Leaving no one behind: a study to reach the last mile in Bhutan


By Tshering Choden, SNV

The project “Beyond the Finish Line - Sustainable Sanitation and Hygiene for All in Bhutan” is funded by DFAT Water for Women (W4W) and led by the PHED (Public health engineering division) under the Ministry of Health (MoH) and SNV in collaboration with ISF and key CSOs. The programme aims to realise progress for equitable, universal access to safely managed sanitation and hygiene that directly benefits more than 275,000 people in eight districts. Of these, 4 are new programme districts and 4 are ongoing districts as part of the national Rural Sanitation and Hygiene Programme. It builds on a proven embedded approach that will enable the current national programme to look beyond households to further progress access and usage in schools, health care facilities and address intra-household issues that meet the needs of all.

As part of the baseline, the programme is intentionally seeking to better understand the challenges faced by the remaining estimated 5% of households in the existing programme districts as part of a study which commenced in late October 2018. The main objective of the study is to safely identify the remaining “last mile” households in the RSAHP districts, whilst integrating a “do no harm” approach and to explore the challenges faced by these households to inform the development of practical and specific recommendations for the national RSAH programme.

The study team of 12 includes representatives with various abilities from SNV, Gross National Happiness Commission, Public Health Engineering Division of the MoH, Dratshang Lhentshog (Monastic Institutions), Bhutan Nuns Foundation, Ability Bhutan Society, Disabled Persons Association of Bhutan (DPAB) and Bhutan Association of Women Entrepreneurs.  Last week, the study team undertook “Do No Harm” training together with other key stakeholders including the SNV team, RENEW and a woman with visual impairment, a DPAB member.

Specific objectives include the following:

  • To better understand the characteristics of households and individuals who have not yet been able to construct a sanitary toilet in the existing RSAHP districts.
  • To better understand the challenges and barriers faced by these households and individuals who have not yet been able to construct a sanitary toilet in the existing RSAHP districts.
  • To come up with practical and realistic recommendations for the programme in line with its current approach comprising of four key components, to better tailor the programme approach to ensure the needs of the “last mile” households and individuals in the effort to achieve improved sanitation and hygiene for all.
  • To build capacity of the programme implementers from the government, CSOs including DPOs and SNV on the “Do No Harm” approach and in conducting qualitative researches in a safe manner.

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