Boosting health

Environmental sanitation is an integral part of human development. It affects the quality of life by improving health. Like many other developing countries, Ghana has been struggling with poor sanitation for many decades. Although significant steps have been made in achieving a number of the Millennium Development Goals (MDGs) such as reducing poverty and improving maternal health, the country is slow on meeting its sanitation target by 2015. Only 14 % of Ghanaians have access to improved sani­tation. According to the Water and Sanitation Programme (WSP, a multi-donor partnership admin­istered by the World Bank), the pace of rapid urbanisation and population growth in Ghana, coupled with limited infrastructure, lead to poor sani­tation in many areas.

In 2010, the government launched a new National Environmental Sanitation Policy (see box on p. 328). Not only public institutions will take part in implementing this new policy, but stakeholders all over the country. Non-governmental organisations (NGOs) are important players in the water and sanitation sector.

These organisations generally fall into four main groups by activity:
– direct service delivery (NGOs that build pit latrines for rural communities, for example),
– community institution building by encouraging active participation of people in addressing water and sanitation issues (getting women involved, dealing with governance issues),
– advocacy and lobbying as well as
– research and capacity building.

The umbrella organisation: CONIWAS

In 1989, several civil society organisations set up the Coalition of NGOs in Water and Sanitation (CONIWAS). The initial focus was on access to water. Since then, the Coalition has expanded activities to include everything under MDG 7 (“Ensure environmental sustainability”), focusing mostly on water and sani­tation. CONIWAS was established with the purpose of:
– providing leadership and a coordinating unit for NGOs in the water and sanitation sector,
– creating public space for NGOs in the field of water, sanitation and hygiene (WASH),
– fostering debate on these issues with a view to influencing policymakers, and
– helping to initiate, develop and maintain collaborative mechanisms among Ghanaian and international NGOs by enhancing communication on matters relating to WASH.
Today, CONIWAS has a membership of more than
70 organisations. Its head office is in Accra, but it also has coordinators nationwide.

Giving NGOs one single voice for lobbying is one of the major strengths of the Coalition. CONIWAS works in partnership with other stakeholders to influence policies and promote access to potable water, sanitation and improved hygiene for the poor and vulnerable. The capacity building activities of CONIWAS include training workshops and skills development on various issues.

In 2011, CONIWAS submitted a memorandum for the adoption of the rights to water and sanitation to the Constitutional Review Committee of Ghana’s Parliament for consideration. The right to water and sani­tation means:
– uninterrupted water supply and access to sanitation facilities,
– affordable water and sanitation services irrespective of economic status,
– adequate policies and legislations to make water and sanitation facilities available,
– no queues for water or using a toilet facility,
– legal obligations for landlords to make provision for water and toilet facilities in houses before renting them,
– government and city authorities ensuring that they provide water and toilet facilities in all public places including schools and
– effective monitoring and maintenance.
The crucial point is that the provision of WASH facilities should not be seen as a favour but as a matter of course. The Committee has since submitted its report to government for consideration.

There is no doubt that CONIWAS has contributed to making things happen in Ghana. This well-established and effective network has convinced the Ghanaian government to create an action plan for sanitation, tackling financing and community mobilisation. This is a case of civil society organisations setting the pace for development.

Early this year, CONIWAS organised a workshop on strategic engagement for improving sanitation. Civil society, government agencies and NGOs were brought together to discuss their experiences re­garding sanitation delivery services and the chal­lenges to scaling up. It is vital to bring together as many stakeholders as possible, including, for instance, public office holders, market women and traditional authorities. They all must play their part.

CONIWAS supports the approach of community-led total sanitation. This approach was developed in India. The basic idea is that local communities eliminate open defecation. In order to do that, they must first assess prevalent habits and take action accordingly. CONIWAS is similarly in favour of forming local committees on water and sanitation. Mobilising communities in these ways is quite effective (see table). Over the years, some 30,000 people have benefitted from the provision of improved latrine facilities.

Finally, CONIWAS directly engages the media and citizens. It has supported high-level advocacy and established the Mole Conference Series. These conferences are held annually and are named after the town where the first one took place in 1989. CONIWAS convenes the Mole conference in a different place each year. It serves to foster sector dialogue and spread knowledge throughout the country.

While the programme has had a significant impact on the thinking of CONIWAS members, building the institutional capacity of its members has proved a challenge. Most member organisations are con­fronted with limited capacity in terms of expert staff and equipment. As membership continues to spread across the whole country, it is becoming increasingly expensive to train member organisations’ staff.

Moreover, CONIWAS funds for advocacy and lobbying are insufficient. It is quite difficult to raise money for these purposes. Donors prefer to grant funding for service-delivery projects. This is the case at the national and international level.

Future outlook

It is important that good sanitation policies and practices underpin socio-economic development and environmental protection. In this regard, the enforcement of laws on environmental sanitation is fundamental. Experience from other countries that have achieved good sanitation shows beyond doubt: the enforcement of environmental laws is key. Sanitation policing must therefore be recommended as the next step – one more step on the way to reach the MDG 7.

Another relevant pillar is research: Recognising the need to develop the human resource capacity to address the sanitation challenges, many tertiary and research institutions are incorporating environmental issues into their curricula. This is a good opportunity for CONIWAS to build partnerships with institutions for research and development.