviour change communication, the second is mass reach, the third pillar is product access and fourth is infrastructure creation and maintenance. We give maximum weight to work around behaviour change communication because we find without BCC infrastructure created will remain only structures that will never be used. So our work is focused around the determinants of behaviour change. We are trying to understand through our work and processes why behaviours are such and what triggers non-behaviours into behaviours.“We give maximum weight to work around behaviour change communication because we find that without BCC infrastructure created…will never be used”

 2. Can you tell us about some activities that you have conducted in the area of behaviour change communication?

Under Banega Swachh India (BSI) we are developing school modules for very young children at the foundation stage which include early-learning goals like personal social and emotional development, knowledge and understanding, physical development. Typically what happens is that some hand washing programs are conducted for a session or two. They aren’t regular sessions, just awareness programs. We are trying introduce a program where there will be modules in place for school children, student work books, activity based learning kits and a school curriculum for the teachers amongst other things, so that there is a regularity in the messages that are disseminated.  We don’t only work on one aspect which is only hygiene or hand washing. We have elaborate modules that range from personal hygiene to hygiene at home, hygiene at school, hygiene during illness, hygiene in neighbourhoods etc. We are making strides at various levels and building a curriculum to implement good hygiene. In the coming months we will roll out a program with some very worthy partners that have been working with us since the launch of our BSI campaign, which is the Banega Swachh India campaign.

 Do you work with other communities as well?

We are starting with schools, but yes we do intend to work with natural leaders and community based leaders. We are also thinking about using a platform to create an enabling environment for the Banega Swachh India campaign to leads us towards the goal of the Swachh Bharat mission. We are currently in dialogue with certain organizations about this.

 3. Do you think that organizations are interpreting the Swachh Bharat campaign to mean “build toilets?” There are other aspects of WASH that are not receiving as much attention, why do you think this is so?

I feel that there are various partners so if someone is constructing toilets, it’s a very big part of the mission. To invest in creation of the infrastructure, a lot of capital is involved. But yes, we should leverage resources that everyone has – corporates, private foundations, international organisations, all have resources and it’s important to leverage these to shape the market.  One part is construction of toilets which is very important, but along with that, companies can come up with various things. Companies have brands and conduct campaigns and so we have experience in this area. We can do something to motivate people like bringing like-minded people together so that everyone contributes. It should not be a standalone thing – there needs to be a spirit of partnership on mutually agreed principles so that people work together and achieve the goal of making India open-defecation free.

4. What are the main issues that you think need intervention in sanitation and how does RB approach these issues?

What’s important here is to work as a consortium rather than alone, because organizations have different skill sets and different strengths, so if everyone comes together there’s a good chance things will happen. To take the example of Samhita and how you bring in multiple stakeholders for an issue – if we do that then we will know what TCS is doing, how someone else is contributing etc.  No organization or company can do this alone, we need to fit in with the overall vision of Swachh Bharat. We are currently exploring the best ways to do this.

5. At the Chicago Booth event, you mentioned an innovative approach that RB is implementing, can you tell us a little bit more about that?

Our work is of 2 kinds. One is hardcore execution on the field through intervention partners. We work on bringing partners together and we also bring some global people together so that the best can be achieved. Our second approach is working on something which is more on the policy level. Here we’re looking at how all this work can be integrated into the larger framework of sanitation.

6. What do see as the major obstacles or challenges to having a Swachh Bharat? What challenges has RB faced?

Let’s call it learnings, not challenges. We see opportunities for where we can do better, not just the challenges. I think we need to have more partnerships and more aligned thinking. It’s very important to have design thinking. We are continuously working on that – improving our design thinking.

7. What do you see as the key development issues in India? What is the role that companies can play?

You see, health, hygiene, sanitation they all go hand in hand. There are various things that need our urgent attention.  You must know that India has committed to the MDGs. The MDGs talk about the latest figures for under 5 mortality and morbidity arising out of diarrhoea. That’s one of the things which is very important. A lot of theories state that this is an unexplored space where companies can come forward to contribute. There are only a few foundations working in this area.

I also see that very simple things like hand-washing can reduce diarrhoea and pneumonia mortality and morbidity rates using very simple tools.

There are 3 aspects on which define your CSR strategy – one is the company’s mission the other is sustainability goal of the company and the third is seeing if there is a match between the two. I would also like to say that without partnerships no one can achieve anything. This is the time to work together to achieve Swatch Bharat Mission and make India Open Defecation Free.