The results of Max Value for WASH I in Bangladesh

“I am proud that people in our project areas have really changed their WASH behaviour.”

Max Foundation just phased out the Max Value For WASH (MVFW) I program in Bangladesh – a four year (2012-2016) partnership program of Max Foundation and the Embassy of the Kingdom of The Netherlands (EKN). The primary goal of the program was to reduce child mortality and morbidity in the poorest and most vulnerable areas in rural Bangladesh. What are the primary results of the program, what are the lessons learnt and: how will Max Foundation be moving forward from here? An interview with Auhidul Islam Kazal – Program Manager at the Bangladesh Country Office.

 You started working for Max Foundation Bangladesh in February 2013. Can you give us an impression of the WASH situation in the program area back then?
When MVFW started its intervention in South Coastal Patuakhali, the sanitation situation was far behind the national target of Bangladesh. It is true that Bangladesh had been declared ‘open defecation free ‘– which means that less than 1% of the population defecates in the open  – but there was a severe lack of good quality sanitation in the area. In November 2013, we conducted a baseline study and found that only 22% of the households had access to improved sanitation. We also found that 36% of the respondents did not have access to safe water, meaning that it took them more than 30 minutes to fetch safe water. Finally, with regards to hygiene, we discovered that only 41% of the respondents washed their hands with soap after defecation and only 6% before eating. Altogether, we recognized that there was a strong need for WASH interventions.

Please, tell us more about the developments within the MVFW program over the last four years?
From the start, the Max-WASH approach was based on three integrated pillars: drinking water supply (deep tube wells), latrines and hygiene education. Since these elements are strongly linked, the effect of integrating them into one program was expected to be greater than the sum of its parts. We are a learning organization and therefore continuously look for opportunities to innovate and strengthen our work. Along the way, school sanitation and educating pre- and postnatal care counsellors have become standard elements in our program and we have integrated other elements like Sexual and Reproductive Health (SRH) and prevention of stunted growth .

As an organization we have gradually developed into a professional one. In 2013 we were with only 2 people running the Bangladesh office, but today we have six staff members working at our office in Dhaka. Since 2014, we have been registered at the Bangladesh NGO Affairs Bureau and today Max Foundation is very much well known in the Bangladesh development sector as a professional international development organization.

What are the main challenges that you faced along the way?
When I started working for Max Foundation in 2013, we were only with two persons working at the Bangladesh Country Office. But at the same time we had a program made up of 6.5 million to manage. There were no guidelines and manuals at all at that time. Therefore, I started developing these guidelines and manuals myself, which took me about 6 months to do. Consequently, our work was delayed and the results of the first year were not very good. However, after these six months we started with the implementation of the program and during the second year our results improved.

Another challenge we faced was due to budget restrictions, since we worked in an area where Max Foundation uses Deep Tube Wells to ensure access to safe water. However, Deep Tube Wells are quite costly, so we discovered that our budget was not sufficient to procure all the planned Deep Tube Wells. We then decided to organize and put together a committee of people from the local Partner NGOs, who were able to procure Deep Tube Wells in large quantities, making them much cheaper to buy. A great solution, but it took us quite some time to organize everything and as a result of this the program was delayed again.

Finally, we faced severe political unrest in Bangladesh in 2015. By that time there was a continuous strike (90 days) observed by the nation. As a result, we were not able to procure Deep Tube Wells and latrine materials. Neither was it possible for us to transport the materials from one place to another. This resulted in another program delay.

What are the main results of the program and what achievements are you proud of?
Overall, we have provided almost 900,000 people  with safe water, adequate sanitation and hygiene education over the last four years. Personally, I am very proud to see that people really have changed their behaviour. Since people are now more aware of the impact of WASH on their health and that of their children, they seem to be more motivated to practice good hygiene in their daily lives. The same accounts for their diet. People started gardening, ever since we made them aware of the positive impact of good nutritious food on the health of their children.

I find it inspiring to see that people are more motivated now to have a latrine close to their home and a safe water source in the residence to wash their hands after defecation and before eating. We developed a low cost sustainable handwashing device – the Maxi Basin – to provide people with an option to wash their hands before cooking and eating. I am extremely proud of the fact that we have managed to install approximately 10,000 Maxi Basins until now.

And: What are the main lessons  learned?
A key lesson I learned is that it is important to have beneficiaries participating in the planning, monitoring and evaluation of our programs. Local knowledge should be recognized and incorporated in the program. Along with community engagement and ownership there will be an increase in the sustainability of the intervention. 

Another lesson I learned, is that people are much more motivated when they become aware of the effect of the intervention on their health and that of their children. Most people want a healthy live and in particular many of them want what is best for their children. Therefore, if we manage to show the results of our interventions on people’s health, we will be much more effective.

Organization wise, I noticed that the Joint Project Management Committee (JPMC) proved to be a successful approach during implementation. The committee started with a brief summary for central procurement, which increased transparency and efficiency. As the JPMC evolved along the way, a much broader range of issues have been discussed and shared. All PNGOs and Max Foundation have considered the monthly meetings as being very valuable.

Finally, with the experience and learning from the MVFW I, a new full-fledged program will be started in the name of Max WASH II. Can you please elaborate on this?
The program aims to reduce water- and faecal-borne diseases, improve child health and contribute to the Sustainable Development Goals (SDGs) in some of the poorest and most vulnerable parts of the South Coastal area of Bangladesh.

One of the highlights of MVFW II is baby WASH. There is a strong link between child health and growth, and WASH. If we want to be more successful in achieving our mission – preventing child mortality in the most effective way – we need to focus on the care of babies. An example is the cleaning of people’s yards. These tend to be very unhygienic in Bangladesh; toddlers can crawl around in these areas and become infected.

Finally, another focus area of the MVFW II program is governance. There are a lot of actors in the WASH sector in Bangladesh i.e. national and local government, NGOs, community based groups and the private sector. They all have an impact on how rural communities receive WASH services and to what quality. The most local tier of Government, the Union Parishad, has a critical role in the process and has been tasked by the Local Government Acts of 2009 with ensuring that all people have access to safe water and sanitation services at an affordable price. Within the MVFW II program, Max Foundation will facilitate good governance of the responsible institutions.

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