Child Faeces Management: addressing a critical gap in CLTS in Solomon Islands

A group of men are sitting or standing around a table in a rural village in Solomon Islands, they are looking at and discussing the illustrated picture prompts on the table which relate to child faeces management, part of this research project

A focus group discussion with men on current child faeces management (CFM) in Isabel, Solomon Islands
(IWC / Diana Botero)  

 

Our thanks to research partners, International WaterCentre & Griffith University for this project reflection. In partnership with Solomon Islands National University and London School of Hygiene and Tropical Medicine, they have recently completed their research project, Promoting Safe Child Faeces Management in Solomon Islands.

 

Where we started

 

At the project outset, the Solomon Islands Community-led Total Sanition (CLTS) approach didn't directly address child faeces management (CFM), despite children under 5 comprising 15% of the population. As a result, most children in rural areas of the Solomon Islands are open defecating, contributing to high rates of malnutrition and childhood stunting. Research confirms CFM is a problem, with more than half of children’s faeces being unsafely disposed of in communities that have completed CLTS. It also demonstrated that females bore most responsibility for CFM. But gender norms influencing men’s involvement in childcare are changing, and women are now comfortable to promote men’s involvement in CFM.

 

The project

 

With input from local sanitation policymakers and CLTS implementers, a CFM behaviour-change intervention was designed based on local ways-of-knowing, taking a strengths-based approach. This partnership of local and international researchers explored the social and psychological drivers of this problem. Based on this evidence, we designed a simple behaviour-change intervention that was integrated into existing sanitation programs. This intervention focused on the highest-risk part of the full CFM sequence of behaviours – the transport and disposal of faeces into latrines.

 

“Definitely CFM strengthens the CLTS [approach] in Solomon Islands. As CLTS is focusing on households [and] CFM is aligned with this aspect, [but] goes beyond targeting parents and onto kids.”

RWASH Official, Ministry of Health and Medical Services, Solomon Islands Government

 

Pilot testing indicated the intervention had positive impacts, but a critical barrier remains - access to safe and conveniently located toilets. However, attitudes improved, and CFM was reported to have changed, with less open defecation and a greater use of nappies/diapers.

A man from Isabel, Solomon Islands is looking at the camera with a big smile, he is carrying his grand daughter, in a floral a sling, her back is towards the camera and his hand is placed on her back. They are surrounded by lush greenery

The intervention also mainstreamed gender norms relating to CFM by targeting ‘parents’ together, emphasising that both mothers and fathers are responsible for childcare, including CFM. Fathers’ attitudes about the importance and ease of properly disposing of children’s faeces improved significantly, and many fathers agreed they should be involved in this childcare task. One mother from Kotawa noted “I have seen my husband taking care of the children and helping me a lot nowadays. In jobs like cooking, washing and especially with removing our children’s waste properly.” Research found that the fathers’ motivation was their desire to nurture their children. This indicates that childcare may be an effective entry-point to challenge gender norms, in at least some contexts, in the Solomon Islands.

 

Left: A grandfather carries his grand daughter in a sling in Isabel Province, Solomon Islands (IWC / Diana Botero)

Where we are now

We have implemented a CFM intervention that:

  • resonates with local epistemologies and situations
  • is simple enough to be easily used by sanitation facilitators in the Solomon Islands
  • can be readily slotted into CLTS without extra resourcing
  • positively challenges inequitable gender norms relating to men’s involvement in childcare and CFM, and
  • will be effective once the barrier of lack of toilets is addressed.

 

"The stories (in the video) are real, and it has motivated me to practice this better way to manage young children’s poo.”

Mother, Marumbo

 

The project produced a number of communications products, including How Clearing Up Kids’ Poop Could Save LivesOpinion: Grounding Positive Norms For Clean Water and A Poo In The Toilet Is Worth 100 In The Bush! to promote the publication of a recent journal article on the program.

 

Broader WASH sector contributions

 

The research was designed to support the efforts of WASH practitioners. The CFM intervention implementation guide, developed by the project, will directly support sanitation efforts, We have made specific modifications into the existing CLTS Facilitators manual so that the CLTS approach integrates CFM.

 

The CFM intervention can also be adopted by any sanitation program in the Solomon Islands and incorporated into other programs interested in children’s health, which UNICEF is currently exploring. Although the stories and imagery used in this CFM intervention are specific to the Solomon Islands, they will resonate with many Melanesian contexts. And, with some adjustments to these elements of the intervention, it could be adopted to address this gap in CLTS and sanitation programs globally. The research contributes significantly to the paucity of global evidence on simple interventions to improve safe and gender-equitable CFM.

 

Other knowledge and learning from the project:


 

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