Nepal Country Brief: Promoting Household Water Treatment and Hygiene

This 6-page brief highlights the approach, accomplishments, and challenges of the Nepal Hygiene Improvement Project (NHIP), which promoted better hygiene practices, including safe treatment and storage of drinking water and handwashing with soap, in 4 pilot districts in Nepal. The project was supported by the United States Agency for International Development (USAID) Hygiene Improvement Project from 2006-2008 in collaboration with the United Nations Children's Fund (UNICEF) and the Nepal Department of Water Supply and Sewerage.

The report details the activities conducted as part of NHIP's main channels: capacity building, mass awareness, facilitation of product availability, and advocacy (scale-up). In brief, using a comprehensive approach that started at the district pilot level with the goal of expanding to the national level, the project trained thousands of frontline community workers and volunteers, health personnel, school staff, retailers, and journalists to reach 500,000 households and increase their awareness of safe water treatment options and the importance of handwashing with soap. As part of a school-based spin-off project, students and teachers at 200 schools received an orientation on safe water issues and handwashing, and children's clubs and school management committees were put in charge of day-to-day operations and monitoring of their school's water treatment technologies.

The report finds that, although NHIP achieved many of its programme design objectives, the project faced a number of challenges: "NHIP's ambitious agenda of bringing about changes in hygiene and water treatment behaviors in a short period of time from almost no use to consistent and correct use required more extensive investment and human resources than were originally budgeted as well as a plan for targeted results. The project did raise significant awareness about the need to treat drinking water and wash hands with soap among the target population, however, more ongoing and strategic activities will be needed to bring about the sustained level of behavior change envisioned."

Furthermore, HIP comments here that "the development of communication materials for safe drinking water treatment options was extremely challenging and took longer than anticipated....Further complicating matters was the need to make materials ethnically and geographically balanced. Extensive demonstration and review of the approaches and technologies was essential during the trainings to ensure promoters/trainers conveyed the correct messages." In response, NHIP refined its approach by setting up demonstrations of the vast array of products in community centres and gathering spots. Yet producers continued to have difficulty meeting demand in remote locations because of limited human and monetary resources.

Finally, as outlined here, a few external constraints hindered smooth project implementation. To cite only one: civil unrest during several periods of the project meant that staff was unable to move from its district headquarters into project areas.

"Despite these challenges, NHIP and its partners are seeing opportunities for scaling up the project's approach and tangible evidence of the effectiveness of safe water treatment and hand washing promotion, making it likely that these approaches will continue to be implemented....It is hoped that with the formation of the National Subcommittee for Household Water Treatment, more organizations will become involved in supporting the Government of Nepal's efforts to achieve water and hygiene-related Millennium Development Goals."