A conference on community-led sanitation, organized by the Ministry of Health and the UN Office was held 11-12 December at the Asmara Palace Hotel. The conference was attended by senior government officials, UN representatives, representatives of the regional administrations, community and village elders, and others.
Over the two days, presentations were conducted by many experts. As well, panel discussions were held on a variety of issues, including sanitation advocacy, community mobilization, and government initiatives to end open defecation. Eritrea’s goal is to eliminate open defecation by 2022. The Government of the State of Eritrea (GSE) has prioritized ensuring citizens’ rights to water and sanitation. It is committed to ending open defecation before 2030 (the international UN Sustainable Development Goals’ deadline) and is paying special attention to the needs of girls and women.
In an address, Ms. Amina Nurhussien, Minister of Health, stated that the results of Eritrea’s national sanitation campaign have been encouraging. The community-led sanitation campaign, launched in 2007/8, aims to keep waste in special dumping areas and increase the use of latrines in particular. “Thanks to our good culture of sanitation and our organizational capacity, we expect to achieve the target of being an open defecation free country by 2022,” she announced.
During the conference, important topics discussed included the need to scale up political will for sanitation, ensuring clear ministerial or departmental commitment and leadership for sanitation, increasing public spending on sanitation, share community experiences on sanitation, identifying strengths and weakness associated with sanitation, and the importance of public-private-partnership around sanitation.
In comments he made during the conference, Dr. Pierre Ngom, UNICEF Representative in Eritrea, noted that, “sanitation is not only linked to the nutritional status and health of children, but also to education and the wellbeing of communities nationwide. Sanitation is one of those subjects which is not easily discussed – but is intricately linked to many Sustainable Development Goals.”
Eritrea comprises 2,625 villages in six regions. The Eritrea Population and Health Survey of 2010 (EPHS) showed that there is a great deal of variation in terms of sanitation coverage and improved access to water between regions.
A guiding principle of the Ministry of Health and the GSE is that no one should be left behind in terms of access to improved sanitation or clean water. Inadequate access to sanitation, particularly in rural areas, is a threat to the individuals and communities. Unhygienic practices of food preparation and inadequate personal hygiene and excreta disposal, coupled with the use of unsafe drinking water, contribute to a high prevalence of diarrheal diseases among children under five, which leads to their dehydration and malnutrition.
At the conference, a number of research papers were presented discussions were held on strategies and approaches to end open defecation in the country. Dr. Zemui Alemu, director of Environmental Health, introduced Eritrea’s Open Defecation Free (ODF) roadmap. He stated that key strategies will be developed to ensure access to sanitation for all, including: community triggering; demand creation and capacity development; advocacy and partnership; communication for development; knowledge management; marketing; supply chains; and real-time monitoring.
There are a number of bottlenecks in improving access to sanitation in Eritrea. These include the absence of an updated rural sanitation policy and urban sanitation policy, lack of clearly stated institutional roles or accountability, a poor sanitation service delivery model, inconsistent provision of resources, insufficient funds for sensitization campaigns, inadequate funding for sanitation delivery services, and a weak monitoring, reporting and feedback system.
According to Dr. Zemui, an estimated budget of $US 14.375 million needs to be mobilized for Eritrea to be declared ODF by 2022: $US 12.5 million is needed to develop the environment to enable ODF, while $US 1.875 million is needed to strengthen supply chains and marketing.
Over the years, numerous villages and areas in Eritrea have been declared ODF. During the conference, many discussions were focused on building upon these achievements. A finding from the EPHS of 2010 revealed that there is sometimes regression after important successes and achievements.
The value of a latrine ultimately depends on whether it is used or not. One of the main ways to address low usage of latrines is through understanding the attitudes and behaviors of individuals and communities. Creating demand for latrines through effective awareness campaigns needs to happen in parallel with building subsidized latrines and providing sanitation infrastructure.
According to figures presented during the conference, as of December 2017, 782 villages in the country had been declared ODF. While this is an improvement, it still only represents 30% of all villages in the country. The Maekel region has the most ODF declared villages, while the Gash Barka region has the fewest. In order for Eritrea to achieve its target of being declared an ODF nation by 2022, its progress will need to be accelerated. For context, there are no Sub-Saharan African countries that have been declared ODF. Although sanitation figures can be improved, it is encouraging that about 97% of people in the country understand the importance of hygience and sanitation.
Throughout the duration of the conference, participants were also entertained by the Fiorina Cultural Group, which had several memorable performances. At the conclusion of the conference, participants recommended that awareness programs should be increased and updated regularly. A number of different awards were also presented to winners of general knowledge competitions and individuals or groups that helped to make the conference possible. The conference was closed the presentation of the Asmara Declaration on Sanitation.