Sanitation and Hygiene Data Collection
1. WASH+: Purpose and Approach
WASH+ is designed to help communities move progressively up the sanitation ladder, improving sanitation infrastructure and hygiene practices step-by-step.
Our model focuses on behaviour change marketing: using local trainers, social marketing, and accessible supply chains, rather than subsidy, to drive community-led improvements.
2. Survey Context
In early 2025, a midline survey was conducted across 9 villages, involving almost 4,000 people. This survey aimed to assess progress so far in sanitation and hygiene practices in WASH+ areas.
3. Key Results and Interpretation
There are encouraging signs:
New Latrines Built: Nearly 85% of household latrines have been constructed since 2023, after DMDO’s involvement began. This shows that WASH+ is stimulating household action.
Private Ownership: 88% of households do not share their toilets with others. Private ownership is an important foundation for safe sanitation and future improvements.
Progress on Sanitation Ladder: Around 19% of households now have pit latrines with washable slabs — a major WASH+ target. These facilities represent a first step toward safely managed sanitation.
However, significant challenges remain:
Dominance of Unimproved Latrines: Despite progress, 47.5% of households still use pit latrines without slabs — open, unimproved structures that pose health risks.³ This underlines how far there is still to go.
Gaps in Pan Adoption: While washable slabs are present in 19.2% of households, 74.2% of households lack a toilet pan. This suggests that even when slabs are added, the pan upgrade — critical for improved sanitation — is often missed.
Persistent Hygiene Gap: 99.4% of households report no handwashing facility in their dwelling or yard.⁵ Handwashing behaviour remains extremely limited, exposing communities to preventable disease.
4. Overall Message
The survey results show that WASH+ is helping to drive new construction and private ownership of latrines.
However, the quality of those improvements remains low, with gaps in pan installation, durable structures, and hygiene practices.
In short: There is clear movement but there is still a long way to go.
5. Emerging Hypotheses
Based on the midline results, several working hypotheses will guide further investigation:
Message Relevance: WASH+ marketing may not yet fully align with household motivations such as pride, convenience, or social status.
Messenger Trust: Communities may not trust, or feel connected to, those delivering sanitation and hygiene messages.
Messaging Exposure: Messaging may not have reached enough households, or been repeated enough times, to drive lasting behaviour change.
Cost Barriers: Even if households are convinced, cost may prevent upgrades, particularly for toilet pans or improved hand-washing setups.
Material Access Barriers: Households may be willing but unable to access materials like SATO pans despite supply efforts.
6. Next Steps: Behavioural Survey and Programme Adjustment
To better understand these issues, a detailed behavioural WASH survey is already underway. This survey investigates:
What motivates households to improve sanitation and hygiene.
Whom communities trust for advice.
How often and how well WASH+ messages are being received.
What financial or physical barriers limit upgrades.
Findings from this survey will inform decisions about:
Adjusting messaging and marketing strategies.
Strengthening the training and trustworthiness of local ToTs.
Supporting access to affordable sanitation improvements.
7. Conclusion
The WASH+ programme has catalysed significant new latrine construction and fostered private ownership.
However, the quality of sanitation and hygiene remains well below target levels.
With behavioural insights and strategic adaptation, WASH+ will strengthen its efforts to help communities continue climbing the sanitation ladder sustainably and with dignity.
